The research proposed involves a series of interrelated studies concerned with family factors associated with the course and treatment of major mental disorders, with particular emphasis upon schizophrenia. The methodology developed by our research group is utilized to study the intrafamilial processes of communication deviance (CD) expressed emotion (EE), and affective style (AS). A number of studies are proposed which study the interrelationships among these variables and their relative prognostic validity in different samples. Three studies focus on family factors associated with the course of mental disorders in populations of: 1) recent onset, young schizophrenics; 2) bipolar patients. Following assessment of family interaction, patients will be followed up for two years to determine whether and in what ways parental and patient attributes relate to the longitudinal course of each disorder. 3) The third study proposed is designed to evaluate the impact of Behavioral Family Management (BFM), as contrasted with Customary Care (CC), in a sample of schizophrenic patients and their families receiving treatment at a local Veteran's Administration Hospital. The families will be assessed on EE and then randomly assigned to BFM or CC for a treatment period of nine months. A two year followup assessment is also planned. Repeat assessments of EE, family coping style and family rejection scale scores will be done pre- and post-therapy to assess whether BFM is effective in modifying key aspects of family interaction hypothesized to be related to a higher probability of relapse by the patient.
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