Expressed Emotion and psychotic relapse
In research concerning Expressed Emotion (EE) families are divided into high and low EE. This very global index neither covers the complex nature of family atmosphere, nor it detects minor changes.
To surmount this problem, a composite scale was developed, based on the Fiv Minute Speech Sample. Six items formed a unidimensional scale concerning criticism/dissatisfaction. A second scale, concerning Emotional Overinvolvement (EOI), involved two FMSS items.
The association between the two EE scales and psychotic relapse was compared to the dichotomous index at follow-up. Survival analyses indicated that the criticism/dissatisfaction scale was related to relapse, while the dichotomous index was not. While the effect was significant for mothers but not for fathers, there was a stronger effect when the scores from fathers and mothers were combined into a family profile score. For the two item EOI scale no significant effect was found.
It may be concluded that dividing families into high and low EE conceals a possible EE effect.