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Updated: Aug 21, 2026

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Published on: December 2, 2015
Causal attributions about schizophrenia in families in China: expressed emotion and patient relapse
Lawrence H Yang1, Michael R Phillips, Deborah M Licht
1Psychiatric Epidemiology Training Program, Columbia University, 722 West 168th Street-MSPH Box 43, 7th Floor/Room 720 F, New York, NY 10032, USA. laryang@attglobal.net
Abstract:
Previous studies have indicated a robust link between relatives' causal attributions and levels of expressed emotion (EE). However, these studies have primarily been conducted in Western cultures. The current study, conducted in China, examined the spontaneous causal attributions made by 54 relatives of schizophrenia patients during the Camberwell Family Interview. Chinese relatives made few controllable and personal attributions overall. Yet as predicted, highly critical and/or hostile EE relatives attributed patients' negative behaviors to more controllable and personal factors. High EE and controllable attributions positively predicted relapse, whereas personal attributions unexpectedly protected against relapse. EE mediated the effect of controllable, but not personal, attributions on relapse. Relatives' use of a particular Chinese characteristic (narrow-mindedness) was integral to the personal dimension's protective effect.
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