A Portuguese/Brazilian study of Expressed Emotion

Expressed Emotion is a measure of family interaction, widely used in studies around the world to predict relapse in severe psychiatric disorders. The instrument was originally developed in London. It depends on subtle vocal nuances emerging in the course of the Camberwell Family Interview (CFI). The extent to which these can be picked up in different languages and different cultures is an interesting question. This paper presents the results of a study of EE from Brazil. The two raters achieved good reliability with master tapes in English, and the CFI was then translated into Portuguese. The raters also showed good reliability in Portuguese. This is at least consistent with the idea that similar behaviours can be picked up in different languages and cultures. Twenty nine relatives of 24 patients with schizophrenia were interviewed using the CFI. It was predicted that high Expressed Emotion would be rare in Brazil, a developing country. In fact, 59% of relatives were rated as high EE. Unlike studies from fully industrialized nations this high level of high EE was largely due to over-involvement. Our findings suggest both contextual and cultural influences on the relative salience of the different components of EE, a theme worth pursuing.