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Expressed emotion and relapse in alcoholic patients
T J O'Farrell1, J Hooley, W Fals-Stewart
1Harvard Families and Addiction Program, Harvard Medical School Psychiatry Department, Veterans Affairs Medical Center, Brockton, Massachusetts 02301, USA. ofarrell@warren.med.harvard.edu
Journal of Consulting and Clinical Psychology
|November 6, 1998
Summary
High expressed emotion (EE) from spouses predicts higher relapse rates in alcoholism patients. Interventions like Antabuse and behavioral marital therapy (BMT) may reduce relapse, especially for those with high EE spouses.
Area of Science:
- Psychiatry
- Psychology
- Addiction Medicine
Background:
- Family expressed emotion (EE) is a known predictor of relapse in schizophrenia and mood disorders.
- The relationship between EE and relapse in alcoholism has not been extensively studied.
Purpose of the Study:
- To examine the association between a spouse's EE and relapse rates in alcoholic patients undergoing behavioral marital therapy (BMT).
Main Methods:
- The study included 86 alcoholic patients (78 men, 8 women) and their spouses.
- Spouse's EE levels were assessed, and patient relapse status was monitored for 12 months post-BMT initiation.
- Statistical analyses controlled for patient age, education, and alcohol problem severity.
Main Results:
- Alcoholic patients with high EE spouses were more likely to relapse, experienced shorter time to relapse, and drank on a greater percentage of days.
- EE remained a significant predictor of relapse even after accounting for patient demographics and problem severity.
- Increased use of Antabuse and more BMT sessions were linked to reduced relapse in patients with high EE spouses.
Conclusions:
- Spousal expressed emotion is a significant factor associated with relapse in alcoholism.
- Behavioral marital therapy and pharmacotherapy (Antabuse) may be particularly beneficial for alcoholic patients with high EE spouses.