Expressed emotion and differentiation of self in the relatives of stable schizophrenia outpatients

This study examined "trait" variables associated with high and low levels of expressed emotion in the parents of long-term stable schizophrenia outpatients. Self-descriptions collected from patients, their parents, and control participants matched to the parents were rated for levels of differentiation and integration, substantiality, relatedness, and self-criticism using established methods. The parents as a group did not differ from controls on any of the self-description variables. When parents were classified based on their expressed emotion status, those with low expressed emotion showed higher levels of differentiation and integration than those with high expressed emotion. Low expressed emotion parents were also lower on self-criticism. There was no difference between expressed emotion groups on substantiality or relatedness. These findings support the idea that high expressed emotion in parents of long-term stable outpatients may be a manifestation in part of relatively low levels of differentiation and integration of self in the parents. Furthermore, though patients as a group scored lower than parents on differentiation and integration and substantiality, patients' ratings on these two variables also correlated with those of their parents, suggesting that these variables are to some extent familially determined.