Perceived Expressed Emotion in the Illness Narratives of Individuals with Chronic Gastrointestinal Disorders
DOI:
https://doi.org/10.29038/eejpl.2021.8.2.pasKeywords:
expressed emotion, illness narrative, narrative elements, perceived criticism, agencyAbstract
While expressed emotion has long been considered a valid predictor of a poor clinical outcome in individuals with mental and physical conditions, the present study marks the empirical investigation to assess specific communication patterns between family members and individuals with chronic gastrointestinal disorders. Following a rich tradition of studying illness narratives and a narrative approach to healing chronic illnesses, the present study examined illness narratives in a group of 40 mid-life adults with chronic gastrointestinal disorders. Two reliable, independent experts unfamiliar with the participants' research objectives and diagnostic status coded all narratives (ICC = .77). Self-narratives describing the illness and its impact on the family life were analyzed for a set of narrative elements, including agency, communion fulfilment, and narrative coherence. In addition, the study applies measures to assess expressed emotion, criticism towards family and perceived criticism towards individuals with a condition. The correlation analysis results indicate an association between agency and criticism (.33) and perceived criticism (.33). The main issue emerging from the multiple regression analysis findings is that agency of the narrative, criticism towards family and duration of disease taken together contribute to perceived criticism of the family towards the individual with a condition. However, a family’s criticism towards the individual with a condition is the only independent significant predictor of perceived criticism. One of the more significant findings from this study is that substantial autonomy from significant others and empowerment of individuals with a condition could worsen the family environment and have an unfavourable clinical outcome. More practical information on service users' autonomy and its impact on disease self-management would help us establish a greater accuracy.
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Adler, J. M., Chin, E. D., Kolisetty, A. P., & Oltmanns, T. F. (2012). The distinguishing characteristics of narrative identity in adults with features of borderline personality disorder: An empirical investigation. Journal of Personality Disorders, 26(4), 498-512. https://doi.org/10.1521/pedi.2012.26.4.498
Ayilara, O., Ogunwale, A., & Babalola, E. (2017). Perceived expressed emotions in relatives of patients with severe mental illness: A comparative study. Psychiatry Research, 257, 137-143. https://doi.org/10.1016/j.psychres.2017.07.037
Bernard W. S. Fan (2014) Measuring Perceived Expressed Emotion of Elderly with Schizophrenia. International Journal of Mental Health, 43(2), 3-16, https://doi.org/10.2753/IMH0020-7411430201
Brokerhof, I. M., Ybema, J. F., & Bal, P. M. (2020). Illness narratives and chronic patients’ sustainable employability: The impact of positive work stories. PloS ONE, 15(2), e0228581. https://doi.org/10.1371/journal.pone.0228581
Brewin, C. R., MacCarthy, B., Duda, K., & Vaughn, C. E. (1991). Attribution and expressed emotion in the relatives of patients with schizophrenia. Journal of Abnormal Psychology, 100(4), 546. https://doi.org/10.1037/0021-843X.100.4.546.
Brown, G. W., Birley, J. L. T., & Wing, J. K. (1972). Influence of family life on the course of schizophrenic disorders: A replication. British Journal of Psychiatry, 121, 241–258. https://doi.org/10.1192/bjp.121.3.241
Carlton, J., Rowen, D., & Elliott, J. (2020). Assessment of the psychometric properties and refinement of the Health and Self-Management in Diabetes Questionnaire (HASMID). Health and Quality of Life Outcomes, 18(1), 1-11. https://doi.org/10.1186/s12955-020-01305-3
Cherry, M. G., Taylor, P. J., Brown, S. L., & Sellwood, W. (2018). Attachment, mentalisation and expressed emotion in carers of people with long-term mental health difficulties. BMC Psychiatry, 18(1), 1-11. https://doi.org/10.1186/s12888-018-1842-4
Çolpan, M., Eray, Ş., Eren, E., & Vural, A. P. (2018). Perceived Expressed Emotion, Emotional and Behavioral Problems and Self-Esteem in Obese Adolescents: A Case-Control Study. Journal of Clinical Research in Pediatric Endocrinology, 10(4), 357. https://doi.org/10.4274/jcrpe.0101
Hooley, J. M., & Gotlib, I. H. (2000). A diathesis-stress conceptualization of expressed emotion and clinical outcome. Applied and Preventive Psychology, 9(3), 135-151. https://doi.org/10.1016/S0962-1849(05)80001-0
Hooley, J. M., & Parker, H. A. (2006). Measuring expressed emotion: An evaluation of the shortcuts. Journal of Family Psychology, 20(3), 386. https://doi.org/10.1146/annurev.clinpsy.2.022305.095236
Jenkins, J. H., & Karno, M. (1992). The meaning of expressed emotion: Theoretical issues raised by cross-cultural research. American Journal of Psychiatry, 149(1), 9-21. https://doi.org/10.1176/ajp.149.1.9
Leff, J., & Vaughn, C. (1985). Expressed emotion in families: Its significance for mental illness. Guilford Press.
López, S. R., Ramírez García, J. I., Ullman, J. B., Kopelowicz, A., Jenkins, J., Breitborde, N. J., & Placencia, P. (2009). Cultural variability in the manifestation of expressed emotion. Family Process, 48(2), 179-194.
Ludvigsson, J. F., Roy, A., Lebwohl, B., Green, P. H., & Emilsson, L. (2017). Anxiety and depression in caregivers of individuals with celiac disease—a population-based study. Digestive and Liver Disease, 49(3), 273-279. https://doi.org/10.1016/j.dld.2016.11.006
Masland, S. R., Drabu, S., & Hooley, J. M. (2019). Is perceived criticism an independent construct? Evidence for divergent validity across two samples. Journal of Family Psychology, 33(2), 133–142. https://doi.apa.org/doiLanding?doi=10.1037%2Ffam0000452
Medina-Pradas, C., Navarro, J. B., López, S. R., Grau, A., & Obiols, J. E. (2011). Further development of a scale of perceived expressed emotion and its evaluation in a sample of patients with eating disorders. Psychiatry Research, 190(2-3), 291-296. https://doi.org/10.1016/j.psychres.2011.06.011
Rienecke, R. D., & Richmond, R. L. (2017). Psychopathology and expressed emotion in parents of patients with eating disorders: Relation to patient symptom severity. Eating Disorders, 25(4), 318-329. https://doi.org/10.1080/10640266.2017.1289795
Sandler R. S, Everhart J. E, Donowitz M., Adams E., Cronin K., Goodman C., Gemmen E., Shah S., Avdic A., Rubin R. (2002). The burden of selected digestive diseases in the United States. Gastroenterology, 122(5), 1500–1511. https://doi.org/10.1053/gast.2002.32978
Shapiro, J. (2011). Illness narratives: reliability, authenticity and the empathic witness. Medical Humanities, 37(2), 68-72.
Wearden, A. J., Tarrier, N., Barrowclough, C., Zastowny, T. R., & Rahill, A. A. (2000). A review of expressed emotion research in health care. Clinical Psychology Review, 20(5), 633-666.
Zasiekina, L. (2020). Trauma, Rememory and Language in Holodomor Survivors’ Narratives. Psycholinguistics, 27(1), 80-94. https://doi.org/10.31470/2309-1797-2020-27-1-80-94
Zasiekina, L., Leshem, B., Hordovska, T., Leshem, N., & Pat-Horenczyk, R. (2021). Forgotten Stories of Women: Intergenerational Transmission of Trauma of Holodomor and Holocaust Survivors’ Offspring. East European Journal of Psycholinguistics, 8(1), 137-158. https://doi.org/10.29038/eejpl.2021.8.1.zas
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