TY - JOUR
T1 - Relatives' attachment anxiety mediates the association between perceived loss and expressed emotion in early psychosis
AU - Hinojosa-Marqués, Lídia
AU - Domínguez-Martínez, Tecelli
AU - Sheinbaum, Tamara
AU - Cristóbal-Narváez, Paula
AU - Kwapil, Thomas R.
AU - Barrantes-Vidal, Neus
N1 - Publisher Copyright:
© 2019 Hinojosa-Marqués et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - A common reaction experienced by family members of patients with psychosis is grief for the loss of their healthy relative. Importantly, high levels of perceived loss have been related to the manifestation of high expressed emotion (EE), which includes the negative attitudes expressed by relatives toward an ill family member. However, the mechanisms underlying the relationship between relatives' perceived loss and EE attitudes in the early stages of psychosis are still not fully understood. In this regard, attachment theory has been suggested as a useful framework for understanding this link. The current study aimed to examine: (1) whether relatives' perceived loss was associated with relatives' EE dimensions (i.e., criticism and emotional over-involvement (EOI)), and (2) whether such associations were mediated by relatives' attachment dimensions (i.e., anxiety and avoidance). Seventy-eight relatives of patients with early psychosis completed the Mental Illness Version of the Texas Inventory of Grief for the assessment of loss reactions. Attachment dimensions and EE attitudes were assessed by the Psychosis Attachment Measure and the Family Questionnaire, respectively. Findings indicated that relatives' perceived loss was associated with EE dimensions. Relatives' attachment anxiety, but not avoidance, mediated the relationship of perceived loss with both criticism and EOI. Findings highlight the importance of examining the role of relatives' attachment characteristics for understanding how perceptions of loss might impact the manifestation of EE attitudes in the early stages of psychosis. Family interventions aimed at assisting relatives to improve their management of negative emotional reactions to loss are fundamental to prevent impairing loss reactions and the entrenchment of high-EE attitudes.
AB - A common reaction experienced by family members of patients with psychosis is grief for the loss of their healthy relative. Importantly, high levels of perceived loss have been related to the manifestation of high expressed emotion (EE), which includes the negative attitudes expressed by relatives toward an ill family member. However, the mechanisms underlying the relationship between relatives' perceived loss and EE attitudes in the early stages of psychosis are still not fully understood. In this regard, attachment theory has been suggested as a useful framework for understanding this link. The current study aimed to examine: (1) whether relatives' perceived loss was associated with relatives' EE dimensions (i.e., criticism and emotional over-involvement (EOI)), and (2) whether such associations were mediated by relatives' attachment dimensions (i.e., anxiety and avoidance). Seventy-eight relatives of patients with early psychosis completed the Mental Illness Version of the Texas Inventory of Grief for the assessment of loss reactions. Attachment dimensions and EE attitudes were assessed by the Psychosis Attachment Measure and the Family Questionnaire, respectively. Findings indicated that relatives' perceived loss was associated with EE dimensions. Relatives' attachment anxiety, but not avoidance, mediated the relationship of perceived loss with both criticism and EOI. Findings highlight the importance of examining the role of relatives' attachment characteristics for understanding how perceptions of loss might impact the manifestation of EE attitudes in the early stages of psychosis. Family interventions aimed at assisting relatives to improve their management of negative emotional reactions to loss are fundamental to prevent impairing loss reactions and the entrenchment of high-EE attitudes.
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U2 - 10.1371/journal.pone.0223425
DO - 10.1371/journal.pone.0223425
M3 - Article
C2 - 31589647
AN - SCOPUS:85072973281
SN - 1932-6203
VL - 14
JO - PloS one
JF - PloS one
IS - 10
M1 - e0223425
ER -