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Biomedical subjects

J Leff

Publications and source records attributed to J Leff.

At least 91 records · Page 5Linked to original sources
PubMed1987

Expressed emotion and schizophrenia in north India. I. Cross-cultural transfer of ratings of relatives' expressed emotion.

A bilingual rater was trained in English in a technique of assessing relatives emotional attitudes to patients, and was then required to rate material in Hindi without any further experience. This strategy revealed that the rating of critical comments, hostility and positive remarks could be transferred from English to Hindi without distortion. There were problems with the remaining two scales, over-involvement and warmth, but these were due to technical issues connected with rating and not to cross-cultural distortion.

Adolescent↗
PubMed1987

Expressed emotion and schizophrenia in north India. II. Distribution of expressed emotion components among relatives of schizophrenic patients in Aarhus and Chandigarh.

We measured the components of expressed emotion among two samples of relatives of first-contact patients from Aarhus (Denmark) and Chandigarh (India). The Danes were very similar in most respects to samples of British relatives, whereas the Indian relatives expressed significantly fewer critical comments, fewer positive remarks, and less over-involvement. Within the Chandigarh sample, city-dwellers were significantly more expressive than villagers of all EE components except over-involvement.

Adolescent↗
PubMed1987

Expressed emotion and schizophrenia in north India. III. Influence of relatives' expressed emotion on the course of schizophrenia in Chandigarh.

We conducted a one-year follow-up of patients who had made a first contact with psychiatric services in Chandigarh, North India, and had been assigned a diagnosis of schizophrenia. The expressed emotion (EE) of the patients' relatives was assessed early on. We found the same associations between the individual components of EE and relapse of schizophrenia as in previous Anglo-American studies, but only the association between hostility and relapse was statistically significant. Applying the same criteria as in the Anglo-American studies for 'high EE', we found a significant relationship between high EE and relapse rates. We conclude that the significantly better outcome of Chandigarh first-contact patients compared with a London sample is largely due to the significantly lower proportion of high-EE relatives in the North Indian sample.

Attitude to Health↗
PubMed1987

Expressed emotion in individual and family settings: a comparative study.

Expressed emotion ratings were performed, in two separate settings, on the parents of 20 children suffering from anorexia nervosa. Ratings were made on conventional individual interviews and on videotapes of a family interview. Comparison of ratings in the two settings showed a very high correlation for 'critical comments'. Findings on the other scales were harder to interpret, but significant correlations as well as differences were noted. Expressed emotion rated in family interviews provides new possibilities for the study of families.

Adolescent↗
PubMed1985

A controlled trial of social intervention in the families of schizophrenic patients: two year follow-up.

The two-year follow-up results are reported of a trial of social intervention in families of schizophrenic patients in high social contact with high-expressed emotion (EE) relatives. For those patients who remained on antipsychotic medication throughout the two years, the social intervention significantly reduced the relapse rate. In those experimental families where relatives' EE and/or face-to-face contact was lowered, the relapse rate was 14% compared with 78% for control patients on regular medication (P = 0.02).

Adult↗
PubMed1984

Educating relatives about schizophrenia.

An education program, which was part of a controlled trial of intervention with families of schizophrenic patients, is described and evaluated. The evidence suggests that this kind of education has a role to play in psychosocial intervention. Assessment of its impact should include not only changes in information acquired but also in attitudes.

Adult↗
PubMed1984

Psychophysiological responses of schizophrenic patients to high and low expressed emotion relatives: a follow-up study.

Measurements of skin conductance response frequencies (SCRf) were obtained from 30 acutely ill schizophrenic patients during a standardised videotaped interview, conducted with the patient's key relative present. Significant differences in SCRf's were demonstrated between patients whose relatives had high and low Expressed Emotion (EE) respectively. Patients at high risk of relapse were allocated either to a control or an experimental group, the latter being offered a number of social interventions in order to reduce the relative's EE and/or contact with the patient. Follow-up measurements were obtained on 19 patients nine months after discharge. Although social intervention was highly successful in reducing relapse rates, its effects did not appear to be directly mediated via SCRf, which was found to be independently related to relapse.

Adult↗
PubMed1984

Psychosocial relevance and benefit of neuroleptic maintenance: experience in the United Kingdom.

The benefits of psychosocial intervention were studied in patients on maintenance neuroleptics who live in high face-to-face contact with relatives who have high levels of expressed emotion. This group is at high risk of relapse when maintained on neuroleptics without social intervention. Relatives of patients in the experimental group received three types of intervention: an educational program, a relatives' group, and family therapy. The goal of intervention was to reduce face-to-face contact and/or relatives' levels of expressed emotion. The results at 9-month and 2-year follow up indicate the benefits of psychosocial intervention, while pointing out the danger in discontinuing maintenance neuroleptics for patients who live in stressful family environments.

Adolescent↗
PubMed1983

Life events, relatives' expressed emotion and maintenance neuroleptics in schizophrenic relapse.

Data from two studies, one naturalistic and the other a controlled trial, were analysed to clarify the relationships between independent life events. Expressed Emotion of a key relative, maintenance neuroleptics and the relapse of schizophrenia. It was found that patients in the community who are unprotected by medication are vulnerable either to acute stress in the form of life events or to chronic stress in the form of living with a high Expressed Emotion relative. Patients on regular medication are protected against one or other stress, but are very likely to relapse if the two forms of stress occur together. A model of schizophrenic susceptibility to environmental stress is constructed to incorporate these observations.

Adult↗
PubMed1983

Characteristics of expressed emotion: its relationship to speech and looking in schizophrenic patients and their relatives.

The measure expressed emotion (EE) is an established indicator of characteristics in the relatives of schizophrenic patients which predict relapse. Despite this, little is known of its construct validity except that schizophrenic patients are less calm in the presence of high EE than low EE relatives. There is also tentative evidence that schizophrenic patients show heightened avoidance responses to aversive social stimuli. It was therefore hypothesized that acutely ill schizophrenic patients would show social behaviours characteristic of avoidance in interaction with high but not low EE relatives. This hypothesis was not confirmed as no patient difference was found, but there were differences in the behaviour of high and low EE relatives. High EE relatives spend more interview time talking and less in looking at the patients. Low EE relatives were more prepared to be silent. This is consistent with the general tendency of high EE relatives to be socially intrusive and low EE relatives to be supportive to schizophrenic patients.

Adult↗
PubMed1983

The relationship between auditory hallucinations and spontaneous fluctuations of skin conductance in schizophrenia.

A sample was collected of schizophrenic patients exhibiting nonverbal signs of intermittent auditory hallucinations. A video-tape record was made for each of a session, during which the patient's skin conductance was monitored. Independent raters achieved reasonable agreement on the onset of periods of hallucinatory activity, as judged from non-verbal signs. The skin conductance tracing was scored independently for spontaneous fluctuations. In the 10 patients with satisfactory records the onset of hallucinatory periods was significantly (P less than 0.01) associated with a rise in the spontaneous fluctuation rate.

Adult↗
PubMed1982

A controlled trial of social intervention in the families of schizophrenic patients.

A study is reported of a controlled trial of social intervention in the families of schizophrenic patients at high risk of relapse. The patients were selected for being in high contact with high Expressed Emotion relatives. All patients were maintained on neuroleptic drugs. One half of the 24 families were randomly assigned to routine out-patient care, while the other half received a package of social interventions. This comprised a programme of education about schizophrenia, a group for the relatives, and family sessions for relatives and patients. The relapse rate in the control group was 50 per cent compared with nine per cent in the experimental group (P = 0.04). The stated aims of the therapeutic interventions were achieved in 73 per cent of experimental families. In these families, no patient relapsed. The results provide evidence for the causal role of relatives' expressed emotion (EE) in schizophrenic relapse, as well as for the therapeutic effectiveness of social intervention combined with drug treatment.

Adult↗
PubMed1981

Voice pitch measurements in schizophrenia and depression.

A monotonous voice is produced by schizophrenic patients whose expression of emotion is damped down and by patients with a severe degree of depression. Clinically, the distinction between these two diagnostic entities is virtually impossible to establish auditorily on the basis of voice quality alone. The laryngograph has been developed recently to record laryngeal activity. It was used to study voice pitch in a series of emotionally blunted and non-blunted schizophrenics, and retarded and non-retarded depressives. The frequency distributions of the laryngographic recordings were analysed to yield kurtosis scores. The group of retarded depressives had a significantly higher kurtosis score than the group of blunted schizophrenics. Hence this technique allows an objective distinction to be made between two kinds of monotonous voice produced by psychiatric patients. Furthermore, blunted schizophrenics had a higher mean kurtosis score than non-blunted schizophrenics, indicating that this measure can also be used as an objective index of blunting of affect in schizophrenia.

Depressive Disorder↗