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Acceptance and Expressed Emotion in Mexican American Caregivers of Relatives with Schizophrenia

Authors


  • This research was supported by a grant from the Paso del Norte Health Foundation's Center for Border Health Research and by a National Institute of Mental Health NRSA Training Grant MH14584 (Psychological Research on Schizophrenic Conditions) both awarded to Ramírez García, as well as by an American Psychological Association Minority Fellowship funded by SAMHSA SM56564 awarded to Hernández. A previous version of the paper was presented as a poster at the Association for Behavior and Cognitive Therapies 40th annual convention, Chicago, IL. We would like to thank James M. Wood, Larry D. Meyer, Bernardo Tarín, and Guillermo Ochoa for their assistance in recruiting participants as well as the family caregivers and their loved ones with mental illness for their time. We appreciate the input of Howard Berenbaum on earlier versions of the paper.

  • Special thanks to the UCLA Camberwell Family Raters: Nick Breitborde, Christina Chang, Perla Placencia, and Susana Solano.

  • Dr. Dorian is now at the California School of Professional Psychology at Alliant International University, San Diego, CA. Dr. López is now professor of Psychology and Social Work at the University of Southern California.

concerning this article should be addressed to Jorge Ramírez García, Department of Psychology, University of Illinois, Urbana-Champaign, Urbana, IL. E-mail: jramirez@uiuc.edu

Abstract

The relation between Expressed Emotion (EE) and caregiver acceptance was tested with the use of video-recorded interactions between 31 Mexican American family caregivers and their relatives with schizophrenia. Borrowing the concept from Integrative Behavioral Couple Therapy, acceptance was defined as caregiver's engagement with the ill relative along with low levels of expectations for behavioral change. Three aspects of caregiver acceptance were measured: global acceptance of the patient, unified detachment (i.e., nonblaming but engaged problem discussion), and low aversive responses to patient behavior (e.g., criticisms and demanding change). Relative to high EE caregivers, low EE caregivers were consistently more accepting of their ill relatives across the three measures of acceptance. Unified detachment was negatively associated with emotional overinvolvement and aversive responses were positively related to criticism. Warmth was not related to acceptance. The findings suggest that the study of acceptance in family caregivers is a heuristic avenue for future research due to its potential to shed light on specifically what family members do in caring for their ill relatives with schizophrenia.

RESUMEN

Aceptación y expresión de las emociones en los cuidadores mexicanos-americanos de familiares con esquizofrenia

Se analizó la relación entre la expresión de las emociones (EE) y la aceptación del cuidador utilizando interacciones grabadas en video entre 31 cuidadores de familia mexicana-americana y sus familiares con esquizofrenia. Utilizando el concepto perteneciente a la terapia de pareja integradora, se definió la aceptación como la dedicación del cuidador al familiar enfermo, junto con niveles bajos de esperanza de cambio de conducta. Se midieron tres aspectos de la aceptación del cuidador: la aceptación global del paciente, el desapego unificado (es decir, la discusión de problemas sin buscar culpables, pero de manera involucrada), y las respuestas de baja aversividad a la conducta del paciente (por ejemplo, críticas y exigencias de cambio). En relación a los cuidadores con una alta EE, los cuidadores con baja EE presentaron consistentemente una mayor aceptación de sus familiares enfermos a través de las tres medidas de aceptación. El desapego unificado se vio asociado negativamente a un exceso de involucración emocional y las respuestas aversivas se vieron asociadas positivamente a las críticas. El cariño no se vio relacionado a la aceptación. Las averiguaciones sugieren que el estudio de la aceptación en cuidadores familiares dará pie a futuras investigaciones, debido a su potencial para arrojar luz sobre lo que los miembros de la familia hacen, concretamente cuando cuidan de sus familiares con esquizofrenia.

Palabras clave: aceptación; expresión de las emociones; esquizofrenia; americanos mexicanos; cuidadores familiares.

Abstract

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