Abstract
Expressed emotion (EE) is a measure of the family environment reflecting the amount of criticism and emotional over-involvement expressed by a key relative towards a family member with a disorder or impairment (Hooley, 2007). Patients with high EE relatives have a poorer illness prognosis than do patients with low EE relatives. Despite EE's well-established predictive validity, however, questions remain regarding why some family members express high EE attitudes while others do not. Based on indirect evidence from previous research, the current study tested whether religious and nonreligious coping and shame and guilt about having a relative with schizophrenia serve as predictors of EE. A sample of 72 family members of patients with schizophrenia completed an EE interview, along with questionnaires assessing situational nonreligious coping, religious coping, and self-conscious emotions. In line with hypotheses, results indicated that nonreligious coping predicted EE. Specifically, less use of adaptive emotion-focused coping predicted high EE. Also consistent with predictions, religious coping predicted high EE above and beyond nonreligious coping. Finally, higher levels of both shame and guilt about having a relative with schizophrenia predicted high EE. Results of the current study elucidate the EE construct and have implications for working with families of patients with schizophrenia.