EXPRESSED EMOTION AND INTERACTIONAL PATTERNS IN THE FAMILIES OF BIPOLAR PATIENTS

The predictive validity of expressed emotion (EE) may derive in part f rom its relationship to important interactional processes in families of patients with major psychiatric disorders. The authors examined the relationship between relatives' EE attitudes, assessed during patient s' bipolar, manic, or mixed episodes, and the interactional behavior o f bipolar patients (n = 48) and their relatives as revealed in problem -solving discussions during the postepisode period. High-EE relatives were more verbally negative than low-EE relatives in these discussions . Patients from high-EE families were more nonverbally negative than t hose from low-EE families, whereas patients from low-EE families were more nonverbally positive than those from high-EE families. Sequential analyses revealed that high-EE families engage in negative interchang es of up to 3 volleys. Thus, levels of EE are associated with stressfu l patterns of interaction between bipolar patients and their relatives during the postepisode period.