ArticleHeliyon2020
High level of expressed emotions in the family of people with schizophrenia: has a covert abrasive behaviours component been overlooked?
Article in Heliyon, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- A Systematic Review Exploring the Relationship Between Family Factors and Symptom Severity, Relapse and Social or Occupational Functioning in First-Episode Psychosis.Early intervention in psychiatry · 2025Pooled it
- Expressed Emotions in Patients with Mild to Moderate Ulcerative Colitis: A Descriptive Study.Annals of neurosciences · 2025Article
- Review
- Survey of High Expressed Emotions Experienced By Community Mental Health Service Users in Hong Kong During the COVID-19 Pandemic.Schizophrenia bulletin open · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigh expressed emotion (EE) in a patient's family is a known risk factor of relapse in schizophrenia. The three components of high EE - criticism, hostility and emotional over-involvement - were developed through a data-driven approach and a focus on overt abrasive behaviours. The influence of covert abrasive behaviours has not been explored. AIMS AND
methodsThis study aims to explore both overt and covert abrasive behaviours through semi-structured interviews conducted with 22 people with schizophrenia, who were recruited through iterative purposive sampling.
resultsThematic analysis suggests that participants' experiences of overt abrasive behaviours resonate with the three-factor structure of high EE, except "emotional over-involvement" is renamed to "over-involvement" to focus on behaviours and embrace different levels or types of emotional reactions. Regarding covert abrasive behaviours, two domains are proposed: disassociation and apathy, which focus on family members' disengaging actions and indifferent attitudes respectively. While both overt and covert abrasive behaviours cause psychological distresses and behavioural reactions on the participants, their precise impacts are not entirely the same.
conclusionPeople with schizophrenia experience both overt and covert abrasive behaviours with family members. The findings of this study may expand the conceptualization of high EE, enhance its content validity, and provide an extended conceptual framework for developing more comprehensive measures.
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Registered trials
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