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Attachment, mentalisation and expressed emotion in carers of people with long-term mental health difficulties

BACKGROUND: Expressed emotion (EE) is a global index of familial emotional climate, which is comprised of emotional over-involvement (EOI) and critical comments (CC)/hostility. Although EE is an established predictor of negative outcomes for both people with long-term mental health difficulties and...

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Autores principales: Cherry, Mary Gemma, Taylor, Peter James, Brown, Stephen Lloyd, Sellwood, William
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6097417/
https://www.ncbi.nlm.nih.gov/pubmed/30115039
http://dx.doi.org/10.1186/s12888-018-1842-4
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author Cherry, Mary Gemma
Taylor, Peter James
Brown, Stephen Lloyd
Sellwood, William
author_facet Cherry, Mary Gemma
Taylor, Peter James
Brown, Stephen Lloyd
Sellwood, William
author_sort Cherry, Mary Gemma
collection PubMed
description BACKGROUND: Expressed emotion (EE) is a global index of familial emotional climate, which is comprised of emotional over-involvement (EOI) and critical comments (CC)/hostility. Although EE is an established predictor of negative outcomes for both people with long-term mental health difficulties and their family carers, its psychological underpinnings remain relatively poorly understood. This paper examined associations between attachment, mentalisation ability and aspects of EE. METHODS: Carers of people with long-term mental health difficulties (n = 106) completed measures of adult attachment (the Experiences in Close Relationships-Short Form questionnaire), mentalisation (the Reading the Mind in the Eyes Test and the Emotional Self-Efficacy Scale) and EE (the Family Questionnaire). Data were analysed using hierarchical multiple regression. RESULTS: Attachment avoidance and facets of mentalisation were directly and uniquely positively associated with CC/hostility, with attachment avoidance and other-directed emotional self-efficacy (one facet of mentalisation) each significantly predicting CC/hostility scores after controlling for the effects of EOI and demographic variables. However, no associations were observed between EOI, attachment anxiety and mentalisation. Furthermore, no indirect effects from attachment to EE via mentalisation was found. CONCLUSIONS: Although it would be premature to propose firm clinical implications based on these findings, data indicate that it may be beneficial for clinicians to consider attachment and mentalisation in their conceptualisation of carers’ criticism and hostility. However, further research is needed to clarify the magnitude of these associations and their direction of effect before firm conclusions can be drawn.
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spelling pubmed-60974172018-08-20 Attachment, mentalisation and expressed emotion in carers of people with long-term mental health difficulties Cherry, Mary Gemma Taylor, Peter James Brown, Stephen Lloyd Sellwood, William BMC Psychiatry Research Article BACKGROUND: Expressed emotion (EE) is a global index of familial emotional climate, which is comprised of emotional over-involvement (EOI) and critical comments (CC)/hostility. Although EE is an established predictor of negative outcomes for both people with long-term mental health difficulties and their family carers, its psychological underpinnings remain relatively poorly understood. This paper examined associations between attachment, mentalisation ability and aspects of EE. METHODS: Carers of people with long-term mental health difficulties (n = 106) completed measures of adult attachment (the Experiences in Close Relationships-Short Form questionnaire), mentalisation (the Reading the Mind in the Eyes Test and the Emotional Self-Efficacy Scale) and EE (the Family Questionnaire). Data were analysed using hierarchical multiple regression. RESULTS: Attachment avoidance and facets of mentalisation were directly and uniquely positively associated with CC/hostility, with attachment avoidance and other-directed emotional self-efficacy (one facet of mentalisation) each significantly predicting CC/hostility scores after controlling for the effects of EOI and demographic variables. However, no associations were observed between EOI, attachment anxiety and mentalisation. Furthermore, no indirect effects from attachment to EE via mentalisation was found. CONCLUSIONS: Although it would be premature to propose firm clinical implications based on these findings, data indicate that it may be beneficial for clinicians to consider attachment and mentalisation in their conceptualisation of carers’ criticism and hostility. However, further research is needed to clarify the magnitude of these associations and their direction of effect before firm conclusions can be drawn. BioMed Central 2018-08-16 /pmc/articles/PMC6097417/ /pubmed/30115039 http://dx.doi.org/10.1186/s12888-018-1842-4 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Cherry, Mary Gemma
Taylor, Peter James
Brown, Stephen Lloyd
Sellwood, William
Attachment, mentalisation and expressed emotion in carers of people with long-term mental health difficulties
title Attachment, mentalisation and expressed emotion in carers of people with long-term mental health difficulties
title_full Attachment, mentalisation and expressed emotion in carers of people with long-term mental health difficulties
title_fullStr Attachment, mentalisation and expressed emotion in carers of people with long-term mental health difficulties
title_full_unstemmed Attachment, mentalisation and expressed emotion in carers of people with long-term mental health difficulties
title_short Attachment, mentalisation and expressed emotion in carers of people with long-term mental health difficulties
title_sort attachment, mentalisation and expressed emotion in carers of people with long-term mental health difficulties
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6097417/
https://www.ncbi.nlm.nih.gov/pubmed/30115039
http://dx.doi.org/10.1186/s12888-018-1842-4
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