BACKGROUND: Expressed Emotion (EE) is a construct assessing the emotional attitudes of relatives of individual with medical or psychiatric condition. Criticism, hostility, emotional overinvolvement are interpersonal aspects included in the EE-concept. The association between EE and the frequency and severity of symptoms, the patients’ management or adjustment to the illness were shown in medical diseases such as diabetes, rheumatoid arthritis or asthma. The purpose of this study is to examine associations between EE and breast cancer.
METHOD: Forty-two women diagnosed with a breast cancer were recruited in order to take part to a longitudinal study. Women and their partner completed a set of questionnaires evaluating their psychological distress (BSI-18, Zabora et al., 2001), their attitudes towards the partner (FAS, Kavanagh et al., 1997) and their relationship’s satisfaction (RAS, Hendrick, 1988). Moreover women filled in the QLQ-BR23 (EORTEC, 1996) assessing symptoms related to the treatment. Finally, each partner was filmed during 5 minutes talking about the other one and their relationship in order to assess EE (FMSS, Magana et al., 1986).
RESULTS: Preliminary results showed associations between partner’s negative attitudes towards the patient and the relationship (High Expressed Emotion HEE) and the level of somatisation, depression and anxiety of the patient. Women showing themselves toward their partners HEE reported higher scores in the scale assessing physical problems related to the operation and in the subscales evaluating their level of depression, anxiety and somatisation than women with a positive attitude (Low Expressed Emotion). Moreover, partner’s level of depression, anxiety and somatisation was higher in couples with a HEE woman. CONCLUSIONS: The preliminary results of this research suggested associations between EE and psychological distress in the context of breast cancer. These results encourage pursuing investigations in this direction. In addition the associations between the patient’s EE and physical problems related to the operation may support the idea to examine the question of whether the EE of the patient and of the partner can affect the course and outcome of the illness.
RESEARCH IMPLICATIONS: This project demonstrated how the EEconstruct initially developed to be used in the psychiatric context could be adapted to medical conditions. Furthermore this study examined as well the EE of the partner as the EE of the patient. Indeed so far studies have only focused on the partner’s EE. CLINICAL IMPLICATIONS: Results of the study will be useful for the development of psychosocial interventions for the patients and their partner. The association between patient’s psychological distress and HEE of each partner talks for a double intervention: 1) an individual one in couples with a HEE women (focusing on the own attitude and emotional-cognitive perspective) and/or 2) a couple-oriented one in couples with a HEE partner.
ACKNOWLEDGEMENT OF FUNDING: This project benefited from the support of the Swiss National Centre of Competence in Research LIVES – Overcoming vulnerability: life course perspectives, which is financed by the Swiss National Science Foundation.