The Role of Shame-Proneness, Guilt-Proneness and Depression in EE Among Relatives of Individuals with Bipolar Disorder

by McMurrich, Stephanie Lynn

Expressed emotion (EE) has been associated with poor patient outcome in many different psychiatric disorders, including bipolar disorder. Given its robust association with relapse, EE has become a major target of family psychoeducational interventions. Most psychoeducational interventions to date have failed to change EE levels among families of those with bipolar disorder. Better intervention strategies, then, may depend on an increased understanding of the predictors of EE. The present study tested three primary predictors of EE among family members of people with bipolar disorder: shame-proneness, guilt-proneness and depression. Results indicated that depression was significantly associated with EE. Post-hoc analyses showed that shame and depression were significantly associated with attribution style. Discussion focuses on limitations and implications of the study, and suggestions for future research.