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Cultural differences in the psychosocial predictors of relapse in schizophrenia: Family environment and negative life events

Dissertation
Author: April Denise Thames
Abstract:
The purpose of the current study was to examine cultural differences in the family environment and appraisal of life events among Caucasian American, Latino American, and Asian American patients with schizophrenia. A total of 66 patients and 46 families were recruited from the Aftercare Research Center at the University of California, Los Angeles. Relatives' expressed emotion was measured using the Camberwell Family Interview and family environment (as perceived by the patient) was measured using the Family Environment Scale. Cognitive appraisal of negative life events was measured using the Cognitive Appraisal of Life Events Scale. The first hypothesis stated that Caucasian American relatives would display higher levels of expressed emotion than Latino American and Asian American relatives. It was also expected that Caucasian American patients would perceive their family environment more negatively compared to Latino American and Asian American patients. The second hypothesis stated that cultural differences would exist in the type of life events that were appraised as stressful. It was expected that Caucasian American patients would appraise independent life events as more stressful than interdependent life events compared to Latino American and Asian American patients. Conversely, it was expected that Latino American and Asian American patients would rate interdependent life events as more stressful compared to Caucasian American patients. The results of the study did not support the first or second hypothesis. There were no statistically significant cultural differences in the overall family environment or the type of life events (i.e., independent, interdependent) that were appraised as stressful among Caucasian, Latino, and Asian American patients. Supplemental analyses examined factors that influenced life event appraisal by considering individual life events reported among Caucasian, Latino, and Asian American patients. Results indicated a statistically significant interaction effect of patients' cultural background and relatives' level of expressed emotion. Latino American patients who came from high expressed emotion families rated negative life events as more stressful whereas Caucasian American and Asian American patients from high expressed emotion households rated life events as less stressful. Results from this study indicate that psychosocial factors must be considered when examining how patients with schizophrenia appraise life events.

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Full document contains 155 pages
Abstract: The purpose of the current study was to examine cultural differences in the family environment and appraisal of life events among Caucasian American, Latino American, and Asian American patients with schizophrenia. A total of 66 patients and 46 families were recruited from the Aftercare Research Center at the University of California, Los Angeles. Relatives' expressed emotion was measured using the Camberwell Family Interview and family environment (as perceived by the patient) was measured using the Family Environment Scale. Cognitive appraisal of negative life events was measured using the Cognitive Appraisal of Life Events Scale. The first hypothesis stated that Caucasian American relatives would display higher levels of expressed emotion than Latino American and Asian American relatives. It was also expected that Caucasian American patients would perceive their family environment more negatively compared to Latino American and Asian American patients. The second hypothesis stated that cultural differences would exist in the type of life events that were appraised as stressful. It was expected that Caucasian American patients would appraise independent life events as more stressful than interdependent life events compared to Latino American and Asian American patients. Conversely, it was expected that Latino American and Asian American patients would rate interdependent life events as more stressful compared to Caucasian American patients. The results of the study did not support the first or second hypothesis. There were no statistically significant cultural differences in the overall family environment or the type of life events (i.e., independent, interdependent) that were appraised as stressful among Caucasian, Latino, and Asian American patients. Supplemental analyses examined factors that influenced life event appraisal by considering individual life events reported among Caucasian, Latino, and Asian American patients. Results indicated a statistically significant interaction effect of patients' cultural background and relatives' level of expressed emotion. Latino American patients who came from high expressed emotion families rated negative life events as more stressful whereas Caucasian American and Asian American patients from high expressed emotion households rated life events as less stressful. Results from this study indicate that psychosocial factors must be considered when examining how patients with schizophrenia appraise life events.