Update on Expressed Emotion: Theoretical, methodological and practical considerations

Abstract

In this theoretical article, issues of different nature related to Expressed Emotion (EE) have been reviewed. From its origins in the late 1960s, EE has become a very fruitful field of work for the understanding of the family factors involved in severe mental disorders and chronic illnesses, although without dedicating it enough critical thinking. An update from a comprehensive look at the literature is needed in several aspects in order to progress in their study qualitatively, which will have also important effect on the clinical work. First, it is called for consideration of the low EE and the inclusion of positive aspects, mainly the warmth, as protective factors, redirecting this subject into the framework of the positive psychology. Second, the bidirectional and dyadic nature of relationships between patients and their families around the EE is underlined, with the consequent methodological and practical implications regarding measurement, studies design, and clinical work.