Emotional involvement/overinvolvement in the relatives of patients with bipolar disorder Public Deposited

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  • March 20, 2019
  • Fredman, Steffany Jane
    • Affiliation: College of Arts and Sciences, Department of Psychology and Neuroscience
  • Emotional overinvolvement (EOI), the tendency of a psychiatric patient’s relative to display intrusiveness, excessive self-sacrifice, or an exaggerated emotional response to the patient, has typically been assessed using the Camberwell Family Interview (CFI). The CFI is conducted in the patient’s absence and combines all three elements into a single, global score. Fredman, Chambless, and Steketee (2004) addressed this limitation by creating an observational coding system that provides separate ratings for each of these behaviors, as observed from direct patient-relative interactions. The current study further refines Fredman et al.’s coding system by differentiating between appropriate and inappropriate displays of emotional involvement. The adapted coding system was applied to a sample of 115 patients with bipolar disorder who had completed pretreatment patient-relative problem-solving interactions prior to entering a family-based psychosocial intervention program for bipolar disorder. Results supported the new measure’s reliability and construct validity and demonstrated the predictive validity of the interactional ratings but not the CFI EOI score. Specifically, in the absence of treatment, low levels of observed inappropriate self-sacrifice and inappropriate emotional response predicted improved outcome for manic symptoms, whereas moderate and high levels of observed inappropriate self-sacrifice and emotional response predicted poor outcomes for manic symptoms. In addition, low and moderate levels of observed appropriate self-sacrifice predicted poor outcome for depressive symptoms, whereas high levels of appropriate self-sacrifice predicted improved outcome for depressive symptoms. Patients receiving family-based treatment demonstrated improvements in mania and depression regardless of relatives’ levels of emotional involvement. Findings are discussed in light of the family environment of bipolar disorder and the potential utility of this methodology to investigate the family environment of other forms of psychopathology.
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  • Baucom, Donald
  • Open access

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