This review examines the contribution of an attribution-based framework to our understanding of both expressed emotion (EE) and the process of patient relapse. It considers all published studies that have assessed the attributions of high- and low-EE relatives and carers. Across these studies, a great deal of consistency is apparent. Critical relatives are more likely to hold patients responsible for their difficulties. On the other hand, attributions made by emotionally overinvolved relatives are similar to the attributions made by those who are low EE. In reviewing the association between attributions and patient relapse, it is concluded that carers' beliefs may play a role in the relapse process in a variety of ways. These include mediating controlling behavior, which may serve to increase patient stress or decrease patients' sense of self-worth. A major limitation of research in this area is the cross-sectional and correlational nature of the data. This makes it impossible to draw conclusions about directions of effect in the association of EE and attributions. Nonetheless, an argument can be made for the development and evaluation of interventions designed to help relatives adopt less blaming and more flexible beliefs about the nature of patients' problems. Particularly helpful in this regard may be interventions that use verbal and behavioral reattribution techniques similar to those described in the cognitive behavioral treatment of emotional disorders.

中文翻译：

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归因和表达的情感：综述。

这篇综述探讨了基于归因的框架对我们对表达情绪（EE）和患者复发过程的理解的贡献。它考虑了所有已评估高EE和低EE亲戚和看护者归因的研究。在这些研究中，很明显的一致性。关键亲属更有可能让患者对自己的困难负责。另一方面，情感上过度投入的亲戚的归因与低EE者的归因相似。在回顾归因与患者复发之间的关联时，可以得出结论，护理者的信念可能以多种方式在复发过程中发挥作用。这些包括调解控制行为，可能会增加患者的压力或减少患者的 自我价值感。该领域研究的主要限制是数据的横截面和相关性。这使得不可能就EE和归因的关联得出结论。但是，可以就旨在帮助亲属减少对患者问题性质的指责和更灵活的信念的干预措施的发展和评估提出论据。在这方面特别有用的可能是使用口头和行为重新归因技术的干预措施，这些技术与情绪障碍的认知行为治疗中所描述的相似。这使得不可能就EE和归因的关联得出结论。但是，可以就旨在帮助亲属减少对患者问题性质的指责和更灵活的信念的干预措施的发展和评估提出意见。在这方面特别有用的可能是使用口头和行为重新归因技术的干预措施，这些技术与情绪障碍的认知行为治疗中所描述的相似。这使得不可能就EE和归因的关联得出结论。但是，可以就旨在帮助亲属减少对患者问题性质的指责和更灵活的信念的干预措施的发展和评估提出论据。在这方面特别有用的可能是使用口头和行为重新归因技术的干预措施，这些技术与情绪障碍的认知行为治疗中所描述的相似。