The family environment represents an important psychosocial factor that impacts psychosis prognosis, but little is known about its effect on the at-risk stages of psychosis. This study presents a comprehensive review and summarizes the state of the art of study on the wide range of family factors related to family functioning in the At-Risk Mental State (ARMS) for psychosis, as well as family interventions in ARMS individuals. Publications were retrieved by an extensive search on MEDLINE, PsycINFO and SCOPUS (1990–2020). Expressed Emotion is the most studied variable in ARMS literature, but there is scarce evidence of the role of other significant family factors at the ARMS stage. Overall, high Expressed Emotion did not appear to be reactive to ARMS patients' poor clinical status. However, initial evidence has suggested that relatives' beliefs about the disorder may play a significant role, either as mediators of these relationships or as predictors of Expressed Emotion. Available literature yet to yield a consistent pattern of findings on the association between Expressed Emotion or other family functioning indicators and negative outcomes, but some longitudinal studies highlight the greater potential for the protective effects of positive family environments at the ARMS stage. Family-based interventions have demonstrated benefits for both ARMS individuals and family dynamics. An increased focus on the impact of the at-risk stage of illness on relatives' mental well-being is required to provide family support based on their needs and to clarify the mechanisms leading to dysfunctional family dynamics during the critical ARMS period.

中文翻译：

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精神病高危精神状态中的家庭环境因素

家庭环境是影响精神病预后的重要社会心理因素，但对其对精神病高危阶段的影响知之甚少。本研究对精神病高危精神状态 (ARMS) 中与家庭功能相关的广泛家庭因素以及对 ARMS 个体的家庭干预进行了全面回顾和总结。通过对 MEDLINE、PsycINFO 和 SCOPUS (1990-2020) 的广泛搜索检索了出版物。表达情绪是 ARMS 文献中研究最多的变量，但很少有证据表明其他重要的家庭因素在 ARMS 阶段的作用。总体而言，高表达的情绪似乎对 ARMS 患者的不良临床状态没有反应。然而，初步证据表明，亲属的 关于疾病的信念可能发挥重要作用，要么作为这些关系的中介，要么作为表达情绪的预测因子。现有文献尚未就表达情绪或其他家庭功能指标与负面结果之间的关联产生一致的发现模式，但一些纵向研究强调了在 ARMS 阶段积极家庭环境的保护作用的更大潜力。基于家庭的干预措施已证明对 ARMS 个人和家庭动态都有好处。需要更加关注疾病的高危阶段对亲属心理健康的影响，以便根据他们的需求提供家庭支持，并阐明在 ARMS 关键时期导致家庭动态功能失调的机制。