{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T17:26:27Z","timestamp":1775582787084,"version":"3.50.1"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,10,15]],"date-time":"2017-10-15T00:00:00Z","timestamp":1508025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Provost Research Award"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Family Process"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:p>Expressed emotion (<jats:styled-content style=\"fixed-case\">EE<\/jats:styled-content>) is a measure of a caregiver's critical and emotionally overinvolved (<jats:styled-content style=\"fixed-case\">EOI<\/jats:styled-content>; e.g., intrusive, self\u2010sacrificing) attitudes and behaviors toward a person with a mental illness. Mounting evidence indicates that high levels of these critical and <jats:styled-content style=\"fixed-case\">EOI<\/jats:styled-content> attitudes and behaviors (collectively termed high <jats:styled-content style=\"fixed-case\">EE<\/jats:styled-content>) in family members are associated with a poorer course of illness for people with a range of disorders, including dementia (Nomura et al., 2005). However, less is known about factors that might trigger high <jats:styled-content style=\"fixed-case\">EE<\/jats:styled-content> and how high <jats:styled-content style=\"fixed-case\">EE<\/jats:styled-content> might impact dementia caregivers\u2019 own mental health. In this study we propose that caregivers who perceive stigma from their relative's illness may be more likely to be critical or intrusive (high <jats:styled-content style=\"fixed-case\">EOI<\/jats:styled-content>) toward their relative in an attempt to control symptomatic behaviors. We further hypothesized that high <jats:styled-content style=\"fixed-case\">EE<\/jats:styled-content> would partially mediate the link between stigma and quality of life (QoL) as there is some evidence that high <jats:styled-content style=\"fixed-case\">EE<\/jats:styled-content> is associated with poorer mental health in caregivers themselves (Safavi et al., 2015). In line with study hypotheses and using a sample of 106 dementia caregivers, we found that greater caregiver stigma was associated with both high <jats:styled-content style=\"fixed-case\">EE<\/jats:styled-content> (for criticism and <jats:styled-content style=\"fixed-case\">EOI<\/jats:styled-content>) and with poorer QoL. Mediational analyses further confirmed that high <jats:styled-content style=\"fixed-case\">EE<\/jats:styled-content> accounts for much of the association between stigma and poorer QoL. Study results suggest that addressing caregiver stigma in therapy could reduce levels of high <jats:styled-content style=\"fixed-case\">EE<\/jats:styled-content> and indirectly therefore improve caregiver QoL. Intervening directly to reduce high <jats:styled-content style=\"fixed-case\">EE<\/jats:styled-content> could also improve caregiver QoL.<\/jats:p>","DOI":"10.1111\/famp.12325","type":"journal-article","created":{"date-parts":[[2017,10,16]],"date-time":"2017-10-16T04:24:47Z","timestamp":1508127887000},"page":"694-706","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Stigma, Expressed Emotion, and Quality of Life in Caregivers of Individuals with Dementia"],"prefix":"10.1111","volume":"57","author":[{"given":"Amy","family":"Weisman de Mamani","sequence":"first","affiliation":[{"name":"University of Miami Coral Gables FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc J.","family":"Weintraub","sequence":"additional","affiliation":[{"name":"University of Miami Coral Gables FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Maura","sequence":"additional","affiliation":[{"name":"University of Miami Coral Gables FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Martinez de Andino","sequence":"additional","affiliation":[{"name":"University of Miami Coral Gables FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caitlin A.","family":"Brown","sequence":"additional","affiliation":[{"name":"University of Miami Coral Gables FL"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,10,15]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Alzheimer Society Canada. 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