The Yale Psychiatric
Institute Family Study:
Research Design and Methods
IN THIS CHAPTER we outline the design of the Yale Psychiatric Institute Family Study and provide a comprehensive overview of the clinical assessment instruments and procedures used to address our central research questions. The more clinically oriented reader may wish to move directly to chapter 5, which introduces the family typology derived from the research methods and findings presented in chapters 4 and 5.
In designing the Yale Psychiatric Institute Family Study (YPIFS), we intended to explore in depth the process of change in families of patients undergoing treatment for major psychiatric illness. We wanted to focus on some of the unanswered questions about the sequence and patterns of individual and family changes, and about linkages between family risk and patient characteristics. Previous research, as discussed in chapter 2, had clearly established a statistical link between certain dysfunctional pattems of relating in families and psychiatric outcome in patients diagnosed with disorders such as schizophrenia, bipolar disorder, and depression. Prediction studies pointed to the family emotional climate as a potential pathogenic factor in the patient's recovery efforts. Certain assumptions followed from the family research, particularly from research on expressed emotion (EE) done in Great Britain, where patients were assumed to be the victims of an overly critical, overinvolved, and hostile family environment. Many of these original investigators believed that EE (overly critical or overinvolved attitudes) was primarily a unilateral force, stemming from within the parent, that directly exerted a negative influ