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Expressed emotion (EE) has been described as a measure of caregivers' appraisals of the quality of their relationship with patients. However, far less is known about how the perception of their caregivers by patients with psychosis is shaped by caregivers' EE, and nothing about the clinical correlates of perceived EE. The current study examines the association of patient ratings of carer criticism with patient and carer characteristics. Patient ratings of carer criticism were also compared with the ratings of the carer derived from the Camberwell Family Interview. Sixty-seven patient-carer dyads participated in the cross-sectional study. Perceived carer criticism was associated with general psychopathology in patients, but not with overall levels of positive or negative symptoms of psychosis. Patients with lower levels of social functioning, higher levels of negative affect, and negative schematic beliefs about other people, tended to perceive greater criticism. Perceptions of carer criticism were associated with Camberwell Family Interview ratings of carer criticism, hostility, and high EE independently of affect, and poorer functioning. High EE was a significant predictor of perceived carer criticism. This study supports the validity of using feedback from patients to assess the emotional climate of the family environment.

Original publication




Journal article


J Nerv Ment Dis

Publication Date





85 - 91


Activities of Daily Living, Adaptation, Psychological, Adolescent, Adult, Affect, Aged, Aged, 80 and over, Caregivers, Cognitive Behavioral Therapy, Cost of Illness, Defense Mechanisms, Expressed Emotion, Family Conflict, Family Therapy, Female, Hostility, Humans, Judgment, Male, Middle Aged, Psychiatric Status Rating Scales, Secondary Prevention, Sick Role, Social Environment, Social Support, Young Adult