COVERT CRITICISM - A NEW CRITERION FOR ASSESSING THE EXPRESSED EMOTION INDEX FOR SPOUSES OF DEPRESSED-PATIENTS FROM THE 5-MINUTE SPEECH SAMPLE

The expressed emotion (EE) index is a measure of affective attitudes held by relatives toward a mentally ill family member. In several studies it has been shown to be a predictor of relapse in the course of schizophrenia and depression. Since the Camberwell Family Interview (CFI) as the traditional method for assessing EE is time-consuming, a brief method - the Five-Minute Speech Sample (FMSS) - has been developed as an alternative for research and clinical work. The FMSS is also suitable for repeated application. Reliability and concurrent validity of the FMSS-EE have been demonstrated in cross-cultural samples of families with a schizophrenic member. However, application of the FMSS coding system to relatives of depressed patients in our sample proved to be problematic. Criticism, the most important EE-component, could not be assessed using the existing rating procedure. Therefore a modified version of the rating system has been developed. A new category named ''covert criticism'' has been defined which also includes indirect criticism. In an ongoing study a high degree of interrater reliability was achieved with the new system. Available data concerning concurrent validity indicate that clinically meaningful results can be derived by using the EE-ratings based on ''covert criticism''.