Family criticism and self-starvation: a study of expressed emotion



The measure Expressed Emotion (EE) has been established as an exceptionally useful indicator of relapse in people with schizophrenia and depression. EE is now also being applied more broadly for the investigation of other disorders. EE is usually rated by conducting the Camberwell Family Interview, i.e. in the course of separate individual interviews with the relatives of the symptomatic individuals. This paper reports the rating of EE in adolescents with eating disorders within a semi-structured family schedule - the Standardized Clinical Family Interview. Consecutive referrals for eating disorders were assessed prior to family therapy and again at regular intervals during therapy. EE ratings for this sample, the prognostic value of EE, and the changes in EE that took place during the course of therapy are presented and their clinical implications discussed. The findings suggest that even low levels of Critical Comments from the parents to the anorexic adolescent are associated with continuing symptoms.