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Perceptions of family criticism and warmth and their link to symptom expression in racially/ethnically diverse adolescents and young adults at clinical high risk for psychosis

Authors

  • Katherine H. Tsai,

    Corresponding author
    1. Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California, USA
    Current affiliation:
    1. University of California, Los Angeles, CA, USA
    • Corresponding author: Dr Katherine H. Tsai, San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, 6363 Alvarado Court, Suite 103, San Diego, CA 92120, USA. Email: katsai@ucla.edu

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  • Steve López,

    1. Department of Psychology, University of Southern California, Los Angeles, California, USA
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  • Sarah Marvin,

    1. Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, California, USA
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  • Jamie Zinberg,

    1. Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, California, USA
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  • Tyrone D. Cannon,

    1. Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, California, USA
    Current affiliation:
    1. Yale University, New Haven, CT, USA
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  • Mary O'Brien,

    1. Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, California, USA
    Current affiliation:
    1. Yale University, New Haven, CT, USA
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  • Carrie E. Bearden

    1. Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, California, USA
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Abstract

Aim

Little is known about the role of expressed emotion (EE) in early symptom expression in individuals at clinical high risk (CHR) for psychosis. In patients with established schizophrenia, the effects of EE on clinical outcomes have purportedly varied across racial/ethnic groups, but this has not yet been investigated among CHR patients. Furthermore, studies have traditionally focused upon caregiver levels of EE via interview-based ratings, whereas the literature on patient perceptions of caregiver EE on psychosis symptoms is relatively limited.

Methods

Linear regression models were conducted to examine the impact of criticism and perceived warmth in the family environment, from the CHR patient's perspective, on positive and negative symptom expression in non-Latino white (NLW; n = 38) and Latino (n = 11) adolescents and young adults at CHR for developing psychosis.

Results

Analyses examining the sample as a whole demonstrated that perceived levels of maternal criticism were negatively associated with negative CHR symptomatology. Additional analyses indicated that race/ethnicity moderated the relationship between criticism/warmth and clinical symptomatology. We found evidence of a contrasting role of patient perceived criticism and warmth depending upon the patient's race/ethnicity.

Conclusion

Family processes shown to impact the course of schizophrenia among NLWs may function differently among Latino than NLW patients. These findings have important implications for the development of culturally appropriate interventions and may aid efforts to improve the effectiveness of mental health services for diverse adolescents and young adults at CHR for psychosis. Given the small sample size of this study, analyses should be replicated in a larger study before more definitive conclusions can be made.

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