Further development of a scale of perceived expressed emotion and its evaluation in a sample of patients with eating disorders

Abstract

High expressed emotion (EE) as measured by the Camberwell Family Interview (CFI) predicts the course of eating disorders (ED). Despite its important contribution to the field, the CFI has two major limitations; it is time-consuming and it does not consider the patient's perspective. Obtaining the patient's view may help shed light on the dyadic nature of caregiver's EE and the patient's illness course. The objectives of our study of 77 patients with ED were to develop further a brief measure to assess the patients' perceptions of their caregivers' EE, the patient version of the Brief Dyadic Scale of Expressed Emotion (BDSEE), and to evaluate its psychometric properties. Three clearly separate factors were identified: perceived criticism, perceived emotional overinvolvement, and perceived warmth. The BDSEE also demonstrated good levels of reliability and construct validity. The BDSEE subscales are significantly related to other measures of the perceived family emotional climate and to the CFI, the gold standard in the field of EE. The clinical implications of the ED patients' perceptions of their caregivers' EE are discussed. Findings support the utility of the expanded BDSEE for both research and clinical practise in assessing the perspective of patients with ED.