Perceived criticism: Biased patients or hypercritical relatives? Commentary on “perceived criticism: A research update for clinical practitioners”.

Abstract

Masland and Hooley (2015) make a convincing case that patients’ ratings on the two-item Perceived Criticism Measure (PCM) provide useful treatment planning information. One issue that has not been resolved is whether high ratings on the PCM reflect the patient's “criticality biases” or are accurate reflections of how much criticism is expressed by relatives. PCM ratings are correlated with observers’ reports of how critical the relative is in interactions with the patient. Therefore, an exclusive treatment focus on PCM ratings as attributional biases risks alienating the patient, who may be perceiving the behavior of relatives accurately. If the clinician opts for a family/marital approach, communication training that fosters a dialogue between the patient and spouse or parent(s) about vulnerable emotions underlying anger may lead to shifts in the patient's interpretation of the meaning of critical comments. Future research should investigate whether PC ratings are moderators of the effectiveness of family psychoeducational interventions or individual treatments that emphasize attentional bias modification.