Perception of negative emotions in close relatives by patients with schizophrenia

The perception of negative emotions in close relatives may play an important role in explaining how external stressors can affect vulnerable individuals with schizophrenia. However, there is considerable debate about the ability of people with schizophrenia to perceive emotions in others. The present study aimed to examine the reliability of patients' perception of relatives' criticism. Secondly, it aimed to investigate whether patients' judgement about relatives' criticism agreed with an independent assessment of relatives' criticism towards patients.

Forty-three patients with a DSM-III-R diagnosis of schizophrenia and their relatives were assessed soon after patients' admission to a psychiatric hospital and again 9 months after their discharge from hospital. Test-retest reliability of patients' answers to a question about patients' perception of relatives' criticism towards them was carried out. The association between patients' perception of relatives' criticism and the expressed emotion (EE) measure of relatives' criticism was examined at inclusion and follow-up. Patients' symptomatology was examined at both assessments.

Reliability of the measurement of patients' perception of relatives' criticism was moderate to good. Patients' judgement of relatives' criticism towards them was associated with the number of critical comments and presence of hostility at inclusion. At follow-up, this association became weaker.

The ability to judge and describe reliably negative emotions in close relationships may help to explain how perception of the external environment may act as a stressor in people who are vulnerable to schizophrenia.