The measurement of expressed emotion: a review

Expressed emotion refers to the affective attitudes and behaviours (i.e., criticism, hostility and emotional overinvolvement) of relatives toward a family member with a psychiatric illness. In this article, the Camberwell Family Interview, the standard method used to assess expressed emotion, and alternative approaches to the measurement of expressed emotion are reviewed. While there is a reasonable correspondence between ratings derived from the Camberwell interview and the less arduous alternative methods, the association is not perfect. In addition, the conceptual similarities and prognostic utility of these measures require replication and further exploration. Of the alternative assessment methods available, the use of the Five Minute Speech Sample or the Level of Expressed Emotion Scale as screening devices is recommended.