The validity and reliability of the measurement of the concept ‘expressed emotion’ in the family members and nurses of Hong Kong patients with schizophrenia

Document Type



School of Nursing and Midwifery, Pakistan


This study aimed to test the validity and reliability of three measures of expressed emotion in a sample of family members and nurses of Hong Kong Chinese people with schizophrenia. Little research has been done in Hong Kong in relation to family expressed emotion (EE) and schizophrenia so the present study set out to pilot some measures that could become reliable and valid measures for future clinical studies. The Adjective Check List (ACL) and the Family Attitude Scale (FAS) were compared to EE ratings obtained after a brief interview. The ratings were made based on the conceptual framework of the Camberwell Family Interview, which includes the dimensions of criticism, hostility and emotional over-involvement. Twenty-one family members and their primary nurses participated in the study which revealed that 13 of the family members and 10 of the primary nurses were rated as high EE, either in terms of criticism, emotional over-involvement or both, based on the interview. The differences in the mean FAS scores between the high EE groups and the low EE group was large but not statistically significant, and there was a significant correlation between the FAS and the brief interview. The ACL revealed some interesting results in terms of the way relatives and nurses see themselves responding to the person with schizophrenia and vice versa. Recommendations for future studies and family education strategies are made.


This work was published before the author joined Aga Khan University.


International Journal of Mental Health Nursing