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Inter-rater reliability of expressed emotion ratings based on the Camberwell Family Interview

Published online by Cambridge University Press:  09 July 2009

H. Bentsen ,
B. Boye ,
O. G. Munkvold ,
G. Uren ,
A. B. Lersbryggen ,
K. H. Oskarsson ,
R. Berg-Larsen ,
O. Lingjærde  and
U. F. Malt
H. Bentsen*
Affiliation:
Blakstad Hospital, Asker, Gaustad Hospital, Oslo and the Department Group of Psychiatry, University of Oslo, Norway
B. Boye
Affiliation:
Blakstad Hospital, Asker, Gaustad Hospital, Oslo and the Department Group of Psychiatry, University of Oslo, Norway
O. G. Munkvold
Affiliation:
Blakstad Hospital, Asker, Gaustad Hospital, Oslo and the Department Group of Psychiatry, University of Oslo, Norway
G. Uren
Affiliation:
Blakstad Hospital, Asker, Gaustad Hospital, Oslo and the Department Group of Psychiatry, University of Oslo, Norway
A. B. Lersbryggen
Affiliation:
Blakstad Hospital, Asker, Gaustad Hospital, Oslo and the Department Group of Psychiatry, University of Oslo, Norway
K. H. Oskarsson
Affiliation:
Blakstad Hospital, Asker, Gaustad Hospital, Oslo and the Department Group of Psychiatry, University of Oslo, Norway
R. Berg-Larsen
Affiliation:
Blakstad Hospital, Asker, Gaustad Hospital, Oslo and the Department Group of Psychiatry, University of Oslo, Norway
O. Lingjærde
Affiliation:
Blakstad Hospital, Asker, Gaustad Hospital, Oslo and the Department Group of Psychiatry, University of Oslo, Norway
U. F. Malt
Affiliation:
Blakstad Hospital, Asker, Gaustad Hospital, Oslo and the Department Group of Psychiatry, University of Oslo, Norway
*
1Address for correspondence: Dr Havard Bentsen, University of Oslo, PO Box 33 Gaustad, N-0320 Oslo, Norway.
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Synopsis

High expressed emotion in relatives has been shown to predict a poorer outcome in a range of disorders and cultures. However, variation in predictive power is considerable, and this could partly be due to low inter-rater reliability. Sixty-nine relatives of 47 acutely admitted schizophrenic patients were interviewed using the Camberwell Family Interview. Audiotapes were assessed by pairs of raters drawn from a group of seven approved raters. Inter-rater reliability was good for criticism, hostility, emotional over-involvement (as a six level scale) and expressed emotion index (EOI cut-off score 2–3); and it was fair, but unsatisfactory, for emotional over-involvement (binary scales), warmth, positive remarks and expressed emotion (EOI cut-off score 3–4). These findings suggest that the warmth scale and the dichotomized versions of the EOI scale should be used with caution. The influence of warmth on the outcome in schizophrenia may have been underestimated because of low reliability.

Type
Original Articles
Information
Psychological Medicine , Volume 26 , Issue 4 , July 1996 , pp. 821 - 828
Copyright
Copyright © Cambridge University Press 1996

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References

REFERENCES

Bartko, J. J. (1991). Measurement and reliability: statistical thinking considerations. Schizophrenia Bulletin 17, 483–489.CrossRefGoogle ScholarPubMed
Bebbington, P. & Kuipers, L. (1994). The predictive utility of expressed emotion in schizophrenia: an aggregate analysis. Psychological Medicine 24, 707–718.CrossRefGoogle ScholarPubMed
Bertrando, P., Beltz, J., Bressi, C., Clerici, M., Farma, T., Invernizzi, G. & Cazzullo, C. L. (1992). Expressed emotion and schizophrenia in Italy. A study of an urban population. British Journal of Psychiatry 161, 223–229.CrossRefGoogle ScholarPubMed
Brown, G. W. & Rutter, M. (1966). The measurement of family activities and relationships: a methodological study. Human Relations 19, 241–263.CrossRefGoogle Scholar
Brown, G. W., Birley, J. L. T. & Wing, J. K. (1972). Influence of family life on the course of schizophrenic disorders: a replication. British Journal of Psychiatry 121, 241–258.CrossRefGoogle ScholarPubMed
Cicchetti, D. V. & Feinstein, A. R. (1990). High agreement but low kappa. II. Resolving the paradoxes. Journal of Clinical Epidemiology 43, 551–558.CrossRefGoogle ScholarPubMed
Dixon, W. J. (1992). BMDP Statistical Software Manual. University of California Press: Berkeley.Google Scholar
Donner, A. & Eliasziw, M. (1987). Sample size requirements for reliability studies. Statistics in Medicine 6, 441–448.CrossRefGoogle ScholarPubMed
Dunn, G. (1989). Design and Analysis of Reliability Studies. The Statistical Evaluation of Measurement Errors. Edward Arnold: London.Google Scholar
Dunn, G. (1992). Design and analysis of reliability studies. Statistical Methods in Medical Research 1, 123–157.CrossRefGoogle ScholarPubMed
Feinstein, A. R. & Cicchetti, D. V. (1990). High agreement but low kappa. I. The problems of two paradoxes. Journal of Clinical Epidemiology 43, 543–549.CrossRefGoogle ScholarPubMed
Fleiss, J. L. (1981). Statistical Methods for Rates and Proportions. John Wiley & Sons: New York.Google Scholar
Fleiss, J. L. (1986). The Design and Analysis of Clinical Experiments. John Wiley & Sons: New York.Google Scholar
Ivanovic, M., Vuletic, Z. & Bebbington, P. (1994). Expressed emotion in the families of patients with schizophrenia and its influence on the course of the illness. Social Psychiatry and Psychiatric Epidemiology 29, 61–65.CrossRefGoogle Scholar
Jenkins, J. H. & Karno, M. (1992). The meaning of expressed emotion: theoretical issues raised by cross-cultural research. American Journal of Psychiatry 149, 9–21.Google ScholarPubMed
Kavanagh, D. J. (1992). Recent developments in expressed emotion and schizophrenia. British Journal of Psychiatry 160, 601–620.CrossRefGoogle ScholarPubMed
Leff, J. & Vaughn, C. (1985). Expressed Emotion in Families. Its Significance for Mental Illness. Guilford Press: New York.Google Scholar
Magana, A. B., Goldstein, M. J., Karno, M., Miklowitz, D. J., Jenkins, J. & Falloon, I. R. H. (1986). A brief method for assessing expressed emotion in the relatives of psychiatric patients. Psychiatry Research 17, 203–212.CrossRefGoogle ScholarPubMed
Martins, C., de Lemos, A. I. & Bebbington, P. E. (1992). A Portuguese/Brazilian study of expressed emotion. Social Psychiatry and Psychiatric Epidemiology 27, 22–27.CrossRefGoogle ScholarPubMed
Mueser, K. T., Bellack, A. S. & Wade, J. H. (1992). Validation of a short version of the Camberwell Family Interview. Psychological Assessment 4, 524–529.CrossRefGoogle Scholar
Rutter, M. L. & Brown, G. W. (1966). The reliability and validity of measures of family life and relationships in families containing a psychiatric patient. Social Psychiatry 1, 38–53.CrossRefGoogle Scholar
Schouten, H. J. A. (1986). Nominal scale agreement among observers. Psychometrika 51, 453–466.CrossRefGoogle Scholar
Strainer, D. L. & Norman, G. R. (1989). Health Measurement Scales. A Practical Guide to Their Development and Use. Oxford Medical Publications: Oxford.Google Scholar
Vaughn, C. E. & Leff, J. P. (1976). The measurement of expressed emotion in the families of psychiatric patients. British Journal of Social and Clinical Psychology 15, 157–165.CrossRefGoogle ScholarPubMed
Wig, N. N., Menon, D. K., Bedi, H., Ghosh, A., Kuipers, L., Leff, J., Korten, A., Day, R., Sartorius, N., Ernberg, G. & Jablensky, A. (1987). Distribution of expressed emotion components among relatives of schizophrenic patients in Aarhus and Chandigarh. British Journal of Psychiatry 151, 160–165.CrossRefGoogle ScholarPubMed