The importance of consumer perceived criticism on clinical outcomes for outpatient African Americans with schizophrenia

Negative emotional reactions to criticism: Perceived criticism and source affects extent of hurt and relational distancing

Criticism is commonly perceived as hurtful and individuals may respond differently to criticism originating from different sources. However, the influence of an individual’s perception of criticism in their social relationships on negative emotional reactions to criticism has not been examined across different relational contexts. The present study investigated the influence of perceived criticism and relational contexts–mother, father, romantic partner, and workplace supervisor–on the feelings of hurt and relational distancing experienced upon receiving criticism. Participants (N = 178) completed the Perceived Criticism Measure and read vignettes describing scenarios of personally directed criticism in the four relational contexts. Significant main effects of perceived criticism and source were found on levels of relational distancing. Participants who perceived their relational partner to be more critical experienced greater distancing upon receiving criticism from them. Greater relational distancing was experienced for criticism received from workplace supervisors compared to mothers, fathers and romantic partners. Results indicate that emotional reactions and relationship outcomes in response to criticism can differ based on individual differences and relational context, suggesting their role in relationship maintenance and development of psychopathology.

Racial Differences in Attributions, Perceived Criticism, and Upset: A Study With Black and White Community Participants

The primary aims of the current investigation were (a) to examine the relationships among attributions, perceived constructive and destructive criticism, and upset due to criticism and (b) to explore racial differences in mean levels of attributions, perceived criticism, upset due to criticism, and warmth in a community sample of Blacks and Whites (N = 272). The Attributions of Criticism Scale (ACS) was used to measure participants' attributions regarding criticism from their relatives. No racial differences were found in mean levels of attributions or type of perceived criticism. However, Blacks were significantly less upset by perceived criticism from their relatives than Whites. When the relationships between attributions, perceived criticism, and upset were explored, results showed that positive attributions were associated with greater perceived constructive criticism and less upset due to criticism, whereas negative attributions were associated with greater perceived destructive criticism and more upset. Perceptions of relatives' warmth were also associated with greater perceived constructive criticism and less perceived destructive criticism, but warmth was only related to less upset for Blacks and not Whites. Findings suggest that attributions and warmth play an important role in the perception of criticism and the extent to which individuals become upset in response to criticism from loved ones. Results also point to potential racial differences in mean levels of these variables and the associations among them.

The association of family functioning and psychosis proneness in five countries that differ in cultural values and family structures

For decades, researchers have attributed the better prognosis of psychosis in developing countries to a host of socio-cultural factors, including family functioning. Nevertheless, it is unknown whether family functioning and its association with symptoms differ across countries. This study assessed family functioning (support, satisfaction with family relations, and criticism) and psychosis proneness in community samples from Chile (n =399), Colombia (n=486), Indonesia (n=115), Germany (n=174) and the USA (n=143). Family functioning was compared between prototypical developing countries (Chile, Columbia, Indonesia) and highly industrialized countries (Germany, USA). Hierarchical regression analysis was used to test for the moderating effect of country on the associations between family functioning and psychosis proneness. Participants from developing countries perceived more support and felt more satisfied. However, they also perceived more criticism than participants from highly industrialized countries. Criticism and family satisfaction were significantly associated with psychosis proneness. Moreover, the relationship between criticism and psychosis proneness was significantly stronger in developing countries compared to highly industrialized countries. Generally, family satisfaction and criticism appear to be more relevant to psychosis proneness than the quantity of family support. Moreover, criticism seems to be more closely related to psychosis proneness in developing countries.

Risk and Protective Factors, Perceptions of Family Environment, Ethnicity, and Schizophrenia Symptoms

The family environment can play either a detrimental or a protective role in symptom severity for people with schizophrenia. The current study examined both patient and caregiver perspectives of the family environment in an ethnically diverse sample of 221 patients with schizophrenia. We hypothesized that environments characterized by high levels of perceived caregiver criticism, low perceived caregiver warmth, and low family cohesion (from both the patient and caregiver perspective) would predict greater symptom severity. As expected, results demonstrated that lower patient ratings of family cohesion and caregiver warmth were associated with greater symptom severity. However, once put into a hierarchical regression analysis, only patient ratings of family cohesion remained significant. Ethnic patterns were also examined and revealed that family cohesion may be particularly protective for ethnic minorities. Study implications are discussed.

Clinical case management for patients with schizophrenia with high care needs

The aim of this study is to establish the effectiveness of a clinical case management (CM) programme compared to a standard treatment programme (STP) in patients with schizophrenia. Patients for the CM programme were consecutively selected among patients in the STP with schizophrenia who had poor functioning. Seventy-five patients were admitted to the CM programme and were matched to 75 patients in the STP. Patients were evaluated at baseline and at 1 year follow-up. At baseline, patients in the CM programme showed lower levels of clinical and psychosocial functioning and more care needs than patients in the STP. Both treatment programmes were effective in maintaining contact with services but the CM programme did not show advantages over the STP on outcomes. Differences between groups at baseline may be masking the effects of CM at one year follow-up. A longer follow-up may be required to evaluate the real CM practices effects.

Attributions and race are critical: perceived criticism in a sample of African American and White community participants

The current investigation had two principal goals: (a) to examine whether attributions regarding the intentions underlying criticism from one's relative predict perceived criticism from that relative and (b) to explore differences between African Americans and Whites in attributions and perceived criticism. A new measure, the Attributions of Criticism Scale, was employed in the present study to assess attributions of perceived criticism. Results showed that the attributions scale demonstrated good psychometric properties in a sample of African American (n=78) and White (n=165) community participants. As hypothesized, attributions were correlated with perceptions of criticism. When racial differences in attributions and perceived criticism were explored, results showed that African Americans made more positive attributions but also perceived more destructive criticism than Whites. No racial differences were observed on overall and constructive criticism, but there was some evidence to suggest that African Americans made more negative attributions than Whites. However, these results were inconsistent across recruitment method. Taken together, these findings suggest that positive and negative attributions are important factors in the perception of criticism and that mean levels of attributions and perceived criticism may differ by race. Possible explanations for effects as well as clinical implications and directions for future research are considered.