Validation of the concise Chinese level of expressed emotion scale

Abstract

Background: Expressed emotion (EE), a strong predictor of relapse of schizophrenia, has significant clinical implications. The study aims to validate a concise Chinese version of the 60-item Level of Expressed Emotion Scale (LEE). Methods: A questionnaire survey was conducted with 188 schizophrenic patients. The battery of validation scales included Hospital Anxiety and Depression Scale (HADS) and 12-item Short Form Health Survey (SF-12). Results: Exploratory factor analysis revealed a 3-factor, 12-item solution. Factor explication named the 3 factors Criticism, Over-involvement and Hostility. Cronbach's alpha of the whole scale was .84, and the 3 sub-scales were .75 to .77. Regarding convergence and divergence construct validity, the Concise Chinese LEE Scale has significant positive correlations with the anxiety and depression scores of HADS (r = .37 and .21 respectively; p < .01); significant negative correlation with the mental component score of SF-12 (r = -0.27; p < .01); and insignificant correlation with the physical component score of SF-12 (r = -0.02). Conclusion: The Concise Chinese LEE Scale showed good psychometric properties in internal consistence and convergence/divergence construct validity. The 3-factor structure is coherent with the original conceptualization of high EE. Further validation of the scale is worth pursuing, especially on predictive validity.