Perceived Criticism in the Treatment of a High‐Risk Adolescent

Abstract

Perceived criticism (PC) is a construct that plays a key role in family relationships of persons with psychiatric disorders. It can be assessed in a brief and simple way using the Perceived Criticism Measure. PC ratings made by patients about their caregivers predict adverse clinical outcomes including increases in symptoms and relapse across a broad range of psychiatric diagnoses. Although research supports the concurrent and predictive validity of PC, the measure is not widely used in clinical practice. Here, we describe the construct of PC and review evidence supporting its clinical utility. We then illustrate how criticism and perceptions of criticism can be addressed in a clinical context, describing a family focused treatment approach used with a depressed adolescent at high risk for bipolar disorder.

Is perceived criticism an independent construct? Evidence for divergent validity across two samples.

“…Evidence is accumulating that PC is a construct relevant to our understanding of clinical outcomes and potentially important for clinical practice (see Chambless et al, 2017; Hooley & Miklowitz, 2017; Masland & Hooley, 2015). Measuring PC is simple and may help identify patients who could benefit from treatment specifically tailored to the experience of high PC.…”

Incorporating family factors into treatment planning for adolescent depression: Perceived parental criticism predicts longitudinal symptom trajectory in the Youth Partners in Care trial

“…Typically, EE has been measured through coding of a parent's voice tone and critical content when describing their children on the relatively lengthy Camberwell Family Interview (Brown et al, 1972;Brown & Rutter, 1966;Vaughn & Leff, 1976) or a briefer five-minute speech sample (Magaña et al, 1986). These behavioral assessments are time consuming and costly, requiring extensive coder experience and training (Hooley & Miklowitz, 2017). Less administratively demanding measures have been developed in response to this methodological limitation.…”

“…These measures appear to be relatively stable, unaffected by changes in mood, and do not vary markedly with depression symptom recovery or in relation to other individual-level factors such as negative mood, neuroticism, and sensitivity to criticism Hooley & Teasdale, 1989;Masland et al, 2017;. Although measuring a youth's perception of maladaptive elements of the family environment could meaningfully guide depression treatment, including during care and monitoring following acute treatment, there is limited research examining this construct in relation to clinical course and outcomes (Hooley & Miklowitz, 2017).…”

Perceived criticism and family attitudes as predictors of recurrence in bipolar disorder

“…The rating on a 10 point scale of the question "How critical is your relative of you?" has been used as a valid indicator of overall criticism in families ( Hooley & Miklowitz, 2017 ; Renshaw, 2007 ). Therefore, in the PCM-P ( Hooley & Teasdale, 1989 ) we asked the patients to rate the question “How critical has he/her been of you?”.…”