A Strategy for Assessing Family Interaction Patterns in Schizophrenia

Educational and behavioral family treatments for schizophrenia patients and their relatives have proven to be highly effective, but there is scant evidence on how these treatments work. We assessed family interaction patterns, in the context of the Collaborative Study on Treatment Strategies in Schizophrenia, National Institute of Mental Health, to examine the effect of treatment on communication and problem solving in the family and to determine if change in interaction patterns was related to outcome. This article reports on the development of a behavioral assessment strategy, the Family Problem-Solving Task (FPST), and a related coding system that were developed for the larger project. The codes were rated reliably and had high internal consistency. The FPST procedure had high test-retest reliability from baseline through 2-year assessments. The data provided considerable support for the construct validity of the coding system. It is notable that critical and intrusive behavior by relatives during the FPST was significantly correlated with dissatisfaction and hostility expressed about the patient during an interview.