FAMILY CLIMATE AND EXPRESSED EMOTION IN THE COURSE OF ALCOHOLISM

Family-based predictors of relapse were examined in. 100 alcoholics wh o participated in a 12-week treatment program with 6-month and 18-mont h followups. ''Expressed Emotion'' (EE), or attitudes of relatives tow ard the alcoholic as measured by the Camberwell Family Interview, scal es measuring rejection of the alcoholic by relatives, and self-reports of partner interaction were evaluated as possible predictors of absti nence. During therapy, partnership interactions showed a transient det erioration with increased temporary friction. Based on conservative cr iteria, the abstinence rate was 40% at 6-month follow-up and 30% at 18 -month followup. An association with the relapse at followup could be obtained for the Patient Rejection Scale (PRS) and, using empirically derived classification rules, for the main three variables of the Camb erwell Family Interview (CFI) conducted on admission: ''Critical Comme nts,'' ''Emotional Overinvolvement,'' and ''Warmth.'' A low number of Critical Comments and a high score in Warmth were associated with a lo wer risk of relapse; however, contrary to expectations, Emotional Over involvement of the significant other was associated with more abstinen ce. In addition, the number of Critical Comments made by relatives abo ut the alcoholic, a major component of high EE as measured by the CFI; had a statistically significant impact on the ''survival function'' o f abstinence, and thus contributed to the prediction of the course of alcoholism in the expected direction.