Expressed emotion and behavior therapy outcome: A prospective study with obsessive-compulsive and agoraphobic outpatients

The relationship of expressed emotion (EE) to behavior therapy outcome for obsessive-compulsive disorder (n = 60) and panic disorder with agoraphobia (n = 41) was investigated. Relatives' emotional overinvolvement and hostility predicted higher rates of treatment dropout. Higher hostility, as assessed by the Camberwell Family Interview (CFI), was related to poorer outcome for target ratings and for the Social Adjustment Scale; higher perceived criticism was also predictive of worse response on target ratings. In contrast, nonhostile criticism on the CFI was associated with better outcome on the behavioral avoidance test. In general, the relationship of EE to outcome was not moderated by type of relative, diagnosis, amount of contact with the relative, or use of psychotropic medication.