The objective of this review was to systematically identify and evaluate quantitative research on familial expressed emotion (EE) in schizophrenia patients from different cultural backgrounds. This adds to the findings of previous reviews of EE by including data from cultural individualism vs. collectivism perspectives using Hofstede’s cultural dimensions theory. Using specific search criteria, 10 research papers were identified and evaluated. Findings indicated that the lowest percentage of high EE relatives were found in samples from countries associated with moderate individualism scores. A similar pattern was also found in high-critical comment (CC) relatives. Results of hostility and Emotional Over-involvement (EOI) are equivocal. In contrast, cultural individualism is negatively correlated with the rate of high warmth among family members. Concerning EE’s ability to predict schizophrenia relapse, high familial EE predicted relapse in most of the studies, and there was not a clear difference in the predictive power of high EE by cultural individualism vs. collectivism. High warmth demonstrated a possible protective function against schizophrenia relapse across all studies that reported on it, as high warmth was consistently associated with a reduced risk of relapse. Inconsistent findings and methodological issues across studies limited conclusions. Further research is needed to pay more attention to warmth, explore the qualitative nature of CC among various cultures, and study culture’s other aspects related to familial EE and schizophrenia besides relapse.

Library of Congress Subject Headings

Schizophrenia; Schizophrenia—Physiological aspects

Date of Award


School Affiliation

Graduate School of Education and Psychology



Degree Type


Degree Name


Faculty Advisor

Stephanie Woo

Included in

Psychology Commons