Publication Date



Open access

Embargo Period


Degree Type


Degree Name

Master of Science (MS)


Psychology (Arts and Sciences)

Date of Defense


First Committee Member

Amy G. Weisman de Mamani

Second Committee Member

Edward Rappaport

Third Committee Member

Saneya H. Tawfik


The family environment is an influential psychosocial factor that can either play a detrimental or a protective role in patient symptom severity. While previous studies have tended to examine family environmental constructs separately, the current study comprehensively examined both risk and protective factors of the family environment in a large, ethnically diverse sample of 221 patients with schizophrenia. Building upon prior research, we hypothesized that family environments characterized by high levels of expressed emotion, criticism, low warmth, and low family cohesion would predict greater symptom severity for the overall sample. We also assessed whether ethnicity moderated the hypothesized relationships between family environment and symptom severity. Finally, we assessed whether greater patient-caregiver discrepancies in perceptions of their family environment predicted greater symptom severity. Study hypotheses were partially supported. Results demonstrated that higher patient ratings of family cohesion and caregiver warmth were associated with lower symptom severity. However, once put into a hierarchical regression analysis, only patient ratings of family cohesion and patient education (a covariate) were significant predictors of symptom severity. Ethnicity was not a significant moderator of this relationship. Our second hypothesis was not supported as there was not a significant association between patient-caregiver discrepancies and patient symptom severity. On an exploratory basis, we also stratified results by ethnicity, which revealed interesting patterns, particularly for African Americans. Study implications are discussed.


schizophrenia; ethnicity; family; environment; perceptions; symptom severity