Association of perceived family criticism with health behaviors.

BACKGROUND

Criticism from family members has been implicated in psychiatric illnesses such as schizophrenia, depression, and eating disorders. Perceived family criticism has also been linked to primary health care use. In our study, we examined the association between perceived family criticism and health behaviors, as well as the potential mediating role of negative affect.

METHODS

A questionnaire was mailed to patients receiving care at a family medicine center. Perceived family criticism was measured using the Family Emotional Involvement and Perceived Criticism Scale. Diet, regular exercise, smoking status, and levels of depression, hostility, and physical health were also assessed through self report.

RESULTS

Nine hundred twenty-two (62%) active family medicine patients responded to our questionnaire. Complete data were available for 875 patients. In univariate analysis, a high level of perceived family criticism was associated with various demographic characteristics, poorer physical health, negative affect, higher fat intake, lack of exercise, and smoking. In multivariate analysis, the association between a high level of perceived criticism and health behavior was independent of demographic characteristics and physical health, for example, high-fat diet (odds ratio [OR] = 1.47; 95% confidence interval [CI], 1.11 - 1.95), no regular exercise (OR = 1.37; 95% CI, 1.02 - 1.84) and current smoking (OR = 1.38; 95% CI, 1.00 - 1.90). None of these associations was statistically significant after controlling for depression and hostility.

CONCLUSIONS

A high level of perceived family criticism is associated with adverse health behaviors. This association appears to be explained by resultant depression and hostility.