The Spanish validation of level of expressed emotion scale for relatives of people with eating disorders

Expressed emotion (EE) is considered a general predictor of poor outcome across a range of conditions, including eating disorders, and is valuable in measuring the effect of family interventions. There are no self-report questionnaires validated in Spanish to measure EE among relatives of patients with a psychiatric condition. The aim of this study was to examine the psychometric properties of the Spanish version of the Level of Expressed Emotion scale (LEE) among relatives of eating disorder patients. A cross-sectional study of 270 relatives of patients with an eating disorder was conducted to examine the factor structure, reliability and validity of the LEE scale. Results indicated that the LEE-S (Spanish version) did not correspond to the a priori subscales described in the original version. The refined 45-item LEE-S scale consisted of four factors which explained 25.5% of variance in EE for relatives. Reliability was acceptable (alpha ranged from .73 to .86). The discriminant validity of the subscales was moderately supported by correlations with psychological distress (GHQ-12; rho = .34) and specific caregiving experience (EDSIS; rho = .39). The LEE-S instrument has adequate psychometric properties and may be of value to assess families at risk of a negative emotional climate at home.