Expressed Emotions and Burden in Caregivers of Patients of Schizophrenia – A Cross-Sectional Study

Abstract Background: Caregiving for individuals with schizophrenia is often associated with high levels of emotional, financial, and social stress, especially in rural and resource-limited settings. Expressed emotions (EE), particularly criticism, are known contributors to caregiver burden (CB), but the buffering roles of self-compassion and life satisfaction remain underexplored in such contexts. Methodology: This descriptive, cross-sectional study included 115 caregivers of patients of Schizophrenia from a rural tertiary care centre in India. Structured interviews were conducted using validated tools: the Family Emotional Involvement and Criticism Scale, WHO Burden Assessment Schedule, Self-Compassion Scale–Short Form, and Life Satisfaction Scale. Non-parametric statistical analyses, mediation models, and multiple linear regression were used to assess associations and predictors of CB. Results: Higher levels of EE, particularly criticism, were significantly associated with increased CB (ρ = 0.54, P = 0.001). Self-compassion was negatively correlated with burden (ρ = –0.5). Unadjusted models showed a small but significant indirect effect, but this mediation was not found significant after adjusting for family type. Life satisfaction did not significantly mediate this relationship ( P = 0.211). Regression analysis indicated that psychological variables, especially self-compassion, explained a substantial portion of the variance in CB (adjusted R ² = 0.367, P < 0.001). Conclusions: EEs, particularly criticism, contribute significantly to CB among caregivers of patients of Schizophrenia. Self-compassion acts as a protective mediator, underscoring the need for interventions aimed at reducing family criticism and enhancing caregiver self-compassion.