CAMBERWELL FAMILY INTERVIEW
2.1 METHODS O F ASSESSING ATTRIBUTIONS
Three main methods of assessment have been used in the study of attributions (Turnquist et al, 1988). By far the most common has been the use of questionnaires or rating scales. Typically, subjects are provided with statements and are required to make ratings on causal dimensions chosen by the experimenter. The responses obtained in this manner allow easy quantification, but the validity of the
attributions has been questioned on the grounds that they may have little or no significance to the subject: "Perhaps the research
participants would not have made any attributions if they were free from the prodding of the research investigators." (Weiner, 1985, p. 74). In the context of attributions about illness, Turnquist et al
(1988) discuss some of the problems of using the second assessment method: asking open ended questions about causality. They point out that variations in the type of probe questions used (such as "Why?" as opposed to "Why did this outcome result?") are not controlled for but can affect subjects' responses. The technique is also subject to the problems of validity noted above.
Dissatisfaction with the reactive nature of rating scales and causal questioning has led to developments in analysing "spontaneous" causal thinking (Weiner, 1985b). Moreover, this opens up the study of
attributions to people who are unable or reluctant to use
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and to spoken or written materials which can be analysed
retrospectively (Harvey, Turnquist and Agostinelli, 1988). In non clinical areas of research there is evidence that people do
spontaneously engage in causal thinking and that attributional
thinking is especially promoted by negative and unexpected outcomes (Weiner, 1985; Schulman, Castellon and Seligman, 1989). As regards clinical problems, Jacobson, McDonald, Follette and Berley (1985) have argued for the need for marital research to look at spontaneously occurring attributions; investigators in the field of depression have focussed on the study of unsolicted attributions (Peterson, Luborsky and Seligman, 1983; Peterson, Bettes and Seligman 1985); and there has been work with anxiety (Riskind, Castellon and Beck, 1989).
Two techniques for the assessment of spontaneous explanations in verbal material have been reported. The Content Analysis of Verbatim
Explanations (CAVE) technique has been developed in the study of depression and explanatory style (Peterson et al, 1983; 1985); and the Leeds Attributional Coding System (LACS) (Stratton, Heard, Hanks, Munton, Brewin and Davidson 1986; Stratton, Munton, Hanks, Heard and Davidson,1988) which was developed for analysing naturally occurring causal beliefs in family therapy sessions.
Brewin et al (1988) used the LACS to assess the causal attributions
p
of relatives of schizophrenic patients using audjapes of the
Camberwell Family Interview (CFI). As was noted in the preceding chapter, the expressed emotion ratings are measured from this interview. The relative is asked many questions about events pertaining to the patient's illness, but causal explanations of events are not directly solicited. The study demonstrated that the CFI
contained causal beliefs that might be usefully analysed with the LACS. This latter system, as well as aspects of the CAVE, were examined for suitability in assessing relatives' attributions in the study to be reported, and the development' of modifications to the LACS will be detailed in this chapter.
In this context, it is useful to divide the analysis of unsolicited causal attributions into two essential components. Firstly, there is the identification of the attributions which are embedded in the source material. This necessitates consideration of what constitutes a causal attribution and how this material can be identified and
extracted. Secondly, the attributions must be reduced into meaningful and measurable units of analysis: causal dimensions must be selected and defined. The CFI was selected as the source of attributional
statements made by the relatives of schizophrenic patients in this study. The problems associated with the analysis of beliefs and the
procedures adopted to overcome these problems will now be described.
2.2 IDENTIFICATION OF ATTRIBUTIONAL STATEMENTS: PROBLEMS OF DEFINITION
Weiner (1985b) gives the typical criteria for identifying instances of causal reasoning as: ''A phrase or sentence in which some performance ou tco m e was linked with a reason for that outcome.” (p. 76). Harvey et al (1980) defined attributions as: "phrases or clauses denoting or connoting causality or responsibility or ascribing traits." The criteria for identifying the cause - event units of the CAVE were more detailed (Peterson et al, 1983; 1985) and have been further developed (Schulman et al, 1989; Peterson, Schulman, Castellon, and Seligman, in press) in the criteria for 'cause - explanation' units. The
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©vent must be unambiguously good or bad from the subject's viewpoint; it must be his/her own view (rather than simply agreeing with another's belief); and there must be a clear causal relationship between the explanation and the event, not just a description or a proof or justification of the event. Extraction of attributions from
verbal material using the CAVE has been described as highly reliable, and one study (Peterson et al, 1985) reports 95% agreement between two independent workers who extracted cause - event units from
written essays of subjects. However, few studies using the CAVE have reported reliability measures for identification of the causal
material. Peterson et al (in press) report that since extraction is
necessarily tedious, the CAVE group tend to use a single researcher to perform the extractions.
In contrast to the CAVE group of workers, Stratton et al (1986) report difficulties in reliably extracting causal statements from transcripts using the LACS. It seems likely that increased inconsistency of judgements stems from a wider definition of causal belief than given
in the CAVE criteria. The LACS manual defines an attributional statement as one that provides an indication of a relationship between events, outcomes and/or behaviours, and their causes. A much wider range of causally qualifying relationships is implied by "indication of relationship" than is suggested in the CAVE's
specification for a "clear causal relationship".
The LACS manual provides some criteria for identifying attributional statements, including exclusion criteria, and examples to familiarise the worker with the definitions. One reliability study for identifying attributional statements is reported (Stratton et al, 1986) where out
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of a total of 315 causal statements extracted, 220 were identified by at least 2 out of the three participating raters. The authors conclude: "The major problem in obtaining coincidence is that raters differ in their judgement about the degree of obscurity to which they feel it approppriate to persue a possible expression of causal belief." (p.304).
This degree of inconsistency between raters and the comments of the LACS group, suggest the need for preciser definitions. The CAVE system reports better agreement for extraction, but excludes the vaguer or implicit causal relationsships. This study was concerned with the sorts of causal ideas that relatives explored or inferred as well as the ones stated more conclusively, so needed to adopt a broad definition of causal beliefs. The LACS and the CAVE techniques for extraction were inadequate and thus it appeared necessary to provide more detailed guidelines of what constituted attributional