Purpose of the Questionnaire (Scale)

The Family Rituals Scale aims to assess the frequency and continuity of ritualistic practices within families, particularly those that include a member diagnosed with schizophrenia. The scale evaluates to what extent a family maintains specific ritual habits, which are considered important for emotional stability and family cohesion. These practices may relate to social, religious, and cultural traditions, functioning as mechanisms of support, structure, and continuity in family life. The scale is primarily used in the context of social psychiatry research and clinical family assessments.

Scale Description

The scale was developed by M. Madianos and M. Economou and was published in 1994. It resulted from a pilot study that initially included 16 questions, from which the 11 most discriminative were selected. Data are collected through a personal interview with a family member regarding specific ritual activities that took place within the past 12 months. These activities include birthday celebrations, Christmas gift exchanges, preparation of traditional foods, family outings, excursions, visits to cemeteries, Sunday meals, and other socially or religiously defined practices. The scale does not include subscales but produces a single total score.

Scoring System

Each of the 11 questions is rated on a four-point Likert scale, where 1 corresponds to “regularly” (i.e., consistent presence of the ritual) and 4 to “never” (i.e., complete absence). The total score ranges from 11 to 44. Higher scores indicate fewer ritual practices within the family. A cutoff score of ≥18 is proposed for dichotomous categorization: families scoring less than 18 are considered to maintain rituals, while those scoring 18 or more are considered not to maintain them.

Statistical Analysis

Statistical processing was conducted on a sample of 71 families with at least one member diagnosed with schizophrenia (total of 250 individuals) and 67 control families from the general population (total of 295 individuals). The scale effectively distinguishes between families with and without rituals, with the cutoff point of 18 offering strong discriminative capability. Higher values are associated with disorganized or absent ritual behavior and may reflect increased dysfunction in family dynamics. High scores may serve as an indicator of the need for psychosocial support.

Validity of the Questionnaire (Scale)

The validity of the scale was confirmed using the Family Atmosphere Scale as an external criterion. The study showed a sensitivity of 0.73 and specificity of 0.75 at the cutoff score of 18, indicating a good ability to distinguish between families based on ritual involvement.

Reliability of the Questionnaire (Scale)

The reliability of the scale was assessed using Cronbach’s alpha. The results demonstrated high internal consistency: 0.89 for the total sample, 0.85 for the general population, and 0.81 for families with a member suffering from psychosis. These findings support the scale’s stability and internal coherence.

References

Madianos, M., & Economou, M. (1994). Schizophrenia and Family Rituals: Measuring Family Rituals among Families of Schizophrenics and “Normals”. European Psychiatry, 9, 46–51.