Perceived Family Criticism and Primary Care Utilization: Psychosocial and Biomedical Pathways

Kevin Fiscella, Peter Franks, Cleveland G. Shields

Research output: Contribution to journalArticle

25 Scopus citations


We explored the relationship of perceived family criticism to subsequent healthcare utilization in patients attending a family medicine center. We examined: a) the relationship of perceived criticism to subsequent utilization for biomedical and psychosocial/somatic problems; b) the mediating effects of self-rated mental health and physical function; and c) the mediating effects of social support. The analyses were adjusted for age, sex, race, education, health insurance, and marital status. Higher perceived criticism predicted more psychosocial/somatic and biomedical visits. The relationship of perceived criticism with psychosocial/somatic visits was entirely mediated through self-rated mental health. The relationship of perceived criticism with biomedical visits was partly mediated through self-rated physical function and, in part, independent. Social support played no role in explaining these relationships. Further research is needed to determine whether lowering perceived family criticism lowers primary care utilization.

Original languageEnglish (US)
Pages (from-to)25-41
Number of pages17
JournalFamily Process
Issue number1
StatePublished - Mar 1997
Externally publishedYes


ASJC Scopus subject areas

  • Psychology(all)
  • Clinical Psychology
  • Social Sciences (miscellaneous)

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