Is Expressed Emotion a Specific Risk Factor for Depression or a Nonspecific Correlate of Psychopathology?

Five Minute Speech Sample Expressed Emotion (FMSS-EE) was examined in families of youth with depressive disorders, nondepressed youth with attention deficit/hyperactivity disorder (ADHD), and community controls screened for the absence of depression and ADHD. Consistent with the hypothesis that FMSS-EE shows some specificity as a risk factor for depression, rates of critical EE were significantly higher among mothers of youth with depression as compared to mothers of nondepressed youth with ADHD, or mothers of controls. When both mothers' and fathers' scores were used to generate family EE ratings, rates of overall EE and critical EE were significantly higher for the depressed group than the control group, but the nondepressed ADHD group did not differ significantly from the other groups. Results support the hypothesis that critical EE in mothers shows some specificity as a risk factor or correlate of depression in youth.     

Confirmatory factor analysis of the Family Emotional Involvement and Criticism Scale: evidence of the dimensionality of expressed emotion

Using a convenience sample of 152 married couples, the present study tested models that alternately considered family members' perceptions of Expressed Emotion to be a one-, two-, three-, or four-factor construct as measured by the Family Emotional Involvement and Criticism Scale. Results of confirmatory factor analysis procedures indicated that perceptions of Expressed Emotion were best represented by a four-factor model that consisted of involvement, criticism, upset feelings, and approval. The methodological implications of these findings are discussed.     

Racial and gender differences in expressed emotion and interpersonal control in families of persons with schizophrenia

Expressed Emotion (EE) has been shown to be predictive of course or severity in many illnesses, but the studies have been largely of white middle-class patients. This study examined gender and racial differences in parental EE level and communication patterns between the parent and patient with schizophrenia, using data from the NIMH Treatment Strategies in Schizophrenia study. Dialogues (n = 140) from 54 patient-parent dyads were coded into the Relational Control Coding System. Resultant data (n = 13,605 sequences) were analyzed with log-linear models. Results show that the relationship between control and EE level was stronger in African American families compared to Caucasians. Gender differences were as expected, with daughters less competitive and more deferential to their parents. Although the total number of high-EE parents with daughters was small, patterns in these families showed parents who responded submissively in contrast to the competitive symmetry in families with male patients.     

Decrease of Relatives' High Levels of Expressed Emotion in Schizophrenic Disorders

Abstract

The family emotional atmosphere, Expressed Emotion, was assessed with the Swedish version of the Camberwell Family Interview, before and after a six-session multifamily education programme. The intervention provided illness-related knowledge and emotional support to relatives of patients with schizophrenic disorders. Relatives' high level of EE decreased significantly. Mainly responsible for the decrease was a reduction in the number of critical remarks, while emotional overinvolvement decreased non-significantly. The findings indicate that high levels of Expressed Emotion in relatives of patients suffering from long-standing schizophrenic disorders may decrease over a relatively short span of time.     

Do adolescent symptomatology and family environment vary over time with fluctuations in paternal alcohol impairment?

This study tested whether adolescent internalizing problems, externalizing problems, heavy alcohol use, fathers' parenting, and family conflict varied over time with fluctuations in fathers' alcohol impairment and also whether children of recovered alcoholic fathers differed from children of nonalcoholic fathers. Fathers and adolescent children (N = 267 families) were interviewed in 3 annual assessments. Results showed that adolescent symptomatology and the family environment did not vary over time as a function of different trajectories of paternal alcohol impairment. However, children of recovered alcoholic fathers exhibited more symptomatology than did children of nonalcoholic fathers. Even though paternal alcoholism has remitted in these families, children of recovered alcoholic fathers might remain on a general higher risk trajectory relative to children of nonalcoholic fathers.     

Young adults' retrospective reports of parenting by mothers and fathers: associations with current relationship quality

The authors examined retrospective reports of both mothers' and fathers' parenting and young adults' (N = 75) relationship quality. Multiple regression analyses showed that, as predicted, young adults' retrospective reports of the positive parenting they experienced as children were significantly related to the extent by which they currently viewed (a) others as accessible and responsive, (b) their relationships with others as meaningful and important, and (c) themselves as able to form healthy relationships. Although both mothers' and fathers' parenting related to the quality of current relationships with parents, only reports of fathers' parenting were related to the quality of current relationships with a romantic partner. Fathers' parenting was also related to views of the self as being able to form secure and close relationships. The authors address both methodological and substantive explanations for these results.     

The Family Environment Scale: comparison with the construct of Expressed Emotion

The Family Environment Scale (FES) was completed by parents of 30 children with conduct disorders (CD), 30 children with emotional disorders (ED), and 30 well-functioning controls. Parents were also interviewed and rated for Expressed Emotion (EE), and mothers completed the Child Behaviour Checklist (CBCL). Clinical families had significantly lower ratings of Cohesion, Expressiveness, Intellectual-Cultural and Active-Recreational Orientation. These differences were not specific to either diagnostic group. Maternal Criticism was associated with reported conflict in the CD group. The EE scales of Criticism and Warmth (absence of warmth) were correlated with child behaviour ratings in the CD group, in contrast with FES sub-scales. Maternal scores of Cohesion were significantly associated with social competence in the ED and the control group. Maternal ratings of Conflict predicted dropping-out of treatment (CD group), and ratings of Cohesion and Control had some value in predicting clinical outcome. The implications for the future use of the Family Environment Scale and other self-rated measures of family functioning are discussed.     

Darwinian grandparenting: preferential investment in more certain kin

Studies on grandparental investment have revealed that mothers' fathers are emotionally closer to their grandchildren than are fathers' mothers. In the current study, it was hypothesized that this difference is caused by the fact that fathers' mothers often have the potential to invest in genetically more certain kin (children through their daughters). To test this hypothesis, 787 participants rated their emotional closeness and exposure to their grandparents and indicated whether they had cousins through paternal and maternal aunts and uncles. Results indicated that participants felt closer to mothers' fathers than fathers' mothers only when alternate investment outlets for fathers' mothers were available. Closeness ratings to fathers' fathers also were reduced when they had grandchildren through their daughters. Exposure to grandparents revealed a similar pattern of findings but did not show the same sensitivity to the presence of more certain kin and did not appear to account for the closeness ratings.     

Loneliness among school-aged children and their parents

The aim of this study was to examine the existence of the intergenerational transmission of loneliness between parents and children, including an examination of its stability and of gender differences. The study consisted of an evaluation of loneliness in mothers ( n = 834), fathers ( n = 661) and their 10-year-old children ( n = 981). Parent's self-reported loneliness was measured once, and their children's social and emotional loneliness were assessed at three time-points. The stability analysis indicated average stability in children's loneliness, especially their social loneliness. Boys were found to experience more emotional loneliness than girls. Structural equation modeling indicated no direct relationship between mothers'/fathers' loneliness and their children's loneliness. However, mothers' and fathers' loneliness reduced their daughters' peer-evaluated cooperating skills, which consequently predicted higher levels of both social and emotional loneliness.     

Mothers' and fathers' depressive symptoms and conflict-resolution strategies in the marriage and children's externalizing and internalizing behaviors

The authors examined mothers' and fathers' avoidance and attacking conflict-resolution strategies in the marriage and their depressive symptoms as they related to children's externalizing and internalizing behaviors. A nonclinical community sample of 51 families and their children's 1st-grade teachers (N = 41) participated. Both mothers and teachers completed a behavior-problem checklist in order to evaluate the incidence of internalizing and externalizing behaviors in the children. Correlational statistics revealed significant associations between parents' avoidance and attacking strategies and their depressive symptoms. Also, parents' use of avoidance was related to more internalizing behaviors in the children. When hierarchical regression analyses were used to examine the contributions of the parents' attributes to children's externalizing and internalizing behaviors, mothers' avoidance and an interaction between mothers' and fathers' avoidance were identified as significant predictors of children's internalizing behaviors.     

Predictors of paternal involvement for resident and nonresident low-income fathers

In a sample of low-income families (N = 239), structural equation models assessed predictors of fathers' involvement with preschool-aged children in instrumental, behavioral, and emotional realms. Results suggest that parental conflict has a strong negative relation with father involvement. Fathers' human capital characteristics, healthy psychosocial functioning, and past stability in family relationships all predicted greater father involvement directly and/or indirectly through parental conflict. Numerous differences emerged in the predictive models between resident and nonresident fathers, although few differences were statistically significant. Results suggest that policy efforts aimed at enhancing fathers' responsible parenting should focus both on increasing fathers' human and social capital and on supporting positive family processes.     

Invariance and convergent and discriminant validity between mothers' and fathers' ratings of oppositional defiant disorder toward adults, ADHD-HI, ADHD-IN, and academic competence factors within Brazilian, Thai, and American children

Confirmatory factor analysis was used to test the invariance of an oppositional defiant disorder toward adults, attention-deficit/hyperactivity disorder-hyperactivity/impulsivity, attention-deficit/hyperactivity disorder-inattention, and an Academic Competence factor model between mothers' and fathers' ratings within Brazilian (n = 894), Thai (n = 2,075), and American (n = 817) children with the Child and Adolescent Disruptive Behavior Inventory (G. L. Burns, T. Taylor, & J. Rusby, 2001a, 2001b). The results showed invariance of item loadings, intercepts, and residuals, as well as factor variances, covariances, and means between mothers' and fathers' ratings within each sample. Convergent and discriminant validity was also observed for the between-parent factor correlations, thus providing additional support for the construct validity of the Child and Adolescent Disruptive Behavior Inventory. The confirmatory factor analysis invariance procedure provides a much better way to examine between-source ratings of behavior problems in children than do the simple correlation and raw discrepancy score procedures.     

Stress and family support as predictors of distress and rejection in people who care for a relative with schizophrenia

Relatives (N=121) of adult schizophrenia patients were interviewed to investigate predictors of their level of psychological distress and of rejecting attitudes toward the sufferer. The relatives' total stress, particularly that associated with poor communication skills in the sufferer, predicted several measures of their psychological distress, and the same variables plus turbulence of sufferer behavior (i.e., violence and disruptiveness) predicted rejection of the sufferer by the relative. In each case, adequacy of family support moderated the influence of the stressors, although this effect was more marked for distress outcomes than for rejection. The results have important implications for the sorts of professional and peer support which relatives may need to encourage their performance of this potentially burdensome role. In addition, the results fit a classic stress management model and provide a feasible alternative to the Expressed Emotion Model of the relationship between relatives' rejection and patients' illness severity.     

Relatives' Perceptions of Their Interactional Behavior with a Schizop/hrenic Family Member

Relatives' (N = 77 ) perceptions of their recent interactional behavior with a schizophrenic family member (N = 51 ), as measured by an adjective checklist, were compared with outside observer ratings of the relatives' Affective Style (AS) and the patients' Coping Style (CS) during a family interaction task. Results indicated that, overall, the relatives in the present sample perceived their own interactional behavior toward the patient, as well as the patients' behavior toward them, in a way that paralleled their affective behavior as assessed by outside raters. Moreover, the relatives' rated their relationship with the patient in a fashion that was more predictive of the observed interactional behavior of both the relatives and the patients than were the outside observers' ratings of the relatives' Expressed Emotion (EE) measured either at the patients' index hospitalization (using the Camberwell Family Interview, CFI-EE) or during the post-discharge period (assessed with a brief Five-Minute Speech Sample method, FMSS-EE).     

PATERNAL SEPARATION ANXIETY:

Employed mothers of young children worry about the effects of daily separation on their children Do fathers have similar anxieties? Because fathers are expected to leave the home and go to work, psychologists have not studied fathers' concerns about daily separation from their babies and pre-school children In this study, we investigated fathers' and mothers' separation anxiety and the relationships between separation anxiety and family and child-care characteristics The sample included 589 married couples from a larger study of families and center-based child care Data were collected through in-home and center visits Fathers and mothers had similar levels of Separation Anxiety However, fathers reported slightly higher Concern for the Child, and mothers reported higher Employment Concerns Fathers' perceptions of their wives' anxieties were higher by half a standard deviation compared with mothers' reports Fathers' and mothers self reported separation anxieties were modestly correlated Paternal separation anxiety was most strongly associated with fathers' perceptions of their wives' separation concerns, not with mothers' reported anxieties, which suggested ego defensiveness and projection     

父亲参与对儿童延迟满足能力的影响：儿童性别的调节作用

以92名35~74个月的健康儿童为被试,采用选择等待范式测查儿童的自我延迟满足能力,通过父亲参与问卷和母亲参与教养问卷测查儿童父母的参与程度,考察控制母亲参与和儿童年龄的情况下,父亲参与对儿童延迟满足能力的影响以及儿童性别在其中的调节作用。结果表明：（1）父亲参与的互动性、可及性、责任性均能显著正向预测儿童的延迟满足能力;（2）儿童性别可以调节父亲参与的互动性及责任性与儿童延迟满足能力的关系。父亲参与的互动性和责任性可以显著预测男童的延迟满足能力,但均不能预测女童的延迟满足能力。     

Measuring Emotion Dysregulation in Children With Attention-Deficit/Hyperactivity Disorder: Revisiting the Factor Structure of the Emotion Regulation Checklist

Emotion dysregulation (ED) is prevalent among youth with Attention-Deficit/Hyperactivity Disorder (ADHD) and significantly impacts functioning. Nuanced measurement of ED is central to understanding its role in this disorder and informing treatment approaches. The present study examined the factor structure of the Emotion Regulation Checklist (ERC) among children with ADHD with and without Oppositional Defiant Disorder (ODD). Exploratory factor analysis (EFA) conducted in a sample of 328 youth (mean age = 6.08) with ADHD indicated a four-factor solution, comprised of the following factors: Negative Emotion Lability, Positive Emotion Lability, Socially Appropriate Affect, and Socially Incongruent Affect. The Negative and Positive Emotion Lability subscales assess the reactivity of negatively and positively valenced emotions, respectively. The Socially Appropriate and Socially Incongruent Affect subscales provide an assessment of social-emotional functioning. All subscales discriminated between children with ADHD only and ADHD with co-morbid ODD, such that children with ODD had greater emotional lability and social-emotional difficulties. This revised factor structure of the ERC facilitates a uniquely brief, yet multifaceted and specific, assessment of emotional difficulties in children with ADHD that can inform treatment planning and operationalize emotional reactivity and social-emotional functioning in future research efforts.     

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.     

Fathers' involvement in their children's healthcare.

Fathers' involvement in the routine healthcare of young children was investigated, and fathers' relative participation in two tasks, staying home with a sick child and taking the child to the doctor or dentist, was assessed. The relationships between fathers' involvement in healthcare and several other measures, including mothers' employment status, fathers' attitudes toward women's rights and roles, the amount of time fathers spent at work, and fathers' involvement in housework, were also examined. The subjects were 50 fathers of young children in intact, White, middle-class families. Both staying home with a sick child and taking a child to the doctor or dentist were usually performed by mothers, but when mothers were employed, fathers were significantly more involved, regardless of the child's sex. Staying home with a sick child and taking a child to the doctor or dentist were positively related to fathers' involvement in housework. Fathers' staying home with a sick child was significantly correlated with fewer hours at work and liberal attitudes toward women's rights and roles; these variables were not related to taking a child to the doctor or dentist. Positive correlations between fathers' involvement in housework and staying home with a sick child and taking a child to the doctor or dentist suggests that fathers' involvement in childcare is viewed as an aspect of family work.     

‘Too busy’? Father's attendance for family appointments

Fathers are often less likely to attend for appointments with their referred children at family and child psychiatry clinics than are mothers. The literature related to this topic is examined. A study of fathers' attendance at family sessions is reported, in which attenders are compared to non-attenders. It is concluded that conventional suppositions regarding fathers' attendance, such as work hours and family roles, are not as important predictors of fathers' attendance as fathers' relationships with their own fathers and current relationships with their partners. Clinical implications are examined.