Expressed Emotion in Mothers of Currently Depressed, Remitted, High-Risk, and Low-Risk Youth: Links to Child Depression Status and Longitudinal Course

Abstract

This study examined Expressed Emotion in the families of children and adolescents who were: (1) in a current episode of Major Depressive Disorder (MDD), (2) in remission from a past episode of MDD, (3) at high familial risk for developing MDD, and (4) low-risk controls. Participants were 109 mother-child dyads (children ages 8-19). Expressed emotion was assessed using the Five Minute Speech Sample. Psychiatric follow-ups were conducted annually following the Five Minute Speech Sample assessment. Mothers of children with a current or remitted episode of MDD and at high risk for MDD were more likely to be rated high on Criticism than mothers of controls. There were no differences in critical expressed emotion among mothers of children in the current, remitted, or highrisk for depression groups. Higher initial critical expressed emotion was associated with a greater likelihood of having a future onset of a depressive episode in high-risk and depressed participants. Diagnostic groups did not differ in Emotional Overinvolvement. Findings suggest that expressed emotion that is critical in nature may be a relatively stable characteristic feature of the family environments of children with and at high-risk for depression, and may be important in understanding the onset and clinical course of child adolescent depressive disorders.Depression during childhood and adolescence is a frequent and recurrent problem that is associated with disruptions in emotional, social and occupational functioning into adulthood and increased rates of attempted and completed suicides (Bardone, Moffitt, Caspi, & Dickson, 1996;Rohde, Lewinsohn, & Seeley, 1994;Weissman et al., 1999). Most adolescents with depression will go on to have recurrent episodes and persistent social impairment between episodes (Puig- Antich et al., 1985b;Weissman et al., 1999). In order to improve upon existing prevention and intervention programs, a better understanding of the contextual factors that contribute to the onset, maintenance, and recurrence of depressive episodes in children and adolescents is crucial.The development and maintenance of depressive disorders in childhood and adolescence involves the interplay among inherited and acquired biological characteristics and the individual's social environment (Cicchetti & Toth, 1998). In particular, features of the family environment appear to play an important role in child adolescent depression (for reviews see Kaslow, Deering, & Racusin, 1994;Sheeber, Hyman, & Davis, 2001). Interpersonal theories of depression emphasize high levels of rejection in the environments of depressed individuals (Coyne, 1976). Consistent with interpersonal theories, a growing body of literature suggests Please address correspondence to Jennifer S. Silk, Western Psychiatric Institute and Clinic, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213. Phone: 412-383-8136. Fax: 412-383-5426. Email: silkj@upmc.edu. that the families of children and adolescents with depressive disorders are characterized by low levels o...

Disrupted physiological reactivity among children with a history of suicidal ideation: Moderation by parental expressed emotion-criticism

“…Responses to the FMSS were assigned values of 2, 1, and 0 to reflect high, borderline-high, and low EE-Crit respectively. A number of studies have supported the reliability and validity of the FMSS EE-Crit subscale (e.g., Asarnow, Tompson, Woo, & Cantwell, 2001; Burkhouse, Uhrlass, Stone, Knopik, & Gibb, 2012; Magaña et al, 1986; McCarty, Lau, Valeri, & Weisz, 2004; Rogosch, Cicchetti, & Toth, 2004; Silk et al, 2009), including concurrent validity with observer’s ratings of parent criticism in a separate interaction task (Calam & Peters, 2006; Moore & Kuipers, 1999). In this study, the FMSS was coded by individuals trained to reliability standards by the creator of the FMSS (Ana Magaña-Amato) and coding was consistent with the creator’s framework.…”

The Relations among Maternal Depressive Disorder, Maternal Expressed Emotion, and Toddler Behavior Problems and Attachment

“…High EE-Criticism has been found to be associated with maladaptive parental behaviors such as antagonism, negativity, disgust, harshness and decreased responsiveness in the context of the parent-child relationship (McCarty, Lau, Valeri, & Weisz, 2004). Previous research has found that high EE-Criticism is associated with adverse functioning in children and adolescents, including higher levels of internalizing and externalizing symptoms (Frye & Garber, 2005), affective disorders (Schwartz, Dorer, Beardslee, & Lavori, 1990; Silk et al, 2009), substance abuse and conduct disorder (Schwartz et al, 1990), antisocial behavior problems (Caspi et al, 2004), and self injurious thoughts and behaviors (Wedig & Nock, 2007). With few exceptions (e.g., Hirshfeld, Biederman, Brody, & Faraone, 1997; Raishevich, Kennedy, & Rapee, 2010), high EE-Emotional Over-Involvement has been found to be less predictive of child behavior problems (Baker, Heller, & Henker, 2000; Nelson, Hammen, Brennan, & Ullman, 2003), and may lack construct validity in the context of the relationship between parents and young offspring where it has been found to be unrelated to observed behaviors during parent-child interactions (McCarty et al, 2004).…”

Expressed emotion and depression in caregivers of older adults with dementia: results from Taiwan

“…There have been many studies on both the relationship between EE and depression in patients (Hayhurst, Cooper, Paykel, Vearnals, & Ramana, 1997;Hinrichsen, Adelstein & Mcmeniman, 2004;Silk et al, 2009) and the association between EE and the caregivers' health among patients with schizophrenia (Breitborde et al, 2009;Breitborde, L opez, & Kopelowicz, 2010). A number of studies have also found that EE in caregivers of dementia patients was related to caregivers' strain and distress (Bledin, MacCarthy, Kuipers, & Woods, 1990), burden (Nomura et al, 2005;Vitaliano, Russo, Young, Teri, & Maiuro, 1991), and psychological well-being (Gilhooly & Whittick, 1989).…”