Parent-Child Interactions in Relation to Critical and Emotionally Overinvolved Expressed Emotion (EE): Is EE a Proxy for Behavior?

Abstract

Expressed emotion measures, encompassing dimensions of criticism (CRIT), and emotional overinvolvement (EOI) are increasingly being used to assess the parent-child relationship in child clinical populations, despite the lack of studies assessing their validity. We examined the correspondence between CRIT, EOI, and parent-child interactions as observed by neutral coders in a sample of 252 clinic-referred children and adolescents, ages 7-17 years. We found support for the validity of the CRIT code, with high critical parents showing more antagonism, negativity, disgust, harshness, and less responsiveness, compared to parents who scored in the low or borderline ranges. In contrast, none of the observed behaviors were found to correspond with parental EOI, suggesting either that this construct lacks validity with juvenile samples or that behaviors that correspond to EOI are difficult to observe. We conclude that high parental CRIT can be used as an index of problematic parent-child interactions. Keywords expressed emotion; parent-child interaction; criticism; emotional overinvolvementEvidence is accumulating that some childhood disorders, such as depression, are associated with low levels of family support (Barrera & Garrison-Jones, 1992;Feldman, Rubenstein, & Rubin, 1988), high family conflict Wierson, Forehand, & McCombs, 1988), or poor family relations (Puig-Antich et al., 1993). Expressed emotion (EE) is one measure that has been used to assess the parent-child relationship among adults, and more recently children, with psychological disorders. Having a caregiver score high on the EE measure has been associated with poorer outcome for adults with mood, anxiety, and schizophrenic disorders, and with the presence of internalizing and externalizing disorders for children (Asarnow, Tompson, Woo, & Cantwell, 2001;Butzlaff & Hooley. 1998; Stubbe, Zahner, Goldstein, & Leckman, 1993;Vostanis, Nicholls, & Harrington, 1994). The assumption underlying EE is that the way parents talk about a child is indicative of the way they treat the child on a day-to-day basis (Chambless, Bryan, Aiken, 6 Address all correspondence to Carolyn A. McCarty, PhD, Child Health Institute, University of Washington, Box 354920, Seattle, Washington, 98195-4920; e-mail:cmccarty@u.washington.edu.. Steketee, & Hooley, 1999). Given the suggested association between parent-child interactions and these disorders and given the increasing use of EE as an index of dyadic relationship problems within the family, it is important to know whether the expressed emotion measure actually corresponds to such interactions. NIH Public AccessEE is assessed via interview or an open-ended query posed to the parent or caregiver. Commonly, EE is measured using the Five-Minute Speech Sample (Magana et al., 1986) wherein caregivers are asked to describe their child and their relationship with him/her and responses are coded for two different components of EE-criticism (CRIT) and emotional overinvolvement (EOI), with a high score on either indicating a "High EE...

Convergence among multiple methods of measuring positivity and negativity in the family environment: Relation to depression in mothers and their children.

“…These findings are a unique contribution to the literature, in that prior studies have not examined relations among family environment measures using more than three assessment methods; the current investigation involved four separate methods and found convergence consistent with previous studies using two methods (e.g., McCarty, Lau, Valeri, & Weisz, 2004). Although we labeled the dimensions slightly differently, our findings regarding conceptual convergence are consistent with those of other studies of different dimensions of the family environment (e.g., Dallaire et al, 2006;Sheeber et al, 1997).…”

“…Moreover, the mother and child selfreport constructs, the behavioral observation measures, and the speech sample indicators all converged onto their respective dimensions of positive and of negative family environment. Thus, we found empirical evidence for both methodological and conceptual convergence on these procedurally distinct measures of positivity and of negativity in the family environment.These findings are a unique contribution to the literature, in that prior studies have not examined relations among family environment measures using more than three assessment methods; the current investigation involved four separate methods and found convergence consistent with previous studies using two methods (e.g., McCarty, Lau, Valeri, & Weisz, 2004). Although we labeled the dimensions slightly differently, our findings regarding conceptual convergence are consistent with those of other studies of different dimensions of the family environment (e.g., Dallaire et al, 2006;Sheeber et al, 1997).…”

Childrearing Style in Families of Anxiety-Disordered Children: Between-Family and Within-Family Differences

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