Parental Expressed Emotion and Youth Psychopathology: New Directions for an Old Construct

Peris, Tara S.; Miklowitz, David J.

doi:10.1007/s10578-014-0526-7

Cited by 134 publications

(112 citation statements)

References 82 publications

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“…A robust body of research has explored the influence of family factors on OCD, specifically with respect to relative 15 and parent 16–17 expressed emotion (EE) and over-involvement 18 , and impacts of parental blame, conflict, and cohesion on treatment outcomes. 19–20 Associations have been demonstrated between pediatric OCD and select aspects of family impairment, such as family accommodation, strain, and stress 21 , and a study has captured simultaneous child and mother perspectives.…”

Section: Introductionmentioning

confidence: 99%

A Multisite Study of Family Functioning Impairment in Pediatric Obsessive-Compulsive Disorder

Stewart

Leung

et al. 2017

Journal of the American Academy of Child & Adolescent Psych

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Objective Familial aspects of pediatric obsessive-compulsive disorder (OCD) including accommodation and treatment have received notable and warranted attention. However, individual perspectives of its repercussions on family functioning, including emotional parental burden, have not been closely examined. The present study details this topic utilizing a large, multi-center sample. Method Participants included 354 youth affected with OCD, mothers and fathers ascertained through pediatric OCD programs in Boston, USA (n=180) and Vancouver, Canada (n=174). The validated OCD Family Functioning (OFF) Scale and standard OCD measures were completed. Descriptive, between-site and cross-perspective comparative analyses were followed by regression model testing to predict family impairment. Results Family functioning was negatively impacted from youth, mother, and father perspectives. Impairment was reportedly more extensive at the time of worst OCD severity and was greater from maternal versus paternal viewpoints. Most frequently impacted family tasks and implicated OCD symptoms included morning and bedtime routines and intrusive thoughts. Emotional repercussions included stress and anxiety, followed by frustration/anger in youth and sadness in parents. Nearly half of mothers and a third of fathers reported daily occupational impairment. Compared to youth self-report, parents perceived fewer social and academic impacts on their child. Family accommodation most consistently predicted family impairment, especially from parent perspectives. OCD and compulsion severity, contamination and religious obsessions, and comorbidities also predicted various perspectives of family subdomain impairment. Conclusion This study quantitatively details the pervasive burden that pediatric OCD places on families, as reported from complementary relative perspectives. Further attention to this topic is warranted in clinical and research realms.

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Section: Introductionmentioning

confidence: 99%

A Multisite Study of Family Functioning Impairment in Pediatric Obsessive-Compulsive Disorder

Stewart

Leung

et al. 2017

Journal of the American Academy of Child & Adolescent Psych

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“…However, ADHD symptom severity also appears to be associated with parental high EE and high criticism (Cartwright et al, 2011; Keown, 2010; Psychogiou et al, 2007, 2008; Peris & Hinshaw, 2003; Peris & Miklowitz, 2015; Pfiffner, McBurnett, Rathouz, & Judice, 2005; Sonuga-Barke et al, 2008, 2009, 2013). While part of this association may be driven by comorbid oppositional/aggressive behavior in ADHD (Baker et al, 2000; Hirshfeld et al, 1997; Peris & Baker, 2000; Vostanis & Nicholls, 1992), research is mixed as to whether there is also a specific EE-ADHD association.…”

mentioning

confidence: 99%

Attention-deficit/hyperactivity disorder developmental trajectories related to parental expressed emotion.

Musser

Karalunas

Dieckmann

et al. 2016

Journal of Abnormal Psychology

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Background In the transition from childhood to adolescence, attention-deficit/hyperactivity disorder (ADHD) developmental trajectories diverge. Family environment, as indexed by parental expressed emotion, may moderate these trajectories. Methods 388 children with ADHD and 127 control children were assessed using a multi-informant, multi-method diagnostic procedure at up to three time points one year apart in an accelerated longitudinal design spanning ages 7-13 years. Latent-class growth analysis (LCGA) was used to identify developmental trajectories for both parent- and teacher-rated ADHD and ODD symptoms within the ADHD sample. Parental expressed emotion, criticism, and emotional over-involvement were coded from a 5-minute speech sample at two time points, one year apart, for 208 of these children and compared to the non-ADHD sample and among the ADHD trajectory groups. Results Parent-rated hyperactivity yielded a four class trajectory solution in LCGA; teacher-rated inattention yielded a three-trajectory solution. Teacher-rated ODD also yielded three-trajectory solution. A parent-rated high persistent hyperactive group was more likely than the other ADHD groups to have parents with stable high criticism (34.6%, p<.001), with ODD symptoms controlled. A teacher-identified high ODD-worsening group was more likely to experience high criticism at either time point, particularly the initial time point; (87.5%, p<.001), with hyperactivity controlled. Conclusion Parental criticism, an index of the family environment, is uniquely associated with divergent developmental trajectories among children with ADHD in addition to those associated with ODD symptoms.

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“…High maternal expressed emotion, rates of which differed across the samples, emerged as a significant predictor of poor outcome in the CBT [77] but not the multimodal treatment study [78]. The extent to which discrepant findings can be attributed to age differences in the relevance of the construct is unclear [79].…”

Section: Expressed Emotionmentioning

confidence: 95%

Personalizing the Treatment of Pediatric Obsessive-Compulsive Disorder: Evidence for Predictors and Moderators of Treatment Outcomes

Caporino

Storch

2016

Curr Behav Neurosci Rep

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Cognitive behavioral therapy (CBT), delivered alone or with a serotonin reuptake inhibitor (SRI), is efficacious for treating pediatric obsessive-compulsive disorder (OCD), but not all youth respond optimally. Research to understand for whom a given intervention is beneficial can inform efforts to personalize treatment or tailor it to specific youths to enhance outcomes. We review studies that examined potential predictors/moderators of response to CBT, medication, and multimodal treatment for pediatric OCD: demographics, disorder-specific characteristics, general illness characteristics, neuropsychological functioning, biomarkers, family factors, and non-specific therapy factors. Methodological differences across studies make it challenging to synthesize findings and more research with large samples is needed. However, family factors have emerged as relatively consistent and strong predictors of treatment outcomes and there is preliminary support for attention to the presence of tics in treatment selection. There is little evidence for age and other demographic differences in treatment response.

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Parental Expressed Emotion and Youth Psychopathology: New Directions for an Old Construct

Cited by 134 publications

References 82 publications

A Multisite Study of Family Functioning Impairment in Pediatric Obsessive-Compulsive Disorder

A Multisite Study of Family Functioning Impairment in Pediatric Obsessive-Compulsive Disorder

Attention-deficit/hyperactivity disorder developmental trajectories related to parental expressed emotion.

Personalizing the Treatment of Pediatric Obsessive-Compulsive Disorder: Evidence for Predictors and Moderators of Treatment Outcomes

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