Abstract
The current study explored the longitudinal relation between parental expressed emotion, a well-established predictor of symptom relapse in various other disorders (e.g., schizophrenia) with externalizing behaviors in 84 children, ages 8–18 (at Time 2), with autism spectrum disorder (ASD). It was found that parental expressed emotion, specifically criticism/hostility at Time 1, significantly related to a change in externalizing behaviors from Time 1 to Time 2, even after controlling for Time 1 family income, ASD symptom severity, parental distress, and parenting practices. That is, higher levels of parental criticism/hostility at Time 1 predicted higher levels of child externalizing behaviors at Time 2. However, the reverse was not found. This finding of a unidirectional relation has important clinical implications.
Similar content being viewed by others
References
Abidin, R. (1995). Parenting stress index, third edition; professional manual. Lutz, FL: Psychological Assessment Resources.
Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school-age forms and profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, and Families.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, 4th edition-text revision (DSM-IV-TR). Washington, DC: American Psychiatric Association.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, 5th edition (DSM-5). Arlington, VA: American Psychiatric Publishing.
Bader, S. H. Barry, T. D., & Hann, J. H. (2014). The relation between parental expressed emotion and externalizing behaviors in children and adolescents with an autism spectrum disorder. Focus on Autism and Other Developmental Disabilities. doi:10.1177/1088357614523065.
Baker, J. K., Smith, L. E., Greenberg, J. S., Seltzer, M., & Taylor, J. (2011). Change in maternal criticism and behavior problems in adolescents and adults with autism across a 7-year period. Journal of Abnormal Psychology, 120, 465–475.
Brookman-Frazee, L. I., Taylor, R., & Garland, A. F. (2010). Characterizing community-based mental health services for children with autism spectrum disorders and disruptive behavior problems. Journal of Autism and Developmental Disorders, 40, 1188–1201.
Butzlaff, R. L., & Hooley, J. M. (1998). Expressed emotion and psychiatric relapse: A meta-analysis. Archives of General Psychiatry, 55, 547–552.
Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159.
De Los Reyes, A., Ehrlich, K. B., Swan, A. J., Luo, T. J., Van Wie, M., & Pabon, S. C. (2013). An experimental test of whether informants can report about child and family behavior based on settings of behavioral expression. Journal of Child and Family Studies, 22, 177–191.
Dumas, J. E. (2005). Mindfulness-based parent training: Strategies to lessen the grip of automaticity in families with disruptive children. Journal of Clinical Child and Adolescent Psychology, 34, 779–791.
Dumas, J. E., Wolf, L. C., Fisman, S. N., & Culligan, A. (1991). Parenting stress, child behavior problems, and dysphoria in parents of children with autism, down syndrome, behavior disorders, and normal development. Exceptionality, 2, 97–110.
Eisner, L. R., & Johnson, S. L. (2008). An acceptance-based psychoeducation intervention to reduce expressed emotion in relatives of bipolar patients. Behavior Therapy, 39, 375–385.
Essau, C. A., Sasagawa, S., & Frick, P. J. (2006). Psychometric properties of the Alabama Parenting Questionnaire. Journal of Child and Family Studies, 15, 597–614.
Fischer, E. H., Dornelas, E. A., & Goethe, J. W. (2001). Characteristics of people lost to attrition in psychiatric follow-up studies. Journal of Nervous and Mental Disease, 189, 49–55.
Frick, P. J. (1991). The Alabama Parenting Questionnaire. Unpublished instrument. Tuscaloosa: University of Alabama.
Greenberg, J. S., Seltzer, M. M., Hong, J., & Orsmond, G. I. (2006). Bidirectional effects of expressed emotion and behavior problems and symptoms in adolescents and adults with autism. American Journal of Mental Retardation, 111, 229–249.
Hartman, C. A., Luteijn, E., Serra, M., & Minderaa, R. (2006). Refinement of the Children’s Social Behavior Questionnaire (CSBQ): An instrument that describes the diverse problems seen in milder forms of PDD. Journal of Autism and Developmental Disorders, 6, 325–342.
Hastings, R. P., Daley, D., Burns, C., & Beck, A. (2006). Maternal distress and expressed emotion: Cross-sectional and longitudinal relationships with behavior problems of children with intellectual disabilities. American Journal of Mental Retardation, 111, 48–61.
Henderson, J. A., Barry, T. D., Bader, S. H., & Jordan, S. S. (2011). The relation among sleep, routines, and externalizing behavior in children with an autism spectrum disorder. Research in Autism Spectrum Disorders, 5, 758–767.
Hoffman, C. D., Sweeney, D. P., Hodge, D., Lopez-Wagner, M. C., & Looney, L. (2009). Parenting stress and closeness: Mothers of typically developing children and mothers of children with autism. Focus on Autism and Other Developmental Disabilities, 24, 178–187.
Hooley, J. M., & Gotlib, I. H. (2000). A diathesis-stress conceptualization of expressed emotion and clinical outcome. Applied and Preventive Psychology, 9, 135–151.
Luteijn, E. F., Luteijn, F., Jackson, A. E., Volkmar, F. R., & Minderaa, R. B. (2000). The Children’s Social Behavior Questionnaire for milder variants of PDD problems: Evaluation of the psychometric characteristics. Journal of Autism and Developmental Disorders, 30, 317–330.
Mahan, S., & Matson, J. L. (2011). Children and adolescents with autism spectrum disorders compared to typically developing controls on the Behavioral Assessment System for Children, Second Edition (BASC-2). Research in Autism Spectrum Disorders, 5, 119–125.
Matson, J. L., & Nebel-Schwalm, M. (2007). Assessing challenging behaviors in children with autism spectrum disorder: A review. Research in Developmental Disabilities, 28, 567–579.
Ozonoff, S., Goodlin-Jones, B. L., & Solomon, M. (2005). Evidence-based assessment of autism spectrum disorders in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 34, 523–540.
Pharoah, F. M., Mari, J. J., & Streiner, D. L. (1999). Family intervention for people with schizophrenia (Cochrane review). The Cochrane library, 4.Oxford, UK: Update Software.
Pitschel-Walz, G., Leucht, S., Bauml, J., Kissling, W., & Engel, R. R. (2001). The effect of family interventions on relapse and rehospitalisation in schizophrenia—a meta-analysis. Schizophrenia Bulletin, 27, 73–92.
Shaffer, A., Lindheim, O., Kolko, D. J., & Trentacosta, C. J. (2013). Bidirectional relations between parenting practices and child externalizing behavior: A cross-lagged panel analysis in the context of a psychosocial treatment and 3-year follow-up. Journal of Abnormal Child Psychology, 41, 199–210.
Shelton, K. K., Frick, P. J., & Wootton, J. (1996). Assessment of parenting practices in families of elementary school-age children. Journal of Clinical Child Psychology, 25, 317–329.
Sikora, D. M., Hall, T. A., Hartley, S. L., Gerrard-Morris, A. E., & Cagle, S. (2008). Does parent report of behavior differ across ADOS-G classifications: Analysis of scores from the CBCL and GARS. Journal of Autism and Developmental Disorders, 38, 440–448.
Stubbe, D. E., Zahner, G. E., Goldstein, M. J., & Leckman, J. F. (1993). Diagnostic specificity of a brief measure of expressed emotion: A community sample of children. Journal of Child Psychology and Psychiatry, 34, 139–154.
Tomanik, S., Harris, G. E., & Hawkins, J. (2004). The relationship between behaviours exhibited by children with autism and maternal stress. Journal of Intellectual and Developmental Disability, 29, 16–26.
Totsika, V., Hastings, R. P., Emerson, E., Lancaster, G. A., & Berridge, D. M. (2011). A population-based investigation of behavioural and emotional problems and maternal health. Associations with autism spectrum disorder and intellectual disability. Journal of Child Psychology and Psychiatry, 52, 91–99.
Vaughn, C. E., & Leff, J. P. (1976). The influence of family and social factors on the course of psychiatric illness: a comparison of schizophrenic and depressed neurotic patients. British Journal of Psychiatry, 129, 125–137.
Wearden, A. J., Tarrier, N., Barrowclough, C., Zastowny, T. R., & Rahill, A. A. (2000). A review of expressed emotion research in health care. Clinical Psychology Review, 20, 633–666.
Wiedemann, G., Rayki, O., Feinstein, E., & Hahlweg, K. (2002). The family questionnaire: Development and validation of a new self-report scale for assessing expressed emotion. Psychiatric Research, 109, 265–279.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bader, S.H., Barry, T.D. A Longitudinal Examination of the Relation Between Parental Expressed Emotion and Externalizing Behaviors in Children and Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 44, 2820–2831 (2014). https://doi.org/10.1007/s10803-014-2142-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10803-014-2142-6