Abstract
The Five Minute Speech Sample’s (FMSS) measure of parental expressed emotion (EE), defined as criticism (CRIT) and emotional overinvolvement (EOI), has been increasingly used to measure family emotional climate in relation to youth psychopathological development. As CRIT and EOI were defined based on adults, a meta-analysis and systematic review was conducted to analyze the presence and strength of an effect among maternal CRIT and EOI with youth internalizing and externalizing problems. A random effects model was used to analyze the 42 studies on families of youth (aged 1.5 to 19). There was a small, significant relation among maternal CRIT with youth internalizing and externalizing problems and among EOI with youth internalizing problems. EOI was not significantly related to externalizing problems. The current study suggests that the FMSS measure of CRIT is a more robust correlate of youth internalizing and externalizing symptoms than EOI, but EOI does relate to internalizing behaviors. Few moderators emerged, highlighting a continued need to identify factors accounting for heterogeneity. The current results suggest that the FMSS measure of CRIT may be a valuable measure of the family emotional climate in families of youth, but care should be taken when including analyses on EOI.
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References
Thompson R, Meyer S (2007) Socialization of emotion regulation in the family. In: Gross J (ed) Handbook of emotion regulation. Guilford Press, New York, NY, pp 249–268
Hooley JM (2007) Expressed emotion and relapse of psychopathology. Annu Rev Clin Psychol 3:329–352
Brown GW, Rutter M (1966) The measurement of family activities and relationships: a methodological study. Hum Relat 19:241–263
Barrowclough C, Hooley JM (2003) Attributions and expressed emotion: a review. Clin Psychol Rev 23:849–880
Greenberg JS, Seltzer MM, Hong J, Orsmond GI (2006) Bidirectional effects of expressed emotion and behavior problems and symptoms in adolescents and adults with autism. Am J Ment Retard 111:229–249
Peris TS, Miklowitz DJ (2015) Parental expressed emotion and youth psychopathology: new directions for an old construct. Child Psychiatry Hum Dev 46:863–873
Weston S, Hawes D, Pasalich D (2017) The Five Minute Speech Sample as a measure of Parent-child dynamics: evidence from observational research. J Child Fam Stud 26:118–136
Magaña-Amato A (2012) Manual for coding expressed emotion from the Five Minute Speech Sample. Unpublished manual from the author
Gresham FM, Cook CR, Crews SD, Barreras R (2008) Direct observation methods in clinical assessment. In: McKay D (ed) Handbook of research methods in abnormal and clinical psychology. Sage Publications Inc, Thousand Oaks, CA, pp 141–157
Sher-Censor E (2015) Five Minute Speech Sample in developmental research: a review. Dev Rev 36:127–155
Stern E (2002) Expressed emotion and interaction patterns in mothers with anxiety disorders and their children (Unpublished doctoral dissertation). Boston University, Boston, MA
Brennan PA, Hammen C, Katz AR, Le Brocque RM (2002) Maternal depression, paternal psychopathology, and adolescent diagnostic outcomes. J Consult Clin Psychol 70(5):1075
Hibbs ED, Hamburger SD, Lenane M, Rapoport JL, Kruesi MJ, Keysor CS, Goldstein MJ (1991) Determinants of expressed emotion in families of disturbed and normal children. J Child Psychol Psychiatry 32(5):757–770
Nelson DR, Hammen C, Brennan PA, Ullman JB (2003) The impact of maternal depression on adolescent adjustment: the role of expressed emotion. J Consult Clin Psychol 71:935–944
Hibbs ED, Hamburger SD, Kruesi MJ, Lenane M (1993) Factors affecting expressed emotion in parents of ill and normal children. Am J Orthopsychiatry 63(1):103–112
Peris TS, Yadegar M, Asarnow JR, Piacentini J (2012) Pediatric obsessive compulsive disorder: family climate as a predictor of treatment outcome. J Obsessive Compuls Relat Disord 1:267–273
Asarnow J, Tompson M, Hamilton E, Goldstein M, Guthrie D (1994) Family-expressed emotion, childhood-onset depression, and childhood-onset schizophrenia spectrum disorders: is expressed emotion a nonspecific correlate of child psychopathology or a specific risk factor for depression? J Abnorm Child Psychol 22:129–146
McCleary L, Sanford M (2002) Parental expressed emotion in depressed adolescents: prediction of clinical course and relationship to comorbid disorders and social functioning. J Child Psychol Psychiatry 43:587–595
Owen-Anderson AF, Bradley SJ, Zucker KJ (2010) Expressed emotion in mothers of boys with gender identity disorder. J Sex Marital Ther 36(4):327–345
Owen-Anderson A (2006) “I know what he is feeling because it is like I am inside of him.” Examining sensory sensitivities, empathy, and expressed emotion in boys with gender identity disorder and their mothers: a comparison to clinical control boys and community control boys and girls (Unpublished doctoral dissertation). Ontario Institute for Studies and Education of the University of Toronto, Toronto, CN.
Peris TS, Hinshaw SP (2003) Family dynamics and preadolescent girls with ADHD: the relationship between expressed emotion, ADHD symptomatology, and comorbid disruptive behavior. J Child Psychol Psychiatry 44:1177–1190
Przeworski A, Zoellner L, Franklin M, Garcia A, Freeman J, March J, Foa E (2012) Maternal and child expressed emotion as predictors of treatment response in pediatric obsessive–compulsive disorder. Child Psychiatry Hum Dev 43:337–353
Stubbe DE, Zahner GE, Goldstein MJ, Leckman JF (1993) Diagnostic specificity of a brief measure of expressed emotion: a community study of children. J Child Psychol Psychiatry 34:139–154
Wedig MM, Nock MK (2007) Parental expressed emotion and adolescent self-injury. J Am Acad Child Adolesc Psychiatry 46:1171–1178
Cruise RC, Sheeber LB, Tompson MC (2011) Behavioral correlates of maternal expressed emotion in interaction tasks. J Fam Psychol 25:781–784
McCarty CA (2000) Affective attitudes among mothers of clinic-referred children (Unpublished doctoral dissertation). University of California, Los Angeles, CA
Gibb BE, Uhrlass DJ, Grassia M, Benas JS, McGeary J (2009) Children’s inferential styles, 5-HTTLPR genotype, and maternal expressed emotion-criticism: an integrated model for the intergenerational transmission of depression. J Abnorm Psychol 118:734–745
Gravener JA, Rogosch FA, Oshri A, Narayan AJ, Cicchetti D, Toth SL (2012) The relations among maternal depressive disorder, maternal expressed emotion, and toddler behavior problems and attachment. J Abnorm Child Psychol 40:803–813
Lancaster RL, Balling K, Hastings R, Lloyd TJ (2014) Attributions criticism and warmth in mothers of children with intellectual disability and challenging behavior: a pilot study. J Intellect Disabil Res 58:1060–1071
Hilsman R (2001) Maternal expressed emotion, child self-cognitions, and psychopathology in children of depressed and nondepressed mothers (Unpublished doctoral dissertation). Vanderbilt University, Nashville, TN
Narayan A, Cicchetti D, Rogosch FA, Toth SL (2015) Interrelations of maternal expressed emotion, maltreatment, and separation/divorce and links to family conflict and children's externalizing behavior. J Abnorm Child Psychol 43:217–228
Klaus N (2006) A psychometric evaluation of two measures of expressed emotion in caregivers of children with mood disorders (Unpublished Doctoral Dissertation). Ohio State University, Columbus, Ohio
Moroney E, Tung I, Brammer WA, Peris TS, Lee SS (2017) Externalizing outcomes of youth with and without ADHD: time-varying prediction by parental ADHD and mediated effects. J Abnorm Child Psychol 45:457–470
Musser ED (2013) A multi-method investigation of intrisic and extrinsic emotion regulation in attention-deficity/hyperactivity disorder (Unpublished Doctoral Dissertation). University of Oregon, Eugene, Oregon
Musser ED, Karalunas SL, Dieckman N, Peris TS, Nigg JT (2016) Attention-deficit/hyperactivity disorder developmental trajectories related to parental expressed emotion. J Abnorm Psychol 125:182–195
Hirshfeld DR, Biederman J, Brody L, Faraone SV, Rosenbaum JF (1996) Associations between expressed emotion and child behavioral inhibition and psychopathology: a pilot study. J Am Acad Child Adolesc Psychiatry 36:205–213
Asarnow JR, Tompson M, Woo S, Cantwell DP (2001) Is expressed emotion a specific risk factor for depression or a nonspecific correlate of psychopathology? J Abnorm Child Psychol 29:573–583
Burkhouse KL, Uhrlass DJ, Stone LB, Knopik VS, Gibb BE (2012) Expressed emotion-criticism and risk of depression onset in children. J Clin Child Adolesc Psychol 41:771–777
Frye A, Garber J (2005) The relations among maternal depression, maternal criticism, and adolescents’ externalizing and internalizing symptoms. J Abnorm Child Psychol 33:1–11
Gar NS, Hudson JL (2008) An examination of the interactions between mothers and children with anxiety disorders. Behav Res Ther 46:1266–1274
Baker BL, Heller TL, Henker B (2000) Expressed emotion, parenting stress, and adjustment in mothers of young children with behavior problems. J Child Psychol Psychiatry 41:907–915
Hastings R, 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. Am J Ment Retard 111:48–61
James KM, Woody ML, Feurer C, Kudinova AY, Gibb BE (2017) Disrupted physiological reactivity among children with a history of suicidal ideation; moderation by parental expressed emotion-criticism. Biol Psychol 130:22–29
Otto MW, Henin A, Hirshfeld-Becker DR, Pollack MH, Biederman J, Rosenbaum JF (2007) Posttraumatic stress disorder symptoms following media exposure to tragic events: impact of 9/11 on children at risk for anxiety disorders. J Anxiety Disord 21:888–902
Raishevich N, Kennedy SJ, Rapee RM (2010) Expressed emotion displayed by the mothers of inhibited and uninhibited preschool-aged children. J Clin Child Adolesc Psychol 39:187–194
Freed R, Tompson M (2011) Predictors of parental locus of control in mothers of pre- and early adolescents. J Clin Child Adolesc Psychol 40:100–110
Bailey J, Hill K, Oesterle S, Hawkins J (2009) Parenting practices and problem behavior across three generations: monitoring, harsh discipline, and drug use in the intergenerational transmission of externalizing behavior. Dev Psychol 45:1214–1226
Gibb B, Johnson A, Benas J, Uhrlass D, Knopik V, McGeary J (2011) Children’s 5-HTTLPR genotype moderates the link between maternal criticism and attentional biases specifically for facial displays of anger. Cogn Emot 25:1104–1120
McCarty CA, Weisz JR (2002) Correlates of expressed emotion in mothers of clinically-referred youth: an examination of the five-minute speech sample. J Child Psychol Psychiatry 43:759–768
McCarty CA, Lau AS, Valeri SM, Weisz JR (2004) Parent-child interactions in relation to critical and emotionally overinvolved expressed emotion (EE): is EE a proxy for behavior? J Abnorm Child Psychol 32:83–93
Khafi TY, Yates TM, Sher-Censor E (2015) The meaning of emotional overinvolvement in early development: prospective relations with child behavior problems. J Fam Psychol 29:585–594
Chorpita BF, Barlow DH (1998) The development of anxiety: the role of control in the early environment. Psychol Bull 124(1):3
van der Bruggen CO, Stams GJJ, Bögels SM (2008) Research review: the relation between child and parent anxiety and parental control: a meta-analytic review. J Child Psychol Psychiatry 49:1257–1269
Perez-Olivas G, Stevenson J, Hadwin JA (2008) Do anxiety-related attentional biases mediate the link between maternal over involvement and separation anxiety in children? Cogn Emot 22:509–521
Sicouri G, Sharpe L, Hudson J, Dudeney J, Jaffe A, Selvadurai H, Hunt C (2017) Parent-child interactions in children with asthma and anxiety. Behav Res Ther 97:242–251
Psychogiou L, Daley DM, Thompson MJ, Sonuga-Barke EJ (2007) Mothers’ expressed emotion toward their school-aged sons: associations with child and maternal symptoms of psychopathology. Eur Child Adolesc Psychiatry 16:458–464
Lindhout IE, Markus MT, Borst SR, Hoogendijk TH, Dingemans PM, Boer F (2009) Childrearing style in families of anxiety-disordered children: between-family and within-family differences. Child Psychiatry and Hum Dev 40:197–212
Han Z, Shaffer A (2014) Maternal expressed emotion in relation to child behavior problems: differential and mediating effects. J Child Fam Stud 23:1491–1500
Wamboldt FS, O’Connor SL, Wamboldt MZ, Gavin LA, Klinnert MD (2000) The five minute speech sample in children with asthma: deconstructing the construct of expressed emotion. J Child Psychol Psychiatry 41:887–898
Nuttall AK, Valentino K (2017) An ecological-transactional model of generational boundary dissolution across development. Marriage Fam Rev 53(2):105–150
Narayan AJ, Herbers JE, Plowman EJ, Gewirtz AH, Masten AS (2012) Expressed emotion in homeless families: a methodological study of the five-minute speech sample. J Fam Psychol 26:648–653
Jenkins JM, Rasbash J, O'Connor TG (2003) The role of the shared family context in differential parenting. Dev Psychol 39:99–113
Dix T, Ruble DN, Zambarano RJ (1989) Mothers' implicit theories of discipline: child effects, parent effects, and the attribution process. Child Dev 60:1373–1391
Kotov R, Krueger R, Watson D, Achenbach T, Althoff R, Bagby R et al (2017) The Hierarchical Taxonomy of Psychopathology (HiTOP): a dimensional alternative to traditional nosologies. J Abnorm Psychol 126:454–477
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med 151:65–95
Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 151:264–269
Forbush K, South S, Krueger RF, Iacono W, Clark L, Keel P et al (2010) Locating eating pathology within an empirical diagnostic taxonomy: evidence from a community-based sample. J Abnorm Psychol 119:282–292
Borenstein M, Hedges L, Higgins J, Rothstein H (2014) Comprehensive meta-analysis (version 3.0.) [Computer software]
Lipsey MW, Wilson DB (2001) Practical meta-analysis. SAGE Publications Inc, Thousand Oaks, CA
Rosenthal R (1991) Effect sizes: Pearson’s correlation, its display via the BESD, and alternative indices. Am Psychol 46:1086–1087
Hedges L, Olkin I (1985) Statistical methods for meta-analysis. Academic Press, San Diego, CA
Higgins J, Thompson S, Deeks J, Altman D (2003) Measuring inconsistency in meta-analyses. Br Med J 327:557–560
Jackson D, Law M, Stijnen T, Viechtbauer W, White I (2017) A comparison of seven random-effects models for meta-analyses that estimate the summary odds ratio. Stat Med 37:1059–1085
Veroniki AA, Jackson D, Viechtbauet W, Bender R, Bowden J, Knapp G, Kuss O, Higgins JPT, Langan D, Salanti G (2016) Methods to estimate the between-study variance and its uncertainty in meta-analysis. Res Synth Methods 7:55–79
Egger M, Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. Br Med J 315:629–634
Jones S, Fabes EN, RA Fabes, MacKinnon DP (2002) Parents’ reactions to elementary school children’s negative emotions: relations to social and emotional functioning at school. Merrill Palmer Q 48:133–159
Patterson R (2013) Attachment, loss and expressed emotion: developmental processes in psychosis. In: Gumley AI, Gilham A, Taylor K, Schwannauer M (eds) Psychosis and emotion: the role of emotions in understanding psychosis, therapy, and recovery. Routledge, London, UK, pp 152–164
Pettit GS, Laird RD, Dodge KA, Bates JE, Criss MM (2001) Antecedents and behavior-problem outcomes of parental monitoring and psychological control in early adolescence. Child Dev 72:583–598
Dadds MR, Barrett PM, Rapee RM, Ryan S (1996) Family process and child anxiety and aggression: an observational analysis. J Abnorm Child Psychol 24(6):715–734
Rosenthal R, Rosnow RL (1991) Essentials of behavioral research: methods and data analysis, 2nd edn. McGraw Hill, New York, NY
Kim Park IJ, Garber J, Ciesla JA, Ellis BJ (2008) Convergence among multiple methods of measuring positivity and negativity in the family environment: relation to depression in mothers and their children. J Fam Psychol 22:123–134
Rosenfarb IS, Bellack AS, Aziz N (2006) A sociocultural stress, appraisal, and coping model of subjective burden and family attitudes toward patients with schizophrenia. J Abnorm Psychol 115:157–165
Forehand R, Kotchick BA (2016) Cultural diversity: a wake-up call for parent training-Republished article. Behav Ther 47:981–992
Kang SK, Chasteen AL (2009) Beyond the double-jeopardy hypothesis: assessing emotion on the faces of multiply-categorizeable targets of prejudice. J Exp Soc Psychol 45:1281–1285
Karreman A, van Tuijl C, van Aken MA, Dekovic M (2008) Parenting, coparenting and effortful control in preschoolers. J Fam Psychol 22:30–40
Juni P, Witschi A, Block R, Egger M (1999) The hazards of scoring the quality of clinical trials for meta-analysis. JAMA 282:1054–1060
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Rea, H.M., Factor, R.S., Kao, W. et al. A Meta-analytic Review of the Five Minute Speech Sample as a Measure of Family Emotional Climate for Youth: Relations with Internalizing and Externalizing Symptomatology. Child Psychiatry Hum Dev 51, 656–669 (2020). https://doi.org/10.1007/s10578-020-00964-z
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DOI: https://doi.org/10.1007/s10578-020-00964-z