Abstract
Coping with a child’s psychiatric disorder involves various challenges for parents that can result in family burden. One factor related to family burden, which has been examined in previous studies, involves the interaction of the parent with the child diagnosed with the disorder. The current study, expanding on this notion, examined the interactions between parents and two of their children, one with a disorder and one without, by assessing parental expressed emotion (EE). The study also assessed the relations between the interactions with each child, examining whether these two interactions were positively or negatively-related: the “spillover hypothesis” and the “compensation hypothesis,” respectively. In addition, the current study examined a mediation model whereby parental competence would mediate the association between parental EE towards each child and perceived family burden. 41 parents, whose children were treated at a mental health center, participated in the study. The Five Minute Speech Sample was administered to the parents to assess parental EE, as well as scales of parental competence and family burden. Results showed positive correlations between parental EE towards the two children (in the relationship and warmth subscales). The mediation model was confirmed only with regard to parental EE (relationship subscale) towards the child with the disorder. These findings support the spillover hypothesis, according to which feelings and cognitions are transferred from one family subsystem to another. Findings also highlight the importance of sense of competence in parenting a child with a psychiatric disorder, as it reduces family burden.
Highlights
-
Parental expressed emotion (EE) towards child with a disorder and healthy child were positively-related.
-
The finding supports the “spillover hypothesis”—transferring emotions from one child to the other.
-
More warmth and less emotional over-involvement towards the healthy child were observed.
-
We found negative association between parents competence and family burden.
-
Parental competence is a key factor in reducing family burden for a child with a disorder.
Similar content being viewed by others
References
Anar, I. (2003). The sense of burden of a caregiver to an elderly person after a stroke. Cognitive state and ADL ability of the elderly and coping styles of the caregiver. MA Thesis. Department of Psychology, BarIlan University, Ramat Gan.
Armstrong, M. I., Birnie-Lefcovitch, S., & Ungar, M. T. (2005). Pathways between social support, family well being, quality of parenting, and child resilience: What we know. Journal of Child and Family Studies, 14(2), 269–281. https://doi.org/10.1007/s10826-005-5054-4.
Benedetto, L., & Ingrassia, M. (2017). Parental self-efficacy in promoting children care and parenting quality. In Parenting-Empirical Advances and Intervention Resources. https://doi.org/10.5772/IntechOpen.68933.
Ben‐Pazi, A., Goldzweig, G., Pijnenborg, G. H. M., Roe, D., & Hasson‐Ohayon, I. (2019). Parental efficacy moderates the association between empathy and burden among parents of children admitted to a psychiatric ward. Family Process. https://doi.org/10.1111/famp.12517.
Beck, A., Daley, D., Hastings, R. P., & Stevenson, J. (2004). Mothers’ expressed emotion towards children with and without intellectual disabilities. Journal of Intellectual Disability Research, 48(7), 628–638. https://doi.org/10.1111/j.1365-2788.2003.00564.x.
Cartwright, K. L., Bitsakou, P., Daley, D., Gramzow, R. H., Psychogiou, L., Simonoff, E., & Sonuga-Barke, E. J. (2011). Disentangling child and family influences on maternal expressed emotion toward children with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 50(10), 1042–1053. https://doi.org/10.1016/j.jaac.2011.07.006.
Casanueva, C., Martin, S. L., Runyan, D. K., Barth, R. P., & Bradley, R. H. (2008). Quality of maternal parenting among intimate-partner violence victims involved with the child welfare system. Journal of Family Violence, 23(6), 413–427. https://doi.org/10.1007/s10896-008-9167-6.
Coleman, P. K., & Karraker, K. H. (2000). Parenting self-efficacy among mothers of school-age children: conceptualization, measurement and correlates. Family Relations, 49, 13–24. https://doi.org/10.1111/j.1741-3729.2000.00013.x.
Delvecchio, E., Di Riso, D., Chessa, D., Salcuni, S., Mazzeschi, C., & Laghezza, L. (2014). Expressed emotion, parental stress, and family dysfunction among parents of nonclinical Italian children. Journal of Child and Family Studies, 23(6), 989–999. https://doi.org/10.1007/s10826-013-9754-x.
Engfer, A. (1988). The interrelatedness of marriage and the mother-child relationship. Relationships within families: Mutual influences, 104–118.
Ercegovac, I. R., Ljubetic, M., & Pericic, M. (2013). Maternal self-competence and mother-child interaction. Hellenic Journal of Psychology, 10(2), 102–119.
Erel, O., & Burman, B. (1995). Interrelatedness of marital relations and parent-child relations: a meta-analytic review. Psychological Bulletin, 118(1), 108 https://doi.org/10.1037/0033-2909.118.1.108.
Gibaud-Wallston, J., & Wandersmann, L. P. (1978). Development and utility of the Parenting Sense of Competence Scale. John F. Kennedy center for research on education and human development.
Graziano, P. A., McNamara, J. P., Geffken, G. R., & Reid, A. (2011). Severity of children’s ADHD symptoms and parenting stress: a multiple mediation model of self-regulation. Journal of Abnormal Child Psychology, 39(7), 1073 https://doi.org/10.1007/s10802-011-9528-0.
Griffith, G. M., Hastings, R. P., Petalas, M. A., & Lloyd, T. J. (2015). Mothers’ expressed emotion towards children with autism spectrum disorder and their siblings. Journal of Intellectual Disability Research, 59(6), 580–587. https://doi.org/10.1111/jir.12178./.
Hassal, R., Rose, J., & McDonald, J. (2005). Parenting stress in mothers of children with an intellectual disability: the effects of parental cognitions in relation to child characteristics and family support. Journal of Intellectual and Disability Research, 49, 405–418. https://doi.org/10.1111/j.1365-2788.2005.00673.x.
Hasson-Ohayon, I., Tuval-Mashiach, R., Morag-Yaffe, M., Gaziel, M., Schapir, L., Zalsman, G., & Shoval, G. (2014). Parents of adolescents with psychiatric disorders: insight into the disorder, self-stigma and parental stress. Comprehensive Psychiatry, 55(5), 1106–1110. https://doi.org/10.1016/j.comppsych.2014.03.003.
Hayes, A. F. (2017). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Guilford publications.
Hoening, J., & Hamilton, M. W. (1996). The schizophrenic patient in the community and his effect on the household. International Journal of Social Psychiatry, 12(3), 165–176. https://doi.org/10.1177/002076406601200301.
Johnston, C., & Mash, E. J. (1989). A measure of parenting satisfaction and efficacy. Journal of Clinical Child Psychology, 18(2), 167–175. https://doi.org/10.1207/s15374424jccp1802_8.
Kitzmann, K. M. (2000). Effect of marital conflict on subsequent triadic family interactions and parenting. Developmental Psychology, 36, 3–13. https://doi.org/10.1037/0012-1649.36.1.3.
Koukia, E. & Madianos, M. G. (2005). Is psychosocial rehabilitation of schizophrenic patients preventing family burden? A comparative study. Journal of Psychiatry Mental Health Nursing, 12(4), 415–422. https://doi.org/10.1111/j.1365-2850.2005.00852.x.
Krishnakumar, A., & Buehler, C. (2000). Interparental conflict and parenting behaviors: A meta‐analytic review. Family Relations, 49(1), 25–44. https://doi.org/10.1111/j.1741-3729.2000.00025.x.
Kuhn, J. C., & Carter, A. S. (2006). Maternal self‐efficacy and associated parenting cognitions among mothers of children with autism. American Journal of Orthopsychiatry, 76(4), 564–575. https://doi.org/10.1037/0002-9432.76.4.564.
Letourneau, N. L., Fedick, C. B., & Willms, J. D. (2007). Mothering and domestic violence: a longitudinal analysis. Journal of Family Violence, 22(8), 649–659. https://doi.org/10.1007/s10896-007-9099-6.
Levendosky, A. A., Huth-Bocks, A. C., Shapiro, D. L., & Semel, M. A. (2003). The impact of domestic violence on the maternal-child relationship and preschool-age children’s functioning. Journal of Family Psychology, 17(3), 275 https://doi.org/10.1037/0893-3200.17.3.275.
Levitzki, N. (2009). Parenting of adult children in an Israeli sample: Parents are always parents. Journal of Family Psychology, 23(2), 226.
Magaña, A. B., Goldstein, M. J., Karno, M., Miklowitz, D. J., Jenkins, J., & Falloon, I. R. (1986). A brief method for assessing expressed emotion in relatives of psychiatric patients. Psychiatry Research, 17(3), 203–212. https://doi.org/10.1016/0165-1781(86)90049-1.
Medina-Pradas, C., Navarro, J. B., Pousa, E., Montero, M. I., & Obiols, J. E. (2013). Expressed and perceived criticism, family warmth, and symptoms in schizophrenia. The Spanish Journal of Psychology, 16. https://doi.org/10.1017/sjp.2013.25.
Meirsschaut, M., Roeyers, H., & Warreyn, P. (2010). Parenting in families with a child with autism spectrum disorder and a typically developing child: mothers’ experiences and cognitions. Research in Autism Spectrum Disorders, 4(4), 661–669. https://doi.org/10.1016/j.rasd.2010.01.002.
Minuchin, S., Rosman, B. L., & Baker, L. (1978). The anorectic family. Psychosomatic families: Anorexia nervosa in context, 51–730
Möller–Leimkühler, A. M. (2005). Burden of relatives and predictors of burden. baseline results from the munich 5–year–follow–up study on relatives of first hospitalized patients with schizophrenia or depression. European Archives of Psychiatry and Clinical Neuroscience, 255(4), 223–231. https://doi.org/10.1007/s00406-004-0550-x.
Möller-Leimkühler, A. M., & Wiesheu, A. (2012). Caregiver burden in chronic mental illness: the role of patient and caregiver characteristics. European Archives of Psychiatry and Clinical Neuroscience, 262(2), 157–166. https://doi.org/10.1007/s00406-011-0215-5.
Ohan, J. L., Leung, D. W., & Johnston, C. (2000). The parenting sense of competence scale: evidence of stable factor-structure and validity. Canadian Journal of Behavioral Science, 32, 218–251. https://doi.org/10.1037/h0087122.
Pagorek-Eshel, S., & Dekel, R. (2015). Parental self-efficacy and paternal involvement in the context of political violence. Clinical Social Work Journal, 43(4), 388–397. https://doi.org/10.1007/s10615-015-0516-7.
Repetti, R. L. (1987). Links between work and family role. In S. Oskamp (Eds.), Family Processes and Problems: Social Psychological Aspects (pp. 98–127). Newbury Park, CA: Sage.
Teti, D. M., & Gelfand, D. M. (1991). Behavioral competence among mothers of infants in the first year: The mediational role of maternal self-efficacy. Child Development, 62(5), 918–929. https://doi.org/10.1111/j.1467-8624.1991.tb01580.x.
Ward, R. A. (2008). Multiple parent–adult child relations and well-being in middle and later life. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 63(4), S239–S247. https://doi.org/10.1093/geronb/63.4.S239.
Winnicott, D. W. (1965). The maturational processes and the facilitating environment: studies in the theory of emotional development. The International Psycho-Analytical Library, 64, 1–276.
Zarit, S. H., Reever, K. E., & Bach-Peterson, J. (1980). Relatives of the impaired elderly: correlates of feelings of burden. The Gerontologist, 20(6), 649–655. https://doi.org/10.1093/geront/20.6.649.
Author information
Authors and Affiliations
Contributions
All authors contributed to the study conception and design. M.G.: leading, conceptualizing the research question and drafting the manuscript. I.H.O.: conceptualizing the research question and drafting the manuscript. G.G.: data analysis and contribution to writing the manuscript. G.S. and N.L.: Assistance in study design application and contribution to writing of the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare no competing interest.
Ethics Approval in Research Involving Human Participants
This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of “Geha” Mental Health Center (28.1.2018./No 0004-18-GEH).
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Gnainsky, M., Shoval, G., Lubbad, N. et al. Parental Expressed Emotion Towards Child with Psychiatric Disorder vs. Healthy Sibling. J Child Fam Stud 31, 764–773 (2022). https://doi.org/10.1007/s10826-021-02052-9
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10826-021-02052-9