Doctor of Philosophy, The Ohio State University, 2006, Psychology

Expressed emotion (EE) refers to criticism, hostility, and emotional overinvolvement (EOI) displayed by family members toward a patient. EE has been associated with higher rates of relapse and poor outcome in adults with a range of psychiatric disorders. In children, caregiver EE is related to presence and course of multiple disorders. EE measures developed for adult populations have been used in studies of children. However, questions have arisen regarding their appropriateness in such applications. The present study examined reliability, stability, and validity of two measures of EE, the Five Minute Speech Sample (FMSS) and Expressed Emotion Adjective Checklist (EEAC), in caregivers of children with mood disorders. During the FMSS, a relative is asked to speak freely about the patient. Audiotaped speech samples are later coded by qualified raters. The EEAC is a self-report measure listing adjectives that are rated according to their frequency of expression by the patient and relative toward each other. Both EE measures were completed by 180 mothers and 106 fathers of children with mood disorders as part of a study examining efficacy of family psychoeducational treatments. Data were also collected on constructs theoretically related and unrelated to EE including reports of the child's behavior, mood, and anxiety symptoms. A subset of parents completed EE measures again six and twelve months later. FMSS interrater reliability was lower in this sample than in previous studies. Stability was greater at one-year than at six-month follow-up, perhaps reflecting seasonal variations in child mood symptoms. Little evidence was found for validity of the EOI scale. Criticism was concurrently related to child, but not parent, variables. Mothers' criticism predicted child mood and anxiety symptoms one year later. EEAC scores remained stable over time. Child subscale scores were most strongly related to other child variables. Parent subscale scores were more strongly related to (open full item for complete abstract)

Committee: Mary Fristad (Advisor) Subjects:

Doctor of Philosophy, The Ohio State University, 2006, Human Development and Family Science

Past research has linked expressed emotion (EE) to a range of mental disorders and poor outcomes, including relapse of schizophrenia and depression in clinical populations. The present study attempted to demonstrate exploratory relationships between EE and psychopathology in a clinical sample (n = 61) of male and female adolescents placed in residential care. Additionally, this study included an examination of the potential impact that adolescent gender would have on the association between EE and psychopathology. While previous studies have documented differences between female and male adolescent rates of depression and other mood disorder-related issues, to date there has been little evidence regarding the impact gender may have on EE levels within the family system. A self-report adjective checklist designed to measure EE levels provided measurement of the adolescents' perspective on their mothers' recent affective attitudes displayed toward them, as well as the adolescents' own affective attitudes toward their mothers. Adolescent psychopathology was assessed through the use of a self-report measure completed by the adolescent. Results indicated that higher levels of EE were significantly related to higher levels of Hostility, Psychoticism, and Somatization. There were no significant gender differences on indicators of either EE or psychopathology. Subsequent analyses, after combining sub-scales of the EE measure, revealed that higher levels of EE negative adjectives were significantly associated with higher levels of the Global Severity Index (a sub-scale indicating global psychopathology), Hostility, and Psychoticism sub-scales, while the positive EE adjectives were significantly associated with the Somatization sub-scale. Finally, utilizing a multivariate analysis, positive EE adjectives were significantly associated with the Somatization sub-scale. The practical implications of the present study are discussed, as well as suggestions for future research.

Committee: Stephen Gavazzi (Advisor) Subjects:

Doctor of Philosophy, The Ohio State University, 2005, Psychology

Expressed emotion (EE) refers to critical or overinvolved communication styles within the home, and negative (‘high') EE has been linked to worse outcomes in adults and children with a variety of psychiatric disorders. The present study examined the relationship between parent factors (Axis I and Axis II psychopathology, current mood symptoms, knowledge of mood disorders) and child factors (current and worst mood severity and global functioning) and EE level in parents of children aged 8-11 with early-onset depression and bipolar disorder. Baseline data from mothers and fathers were examined separately using logistic and linear regressions. Data initially were analyzed using a dichotomous high versus low EE rating scored from the Five Minute Speech Sample (FMSS). In the mothers, lower child current global functioning and higher parent-reported current mood severity in the child were the only significant predictors of high EE status. For the fathers, only lower child current functioning was a significant predictor of high EE status. Next, data were analyzed using a continuous measure of critical comments obtained from the FMSS. In the mothers, lower child current functioning and higher parent-reported current mood severity in the child were significant predictors of critical comments made. No factors significantly predicted critical comments made by the fathers. Finally, EE was examined using a self-report Expressed Emotion Adjective Checklist, which provides a continuous scoring system of attitudes and behaviors expressed within parent-child dyads. For the mothers, all parent characteristics other than knowledge of mood disorders were significant predictors of more negative attitudes expressed by the parent toward the child. In the fathers, lower knowledge of mood disorders and higher Axis II Cluster B and Appendix B (depressive and negativistic personality disorders) symptoms were significant predictors of more negative attitudes expressed by the parent toward the (open full item for complete abstract)

Committee: Mary Fristad (Advisor) Subjects: