Restricted accessResearch articleFirst published online 2016-3
Parents’ expressed emotion and mood,rather than their physical disability are associated with adolescent adjustment: a longitudinal study of families with a parent with multiple sclerosis
This study investigated the impact of the severity of parental multiple sclerosis, parents’ expressed emotion and psychological well-being on offspring’s psychological difficulties.
Design:
A longitudinal study including baseline and 6-month follow-up data collected from parents and children.
Subjects:
Adolescents (n=75), their parents with multiple sclerosis (n=56) and the partner without multiple sclerosis (n=40).
Main measures:
Parents completed the Hospital Anxiety and Depression Scale and the Five Minutes Speech Sample, a standardised interview of expressed emotion towards their child. Parents with multiple sclerosis also completed the Expanded Disability Status Scale, a measure of illness severity. Adolescents completed the Strength and Difficulties Questionnaire, a self-report measure of psychological difficulties.
Results:
Higher depression scores of the parents with multiple sclerosis at baseline correlated with increased adolescents’ internalising symptoms at 6-month follow-up (γdep=0.31, P=.004). Higher expressed emotion scores of parents with multiple sclerosis at baseline were associated with increased adolescent externalising symptoms at 6-month follow-up (γEE=4.35, P=.052). There was no direct effect of severity, duration or type of multiple sclerosis on adolescents’ adjustment at baseline or follow-up.
Conclusions:
Emotional distress and expressed emotion in parents with multiple sclerosis, rather than the severity and type of multiple sclerosis had an impact on adolescents’ psychological difficulties.
SiehDSMeijerAMOortFJVisser-MeilyJMVan der LeijDA. Problem behavior in children of chronically ill parents: a meta-analysis. Clin Child Fam Psychol Rev2010; 13: 384–397.
2.
DeatrickJABrennanDCameronME. Mothers with multiple sclerosis and their children - Effects of fatigue and exacerbations on maternal support. Nurs Res1998; 47: 205–210.
3.
PakenhamKIBursnallS. Relations between social support, appraisal and coping and both positive and negative outcomes for children of a parent with multiple sclerosis and comparisons with children of healthy parents. Clin Rehabil2006; 20: 709–723.
4.
SteckBAmslerFGretherA. Mental health problems in children of somatically ill parents, e.g. multiple sclerosis. Eur Child Adolesc Psychiatry2007; 16:199–207.
5.
DiaremeSTsiantisJKolaitisG. Emotional and behavioural difficulties in children of parents with multiple sclerosis: a controlled study in Greece. Eur Child Adolesc Psychiatry2006; 15: 309–318.
6.
PakenhamKICoxS. Test of a model of the effects of parental illness on youth and family functioning. Health Psychol2012; 31: 580–590.
7.
BogosianAMoss-MorrisRHadwinJ. Psychosocial adjustment for children and adolescents with aparent with Multiple Sclerosis: a systematic review. Clin Rehabil2010; 24: 789–801.
8.
AsarnowJTompsonMHamiltonEGoldsteinMGuthrieD. 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 Psych1994; 22: 129–146.
9.
HirshfeldDRBiedermanJBrodyLFaraoneSVRosenbaumJF. Expressed emotion toward children with behavioral inhibition: associations with maternal anxiety disorder. J Am Acad Child Adolesc Psychiatry1997; 36: 910–917.
10.
PerisTSBakerBL. Applications of the Expressed Emotion Construct to Young Children with Externalizing Behavior: Stability and Prediction over Time. J Child Psychol Psych2000; 41: 457–462.
11.
PsychogiouLDaleyDMThompsonMJSonuga-BarkeEJ. Do maternal attention-deficit/hyperactivity disorder symptoms exacerbate or ameliorate the negative effect of child attention-deficit/hyperactivity disorder symptoms on parenting?Dev Psychopathol2008; 20: 121–137.
12.
BogosianAMoss-MorrisRBishopFLHadwinJ. How do adolescents adjust to their parent’s multiple sclerosis? An interview study. Br J Health Psychol2011; 16: 430–444.
13.
RomerGBarkmannCSchulte-MarkwortMThomallaGRiedesserP. Children of Somatically Ill Parents: A Methodological Review. Clin Child Psychol Psych2002; 7: 17–38.
14.
BowenJGibbonsLGianasAKraftGH. Self-administered Expanded Disability Status Scale with functional system scores correlates well with a physician-administered test. Mult Scler2001; 7: 201–206.
15.
ZigmondASSnaithRP. The Hospital Anxiety and Depression Scale. Acta Psychiatric Scandinavia. 1983; 67: 361–370.
16.
HerrmannC. International experiences with the Hospital Anxiety and Depression Scale-a review of validation data and clinical results. J Psychosom Res. 1997; 42:17–41.
17.
BjellandIDahlAAHaugTTNeckelmannD. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res2002; 52: 69–77.
18.
MaganaABGoldsteinJMKarnoMMiklowitzDJJenkinsJFalloonIR. A brief method for assessing expressed emotion in relatives of psychiatric patients. Psychiatry Res1986; 17: 203–212.
19.
BeckADaleyDHastingsRPStevensonJ. Mothers’ expressed emotion towards children with and without intellectual disabilities. J Intellect Disabil Res2004; 48: 628–638.
20.
DaleyDSonuga-BarkeEJThompsonM. Assessing expressed emotion in mothers of preschool AD/HD children: psychometric properties of a modified speech sample. Br J Clin Psychol2003; 42: 53–67.
21.
LandisJRKochGG. The measurement of observer agreement for categorical data. Biometrics. 1977; 33:159–174.
22.
GoodmanRScottS. Comparing the Strengths and Difficulties Questionnaire and the Child Behavior Checklist: Is Small Beautiful?J Abnorm Child Psych1999; 27: 17–24.
23.
GoodmanR. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry2001; 40: 1337–1345.
24.
GoodmanALampingDLPloubidisGB. When to use broader internalising and externalising subscales instead of the hypothesised five subscales on the Strengths and Difficulties Questionnaire (SDQ): data from British parents, teachers and children. J Abnorm Child Psych2010; 38: 1179–1191.
25.
Diez RouxAV. A glossary for multilevel analysis. J Epidemiol Community Health2002; 56: 588–594.
26.
AsarnowJRGoldsteinMJTompsonMGuthrieD. One-year outcomes of depressive disorders in child psychiatric in-patients: evaluation of the prognostic power of a brief measure of expressed emotion. J Child Psychol Psych1993; 34: 129–137.
27.
HibbsEDHamburgerSDLenaneM. Determinants of expressed emotion in families of disturbed and normal children. J Child Psychol Psych. 1991; 32:757–770.
28.
LiakopoulouMAlifierakiTKatideniouA. Maternal expressed emotion and metabolic control of children and adolescents with diabetes mellitus. Psychother Psychosom2001; 70: 78–85.
29.
StubbeDEZahnerGEGoldsteinMJLeckmanJF. Diagnostic specificity of a brief measure of expressed emotion: a community study of children. J Child Psychol Psych1993; 34: 139–154.
30.
BoltonCCalamRBarrowcloughC. Expressed emotion, attributions and depression in mothers of children with problem behaviour. J Child Psychol Psych2003; 44: 242–254.
BeardsleeWRVersageEMGladstoneTR. Children of affectively ill parents: a review of the past 10 years. J Am Acad Child Adoles Psych1998; 37: 1134–1141.
33.
HammenCBurgeDAdrianC. Timing of Mother and Child Depression in a Longitudinal-Study of Children at Risk. J Consult Clin Psych1991; 59: 341–345.
34.
EisenbergNGershoffETFabesRA. Mothers’ emotional expressivity and children’s behavior problems and social competence: Mediation through children’s regulation. Dev Psychol2001; 37: 475–490.
35.
McCartyCAWeiszJR. Correlates of expressed emotion in mothers of clinically-referred youth: an examination of the five-minute speech sample. J Child Psychol Psych2002; 43: 759–768.
