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Introduction: Expressed emotion (EE), the affective attitudes and behaviors of one toward another, can affect caregivers’ behaviors toward their child. Research examining associations between EE and child/family outcomes is mixed; these associations may be affected by other influences such as the presence of a chronic disease or parent mental health. In this study of families living in an urban area, we examined associations between EE and child outcomes (anxiety/depressive symptoms) and family functioning, with parent anxiety as a covariate. We evaluated child asthma status as a moderator in these associations as the presence of a chronic illness may strengthen the association between EE and child/family outcomes.
Methods: 96 children (mean±SD age=8.83±2.03 years, 48.9% female, 92.6% African American; 47 with asthma) and their parents (81.3% annual household income<$25,000) completed an observational study including interviews and questionnaires. Measures included the Multidimensional Anxiety Scale for Children (MASC), Children’s Depressive Symptoms Inventory (CDI), Self-Report Family Inventory (SFI), Generalized Anxiety Disorder scale (GAD-7), and Five-Minute Speech Sample (FMSS) coded for EE. To examine study aims, regression analyses were conducted using PROCESS macro version 3.1. Asthma status (yes/no) was examined as a moderator.
Results: EE was associated with child anxiety symptoms, child depressive symptoms, and family functioning, controlling for parent anxiety symptoms (F(1,70) =6.74, p=.011; F(1,69) =7.803, p=.007; F(1,68) =8.637, p=.004). Asthma status did not moderate any of the associations.
Conclusions: Results suggested that high levels of caregiver EE were associated with child mental health symptoms and family functioning, but asthma status did not moderate associations. It is possible that regardless of additional family demands related to asthma, EE is associated with child mental health and family functioning. Further examination into other systemic stressors that may moderate these associations is warranted, as well as the impact that minimizing parent anxiety might have on overall EE.
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