TY - JOUR
T1 - Disentangling child and family influences on maternal expressed emotion toward children with attention-deficit/hyperactivity disorder
AU - Cartwright, Kim L.
AU - Bitsakou, Paraskevi
AU - Daley, David
AU - Gramzow, Richard H.
AU - Psychogiou, Lamprini
AU - Simonoff, Emily
AU - Thompson, Margaret J.
AU - Sonuga-Barke, Edmund J.S.
N1 - Funding Information:
Disclosure: Dr. Daley has served on the speakers' bureau for Janssen-Cilag, UCB, and Eli Lilly and Co. He has supervised doctoral students sponsored by Eli Lilly and Co. and Janssen-Cilag. He has received conference sponsorship from Eli Lilly and Co. He has received research support from Shire. Dr. Thompson has received educational sponsorship from, served on the speakers' bureau for, participated in drug trials with, and supervised doctoral students sponsored by Eli Lilly and Co. and Janssen-Cilag. She has received unrestricted research grants from Eli Lilly and Co. , Janssen-Cilag , UCB , and Shire . She has served on the advisory board for Eli Lilly and Co., UCB, and Shire. Dr. Sonuga-Barke has served on the speakers' bureau and as a consultant for Shire and UCB. He has received research support from Janssen-Cilag, Shire, Qbtech, and Flynn. He has served on the advisory board for Shire, Flynn, UCB, and AstraZeneca. He has received conference support from Shire. Drs. Bitsakou, Gramzow, Psychogiou, and Simonoff, and Ms. Cartwright report no biomedical financial interests or potential conflicts of interest.
PY - 2011/10
Y1 - 2011/10
N2 - Objective: We used multi-level modelling of sibling-pair data to disentangle the influence of proband-specific and more general family influences on maternal expressed emotion (MEE) toward children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Method: MEE was measured using the Five Minute Speech Sample (FMSS) for 60 sibling pairs (aged 5 through 17 years) each comprising one proband with ADHD and one child without ADHD. Questionnaire measures were used to assess child and adolescent conduct and emotional problems and maternal depression and ADHD. Multi-level models partitioned the effects of five MEE components (initial statement [IS], relationship [REL], warmth [WAR], critical comments [CC], and positive comments [PC]) into proband-specific and general family effects. Results: Significant proband-specific effects were confirmed for all MEE components, with higher levels of MEE expressed toward probands with ADHD than siblings without ADHD. For REL, PC, and CC, this effect was explained by comorbid child conduct problems rather than ADHD. Only low WAR was associated with child ADHD itself. Furthermore, only low WAR was related to variations in more general family characteristics, especially levels of maternal depression. Conclusions: MEE toward children with ADHD was influenced by proband-specific factors. For most components, these were driven by comorbid symptoms of conduct problems rather than ADHD itself. WAR was different; it was influenced by both child-specific and more general characteristics of the family. Further studies utilising a longitudinal design are required to establish the direction of causation and extend our understanding of the relationship between EE components and ADHD.
AB - Objective: We used multi-level modelling of sibling-pair data to disentangle the influence of proband-specific and more general family influences on maternal expressed emotion (MEE) toward children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Method: MEE was measured using the Five Minute Speech Sample (FMSS) for 60 sibling pairs (aged 5 through 17 years) each comprising one proband with ADHD and one child without ADHD. Questionnaire measures were used to assess child and adolescent conduct and emotional problems and maternal depression and ADHD. Multi-level models partitioned the effects of five MEE components (initial statement [IS], relationship [REL], warmth [WAR], critical comments [CC], and positive comments [PC]) into proband-specific and general family effects. Results: Significant proband-specific effects were confirmed for all MEE components, with higher levels of MEE expressed toward probands with ADHD than siblings without ADHD. For REL, PC, and CC, this effect was explained by comorbid child conduct problems rather than ADHD. Only low WAR was associated with child ADHD itself. Furthermore, only low WAR was related to variations in more general family characteristics, especially levels of maternal depression. Conclusions: MEE toward children with ADHD was influenced by proband-specific factors. For most components, these were driven by comorbid symptoms of conduct problems rather than ADHD itself. WAR was different; it was influenced by both child-specific and more general characteristics of the family. Further studies utilising a longitudinal design are required to establish the direction of causation and extend our understanding of the relationship between EE components and ADHD.
KW - ADHD
KW - child effects
KW - expressed emotion
KW - family effects
KW - sib-pairs
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U2 - 10.1016/j.jaac.2011.07.006
DO - 10.1016/j.jaac.2011.07.006
M3 - Article
C2 - 21961778
AN - SCOPUS:80053379950
SN - 0890-8567
VL - 50
SP - 1042
EP - 1053
JO - Journal of the American Academy of Child and Adolescent Psychiatry
JF - Journal of the American Academy of Child and Adolescent Psychiatry
IS - 10
ER -