Expressed Emotion in Families of 1-year-old Children


This study, in Child: Care, Health and Development, adds to the research that “high levels of expressed emotion (EE) in parents have been found to put (school-age) children at risk for emotional and behavioural problems” by extending the research into family environments of 1-year-olds. “By intervening earlier in children’s lives it may be possible to prevent the establishment of ‘coercive cycles’ of interaction, in which both the parent and the child reinforce each other’s maladaptive behaviour. These facets of the parent–child relationship might be potentially important targets for clinical intervention.”

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Psychogiou, L, Netsi, E., Sethna, V., Ramchandani, P.G; “Expressed emotion as an assessment of family environment with mothers and fathers of 1-year-old children.” Child: Care, Health and Development. Online July 9, 2012

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. It is a confusing term as they use it, but when I read the article, they seem to be talking about criticism and intense reactions to negative behavior, not verbal or non-verbal expression of emotion. “Emotional reactivity” might be a better term to describe it. Basically, it sounds like they are saying that hostility and criticism lead to more emotional problems, which should surprise nobody. Maybe they’ll argue that being criticized “imbalances your brain chemistry” to get around this one.

    Pretty obvious stuff, but I guess I’m glad someone is saying it.

    —- Steve

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  2. “Expressed emotion” is a bad, misleading name for this. It always turned me off because it seems to denigrate lots of positive emotions too, as well as expressing negative emotions in constructive ways – in contexts that let others know you aren’t attacking them, and let them know they don’t have to bury their own emotions to stay on your good side.

    It could take some thought to name this just right, but I think they are referring to the kinds of feelings and ways to express them toward oneself, one’s spouse and one’s child that we associate with being more hurtful than helpful. I may be expanding the concept here, but if so, it would still be interesting to explore it as expanded.

    To me, the importance of this study is that it addresses what has been suggested as a psychosocial contributor to schizophrenia. Studies show high EE in patients’ families is associated with bad outcomes when patients returns home. It’s easy to extend high EE in this context to high EE as a potential cause of schizophrenia. That then stirs up the debate over whether psychosocial family dynamics help cause schizophrenia, or whether medical model advocates and NAMI say no – that’s blaming the parents and the real problem is inherited brain defects.

    The medical model would say high EE in the family is likely caused BY the patient’s problems, not the cause OF his/her problems. This study sheds light on this – it takes parents of virtual newborns and shows high EE existed too early for a child’s not-yet-manifested “schizophrenia” (or whatever) to have caused the hight EE. If they later correlate negative child outcomes with high EE parents, it would support that EE DOES as a possible cause in the child’s negative outcome, and the child’s outcome did not cause the high EE.

    This debate over the direction of causality is pretty important.

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