title: The effect of parental expressed emotion on glycaemic control in children with Type 1 diabetes. Parental expressed emotion and glycaemic control in children.
abstract: OBJECTIVE
  To measure expressed emotion (EE) in parents of young children with diabetes and to examine the relation between EE and glycaemic control in children with Type 1 diabetes in a longitudinal study over 24 months. We hypothesised that good glycaemic control, as measured by low glycated haemoglobin levels, would be predicted by high parental emotional over-involvement, low frequency of critical comments and absence of hostility. We predicted that these effects would be stronger in maternal than paternal scores.
  
  
  METHODS
  Forty-seven children attending a Paediatric Diabetes Clinic and their parents were studied over 24 months. Glycated haemoglobin was measured on three occasions, at the start of the study period, 12 and 24 months later. At 12 months, parental EE was measured using an adapted version of the Camberwell Family Interview, and child emotional and behavioural problems were measured using the parent version of the Child Behavior Checklist. Multiple regression models were used to test the hypotheses.
  
  
  RESULTS
  Forty-three maternal and 33 paternal interviews of adequate quality for analysis were obtained. Paternal hostility was found to be associated with elevated glycated haemoglobin measured 12 months before interview and 12 months after interview, accounting for 22% and 29% of the variation in glycated haemoglobin respectively.
  
  
  CONCLUSIONS
  We did not find that parental emotional over-involvement or criticism predicted glycaemic control. Presence of hostility was important, but in contrast to our hypothesis, this was paternal rather than maternal hostility. We suggest that (i) relatively absent, rejecting fathers play little role in diabetes management and children perceive this negatively, or (ii) mothers who are unsupported by fathers cannot in turn support their children in diabetes care.
authors.affiliation: Academic Unit of Psychiatry and Behavioural Sciences, Child and Adolescent Psychiatry, School of Medicine, University of Leeds, 12A Clarendon Road, LS2 9NN, Leeds, UK.
authors.forename: Anne
authors.initials: A
authors.lastname: Worrall-Davies
authors.forename: David
authors.initials: D
authors.lastname: Owens
authors.forename: Philip
authors.initials: P
authors.lastname: Holland
authors.forename: David
authors.initials: D
authors.lastname: Haigh
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000473:pathology / Q000523:psychology*; D019260:Expressed Emotion; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006791:Hostility; D006801:Humans; D007003:Hypoglycemia; D008297:Male; D010287:Parent-Child Relations
chemical_list: D006442:Glycated Hemoglobin