title: Expressed emotion in eating disorders assessed via self-report: an examination of factors associated with expressed emotion in carers of people with anorexia nervosa in comparison to control families.
abstract: OBJECTIVE
  High expressed emotion (EE) has been linked to outcome in anorexia nervosa (AN). Traditional interview measures of EE require considerable resources. The aim was to compare EE, measured with a self report tool, in parents of people with AN (carers; N = 151) with that of parents of healthy people (controls; N = 93), and to explore factors associated with EE.
  
  
  METHODS
  A cross-sectional design was used to assess EE (Family Questionnaire) and psychological distress (Hospital Anxiety and Depression Scale).
  
  
  RESULTS
  Over 60% (96/151) of carers showed high emotional over-involvement (EOI) compared with 3% (3/93) of controls, whereas 47% (71/151) of carers showed high criticism (CC) compared with 15% (14/93) of controls. The most significant variable related to CC was "negative/difficult behaviors," and anxiety, for EOI.
  
  
  CONCLUSIONS
  The FQ was sensitive both to CC and EOI. Interventions aimed at reducing EE may need to focus on decreasing carers' anxiety and teaching skills to moderate difficult behaviors.
authors.affiliation: Section of Eating Disorders, Institute of Psychiatry, King's College London, London, United Kingdom. o.kyriacou@iop.kcl.ac.uk
authors.forename: Olivia
authors.initials: O
authors.lastname: Kyriacou
authors.forename: Janet
authors.initials: J
authors.lastname: Treasure
authors.forename: Ulrike
authors.initials: U
authors.lastname: Schmidt
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D019260:Expressed Emotion; D001068:Feeding and Eating Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015588:Observer Variation; D010361:Patients / Q000523:psychology* / Q000706:statistics & numerical data*; D015995:Prevalence; D011594:Psychometrics; D012307:Risk Factors; D011795:Surveys and Questionnaires