title: How does longitudinally measured maternal expressed emotion affect internalizing and externalizing symptoms of adolescents from the general community?
abstract: BACKGROUND
  In previous studies, maternal expressed emotion (EE) has been found to be a good predictor of the course of adolescent internalizing and externalizing symptoms. However, these studies have been cross-section as opposed to longitudinal. The goal of this study is to examine longitudinal data of perceived maternal EE and adolescent internalizing and externalizing symptoms to determine if maternal EE affected the course of adolescent symptoms (a parent effect model), or if the course of adolescent symptoms affected maternal EE (a child effect model), or if maternal EE and adolescent symptoms affected one another bidirectionally.
  
  
  METHODS
  Dutch adolescents (N = 497; 57% boys; M = 13 years) from the general community and their mothers were prospectively studied annually for three years. At all waves the mothers completed the Level of Expressed Emotion (LEE) questionnaire and the adolescents completed self-rated measures of internalizing and externalizing symptoms. Structural equation modeling (SEM) was used to analyze the longitudinal data.
  
  
  RESULTS
  The results of the SEM analyses clearly demonstrate that a child effect model best describes the relationship between maternal EE and the course of adolescent internalizing and externalizing symptoms.
  
  
  CONCLUSIONS
  This longitudinal study of the mothers' EE perceptions suggests that it is the course of the internalizing and externalizing symptoms of adolescents from the general community that affects maternal EE, and not the mothers' perceived EE influencing the course of the adolescents' symptoms. Since this study was based on adolescents from the general community, it is suggested that these findings should also be replicated in clinical samples of adolescents.
authors.affiliation: Research Center Adolescent Development at Utrecht University, The Netherlands. b.hale@uu.nl
authors.forename: William W
authors.initials: WW
authors.lastname: Hale
authors.forename: Loes
authors.initials: L
authors.lastname: Keijsers
authors.forename: Theo A
authors.initials: TA
authors.lastname: Klimstra
authors.forename: Quinten A W
authors.initials: QA
authors.lastname: Raaijmakers
authors.forename: Skyler
authors.initials: S
authors.lastname: Hawk
authors.forename: Susan J T
authors.initials: SJ
authors.lastname: Branje
authors.forename: Tom
authors.initials: T
authors.lastname: Frijns
authors.forename: Saskia A M
authors.initials: SA
authors.lastname: Wijsbroek
authors.forename: Pol
authors.initials: P
authors.lastname: van Lier
authors.forename: Wim H J
authors.initials: WH
authors.lastname: Meeus
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology*; D019260:Expressed Emotion; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007389:Internal-External Control; D007604:Juvenile Delinquency / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D009426:Netherlands; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D011795:Surveys and Questionnaires