Mother and adolescent expressed emotion and adolescent internalizing and externalizing symptom development: a six-year longitudinal study.

In expressed emotion (EE) theory, it is held that high EE household environments enhance adolescent psychopathological distress. However, no longitudinal study has been conducted to examine if either the mother's EE or the adolescent's perception of EE predicts adolescent internalizing and externalizing symptom dimensions (an EE effect model) or vice versa (psychopathological effect model) together in one model. To unravel the reciprocal influences of maternal and adolescent perceived EE to adolescent internalizing and externalizing symptom dimensions, we tested two (i.e., one for internalizing and one for externalizing) cross-lagged panel models. In this study, it was found that both internalizing and externalizing symptom dimensions predicted the adolescent's perception of maternal EE as well as the mother's own rated EE criticism over time. The findings of this study should give both researchers and therapists a reason to reevaluate only using the EE effects model assumption in future EE studies.