Associations between Parental Depression and Anxiety and Children’s Internalizing and Externalizing Problems: Investigating Expressed Emotion as a Transdiagnostic Mechanism

Parental psychopathology can influence the development of internalizing and externalizing problems in children through its effects on the emotional climate at home. Expressed Emotion (EE) is a measure of family climate that reflects the emotional quality of attributions parents make about their child and is proposed to be a transdiagnostic risk factor for the development of emotional and behavioral problems. The current study included children (N = 247; aged 4-7; 70.7% male) referred by teachers for emerging psychosocial problems at school and their caregivers. To assess psychopathology, parents completed the Hospital Anxiety and Depression Scale (HADS) and the Child Behavior Checklist (CBCL). The Five-Minute Speech Sample (FMSS) and Expressed Emotion Coding System [1] were used to measure EE. Correlations demonstrated that EE, symptoms of parental anxiety and depression, and child internalizing and externalizing problems were all significantly positively associated. Regression analyses revealed that EE was more strongly associated with severity of internalizing and externalizing problems than parental mental health symptoms. EE explained more variance in child internalizing problems than parental anxiety and was a particularly strong predictor of severity of externalizing problems in young children, alongside socioeconomic deprivation and parental anxiety. These findings support attributional models of EE and demonstrate its potential transdiagnostic role in the development of internalizing and externalizing problems in young children. This can inform the design of interventions to tackle emerging mental health problems in childhood.