Maternal expressed emotion and adjustment in children with epilepsy

Epilepsy in childhood may alter family relationships but the relevance of t hese changes for the increased rates of psychopathology has been little inv estigated. This study uses maternal expressed emotion (EE) to examine famil y relationships of children with epilepsy and the association with high ris k for psychiatric disorder. EE was assessed using the Camberwell Family Int erview carried out with the mothers of 22 schoolchildren with chronic epile psy who were attending a general hospital outpatient clinic. Sixteen of the se children had similarly aged healthy siblings who served as controls. Hig h risk for psychiatric disorder in the children and mothers was assessed us ing behavioural, mood, and self-esteem questionnaires completed by mothers, teachers, and children. It was found that mothers showed significantly mor e emotional overinvolvement and a trend for more hostility towards their ch ildren with epilepsy than towards sibling controls. For the 22 children wit h epilepsy, maternal emotional overinvolvement was not associated with chil d behavioural deviance. High levels of criticism and, to a lesser extent, h ostility did show associations with child behavioural deviance, and the str ongest links were between maternal criticism and maternal rated antisocial and overactive behaviour in the child. Fewer positive comments by mothers t owards the children were associated with child emotional symptoms and lower self-esteem in a number of areas. This study suggests that further researc h could consider the appropriateness of psychological intervention for fami lies in which mothers are critical and hostile and whose children show anti social behaviour.