Expressed Emotion In Parents Of Behaviourally Disturbed Learning Disabled Children
Expressed emotion (EE) represents a measure of the emotional quality of the relationship between a key caregiver and relative, where the latter is experiencing a psychiatric or medical condition, and with implications for the course of this condition. To the author's knowledge, despite the salience of behavioural disturbance for families with learning disabled children, no published study has specifically investigated the relationship between parental EE and child behavioural disturbance. The current study focused on a comparison of high and low EE households with regards to child behavioural disturbance, parental stress and coping, and service and respite care usage. Forty parents were interviewed with a modified Camberwell Family Interview. The results showed no significant difference between high and low EE groups with regards to child behavioural disturbance, parental coping as related to factors such as social support and familial resources, and service and respite care usage. High EE parents reported significantly higher levels of stress and significantly less use of support and advice outside the family system than low EE parents. The findings conflict with conclusions from EE research e.g . with learning disabled adolescents, dementia and non-learning disabled children, which have demonstrated a relationship between EE and behavioural disturbance, but concur with studies, mainly with regards to schizophrenia, which have found that level of EE is independent of behavioural disturbance. Thus level of EE in the current study appears principally to reflect parental characteristics as opposed to child-related characteristics. The results suggest that a focus on parental psychological needs in relation to both the emotional quality of the parent-child relationship, and the care of the child more generally, might be more appropriate for both parents and children, as opposed to a traditional child-centric service delivery . Further research is required to elucidate the relationship between EE and behaviour, and there is value in exploring the relationship between EE and behaviour over time, within a longitudinal design. Indeed, the scope for further study of EE in the area of learning disability is tremendous, and the inherent modifiability of the EE construct renders it an appealing guide in terms of service development and outcome evaluation.
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