Category: Parenting / Families


Expressed Emotion and Eating Disorders

Sunday, November 19
8:30 AM - 10:00 AM
Location: Cobalt 502, Level 5, Cobalt Level

Keywords: Eating Disorders | Families | Adolescents
Presentation Type: Symposium

Parental expressed emotion (EE) has been found to play an important role in treatment dropout and treatment outcome for individuals with eating disorders.  Prevalence rates of EE among families of adults and adolescents with anorexia nervosa and bulimia nervosa will be reviewed, as will relevance to caregiver well-being, family functioning, and patient treatment outcome.  High parental EE is associated with parental anxiety and depression and worse family functioning among patients with eating disorders.  In families of patients with anorexia nervosa, high parental EE has been associated with treatment dropout and poor treatment outcome, with some studies finding a particularly important role for maternal criticism, whereas parental warmth has been found to predict good treatment outcome.  In addition, the bidirectional nature of EE in adolescent eating disorders will be reviewed.  Specifically, family profiles of EE among adolescents with eating disorders and their parents reveal that adolescents with bulimia nervosa have better treatment outcomes when they are matched with their parents on EE level (low patient EE/low parent EE or high patient EE/high parent EE).  This is in contrast to adolescents with anorexia nervosa, who have better treatment outcomes when they are part of low parent EE families, regardless of the adolescent’s level of EE.  Differences in temperament that may explain these findings will be discussed.  Parental EE in the context of family-based treatment for adolescent anorexia nervosa will also be reviewed.  Patients of mothers high on EE have been found to do better in separated rather than conjoint family-based treatment, and high maternal hostility has been found to predict better outcome in individual therapy rather than family-based treatment.  Finally, interventions to reduce EE among families of individuals with eating disorders will be explored.  This may be particularly important for caregivers of adolescents, given that family-based treatment is considered by many to be the first-line treatment for adolescents with anorexia nervosa.  

Renee Rienecke

Assistant Professor
Florida International University


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Expressed Emotion and Eating Disorders

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