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High expressed emotion (EE) attitudes among parents are associated with an increased likelihood of relapse among bipolar patients, but the origins of these attitudes are unclear. This study examined characteristics of bipolar disorder in adolescents that might be associated with high EE attitudes among parents. We hypothesized that an earlier onset of mood disorder and greater current illness severity would predict higher levels of criticism and emotional overinvolvement among parents. Demographic, diagnostic, and EE data were collected from interviews with parents of 44 bipolar adolescents (mean age 14.5 yrs.). Current illness severity and functioning were not associated with high-EE attitudes. Parents of girls, however, were more likely to be high in criticism than parents of boys. Parents of girls expressed more critical comments when the child had an adolescent compared to a childhood onset of bipolar disorder, whereas the reverse pattern was evident among parents of boys. We encourage prospective investigations of the developmental correlates of parental EE attitudes in larger, more heterogeneous samples of bipolar adolescents and children.

Original publication




Journal article


J Clin Psychol

Publication Date





438 - 449


Adaptation, Psychological, Adolescent, Antimanic Agents, Attitude, Bipolar Disorder, Combined Modality Therapy, Expressed Emotion, Family Therapy, Female, Humans, Interview, Psychological, Male, Parent-Child Relations, Personality Assessment, Psychometrics, Sex Factors, Social Adjustment