Maternal expressed emotion as a predictor of emotional and behavioral problems in low birth weight children

The purpose of this study was to determine the degree to which maternal emotions expressed toward low birth weight infants (<2500 gm) at six months of age predicted emotional and behavioral problems at two years of age. With a sample of 83 mother-infant dyads, a Revised Five Minute Speech Sample (R-FMSS) was used to measure the Expressed Emotion (EE) constructs of Negative EE (criticism, hostility), Positive EE (positive remarks, warmth) and Overinvolved EE. Problem behaviors were measured at two years of the child's age utilizing the Child Behavior Checklist/2-3. Infant temperament was controlled for using the Revised Infant Temperament Questionnaire. While temperament contributed the most variance to the development of emotional and behavioral problems, results indicated that Negative EE was a significant predictor of internalizing problems such as anxiety and withdrawal. The detrimental impact of Negative EE was most substantial for infants who adapted less readily to the demands of their environments and who had more difficulty persisting with a task or activity. Although Positive EE did not influence the incidence of problems for children in general, it did appear to reduce the likelihood of developing internalizing problems for more persistent children. Overinvolved EE showed no relationship to the incidence of problems reported for a child. Nurses are in the prime position to identify negative maternal-infant interactions during the first year of life that may place the low birth weight infant at risk for poor mental health outcomes.