Journal of Consulting and Clinical Psychology (2003) 71(5) : 935-944. doi: 10.1037/0022-006X.71.5.935 The Impact of Maternal Depression on Adolescent Adjustment : The Role of Expressed Emotion Denise R. Nelson 1 , Constance Hammen 2 , Patricia A. Brennan 3 , Jodie B. Ullman 4 1 Department of Psychiatry and Neuropsychiatric Institute, University of California, Los Angeles 2 Department of Psychology, University of California, Los Angeles 3 Department of Psychology, Emory University 4 Department of Psychology, California State University, San Bernardino Abstract The present study evaluated the role of expressed emotion (EE) as a predictor of child symptomatology and functional impairment in a sample of nearly 800 adolescent children of mothers with varying histories of depression or who were nondepressed. Structural equation modeling was used to test the hypothesized associations in half of the sample, and all models were cross-validated on the other half of the study sample. Results indicated that EE criticism and degree of maternal depression both had independent predictive associations with youths’ externalizing symptoms and functional impairment. In addition, high EE criticism served as an intervening variable between maternal depression and child functioning (externalizing symptoms and functional impairment). Results are discussed in terms of the mutual effects of depressed mothers and dysfunctional youths on each other. The purpose of the present study is to address unresolved issues about expressed emotion (EE) as a risk marker for children’s negative outcomes and to test the hypothesis that degree of maternal depression predicts maternal EE, which functions as an intervening variable between maternal depression and child disorder and dysfunction. The construct of negative EE (high EE) has been empirically successful as a predictor of relapse in schizophrenia and other adult psychopathology including mood disorders (e.g., Butzlaff & Hooley, 1998; Coiro & Gottesman, 1996). Although lacking a clear theoretical basis (e.g., Coiro & Gottesman, 1996; Hooley, 1985), EE is thought to reflect the emotional atmosphere of the family. An assumption of the EE construct is that the way parents/partners talk about their psychiatrically impaired relative to an interviewer mirrors the way the relative is treated on a daily basis. Negative attitudes reflecting high EE may serve as stressors that increase the likelihood that the vulnerable individual will experience symptomatology or relapse (Butzlaff & Hooley, 1998; Coiro & Gottesman, 1996). More recent studies have also begun to focus on more specific processes consistent with high EE; specifically, current studies have distinguished between different subtypes of high EE-criticism and emotional overinvolvement (EOI). EE research has also been extended to child samples and has been identified as a correlate or risk factor for child psychopathology (e.g., Hibbs et al., 1991; Kershner, Cohen, & Coyne, 1996; Schwartz, Dorer, Beardslee, Lavori, & Keller, 1990). Several studies have found that maternal EE criticism is an especially potent predictor of children’s disorders (e.g., Asarnow, Tompson, Hamilton, Goldstein, & Guthrie, 1994; Asarnow, Tompson, Woo, & Cantwell, 2001; Goodman, Adamson, Riniti, & Cole, 1994; Hirshfield, Biederman, Brody, Faraone, & Rosenbaum, 1997; Vostanis, Nicholls, & Harrington, 1994). Despite strong evidence of its association with children’s disorders, there are several conceptual and empirical gaps in the use of EE in predicting children’s outcomes. Conceptually, as noted, it is generally assumed that high EE is a stressor that provokes increased symptoms in the target. However, the construct of EE has an unclear association with caretaker symptomatology; thus, the EE constructs of criticism or emotional overinvolvement might simply reflect symptomatology in