The Five Minute Speech Sample in Children with Asthma: Deconstructing the Construct of Expressed Emotion

• Published in: Journal of child psychology and psychiatry 2000-10, Vol.41 (7), p.887-898
• Main Authors: Wamboldt, Frederick S., O'Connor, Shannon L., Wamboldt, Marianne Z., Gavin, Leslie A., Klinnert, Mary D.
• Format: Article
• Language: English
• Subjects: Adolescent; Age Factors; Asthma; Asthma - psychology; Biological and medical sciences; Case-Control Studies; Child; Child psychology; Children; Children & youth; chronic asthma; Chronic Disease; criticism; emotional overinvolvement; Emotions; Expressed Emotion; Expressed emotions; Female; Five Minute Speech Sample; Humans; Inpatients - psychology; Male; Medical sciences; Outpatients - psychology; parent-child conflict; Parent-Child Relations; Parents & parenting; Patient Compliance - psychology; Psychiatric Status Rating Scales; Psychological tests; Psychology. Psychoanalysis. Psychiatry; Psychometrics; Psychometrics. Diagnostic aid systems; Psychopathology. Psychiatry; Reproducibility of Results; Severity of Illness Index; Speech; Techniques and methods
• ISSN: 0021-9630; 1469-7610
• DOI: 10.1111/1469-7610.00676

Objective: To use the Five Minute Speech Sample (FMSS) to assess Expressed Emotion (EE) in various samples of children with asthma in order to clarify (1) developmental and validity issues for the EE construct and (2) the use of the FMSS technique, specifically, in children with chronic medical illness. Method: Data were collected on a sample of 84 adolescents with severe, chronic asthma who had failed outpatient management. In addition, a sample of 30 children with asthma, ages 6–9, were recruited from an outpatient pediatric clinic. A comparison sample of 15 children without any chronic illness, ages 6–9, were recruited by notices posted in the community. The primary caregiver of each child was assessed using the FMSS. Results: FMSS interviews were reliability coded in all samples. Rates of high Criticism (FMSS CRIT), Emotional Overinvolvement (FMSS EOI), and EE were comparable to rates previously reported in child and adolescent samples. Although the validity for ratings of FMSS CRIT was well supported, the validity of FMSS EOI ratings and the overall EE construct were more problematic. Conclusions: The FMSS is a useful and largely valid measure in children with asthma. Ratings of FMSS CRIT were found to have strong validity. There was little problem shifting the context of FMSS administration from chronic mental to chronic medical illness, but a variety of developmental considerations arose, especially regarding FMSS EOI ratings. Although we raise concerns about viewing EE as a valid construct, it may remain a useful predictive index.