Expressed Emotion in Families of Patients with Eating Disorders: A Review of the Literature

Objective: To review studies assessing Expressed Emotion among parents/relatives of patients with Anorexia Nervosa and Bulimia Nervosa. Method: A systematic computerized search was performed in Medline complemented by a manual search of the literature for all studies published between 1981 and 2011. A total of 27 papers in English were reviewed for their methods, instruments used and results. Results: Comparisons were not easy due to methodological disparities in assessments. Levels of Expressed Emotion depend concurrently on parental characteristics (parent assessed, social status and psychological distress), patient characteristics (age, social adjustment) and Eating Disorders characteristics (type of Eating Disorders, duration and severity of illness and previous treatment). Expressed Emotion has a predictive value for patient outcome and for compliance with/ and implication in treatment. Levels of Expressed Emotions vary with the parent assessed. The crosscultural aspects of Expressed Emotion in Eating Disorders are not widely documented. Discussion: Both positive and negative aspects of Expressed Emotion are important therapeutic targets and further research on this topic is needed.