Beyond Words: Associations between the Maternal Emotional Environment and Children's Internalizing and Externalizing Symptoms.

Mothers are rich sources of emotional information for children. Childhood emotional and behavioral problems have been associated with maternal anxiety, depression, Expressed Emotion (EE), and facial expressivity. However, no study has examined these factors together. The current study adopted a multimodal approach to assess how the maternal emotional environment relates to severity of internalizing and externalizing problems in children. The sample included children (N = 134; aged 4–7; 68.7% male) referred for assessment by teachers for exhibiting psychosocial problems at school. To assess psychopathology, parents completed the Hospital Anxiety and Depression Scale (HADS) and the Child Behavior Checklist (CBCL). EE was measured during the Five-Minute Speech Sample (FMSS) using the Expressed Emotion Coding System; facial expressivity was assessed using AFFDEX analysis during the FMSS. Maternal mental health, EE, facial expressivity, and child outcomes were significantly related. Regression analyses showed that fewer and less intense maternal facial anger expressions during negative comments were the best predictors of more severe child internalizing and externalizing problems, alongside EE. These findings highlight the role of the maternal expressed emotion over and above maternal mental health problems in children’s psychosocial problems and can inform the development of parenting and emotion-based interventions to tackle emerging mental health problems in children.