Emotional Overinvolvement with Adolescents: a Problematic Construct?

Purpose of review: The purpose of the current study was to examine emotional overinvolvement (EOI) among caregivers of adolescents with a range of physical and psychiatric disorders to determine whether it is a problematic construct. Recent findings: Expressed emotion is a robust predictor of treatment dropout, outcome, and relapse across a range of physical and psychiatric disorders. The two components of expressed emotion that have received the most research attention are criticism and EOI. Although criticism plays a significant role in treatment outcome, evidence is mixed for EOI, particularly in children and adolescent populations. Forty-seven articles published between 2000 and 2018 were included in the current review, covering eating disorders, depression and bipolar disorder, ADHD, internalizing/externalizing behaviors, nonsuicidal self-injury/parasuicide, schizophrenia/psychosis, autism, posttraumatic stress, tic disorders, general psychopathology, and a number of medical illnesses. Summary: The majority of studies did not find a relationship between EOI and problematic symptoms or behaviors, and several found that EOI was associated with improved outcome. It is possible that EOI may be appropriate for caregivers of adolescents with a physical or psychiatric illness, or that a number of disparate constructs are being assessed by current measures of EOI. Avenues for future research are discussed.