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Nobakht HN, Steinsbekk S, Wichstrøm L. Development of symptoms of oppositional defiant disorder from preschool to adolescence: the role of bullying victimization and emotion regulation. J Child Psychol Psychiatry 2024; 65:343-353. [PMID: 37258090 DOI: 10.1111/jcpp.13845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Childhood oppositional defiant disorder (ODD) is associated with adverse outcomes which can continue to impair life well into adulthood. Identifying modifiable etiological factors of ODD is therefore essential. Although bullying victimization and poor emotion regulation are assumed to be risk factors for the development of ODD symptoms, little research has been conducted to test this possibility. METHODS A sample (n = 1,042) from two birth cohorts of children in the city of Trondheim, Norway, was assessed biennially from age 4 to 14 years. Parents and children (from age 8) were assessed with clinical interviews to determine symptoms of ODD, children reported on their victimization from bullying, and teachers reported on children's emotion regulation. RESULTS Oppositional defiant disorder symptoms increased from age 4 to 6, from age 8 to 10, and then started to wane as children entered adolescence. A Random Intercept Cross-Lagged Panel Model revealed that increased emotion regulation predicted a reduced number of ODD symptoms across development (β = -.15 to -.13, p < .001). This prediction was equally strong for the angry/irritable and argumentative/defiant dimensions of ODD. No longitudinal links were observed between bullying victimization and ODD symptoms. CONCLUSIONS Improving emotion regulation skills may protect against ODD symptoms throughout childhood and adolescence.
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Affiliation(s)
- Habib Niyaraq Nobakht
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Silje Steinsbekk
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Lars Wichstrøm
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Child and Adolescent Psychiatry, St Olavs Hospital, Trondheim, Norway
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Böttinger BW, Aggensteiner PM, Hohmann S, Heintz S, Ruf M, Glennon J, Holz NE, Banaschewski T, Brandeis D, Baumeister S. Exploring real-time functional magnetic resonance imaging neurofeedback in adolescents with disruptive behavior disorder and callous unemotional traits. J Affect Disord 2024; 345:32-42. [PMID: 37852585 DOI: 10.1016/j.jad.2023.10.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/24/2023] [Accepted: 10/08/2023] [Indexed: 10/20/2023]
Abstract
INTRODUCTION Adolescents with increased callous unemotional traits (CU traits) in the context of disruptive behavior disorder (DBD) show a persistent pattern of antisocial behavior with shallow affect and a lack of empathy or remorse. The amygdala and insula as regions commonly associated with emotion processing, empathy and arousal are implicated in DBD with high CU traits. While behavioral therapies for DBD provide significant but small effects, individualized treatments targeting the implicated brain regions are missing. METHODS In this explorative randomized controlled trial we randomly assigned twenty-seven adolescents with DBD to individualized real-time functional magnetic resonance neurofeedback (rtfMRI-NF) or behavioral treatment as usual (TAU). Visual feedback of either amygdala or insula activity was provided during rtfMRI-NF by gauges and included a simple and concurrent video run plus a transfer run. A linear mixed model (LMM) was applied to determine improvement of self-regulation. Specificity was assessed by correlating individual self-regulation improvement with clinical outcomes. RESULTS The rtfMRI-NF (n = 11) and TAU (n = 10) completers showed comparable and significant clinical improvement indicating neither superiority nor inferiority of rtfMRI-NF. The exploratory LMM revealed successful learning of self-regulation along the course of training for participants who received feedback from the amygdala. A significant exploratory correlation between individual target region activity in the simple run and clinical improvement was found for one dimension of DBD. CONCLUSIONS This exploratory study demonstrated feasibility and suggests clinical efficacy of individualized rtfMRI-NF comparable to active TAU for adolescents with DBD and increased CU traits. Further studies are needed to confirm efficacy, specificity and to clarify underlying learning mechanisms.
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Affiliation(s)
- Boris W Böttinger
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Pascal-M Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Heintz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Matthias Ruf
- Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jeffrey Glennon
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands; Conway Institute of Biomolecular and Biomedical Research, School of Medicine, University College Dublin, Dublin, Ireland
| | - Nathalie E Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Donders Center for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, the Netherlands; Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH, Zurich, Zurich, Switzerland
| | - Sarah Baumeister
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
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Riise EN, Wergeland GJH, Njardvik U, Öst LG. Cognitive behavior therapy for externalizing disorders in children and adolescents in routine clinical care: A systematic review and meta-analysis. Clin Psychol Rev 2020; 83:101954. [PMID: 33418192 DOI: 10.1016/j.cpr.2020.101954] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/09/2020] [Accepted: 11/23/2020] [Indexed: 12/11/2022]
Abstract
Various Cognitive Behavioral Therapy (CBT) programs for externalizing disorders in children and adolescents are supported by a substantial body of empirical evidence. Most of the research evidence comes from efficacy studies conducted in university settings, but there is less knowledge about the effect of these treatments in routine clinical care. The purpose of this meta-analysis was to investigate the effectiveness of CBT in non-university settings for Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD). Embase OVID, Ovid MEDLINE and PsycINFO were systematically searched for eligible studies published up to May 2020. In total, 51 treatment effectiveness studies involving 5295 patients were included. The average within-group effect size at post-treatment was significant (g = 0.91), and there were large effect sizes for both ADHD (g = 0.80) and CD/ODD (g = 0.98). At post treatment, remission rates were 38% for ADHD and 48% for CD/ODD, and the overall attrition rate was 14%. Benchmarking against efficacy studies showed that CBT in routine clinical care yields remission rates, within-group effect sizes and attrition rates that are very similar to those found in university settings. The findings support the transportability of CBT for externalizing disorders from university settings to routine clinical care. PROSPERO registration: CRD42020147524.
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Affiliation(s)
- Eili N Riise
- Department of Child and Adolescent Psychiatry, District General Hospital of Førde, Førde, Norway.
| | - Gro Janne H Wergeland
- Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Norway
| | - Urdur Njardvik
- Department of Psychology, University of Iceland, Reykjavik, Iceland
| | - Lars-Göran Öst
- Department of Psychology, Stockholm University, Stockholm, Sweden; Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
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Granski M, Javdani S, Anderson VR, Caires R. A Meta-Analysis of Program Characteristics for Youth with Disruptive Behavior Problems: The Moderating Role of Program Format and Youth Gender. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 65:201-222. [PMID: 31449683 PMCID: PMC8796870 DOI: 10.1002/ajcp.12377] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
There is high variability in efficacy for interventions for youth with disruptive behavior problems (DBP). Despite evidence of the unique correlates and critical consequences of girls' DBP, there is a dearth of research examining treatment efficacy for girls. This meta-analysis of 167 unique effect sizes from 29 studies (28,483 youth, 50% female; median age: 14) suggests that existing treatments have a medium positive effect on DBP (g = .33). For both boys and girls, the most effective interventions included (a) multimodal or group format, (b) cognitive skills or family systems interventions, and (c) length-intensive programs for (d) younger children. Boys demonstrated significantly greater treatment gains from group format interventions compared to girls, which is particularly important given that the group program format was the most prevalent format for boys and girls, with 14 studies involving 10,433 youth encompassing this category. This is the first meta-analysis to examine the effect of program characteristics in a sample of programs selected to be specifically inclusive of girls. Given that girls are underrepresented in intervention research on DBP, findings are discussed in terms of gender-responsive considerations and elucidating how key aspects of program structure can support more effective intervention outcomes for youth.
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Affiliation(s)
- Megan Granski
- Department of Applied Psychology, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA
| | - Shabnam Javdani
- Department of Applied Psychology, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA
| | | | - Roxane Caires
- Department of Applied Psychology, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA
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Hendriks AM, Bartels M, Colins OF, Finkenauer C. Childhood aggression: A synthesis of reviews and meta-analyses to reveal patterns and opportunities for prevention and intervention strategies. Neurosci Biobehav Rev 2018; 91:278-291. [PMID: 29580961 DOI: 10.1016/j.neubiorev.2018.03.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/19/2018] [Accepted: 03/20/2018] [Indexed: 01/27/2023]
Abstract
This study provides a synthesis of meta-analyses and systematic reviews on non-pharmacological treatments for childhood aggression. Treatments referred to universal prevention, selective prevention, indicated prevention, or intervention (Mrazek and Haggerty, 1994). Seventy-two meta-analyses and systematic reviews met the inclusion criteria. We describe their characteristics, effect sizes across types of treatments, and the effects of various moderators. For universal and selective prevention, effects were mostly absent or small; for indicated prevention and interventions, effects were mostly small or medium. Only two moderators had a positive effect on treatment effectiveness, namely pre-test levels of aggression and parental involvement. These results identified similarities between indicated prevention and intervention treatments, on the one hand, and universal prevention and selective prevention, on the other. Our findings suggest that research distinguishing between targets of treatments (i.e., factors associated with childhood aggression vs. present aggressive behaviors) would be promising. Moreover, to further increase effectiveness of treatments for childhood aggression, individual differences warrant scientific attention.
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Affiliation(s)
- A M Hendriks
- Department of Biological Psychology, Vrije Universiteit Amsterdam, van den Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - M Bartels
- Department of Biological Psychology, Vrije Universiteit Amsterdam, van den Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - O F Colins
- Department of Child and Adolescent Psychiatry, Leiden University Medical Centre, Endegeesterstraatweg 27, 2342 AK Oegstgeest, The Netherlands.
| | - C Finkenauer
- Department of Biological Psychology, Vrije Universiteit Amsterdam, van den Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; Interdisciplinary Social Sciences: Youth Studies, Utrecht University, Faculty of Social and Behavioural Sciences, Martinus J. Langeveld Building, Heidelberglaan 1, 3584 CH Utrecht, The Netherlands.
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McCart MR, Sheidow AJ. Evidence-Based Psychosocial Treatments for Adolescents With Disruptive Behavior. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2016; 45:529-563. [PMID: 27152911 PMCID: PMC5055452 DOI: 10.1080/15374416.2016.1146990] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This article updates the earlier reviews of evidence-based psychosocial treatments for disruptive behavior in adolescents (Brestan & Eyberg, 1998; Eyberg, Nelson, & Boggs, 2008), focusing primarily on the treatment literature published from 2007 to 2014. Studies were identified through an extensive literature search and evaluated using Journal of Clinical Child and Adolescent Psychology (JCCAP) level of support criteria, which classify studies as well-established, probably efficacious, possibly efficacious, experimental, or of questionable efficacy based on existing evidence. The JCCAP criteria have undergone modest changes in recent years. Thus, in addition to evaluating new studies from 2007 to 2014 for this update, all adolescent-focused articles that had been included in the 1998 and 2008 reviews were reexamined. In total, 86 empirical papers published over a 48-year period and covering 50 unique treatment protocols were identified and coded. Two multicomponent treatments that integrate strategies from family, behavioral, and cognitive-behavioral therapy met criteria as well-established. Summaries are provided for those treatments, as well as for two additional multicomponent treatments and two cognitive-behavioral treatments that met criteria as probably efficacious. Treatments designated as possibly efficacious, experimental, or of questionable efficacy are listed. In addition, moderator/mediator research is summarized. Results indicate that since the prior reviews, there has been a noteworthy expansion of research on treatments for adolescent disruptive behavior, particularly treatments that are multicomponent in nature. Despite these advances, more research is needed to address key gaps in the field. Implications of the findings for future science and clinical practice are discussed.
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