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Marquet-Doléac J, Biotteau M, Chaix Y. Behavioral Parent Training for School-Aged Children With ADHD: A Systematic Review of Randomized Control Trials. J Atten Disord 2024; 28:377-393. [PMID: 38083879 DOI: 10.1177/10870547231211595] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND All guidelines for the treatment of ADHD in children include behavioral parent training in combination with other strategies. In the past, several systematic reviews have been carried out that were either outdated or not sufficiently specific to ADHD. We wanted to conduct a new review focusing on a specific ADHD population of school age (4-12 years) and on behavioral and cognitive programs. We aimed to test our hypothesis that behavioral parent training would improve parents' difficulties, children's symptomatology, and the quality of life of families with ADHD. METHODS PUBMED, PsychInfo, Web of Science, ERIC, and Cochrane databases were searched for original articles on randomized control trials on behavioral parent training group for children with ADHD aged from 4 to 12 years until July 2023. RESULTS A total of 20 studies were included in the systematic review. The results were divided into four categories: parent data, child data collected by parents, teachers, or researchers. A qualitative analysis revealed for parents, effects on parental stress, feelings of parental efficacy, and negative parental educational behavior. As regard children, only effects are noted for parental assessment, on ADHD symptomatology, externalized disorders, and social skills. CONCLUSION Despite the heterogeneity or small number of studies in some categories, BPTs have positive effects on both parents and children. There are no convincing results to support the generalization of progress. This would seem to indicate that it remains essential to consider actions specific to each problematic environment for the child.
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Affiliation(s)
- Jerome Marquet-Doléac
- University of Toulouse, INSERM, UPS, France
- University of Toulouse 3 Paul Sabatier, France
| | - Maëlle Biotteau
- University of Toulouse, INSERM, UPS, France
- Purpan University Hospital, Toulouse, France
| | - Yves Chaix
- University of Toulouse, INSERM, UPS, France
- Purpan University Hospital, Toulouse, France
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Miklósi M, Kovács B, Janovicz J, Lelki F, Kassai R. Adult attention-deficit/hyperactivity symptoms and parental cognitions: a meta-analysis. Front Psychiatry 2024; 14:1321078. [PMID: 38268568 PMCID: PMC10807045 DOI: 10.3389/fpsyt.2023.1321078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 11/27/2023] [Indexed: 01/26/2024] Open
Abstract
Introduction Attention-deficit/hyperactivity disorder (ADHD) symptoms in adults interfere with parental functioning. Dysfunctional parental cognitions may play a role in this impairment. Despite the importance of parental cognitions on parents and children's outcomes, up to now, no systematic review or meta-analysis of these findings is available. To fill this gap, this meta-analysis aimed to evaluate the relationship between adult ADHD symptoms and parental cognitions. Methods We conducted searches in Web of Science, PubMed, and ProQuest from January 2000 to June 2023. Studies were included if they provided data on the relationship between parental ADHD symptoms and parental cognitions by means of a row correlational coefficient, or means and standard deviation were reported for each study group. A random-effects model was used. Publication bias was assessed by funnel plot and Rosenthal's fail-safe N. Moderator analyses were conducted by means of subgroup analysis and meta-regression analyses. Results Fifteen published papers were included (N = 2851), and 51 effect sizes were analysed. The weighted mean effect size was small but significant (Fisher's Z = 0.186, k = 15, 95% CI [0.120 - 0.252], z = 5.539, p < 0.001), indicating that ADHD symptoms in adults are associated with more negative and less positive parental cognitions. The Fail-Safe N analysis suggested a robust effect. Tweedie's trim and fill results suggested that five studies were missing; after five missing studies had been imputed, the mean overall effect size dropped to 0.116 (0.080 - 0.152). There was significant heterogeneity among effect sizes. The methodology of the study was found to be a significant moderator. Meta-regression analyses revealed that the lower age of the parent and the child were related to more negative parental cognitions. Discussion Though the analysis might be inflated by publication bias, our results suggest a significant association between ADHD symptom level and dysfunctional parental cognitions. Biased negative perceptions of the parental role, the child and co-parenting may play a central mediator role between parental ADHD and parent and child outcomes. Given the familiar nature of ADHD, targeting dysfunctional parental cognitions in parent training programs is warranted. Systematic review registration osf.io/pnur7.
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Affiliation(s)
- Mónika Miklósi
- Psychological Institute, Eötvös Loránd University, Budapest, Hungary
- Department of Clinical Psychology, Semmelweis University, Budapest, Hungary
- Centre of Mental Health, Heim Pál National Paediatric Institute, Budapest, Hungary
| | - Barbara Kovács
- Psychological Institute, Eötvös Loránd University, Budapest, Hungary
| | - Júlia Janovicz
- Psychological Institute, Eötvös Loránd University, Budapest, Hungary
| | - Franciska Lelki
- Psychological Institute, Eötvös Loránd University, Budapest, Hungary
| | - Réka Kassai
- School of Doctoral Studies, Eötvös Loránd University, Budapest, Hungary
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3
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Doffer DPA, Dekkers TJ, Hornstra R, van der Oord S, Luman M, Leijten P, Hoekstra PJ, van den Hoofdakker BJ, Groenman AP. Sustained improvements by behavioural parent training for children with attention-deficit/hyperactivity disorder: A meta-analytic review of longer-term child and parental outcomes. JCPP ADVANCES 2023; 3:e12196. [PMID: 37720584 PMCID: PMC10501699 DOI: 10.1002/jcv2.12196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 08/02/2023] [Indexed: 09/19/2023] Open
Abstract
Background Behavioural parent training is an evidence-based intervention for children with attention-deficit/hyperactivity disorder (ADHD), but little is known about the extent to which initial benefits are maintained. Aims This meta-analytic review investigated longer-term (i.e., more than 2 months post-intervention) child and parental outcomes of behavioural parent training for children with ADHD. Materials & Methods We searched for randomized controlled trials and examined ADHD symptoms, behavioural problems, positive parenting, negative parenting, parenting sense of competence, parent-child relationship quality, and parental mental health as outcomes. We included 27 studies (31 interventions; 217 effect sizes), used multilevel random-effects meta-analyses for between- and within-group comparisons (pre-intervention to follow-up and post-intervention to follow-up), and explored twelve predictors of change. Results Between pre-intervention and follow-up (M = 5.3 months), we found significant small-to-moderate between-group effects of the intervention on ADHD symptoms, behavioural problems, positive parenting, parenting sense of competence and parent-child relationship quality. Within-group findings show sustained improvements in the intervention conditions for all outcome domains. There were few significant changes from post-intervention to follow-up. Additionally, the large majority of the individual effect sizes indicated sustained outcomes from post-intervention to follow-up. There were seven significant predictors of change in child outcomes, including stronger reductions in ADHD symptoms of girls and behaviour problems of younger children. In contrast with some meta-analyses on short-term effects, we found no differences between masked and unmasked outcomes on ADHD symptoms at follow-up. Discussion & Conclusion We conclude that behavioural parent training has longer-term benefits for children's ADHD symptoms and behavioural problems, and for positive parenting behaviours, parenting sense of competence and quality of the parent-child relationship.
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Affiliation(s)
- Dominique P. A. Doffer
- Department of Child and Adolescent PsychiatryUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
- Accare Child Study CenterGroningenThe Netherlands
| | - Tycho J. Dekkers
- Department of Child and Adolescent PsychiatryUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
- Accare Child Study CenterGroningenThe Netherlands
- Levvel, Academic Center for Child and Adolescent PsychiatryAmsterdamThe Netherlands
- Department of PsychologyUniversity of AmsterdamAmsterdamThe Netherlands
- Department of Child and Adolescent PsychiatryAmsterdam University Medical Centers (AUMC)AmsterdamThe Netherlands
| | - Rianne Hornstra
- Department of Child and Adolescent PsychiatryUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
- Accare Child Study CenterGroningenThe Netherlands
| | - Saskia van der Oord
- KU LeuvenClinical PsychologyFaculty of Psychology and Educational SciencesLeuvenBelgium
| | - Marjolein Luman
- Levvel, Academic Center for Child and Adolescent PsychiatryAmsterdamThe Netherlands
- Department of Clinical, Neuro, and Developmental PsychologyVrije Universiteit AmsterdamAmsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | - Patty Leijten
- University of AmsterdamResearch Institute of Child Development and EducationAmsterdamThe Netherlands
| | - Pieter J. Hoekstra
- Department of Child and Adolescent PsychiatryUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
- Accare Child Study CenterGroningenThe Netherlands
| | - Barbara J. van den Hoofdakker
- Department of Child and Adolescent PsychiatryUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
- Accare Child Study CenterGroningenThe Netherlands
- Department of Clinical Psychology and Experimental PsychopathologyUniversity of GroningenGroningenThe Netherlands
| | - Annabeth P. Groenman
- Department of Child and Adolescent PsychiatryUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
- Accare Child Study CenterGroningenThe Netherlands
- University of AmsterdamResearch Institute of Child Development and EducationAmsterdamThe Netherlands
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Examining Relations Between Parent and Child Psychopathology in Children with ADHD: Do Parent Cognitions Matter? JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2023. [DOI: 10.1007/s10862-023-10023-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Jiang Y, Delucchi K, Kaiser N, Hinshaw SP, McBurnett K, Pfiffner LJ. The Two-Factor Structure of the Parent Cognitive Error Questionnaire: A Measure of Parental Cognitive Errors in Relation to Child Problems. Res Child Adolesc Psychopathol 2022; 50:1249-1260. [PMID: 35596823 DOI: 10.1007/s10802-022-00934-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2022] [Indexed: 11/29/2022]
Abstract
This study evaluated the factor structure of the scores from a parent rating scale, the Parent Cognitive Error Questionnaire (PCEQ), which measures parents' attributions of child misbehavior and problems. The factor structure of the scores of the PCEQ was examined among 199 children (ages 7-11; mean age: 8.64 years, 58.30% boys, 53.80% White) with Attention-Deficit/Hyperactivity Disorder (ADHD), Predominantly Inattentive Presentation. Reliability and validity of the factors were assessed. Two factors emerged from this sample: (1) parent-specific cognitive errors (self-blame for child problems), and (2) child-specific cognitive errors (child-blame for child problems). Both were related to parent-rated parental depression, parenting satisfaction, parenting self-efficacy, and child ADHD and Oppositional Defiant Disorder (ODD) symptoms. After adjusting for child-specific cognitive errors, parent-specific errors were related to parent-rated parent depressive symptoms, and after adjustment for parent-specific cognitive errors, child-specific cognitive errors were related to parent-rated child ADHD and ODD symptoms. A two-factor structure for the PCEQ scores from this sample was found with evidence of reliability and validity of factors, showing promise for measuring sources of parental attributions regarding child problems.
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Affiliation(s)
- Yuanyuan Jiang
- School of Counselling, Psychotherapy, and Spirituality, Saint Paul University, 223 Main Street, K1S 1C4, Ottawa, Ontario, Canada. .,Department of Educational Psychology, University of Alberta, 11210 87 Ave., T6G 2G5, Edmonton, Alberta, Canada.
| | - Kevin Delucchi
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., 94143, San Francisco, California, United States
| | - Nina Kaiser
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., 94143, San Francisco, California, United States
| | - Stephen P Hinshaw
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., 94143, San Francisco, California, United States.,Department of Psychology, University of California, Berkeley, 2121 Berkeley Way, 94720, Berkeley, California, United States
| | - Keith McBurnett
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., 94143, San Francisco, California, United States
| | - Linda J Pfiffner
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., 94143, San Francisco, California, United States
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Dekkers TJ, Hornstra R, van der Oord S, Luman M, Hoekstra PJ, Groenman AP, van den Hoofdakker BJ. Meta-analysis: Which Components of Parent Training Work for Children With Attention-Deficit/Hyperactivity Disorder? J Am Acad Child Adolesc Psychiatry 2022; 61:478-494. [PMID: 34224837 DOI: 10.1016/j.jaac.2021.06.015] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 06/02/2021] [Accepted: 06/25/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Behavioral parent training is an evidence-based intervention for children with attention-deficit/hyperactivity disorder (ADHD), but it is unknown which of its components are most effective. This meta-regression analysis investigated which specific behavioral techniques that parents learn in parent training are associated with effects on parental outcomes. METHOD A search was performed for randomized controlled trials on parent training for children with ADHD, with positive parenting, negative parenting, parenting sense of competence, parent-child relationship quality, and parental mental health as outcome measures. After screening 23,026 publications, 29 studies contributing 138 effect sizes were included (N = 2,345). For each study, the dosage of 39 behavioral techniques was derived from intervention manuals, and meta-regression determined which techniques were related to outcomes. RESULTS Parent training had robust small- to medium-sized positive effects on all parental outcomes relative to control conditions, both for unblinded and probably blinded measures. A higher dosage of techniques focusing on the manipulation of antecedents of behavior was associated with better outcomes on parenting sense of competence and parental mental health, and a higher dosage of techniques focusing on reinforcement of desired behaviors was related to larger decreases in negative parenting. Higher dosages of psychoeducation were negatively related to parental outcomes. CONCLUSION Although techniques were not investigated in isolation, the results suggested that manipulation of antecedents of behavior and reinforcement techniques are key components of parent training for children with ADHD in relation to parental outcomes. These exploratory findings may help to strengthen and tailor parent training interventions for children with ADHD.
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Affiliation(s)
- Tycho J Dekkers
- University of Groningen, the Netherlands; University of Amsterdam, the Netherlands; Levvel, Academic Center for Child- and Adolescent Psychiatry and Specialized Youthcare, Amsterdam, the Netherlands; Amsterdam University Medical Center, the Netherlands.
| | | | - Saskia van der Oord
- University of Amsterdam, the Netherlands; KU Leuven, Research Group Clinical Psychology, Belgium
| | - Marjolein Luman
- Levvel, Academic Center for Child- and Adolescent Psychiatry and Specialized Youthcare, Amsterdam, the Netherlands; Vrije Universiteit Amsterdam, the Netherlands
| | | | - Annabeth P Groenman
- University of Groningen, the Netherlands; University of Amsterdam, the Netherlands
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7
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Examining daily parent involvement in caregivers of children with ADHD using electronic diaries. J Sch Psychol 2022; 91:195-208. [DOI: 10.1016/j.jsp.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/12/2021] [Accepted: 01/14/2022] [Indexed: 11/20/2022]
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8
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Effective Interventions to Support Self-management for Parents of Children with a Chronic Condition: A Systematic Review. Matern Child Health J 2021; 25:1842-1865. [PMID: 34655426 DOI: 10.1007/s10995-021-03244-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION This systematic review aims to determine the efficacy of interventions to support the self-management for parents of children with a chronic condition. An overview of prior research, regardless of the children's diagnosis, is lacking. Therefore, this systematic review provides an overview of the most recent available scientific literature that describes interventions to support self-management for parents of children with a chronic condition. METHODS A systematic search of Randomised Controlled Trials (RCTs) was conducted in CENTRAL, CINAHL, EMBASE, MEDLINE and PsychInfo. Studies that describe any type of self-management intervention or a combination of self-management interventions that support parents of children with a chronic condition between 0 and 18 years were included. The interventions and results were reported, hence categorized in the four areas of self-management: medical management, adjustment of lifestyle, shared decision-making and managing the consequences of a chronic condition. RESULTS The study included 23 RCTs. Due to the heterogeneity of the included studies a meta-analysis was impossible. Twenty studies showed statistically significant effects in favour of the intervention on at least one of the outcomes. Twenty-two studies showed risk of bias. The results indicate that disease management, (parent) group training, psycho-education and the Triple P intervention are effective interventions to support self-management. There were limited studies found in the areas lifestyle adjustment and shared decision making. DISCUSSION Effective interventions to support self-management for parents of children with a chronic condition are described, but the moderate quality of the studies hampers firm conclusions.
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Kil H, Aitken M, Henry S, Hoxha O, Rodak T, Bennett K, Andrade BF. Transdiagnostic Associations Among Parental Causal Locus Attributions, Child Behavior and Psychosocial Treatment Outcomes: A Systematic Review. Clin Child Fam Psychol Rev 2021; 24:267-293. [PMID: 33598852 DOI: 10.1007/s10567-020-00341-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 12/18/2022]
Abstract
Parents' interpretations of the cause of their children's behavior, i.e., parental attributions, are linked to parenting behavior and child development. However, it is not yet known whether parental attributions are systematically associated with children's internalizing and externalizing symptoms and behavior or psychosocial treatment engagement and outcomes across diagnostic categories. This systematic review aimed to fill this knowledge gap using a transdiagnostic perspective to synthesize the literature on the associations between parent-causal and child-responsible attributions and children's internalizing and externalizing behavior, treatment engagement, and treatment outcomes for parents and children. A total of 67 studies were identified. Overall, biased child-responsible attributions were associated with elevated child internalizing and externalizing symptoms and behavior across diagnoses, while findings on the association between parent-causal attributions and child behavior were inconsistent. The link between parental attributions and treatment engagement was also mixed, varying across treatment type, child diagnosis, and focus of attributions. Regarding treatment outcomes, less biased parent-causal and child-responsible attributions were linked to post-treatment improvements in children's behaviors, while mixed findings were reported on post-treatment improvements in parental attributions. Findings are discussed with a focus on approaches to enhance the effectiveness of assessment and psychosocial treatment approaches across diagnostic categories with consideration of parental attributions.
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Affiliation(s)
- Hali Kil
- McCain Centre for Child Youth and Family Mental Health, Child Youth and Emerging Adult Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Madison Aitken
- McCain Centre for Child Youth and Family Mental Health, Child Youth and Emerging Adult Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Shanelle Henry
- McCain Centre for Child Youth and Family Mental Health, Child Youth and Emerging Adult Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
| | - Ortenc Hoxha
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Terri Rodak
- Centre for Addiction and Mental Health Library, Toronto, ON, Canada
| | - Kathryn Bennett
- Department of Health Research Methods, Evidence and Impact (Formerly Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, ON, Canada
| | - Brendan F Andrade
- McCain Centre for Child Youth and Family Mental Health, Child Youth and Emerging Adult Program, Centre for Addiction and Mental Health, Toronto, ON, Canada. .,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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