1
|
Meijer L, Finkenauer C, Blankers M, de Gee A, Kramer J, Shields-Zeeman L, Thomaes K. Study protocol: development and randomized controlled trial of a preventive blended care parenting intervention for parents with PTSD. BMC Psychiatry 2023; 23:102. [PMID: 36765312 PMCID: PMC9921412 DOI: 10.1186/s12888-023-04548-8] [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: 03/29/2022] [Accepted: 01/13/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Children of parents with post-traumatic stress disorder (PTSD) are at increased risk of adverse psychological outcomes. An important risk mechanism is impaired parental functioning, including negative parenting behavior, perceived incompetence, and lack of social support. Several parenting interventions for trauma-exposed parents and parents with psychiatric disorders exist, but none have specifically targeted parents with PTSD. Our objective is to evaluate the effectiveness of a blended care preventive parenting intervention for parents with PTSD. METHODS The intervention was adapted from an existing online intervention, KopOpOuders Self-Help. In co-creation with parents with PTSD and partners, the intervention was adapted into KopOpOuders-PTSD, by adding PTSD-specific content and three in-person-sessions with a mental health prevention professional. Effectiveness will be tested in a randomized controlled trial among N = 142 parents being treated for PTSD at Arkin Mental Health Care (control condition: treatment as usual, n = 71; intervention condition: treatment as usual + intervention, n = 71). Online questionnaires at pretest, posttest, and three-month follow-up and ecological momentary assessment at pretest and posttest will be used. Intervention effects on primary (parenting behavior) and secondary outcomes (perceived parenting competence, parental social support, parenting stress, child overall psychological problems and PTSD symptoms) will be analyzed using generalized linear mixed modeling. We will also analyze possible moderation effects of parental PTSD symptoms at pretest on primary and secondary outcomes. DISCUSSION This study protocol describes the randomized controlled trial of KopOpOuders-PTSD, a blended care preventive parenting intervention for parents with PTSD. Findings can contribute to understanding of the effectiveness of parenting support in clinical practice for PTSD. TRIAL REGISTRATION This protocol (Version 1) was registered on 11-02-2022 at ClinicalTrials.gov under identification number NCT05237999.
Collapse
Affiliation(s)
- Laurien Meijer
- Sinai Centrum / Arkin Mental Health Care, Laan van de Helende Meesters 2, 1186 AM, Amstelveen, The Netherlands. .,Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands.
| | - Catrin Finkenauer
- grid.5477.10000000120346234Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Matthijs Blankers
- grid.491093.60000 0004 0378 2028Arkin Mental Health Care, Amsterdam, the Netherlands ,grid.416017.50000 0001 0835 8259Trimbos Institute/Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Anouk de Gee
- grid.416017.50000 0001 0835 8259Trimbos Institute/Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Jeannet Kramer
- grid.416017.50000 0001 0835 8259Trimbos Institute/Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Laura Shields-Zeeman
- grid.416017.50000 0001 0835 8259Trimbos Institute/Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Kathleen Thomaes
- grid.491093.60000 0004 0378 2028Sinai Centrum / Arkin Mental Health Care, Laan van de Helende Meesters 2, 1186 AM Amstelveen, The Netherlands ,grid.509540.d0000 0004 6880 3010Department of Psychiatry, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands
| |
Collapse
|
2
|
Allen ES, Renshaw KD, Fredman SJ. An exploration of potential pressures to engage in parenting accommodation of PTSD symptoms for military couples. FAMILY PROCESS 2023. [PMID: 36720198 DOI: 10.1111/famp.12858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 06/18/2023]
Abstract
In the context of service member posttraumatic stress disorder (PTSD) symptoms, intimate partners may experience pressure to take over parenting roles and run interference between the service member and the children; that is, to engage in partner accommodation focal to parenting. The current study quantitatively assessed potential pressures to engage in parenting accommodation (PPEPA) in a sample of 207 female partners married to male service members with at least one child in the home and the convergence of PPEPA with service member PTSD symptoms, general partner accommodation, couple functioning, parenting, and child functioning. Partners' reports of PPEPA were associated with higher levels of service member PTSD symptoms and partners' general accommodation of PTSD symptoms. When controlling for service member PTSD symptoms and general partner accommodation, partner reports of PPEPA still accounted for unique variance in lower parenting alliance (as reported by both service member and partner), lower levels of service members' reports of closeness with children in the home, higher levels of harsh parenting by both the service member and partner, and greater child behavioral difficulties. Findings support PPEPA as related to partners' accommodative responses to PTSD but demonstrating unique associations with parenting alliance, parenting, and child outcomes. Parenting interventions in the context of PTSD may benefit from conjoint or family approaches that attend to the intersection of PTSD and broader family functioning, including pressures to engage in accommodation focal to the parenting domain.
Collapse
Affiliation(s)
- Elizabeth S Allen
- Department of Psychology, University of Colorado Denver, Denver, Colorado, USA
| | - Keith D Renshaw
- Department of Psychology, George Mason University, Fairfax, Virginia, USA
| | - Steffany J Fredman
- Department of Human Development and Family Studies, The Pennsylvania State University, State College, Pennsylvania, USA
| |
Collapse
|
3
|
DeGarmo DS, Gewirtz AH, Li L, Tavalire HF, Cicchetti D. The ADAPT Parenting Intervention Benefits Combat Exposed Fathers Genetically Susceptible to Problem Drinking. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:150-160. [PMID: 36057024 DOI: 10.1007/s11121-022-01424-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2022] [Indexed: 02/03/2023]
Abstract
Testing a vantage sensitivity model from differential susceptibility theory (DST), we examined a G × E × I hypothesis; that is, whether a military parenting intervention program (I) might buffer a G × E susceptibility for military deployed fathers exposed to deployment combat stress and trauma. We hypothesized that combat stress (E, referring to the natural environmental factor) would lead to increases in problem drinking, and that the effect of problem drinking would be amplified by genetic predisposition (G) for drinking reward systems, substance use, and addictive behaviors (i.e., differential vulnerability). Providing a preventive intervention designed to improve post-deployment family environments (I, vantage sensitivity) is hypothesized to buffer the negative impacts of combat exposure and genetic susceptibility. The sample included 185 post-deployed military fathers who consented to genotyping, from a larger sample of 294 fathers enrolled in a randomized effectiveness trial of the After Deployment Adaptive Parenting Tools (ADAPT) intervention. Trauma-exposed military fathers at genetic susceptibility for problem drinking assigned to the ADAPT intervention reported significantly more reductions in risky drinking compared with fathers at genetic susceptibility assigned to the control group, with a small effect size for the G × E × I interaction (d = .2). Trial Registration. The ADAPT trial is registered at the US National Institutes of Health ( ClinicalTrials.gov ) # NCT03522610.
Collapse
Affiliation(s)
- David S DeGarmo
- Prevention Science Institute, University of Oregon, Eugene, USA
| | - Abigail H Gewirtz
- Department of Psychology, REACH Institute, Arizona State University, Tempe, USA.
| | - Lijun Li
- Department of Family Social Science, University of Minnesota-Twin Cities, Minneapolis, USA
| | | | - Dante Cicchetti
- Institute of Child Development, University of Minnesota-Twin Cities, Minneapolis, USA
| |
Collapse
|
4
|
Creech SK, Pearson R, Saenz JJ, Braciszewski JM, Riggs SA, Taft CT. Pilot trial of Strength at Home Parents, a trauma-informed parenting support treatment for veterans. COUPLE & FAMILY PSYCHOLOGY 2022; 11:205-216. [PMID: 36185500 PMCID: PMC9524484 DOI: 10.1037/cfp0000232] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PTSD is associated with compromised parenting which is not adequately addressed in available evidence-based PTSD treatments. Strength at Home - Parents (SAHP) is a trauma-informed parenting intervention which aims to improve parenting behaviors and overall parent-child functioning. Here we report pilot data obtained in a sample of veterans (N=21) with PTSD and parent-child functioning difficulties. Results support feasibility of study methods, and intervention acceptability, credibility and satisfaction. Movement on primary outcome measures suggested improved overall family functioning, a decrease in the use of dysfunctional parenting practices, an increase in positive parenting practices and a trend towards a reduction in parenting stress. Results should be interpreted with caution because of the small sample size and attrition at follow-up. Limitations withstanding, findings support further study of the intervention, which would provide insights into whether an efficacy trial is indicated.
Collapse
Affiliation(s)
- Suzannah K Creech
- VHA VISN 17 Center of Excellence for Research on Returning War Veterans, Central Texas Veterans Affairs Healthcare System, Waco, TX; and the Dell Medical School of the University of Texas, Department of Psychiatry and Behavioral Sciences, Austin, TX
| | - Rahel Pearson
- VHA VISN 17 Center of Excellence for Research on Returning War Veterans, Central Texas Veterans Affairs Healthcare System, Waco, TX; and the Dell Medical School of the University of Texas, Department of Psychiatry and Behavioral Sciences, Austin, TX
| | - Jeremy J Saenz
- VHA VISN 17 Center of Excellence for Research on Returning War Veterans, Central Texas Veterans Affairs Healthcare System, Waco, TX; and the Dell Medical School of the University of Texas, Department of Psychiatry and Behavioral Sciences, Austin, TX
| | | | - Shelley A Riggs
- University of North Texas, Denton, TX; and Sam Houston State University, Huntsville, TX
| | - Casey T Taft
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA; and Boston University School of Medicine, Boston, MA
| |
Collapse
|
5
|
Effectiveness of GenerationPMTO to Promote Parenting and Child Adjustment: A Meta-Analytic Review. Clin Child Fam Psychol Rev 2022; 25:702-719. [PMID: 35674973 DOI: 10.1007/s10567-022-00400-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2022] [Indexed: 11/03/2022]
Abstract
GenerationPMTO is a theory- and evidence-based behavioral parenting program widely implemented in the past three decades. This systematic review and meta-analysis examined the effectiveness of twenty GenerationPMTO studies on parenting and child adjustment among 3893 families in six countries. Hedges' g from studies with pretest-posttest-controlled designs were computed and robust variance estimation (RVE) was used to deal with the effect size dependency. Results showed that GenerationPMTO significantly promoted parenting and child adjustment with moderate to high levels of heterogeneity. Specifically, GenerationPMTO improved parental discipline, parenting monitoring, skill encouragement, child externalizing problems, and child internalizing problems. Subgroup analyses revealed several important moderators, including type of comparison group, measurement, informant, risk of bias, etc. Intervention effects were quite robust across countries and multiple demographic characteristics. No publication bias across studies for parenting and child adjustment was detected. The revised Cochrane risk of bias for randomized trials (RoB 2) procedure was used to assess risk of bias within the included studies. Some studies showed a higher level of risk due to problems with the randomization process, missing data, low measurement quality, and reporting bias. Due to lack of data, we did not examine intervention effects on parental mental health or couple relationship quality. Future studies should test mediation models to understand the mechanisms of change and to identify moderators in order to understand the high levels of heterogeneity in GenerationPMTO studies.
Collapse
|
6
|
Zhang J, Buchanan GJR, Monn AR, Gewirtz AH. Inhibitory Control Moderates the Intervention Effects of a Preventive Parenting Program on Posttraumatic Stress Disorder Symptoms Among Male Service Members. J Trauma Stress 2022; 35:235-245. [PMID: 34388288 PMCID: PMC9707609 DOI: 10.1002/jts.22724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 05/11/2021] [Accepted: 06/13/2021] [Indexed: 02/03/2023]
Abstract
Military servicemembers face substantial challenges due to war-related trauma exposure, including posttraumatic stress disorder (PTSD). Individuals with deficits in inhibitory control (IC) may have an increased risk of developing PTSD due to a reduced ability to regulate their cognitive responses to and disengage from trauma-related stimuli. After Deployment, Adaptive Parenting Tools (ADAPT) is a mindfulness-infused parenting program for military families that has also been found to have crossover effects on parental mental health. The present study examined whether fathers' IC at baseline affected their response to this emotional skills-focused intervention and further influenced their PTSD symptoms 1 year later. The sample included 282 male National Guard and Reserve (NG/R) service members who had recently been deployed to Iraq or Afghanistan. Fathers were randomly assigned to either the ADAPT program or a control condition, with IC measured at baseline and PTSD symptoms measured at baseline and 1-year follow-up. Intent-to-treat analyses revealed no significant main effect of the intervention on fathers' PTSD symptoms. However, fathers' IC moderated intervention effects on PTSD symptoms, f2 = 0.03. The intervention had more beneficial effects on reducing fathers' PTSD symptoms for participants with low IC at baseline. These findings are consistent with compensatory effects in the risk moderation hypothesis, which suggests that prevention or intervention programs are more effective for high-risk subgroups.
Collapse
Affiliation(s)
- Jingchen Zhang
- Department of Family Social Science, University of Minnesota – Twin Cities, Minneapolis, Minnesota, USA
| | - Gretchen J. R. Buchanan
- Department of Family Social Science, University of Minnesota – Twin Cities, Minneapolis, Minnesota, USA
| | - Amy R. Monn
- Green Hills Family Psych, Nashville, Tennessee, USA
| | - Abigail H. Gewirtz
- Department of Family Social Science and Institute of Child Development, University of Minnesota – Twin Cities, Minneapolis, Minnesota, USA
| |
Collapse
|
7
|
Peak JM, Ingram V, Urbanoski K, Milligan K. Specifying the Relations among PTSD Symptom Clusters and Parenting Stress in Mothers Engaged in Substance Use Treatment. Subst Use Misuse 2022; 57:1552-1562. [PMID: 35819030 DOI: 10.1080/10826084.2022.2096236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Parenting stress is often heightened in mothers receiving treatment for substance use. Experiences of trauma are commonly seen in this population, which may give rise to Posttraumatic Stress Disorder (PTSD) symptoms, including intrusion, avoidance, negative cognition and mood, and affective arousal. While past research has demonstrated a significant relation between PTSD symptoms and parenting stress, no studies have examined the relative contributions of these symptoms to parenting stress in mothers engaged in substance use treatment. METHODS Seventy-four mothers attending outpatient substance use treatment who were parenting children aged 0-3 years completed measures of parenting stress, PTSD, substance use, and depression symptoms. RESULTS A canonical correlation analysis indicated two canonical variates accounting for significant variance between PTSD symptom clusters and parenting stress measures. The first canonical variate, primarily reflecting depressive and PTSD cognition and mood symptoms, was predominantly related to the parental distress aspect of parenting stress (40%). The second canonical variate, primarily reflecting intrusion and avoidance PTSD symptoms, was associated with increased parental perceptions of their child as difficult (10%). CONCLUSION Future research directions and clinical implications of these results are discussed for designing parenting interventions with mothers attending substance use treatment who present with PTSD symptoms.
Collapse
Affiliation(s)
- Julia Marie Peak
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | - Victoria Ingram
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | - Karen Urbanoski
- Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - Karen Milligan
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| |
Collapse
|
8
|
Stewart J, Witte TH. Secondary Trauma and Parenting Practices in Internet Crimes against Children Task Force Investigators. AMERICAN JOURNAL OF CRIMINAL JUSTICE : AJCJ 2020; 45:1080-1099. [PMID: 32837153 PMCID: PMC7274939 DOI: 10.1007/s12103-020-09530-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 05/29/2020] [Indexed: 06/01/2023]
Abstract
Investigating cases of child pornography requires daily exposure to sexually explicit material involving children and may have negative implications on the mental well-being of those in this line of work. This study aimed to identify whether secondary traumatic stress symptoms were associated with participants' parenting behaviors and concerns about their own children's use of the internet. Internet Crimes Against Children Task Force workers (n = 212) completed online questionnaires measuring work exposure to sexually explicit material, secondary traumatic stress symptoms, and parenting behaviors. Professionals in this field reported a wide range of secondary trauma symptoms, and their parenting behaviors were both directly and indirectly (via secondary trauma) affected by prolonged exposure to sexually explicit material involving children. Internet monitoring behaviors were more prevalent for parents of younger children, and mothers' parenting behaviors were more strongly associated with secondary trauma symptoms than were fathers. Results have implications for mental health and parenting services for professionals in this field.
Collapse
|
9
|
The Physiological Regulation of Emotion During Social Interactions: Vagal Flexibility Moderates the Effects of a Military Parenting Intervention on Father Involvement in a Randomized Trial. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 21:691-701. [PMID: 32303894 DOI: 10.1007/s11121-020-01122-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
To make prevention programs more effective and understand "what works for whom," evidence regarding what individual characteristics predict intervention responsiveness is needed. Previous studies have evaluated a military parent training program known as After Deployment Adaptive Parenting Tools/ADAPT, yet less is understood about the program's varying effects for fathers. We tested the physiological regulation of emotion during social interactions as a moderator predicting fathers' responsiveness in a randomized trial of ADAPT, in which emotion regulation was operationally measured through vagal flexibility (VF; dynamic changes in cardiac vagal tone). Families with a child aged between 4 and 13 years for whom physiological data were gathered (n = 145) were randomly assigned to ADAPT (14-week face-to-face group intervention) or a control group (services as usual). Fathers in these families were National Guard/Reserve members who had been deployed to war in Iraq and/or Afghanistan and recently returned. Prior to the intervention, cardiac data was collected in-home throughout a set of family interaction tasks and VF was operationalized as the changes in high frequency (HF) power of heart rate variability (HRV) from a reading task to a problem-solving task. Parenting behaviors were observed and coded based on theory-driven indicators pre-intervention and at 1-year follow-up. Results of structural equation modeling showed that VF significantly moderated fathers' intervention responsiveness, such that fathers with higher vs. lower VF exhibited more effective parenting at 1-year follow-up if they were randomized into ADAPT vs. the control group. This study is the first to demonstrate that parasympathetic vagal functioning may be a biomarker to predict response to a military parenting intervention to enhance parenting in combat deployed fathers. The implications for precision-based prevention are discussed.
Collapse
|
10
|
Fredman SJ, Le Y, Marshall AD, Garcia Hernandez W, Feinberg ME, Ammerman RT. Parents' PTSD symptoms and child abuse potential during the perinatal period: Direct associations and mediation via relationship conflict. CHILD ABUSE & NEGLECT 2019; 90:66-75. [PMID: 30753996 DOI: 10.1016/j.chiabu.2019.01.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 01/22/2019] [Accepted: 01/30/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) symptoms are associated with parental aggression towards children, but little is known about the relation between parents' PTSD symptoms and their risk for perpetrating child physical abuse during the early parenting years, when the potential for prevention of abuse may be highest. OBJECTIVE To examine direct associations between mothers' and fathers' PTSD symptoms and child abuse potential, as well as indirect effects through couple relationship adjustment (i.e., conflict and love) in a high-risk sample of parents during the perinatal period, most of whom were first-time parents. PARTICIPANTS AND SETTING From March 2013 to August 2016, data were collected from 150 expecting or new parental dyads in which the mother was participating in a home visiting program. METHODS Data were analyzed using the Actor-Partner Interdependence Mediation Model. RESULTS For mothers and fathers, there were direct associations between PTSD symptom severity and child abuse potential (βs = .51, ps <.001), and this association for fathers was stronger at higher levels of mothers' PTSD symptoms (β = .15, p = .03). In addition, parents' own and their partners' PTSD symptoms were each indirectly associated with parents' own child abuse potential through parents' report of interparental conflict (standardized indirect effects = .052-.069, ps = .004) but not love. CONCLUSIONS Addressing parents' PTSD symptoms and relationship conflict during the perinatal period using both systemic and developmental perspectives may uniquely serve to decrease the risk of child physical abuse and its myriad adverse consequences.
Collapse
Affiliation(s)
- Steffany J Fredman
- Department of Human Development and Family Studies, The Pennsylvania State University, 115 Health and Human Development, University Park, PA, 16802, United States.
| | - Yunying Le
- Department of Human Development and Family Studies, The Pennsylvania State University, 115 Health and Human Development, University Park, PA, 16802, United States.
| | - Amy D Marshall
- Department of Psychology, The Pennsylvania State University, 259 Moore Building, University Park, PA, 16802, United States.
| | - Walter Garcia Hernandez
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, United States.
| | - Mark E Feinberg
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, 310 Biobehavioral Health, University Park, PA, 16802, United States.
| | - Robert T Ammerman
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, United States; University of Cincinnati College of Medicine, United States.
| |
Collapse
|
11
|
Mills SL, Babinski DE, Waschbusch DA. Maternal PTSD and Behavioral Parent Training Treatment for a Girl With Conduct Disorder and Callous–Unemotional Traits. Clin Case Stud 2018. [DOI: 10.1177/1534650118795276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Very little is known about the impact of parental psychopathology on treatment outcome for youth with conduct problems (CPs) and callous–unemotional (CU) traits. This case study describes behavioral parent training (BPT) for “Amy,” an 11-year-old girl presenting with CP/CU traits who had a mother diagnosed with posttraumatic stress disorder (PTSD). Maternal and paternal reports of child behavior problems and impairments were collected to assess treatment outcome. Weekly ratings of maternal PTSD were also collected to examine changes in maternal psychopathology over the course of BPT. Parent ratings showed that treatment was associated with reductions in oppositional defiant disorder (ODD) symptoms, conduct disorder (CD) symptoms, and impairment, and with improvements in treatment goal progress. However, the frequency of negative behaviors remained high throughout treatment. Maternal PTSD symptoms remained in the clinical range throughout BPT, but there was some evidence of synchrony between maternal PTSD symptoms and child negative behaviors. These findings highlight the importance of examining parental psychopathology in understanding BPT outcomes for children with CP/CU traits and call for greater attention to addressing child and parent difficulties that may impede improvement in treatment for youth with CP/CU traits.
Collapse
|