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Featherston R, Barlow J, Song Y, Haysom Z, Loy B, Tufford L, Shlonsky A. Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents. Cochrane Database Syst Rev 2024; 1:CD012445. [PMID: 38197473 PMCID: PMC10777456 DOI: 10.1002/14651858.cd012445.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
BACKGROUND Emotional and behavioural difficulties (EBD) in children are common, characterised by externalising or internalising behaviours that can be highly stable over time. EBD are an important cause of functional disability in childhood, and predictive of poorer psychosocial, academic, and occupational functioning into adolescence and adulthood. The prevalence, stability, and long-term consequences of EBD highlight the importance of intervening in childhood when behavioural patterns are more easily modified. Multiple factors contribute to the aetiology of EBD in children, and parenting plays an important role. The relationship between parenting and EBD has been described as bidirectional, with parents and children shaping one another's behaviour. One consequence of bidirectionality is that parents with insufficient parenting skills may become involved in increasingly negative behaviours when dealing with non-compliance in children. This can have a cyclical effect, exacerbating child behavioural difficulties and further increasing parental distress. Behavioural or skills-based parenting training can be highly effective in addressing EBD in children. However, emotional dysregulation may intercept some parents' ability to implement parenting skills, and there is recognition that skills-based interventions may benefit from adjunct components that better target parental emotional responses. Mindful parenting interventions have demonstrated some efficacy in improving child outcomes via improvements in parental emotion regulation, and there is potential for mindfulness training to enhance the effectiveness of standard parent training programmes. OBJECTIVES To assess the effectiveness of mindfulness-enhanced parent training programmes on the psychosocial functioning of children (aged 0 to 18 years) and their parents. SEARCH METHODS We searched the following databases up to April 2023: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL Plus, PsycINFO, Sociological Abstracts, Social Sciences Citation Index, Conference Proceedings Citation Index - Social Science & Humanities, AMED, ERIC, ProQuest Dissertations & Theses, Cochrane Database of Systematic Reviews, Campbell Collaboration Library of Systematic Reviews, as well as the following trials registers: ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP). We also contacted organisations/experts in the field. SELECTION CRITERIA We included randomised and quasi-randomised trials. Participants were parents or caregivers of children under the age of 18. The intervention was mindfulness-enhanced parent training programmes compared with a no-intervention, waitlist, or attentional control, or a parent training programme with no mindfulness component. The intervention must have combined mindfulness parent training with behavioural or skills-based parent training. We defined parent training programmes in terms of the delivery of a standardised and manualised intervention over a specified and limited period, on a one-to-one or group-basis, with a well-defined mindfulness component. The mindfulness component must have included mindfulness training (breath, visualisation, listening, or other sensory focus) and an explicit focus on present-focused attention and non-judgemental acceptance. DATA COLLECTION AND ANALYSIS We followed standard Cochrane procedures. MAIN RESULTS Eleven studies met our inclusion criteria, including one ongoing study. The studies compared a mindfulness-enhanced parent training programme with a no-treatment, waitlist, or attentional control (2 studies); a parent training programme with no mindfulness component (5 studies); both a no-treatment, waitlist, or attentional control and a parent training programme with no mindfulness component (4 studies). We assessed all studies as being at an unclear or high risk of bias across multiple domains. We pooled child and parent outcome data from 2118 participants to produce effect estimates. No study explicitly reported on self-compassion, and no adverse effects were reported in any of the studies. Mindfulness-enhanced parent training programmes compared to a no-treatment, waitlist, or attentional control Very low certainty evidence suggests there may be a small to moderate postintervention improvement in child emotional and behavioural adjustment (standardised mean difference (SMD) -0.46, 95% confidence interval (CI) -0.96 to 0.03; P = 0.06, I2 = 62%; 3 studies, 270 participants); a small improvement in parenting skills (SMD 0.22, 95% CI 0.06 to 0.39; P = 0.008, I2 = 0%; 3 studies, 587 participants); and a moderate decrease in parental depression or anxiety (SMD -0.50, 95% CI -0.96 to -0.04; P = 0.03; 1 study, 75 participants). There may also be a moderate to large decrease in parenting stress (SMD -0.79, 95% CI -1.80 to 0.23; P = 0.13, I2 = 82%; 2 studies, 112 participants) and a small improvement in parent mindfulness (SMD 0.21, 95% CI -0.14 to 0.56; P = 0.24, I2 = 69%; 3 studies, 515 participants), but we were not able to exclude little to no effect for these outcomes. Mindfulness-enhanced parent training programmes compared to parent training with no mindfulness component Very low certainty evidence suggests there may be little to no difference postintervention in child emotional and behavioural adjustment (SMD -0.09, 95% CI -0.58 to 0.40; P = 0.71, I2 = 64%; 5 studies, 203 participants); parenting skills (SMD 0.13, 95% CI -0.16 to 0.42; P = 0.37, I2 = 16%; 3 studies, 319 participants); and parent mindfulness (SMD 0.11, 95% CI -0.19 to 0.41; P = 0.48, I2 = 44%; 4 studies, 412 participants). There may be a slight decrease in parental depression or anxiety (SMD -0.24, 95% CI -0.83 to 0.34; P = 0.41; 1 study, 45 participants; very low certainty evidence), though we cannot exclude little to no effect, and a moderate decrease in parenting stress (SMD -0.51, 95% CI -0.84 to -0.18; P = 0.002, I2 = 2%; 3 studies, 150 participants; low certainty evidence). AUTHORS' CONCLUSIONS Mindfulness-enhanced parenting training may improve some parent and child outcomes, with no studies reporting adverse effects. Evidence for the added value of mindfulness training to skills-based parenting training programmes is suggestive at present, with moderate reductions in parenting stress. Given the very low to low certainty evidence reviewed here, these estimates will likely change as more high-quality studies are produced.
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Affiliation(s)
- Rebecca Featherston
- Department of Social Work, School of Primary and Allied Health Care, Faculty of Medicine Nursing & Health Sciences, Monash University, Caulfield, Australia
| | - Jane Barlow
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Yunshan Song
- Department of Social Work, School of Primary and Allied Health Care, Faculty of Medicine Nursing & Health Sciences, Monash University, Caulfield, Australia
| | - Zoe Haysom
- Department of Social Work, School of Primary and Allied Health Care, Faculty of Medicine Nursing & Health Sciences, Monash University, Caulfield, Australia
| | - Brenda Loy
- Department of Social Work, School of Primary and Allied Health Care, Faculty of Medicine Nursing & Health Sciences, Monash University, Caulfield, Australia
| | - Lea Tufford
- School of Nursing and Allied Health Professions, Laurentian University, Ontario, Canada
| | - Aron Shlonsky
- Department of Social Work, School of Primary and Allied Health Care, Faculty of Medicine Nursing & Health Sciences, Monash University, Caulfield, Australia
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Kratochwill TR, Shernoff ES. Evidence-Based Practice: Promoting Evidence-Based Interventions in School Psychology. SCHOOL PSYCHOLOGY REVIEW 2019. [DOI: 10.1080/02796015.2004.12086229] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Gatti U, Grattagliano I, Rocca G. Evidence-based psychosocial treatments of conduct problems in children and adolescents: an overview. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2018; 26:171-193. [PMID: 31984071 PMCID: PMC6762114 DOI: 10.1080/13218719.2018.1485523] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 05/27/2018] [Indexed: 06/10/2023]
Abstract
The aims of the present study were to identify empirically supported psychosocial intervention programs for young people with conduct problems and to evaluate the underpinnings, techniques and outcomes of these treatments. We analyzed reviews and meta-analyses published between 1982 and 2016 concerning psychosocial intervention programs for children aged 3 to 12 years with conduct problems. Parent training should be considered the first-line approach to dealing with young children, whereas cognitive-behavioral approaches have a greater effect on older youths. Family interventions have shown greater efficacy in older youths, whereas multi-component and multimodal treatment approaches have yielded moderate effects in both childhood and adolescence. Some limitations were found, especially regarding the evaluation of effects. To date, no single program has emerged as the best. However, it emerges that the choice of intervention should be age-specific and should take into account developmental differences in cognitive, behavioral, affective and communicative abilities.
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Affiliation(s)
- Uberto Gatti
- Department of Health Sciences, Section of Criminology, University of Genoa, Genoa, Italy
| | | | - Gabriele Rocca
- Department of Health Sciences, Section of Criminology, University of Genoa, Genoa, Italy
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Shlonsky A, Dennis JA, Devine B, Tufford L, Barlow J, Bjørndal A. Mindfulness-based parenting programmes for improving psychosocial outcomes in children from birth to age 18 and their parents. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2016. [DOI: 10.1002/14651858.cd012445] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Aron Shlonsky
- The University of Melbourne; Department of Social Work, Melbourne School of Health Sciences; Alan Gilbert Building 161 Barry Street, Carlton Melbourne Victoria Australia 3053
| | - Jane A Dennis
- University of Bristol; Musculoskeletal Research Unit, School of Clinical Sciences; Learning and Research Building [Level 1] Southmead Hospital Bristol UK BS10 5NB
| | - Ben Devine
- Parenting Research Centre; Knowledge Exchange and Implementation Division; Level 5, 232 Victoria Parade East Melbourne Victoria Australia 3002
| | - Lea Tufford
- University of Toronto; Factor-Inwentash Faculty of Social Work; 246 Bloor Street West Toronto ON Canada M5S 1V4
| | - Jane Barlow
- University of Oxford; Department of Social Policy and Intervention; Barnett House 32 Wellington Square Oxford UK OX1 2ER
| | - Arild Bjørndal
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway; RBUP, Postboks 4623 Nydalen Oslo Norway 0405
- University of Oslo; Faculty of Medicine; Oslo Norway
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Owens EB, Hinshaw SP, McBurnett K, Pfiffner L. Predictors of Response to Behavioral Treatments Among Children With ADHD-Inattentive Type. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2016; 47:S219-S232. [PMID: 27806212 DOI: 10.1080/15374416.2016.1228461] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The goal of the study was to examine baseline characteristics-child gender, IQ, age, internalizing problems, symptoms of hyperactivity/impulsivity (HI), oppositional defiant disorder, and sluggish cognitive tempo, and parent income, education, attention deficit/hyperactivity disorder (ADHD) severity, and anxiety/depression (A/D)-associated with response to behavioral treatments for ADHD, predominantly inattentive type. We employed data from 148 children (M = 8.7 years), 58% male, and 57% Caucasian in a randomized clinical trial. Positive treatment response was defined as (a) 5 or fewer inattentive symptoms and (b) a decrease of at least 3 inattentive symptoms from baseline to posttreatment. Child HI, parental A/D, and child IQ were associated with positive response, as follows: Child HI had a main effect in which it was negatively associated with treatment response (36% with 2 or more HI symptoms were positive responders vs. 59% of those with 1 or no symptoms) that was qualified by parental A/D and child IQ. When children had 2 or more symptoms of HI and higher parental A/D, positive response rate was low at 25%; when children had 2 or more symptoms of HI, low parental A/D, and an IQ of 105 or higher, positive response rate was 85%. Furthermore, the group with the poorest response rate (25%) had parents who self-reported greater ADHD severity, and the group with a relatively good rate of positive response (59%) had the lowest number of oppositional defiant disorder symptoms. Likelihood of positive response to our behavioral treatment for ADHD-I is dependent on child and parent factors.
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Affiliation(s)
- Elizabeth B Owens
- a Institute of Human Development , University of California , Berkeley
| | | | - Keith McBurnett
- c Department of Psychiatry , University of California , San Francisco
| | - Linda Pfiffner
- c Department of Psychiatry , University of California , San Francisco
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Abstract
This study explored predictors of treatment response and attrition in Parent-Child Interaction Therapy (PCIT). Participants were 99 families of 3- to 6-year-old children with disruptive behavior disorders. Multiple logistic regression was used to identify those pretreatment child, family, and accessibility factors that were predictive of success or attrition. For all study participants, waitlist group assignment and maternal age were the significant predictors of outcome. For treatment participants (study participants excluding those who dropped out after the initial evaluation but before treatment began), only maternal ratings of parenting stress and maternal inappropriate behavior during parent-child interactions were significant predictors of treatment outcome. These results suggest that for treatment studies of disruptive preschoolers, the benefits of using a waitlist control group may be outweighed by the disproportionate number of dropouts from this group. Once families begin PCIT, however, parent-related variables become salient in predicting treatment outcome.
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Chen D, Drabick DAG, Burgers DE. A Developmental Perspective on Peer Rejection, Deviant Peer Affiliation, and Conduct Problems Among Youth. Child Psychiatry Hum Dev 2015; 46:823-38. [PMID: 25410430 PMCID: PMC4440840 DOI: 10.1007/s10578-014-0522-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Peer rejection and deviant peer affiliation are linked consistently to the development and maintenance of conduct problems. Two proposed models may account for longitudinal relations among these peer processes and conduct problems: the (a) sequential mediation model, in which peer rejection in childhood and deviant peer affiliation in adolescence mediate the link between early externalizing behaviors and more serious adolescent conduct problems; and (b) parallel process model, in which peer rejection and deviant peer affiliation are considered independent processes that operate simultaneously to increment risk for conduct problems. In this review, we evaluate theoretical models and evidence for associations among conduct problems and (a) peer rejection and (b) deviant peer affiliation. We then consider support for the sequential mediation and parallel process models. Next, we propose an integrated model incorporating both the sequential mediation and parallel process models. Future research directions and implications for prevention and intervention efforts are discussed.
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Affiliation(s)
- Diane Chen
- Division of Adolescent Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 10B, Chicago, IL, 60611-2605, USA.
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | | | - Darcy E Burgers
- Department of Psychology, Temple University, Philadelphia, PA, USA
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Impact of Early Adolescent Externalizing Problem Behaviors on Identity Development in Middle to Late Adolescence: A Prospective 7-Year Longitudinal Study. J Youth Adolesc 2013; 42:1745-58. [DOI: 10.1007/s10964-013-9924-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 01/28/2013] [Indexed: 10/27/2022]
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9
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Schechter JC, Brennan PA, Cunningham PB, Foster SL, Whitmore E. Stress, cortisol, and externalizing behavior in adolescent males: an examination in the context of multisystemic therapy. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2012; 40:913-22. [PMID: 22350278 DOI: 10.1007/s10802-012-9612-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Stress and hypothalamic-pituitary-adrenal (HPA) axis dysregulation have been associated with externalizing behavior in adolescence, but few studies have examined these factors in a treatment context. This study investigated the relationship between stress, cortisol, and externalizing behavior among 120 adolescent males (mean age = 15) receiving Multisystemic Therapy (MST). To examine the differential relationship of cortisol with various types of stressors, self-report measures assessed lifetime stress, current episodic stress, and daily hassles. Morning and afternoon cortisol samples were collected to examine whether the relationship between stress and treatment outcome depended on the youth's biological stress levels. Regression analyses indicated that awakening cortisol levels moderated the relationship between daily hassles and externalizing behaviors at post-treatment. More specifically, higher levels of daily hassles predicted worse outcomes only among adolescents with high levels of morning cortisol. In addition, lifetime stressors and afternoon measures of cortisol interacted to predict changes in caretaker reports of externalizing problems and youth arrests following treatment; lifetime stressors were positively associated with externalizing behavior when adolescents had low levels of afternoon cortisol. Implications for theory and future directions for evidence-based treatment are discussed.
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Farmer CA, Arnold LE, Bukstein OG, Findling RL, Gadow KD, Li X, Butter EM, Aman MG. The treatment of severe child aggression (TOSCA) study: Design challenges. Child Adolesc Psychiatry Ment Health 2011; 5:36. [PMID: 22074813 PMCID: PMC3231878 DOI: 10.1186/1753-2000-5-36] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Accepted: 11/10/2011] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Polypharmacy (the concurrent use of more than one psychoactive drug) and other combination interventions are increasingly common for treatment of severe psychiatric problems only partly responsive to monotherapy. This practice and research on it raise scientific, clinical, and ethical issues such as additive side effects, interactions, threshold for adding second drug, appropriate target measures, and (for studies) timing of randomization. One challenging area for treatment is severe child aggression. Commonly-used medications, often in combination, include psychostimulants, antipsychotics, mood stabilizers, and alpha-2 agonists, which vary considerably in terms of perceived safety and efficacy. RESULTS In designing our NIMH-funded trial of polypharmacy, we focused attention on the added benefit of a second drug (risperidone) to the effect of the first (stimulant). We selected these two drugs because their associated adverse events might neutralize each other (e.g., sleep delay and appetite decrease from stimulant versus sedation and appetite increase from antipsychotic). Moreover, there was considerable evidence of efficacy for each drug individually for the management of ADHD and child aggression. The study sample comprised children (ages 6-12 years) with both diagnosed ADHD and disruptive behavior disorder (oppositional-defiant or conduct disorder) accompanied by severe physical aggression. In a staged sequence, the medication with the least problematic adverse effects (stimulant) was openly titrated in 3 weeks to optimal effect. Participants whose behavioral symptoms were not normalized received additional double-blind medication, either risperidone or placebo, by random assignment. Thus children whose behavioral symptoms were normalized with stimulant medication were not exposed to an antipsychotic. All families participated in an empirically-supported parent training program for disruptive behavior, so that the actual comparison was stimulant+parent training versus stimulant+antipsychotic+parent training. CONCLUSIONS We hope that the resolutions of the challenges presented here will be useful to other investigators and facilitate much-needed research on child psychiatric polypharmacy. TRIAL REGISTRATION ClinicalTrials.gov NCT00796302.
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Affiliation(s)
| | | | - Oscar G Bukstein
- Youth and Family Research Program, Western Psychiatric Institute and Clinic, Pittsburgh, USA
| | - Robert L Findling
- Department of Psychiatry, Case Western Reserve University, Cleveland, USA
| | - Kenneth D Gadow
- Department of Psychiatry, Stony Brook University, Stony Brook, USA
| | - Xiaobai Li
- Center for Biostatistics, Ohio State University, Columbus, USA
| | - Eric M Butter
- Nisonger Center, Ohio State University, Columbus, USA
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Wijsbroek SA, Hale WW, Van Doorn MD, Raaijmakers QA, Meeus WH. Is the resolution style ‘exiting statements’ related to adolescent problem behavior? JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2010. [DOI: 10.1016/j.appdev.2009.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Salmon K, Dadds MR, Allen J, Hawes DJ. Can emotional language skills be taught during parent training for conduct problem children? Child Psychiatry Hum Dev 2009; 40:485-98. [PMID: 19373551 DOI: 10.1007/s10578-009-0139-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2008] [Accepted: 03/30/2009] [Indexed: 11/28/2022]
Abstract
To assess the effectiveness of providing training in elaborative, emotion rich reminiscing (emotional reminiscing, ER) as an adjunct to Parent Management Training (PMT) for parents of children (N = 38, M age = 56.9, SD = 15.8 months) with oppositional behaviors. Control parents received PMT and non-language adjunct intervention, child-directed play. All components of the intervention were manualized. Parents in both conditions received training in an abbreviated course of PMT. Parents in the ER condition additionally received brief training in discussing everyday past events with their child incorporating emotion labels and causes, "wh" questions, and detailed descriptive information. Parents in the control condition received training in allowing their child to lead during play sessions. Across both conditions, children's oppositional behaviors decreased between the beginning and end of training. Providing parents with training parents in an elaborative, emotion-rich reminiscing style resulted in greater parent and child use of elaborations and emotion references during shared conversations. Given findings in the literature of an association between parental emotion talk and children's emotional competence, developmental skills that are frequently compromised in oppositional children, the current pilot study has implications for interventions that broaden the focus of PMT.
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Chacko A, Wymbs BT, Wymbs FA, Pelham WE, Swanger-Gagne MS, Girio E, Pirvics L, Herbst L, Guzzo J, Phillips C, O'Connor B. Enhancing Traditional Behavioral Parent Training for Single Mothers of Children with ADHD. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2009; 38:206-18. [DOI: 10.1080/15374410802698388] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Anil Chacko
- a Department of Psychology , State University of New York at Buffalo ,
| | - Brian T. Wymbs
- a Department of Psychology , State University of New York at Buffalo ,
| | - Frances A. Wymbs
- a Department of Psychology , State University of New York at Buffalo ,
| | - William E. Pelham
- a Department of Psychology , State University of New York at Buffalo ,
| | | | - Erin Girio
- a Department of Psychology , State University of New York at Buffalo ,
| | - Lauma Pirvics
- a Department of Psychology , State University of New York at Buffalo ,
| | - Laura Herbst
- a Department of Psychology , State University of New York at Buffalo ,
| | - Jamie Guzzo
- a Department of Psychology , State University of New York at Buffalo ,
| | - Carlie Phillips
- a Department of Psychology , State University of New York at Buffalo ,
| | - Briannon O'Connor
- a Department of Psychology , State University of New York at Buffalo ,
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Loeber R, Burke J, Pardini DA. Perspectives on oppositional defiant disorder, conduct disorder, and psychopathic features. J Child Psychol Psychiatry 2009; 50:133-42. [PMID: 19220596 DOI: 10.1111/j.1469-7610.2008.02011.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This paper presents a few perspectives on oppositional defiant disorder (ODD), conduct disorder (CD), and early forms of psychopathy. The developmental changes and stability of each, and the interrelationship between the three conditions are reviewed, and correlates and predictors are highlighted. The paper also examines effective interventions for each of the three conditions and makes recommendations for future research.
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Affiliation(s)
- Rolf Loeber
- School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA. USA.
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Chamberlain P, Price J, Leve LD, Laurent H, Landsverk JA, Reid JB. Prevention of behavior problems for children in foster care: outcomes and mediation effects. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2008; 9:17-27. [PMID: 18185995 PMCID: PMC4046586 DOI: 10.1007/s11121-007-0080-7] [Citation(s) in RCA: 128] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2007] [Accepted: 12/04/2007] [Indexed: 10/22/2022]
Abstract
Parent training for foster parents is mandated by federal law and supported by state statues in nearly all states; however, little is known about the efficacy of that training, and recent reviews underscore that the most widely used curricula in the child welfare system (CWS) have virtually no empirical support (Grimm, Youth Law News, April-June:3-29, 2003). On the other hand, numerous theoretically based, developmentally sensitive parent training interventions have been found to be effective in experimental clinical and prevention intervention trials (e.g., Kazdin and Wassell, Journal of the American Academy of Child and Adolescent Psychiatry, 39:414-420, 2000; McMahon and Forehand, Helping the noncompliant child, Guilford Press, New York, USA, 2003; Patterson and Forgatch, Parents and adolescents: I. Living together, Castalia Publishing, Eugene, OR, USA, 1987; Webster-Stratton et al., Journal of Clinical Child Pyschology Psychiatry, 42:943-952, 2001). One of these, Multidimensional Treatment Foster Care (MTFC; Chamberlain, Treating chronic juvenile offenders: Advances made through the Oregon Multidimensional Treatment Foster Care model, American Psychological Association, Washington, DC, USA, 2003), has been used with foster parents of youth referred from juvenile justice. The effectiveness of a universal intervention, KEEP (Keeping Foster Parents Trained and Supported) based on MTFC (but less intensive) was tested in a universal randomized trial with 700 foster and kinship parents in the San Diego County CWS. The goal of the intervention was to reduce child problem behaviors through strengthening foster parents' skills. The trial was designed to examine effects on both child behavior and parenting practices, allowing for specific assessment of the extent to which improvements in child behavior were mediated by the parenting practices targeted in the intervention. Child behavior problems were reduced significantly more in the intervention condition than in the control condition, and specific parenting practices were found to mediate these reductions, especially for high-risk children in foster families reporting more than six behavior problems per day at baseline.
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Affiliation(s)
- Patricia Chamberlain
- Oregon Social Learning Center and Center for Research to Practice, Eugene, OR 97401-4928, USA.
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Beauchaine TP, Neuhaus E, Brenner SL, Gatzke-Kopp L. Ten good reasons to consider biological processes in prevention and intervention research. Dev Psychopathol 2008; 20:745-74. [PMID: 18606030 PMCID: PMC2690981 DOI: 10.1017/s0954579408000369] [Citation(s) in RCA: 138] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Most contemporary accounts of psychopathology acknowledge the importance of both biological and environmental influences on behavior. In developmental psychopathology, multiple etiological mechanisms for psychiatric disturbance are well recognized, including those operating at genetic, neurobiological, and environmental levels of analysis. However, neuroscientific principles are rarely considered in current approaches to prevention or intervention. In this article, we explain why a deeper understanding of the genetic and neural substrates of behavior is essential for the next generation of preventive interventions, and we outline 10 specific reasons why considering biological processes can improve treatment efficacy. Among these, we discuss (a) the role of biomarkers and endophenotypes in identifying those most in need of prevention; (b) implications for treatment of genetic and neural mechanisms of homotypic comorbidity, heterotypic comorbidity, and heterotypic continuity; (c) ways in which biological vulnerabilities moderate the effects of environmental experience; (d) situations in which Biology x Environment interactions account for more variance in key outcomes than main effects; and (e) sensitivity of neural systems, via epigenesis, programming, and neural plasticity, to environmental moderation across the life span. For each of the 10 reasons outlined we present an example from current literature and discuss critical implications for prevention.
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Nock MK, Kazdin AE, Hiripi E, Kessler RC. Lifetime prevalence, correlates, and persistence of oppositional defiant disorder: results from the National Comorbidity Survey Replication. J Child Psychol Psychiatry 2007; 48:703-13. [PMID: 17593151 DOI: 10.1111/j.1469-7610.2007.01733.x] [Citation(s) in RCA: 281] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Oppositional defiant disorder (ODD) is a leading cause of referral for youth mental health services; yet, many uncertainties exist about ODD given it is rarely examined as a distinct psychiatric disorder. We examined the lifetime prevalence, onset, persistence, and correlates of ODD. METHODS Lifetime prevalence of ODD and 18 other DSM-IV disorders was assessed in a nationally representative sample of adult respondents (n = 3,199) in the National Comorbidity Survey Replication. Retrospective age-of-onset reports were used to test temporal priorities with comorbid disorders. RESULTS Lifetime prevalence of ODD is estimated to be 10.2% (males = 11.2%; females = 9.2%). Of those with lifetime ODD, 92.4% meet criteria for at least one other lifetime DSM-IV disorder, including: mood (45.8%), anxiety (62.3%), impulse-control (68.2%), and substance use (47.2%) disorders. ODD is temporally primary in the vast majority of cases for most comorbid disorders. Both active and remitted ODD significantly predict subsequent onset of secondary disorders even after controlling for comorbid conduct disorder (CD). Early onset (before age 8) and comorbidity predict slow speed of recovery of ODD. CONCLUSIONS ODD is a common child- and adolescent-onset disorder associated with substantial risk of secondary mood, anxiety, impulse-control, and substance use disorders. These results support the study of ODD as a distinct disorder. Prospective and experimental studies are needed to further delineate the temporal and causal relations between ODD and related disorders.
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Affiliation(s)
- Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, MA 02138, USA.
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Systemische Familientherapie bei Störungen des Kindes- und Jugendalters. Eine Metainhaltsanalyse von 47 randomisierten Primärstudien. PSYCHOTHERAPEUT 2006. [DOI: 10.1007/s00278-006-0480-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nock MK, Goldman JL, Wang Y, Albano AM. From science to practice: The flexible use of evidence-based treatments in clinical settings. J Am Acad Child Adolesc Psychiatry 2004; 43:777-80. [PMID: 15167095 DOI: 10.1097/01.chi.0000120023.14101.58] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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