Effectiveness of interventions and factors of relevance in the treatment of children with conduct problems
Year: 2008
Type: dissertation
Abstract: The principal aim of this dissertation was to study the effectiveness of treatment of children for severe conduct problems, and to explore factors of relevance for the effects of treatment on these children. In three studies, 127\nchildren aged 4‐8 years and their families participated in a randomized\ncontrolled trial of the Incredible Years training sessions that were implemented\nin two outpatient clinics for children and adolescent’s mental health in two\ncities in Norway. In addition, a meta‐analysis was performed in order to\nidentify the effects of treatment on children and adolescents with conduct\nproblems and to explore additional treatment effects, i.e. effects in day‐care\nand school, changes in children’s and adolescents’ social functioning and\nchanges in parental distress.\n In the replication study of the Incredible Years moderate reductions in\nchildren’s conduct problems were reported by the parents, while 40% of the\nchildren were within the normal range in terms of conduct immediately after\ntreatment, according to their mothers. Positive additional effects were\nobtained in terms of parents experiencing moderate to large reductions in\nparental stress. Alterations in parenting behaviour were also moderate to\nlarge, and self‐reported inconsistent and harsh disciplining were both\nsignificant partial mediators of change in children’s conduct problems.\nAlthough parents reported positive reductions in parental stress, maternal\nstress was a significant predictor of worsened treatment outcome.\nFurthermore, Attention Deficit Hyperactivity Disorder (ADHD) predicted\nworsened treatment outcome as experienced by both mothers and teachers.\nFinally, the mothers of girls scored the girls less below cut‐off at posttreatment\nthan did mothers of boys.\n In general, although the similarities in parents’ perceptions of boys and girls\nwith conduct problems at pretreatment were more evident than the\ndifferences, parental stress was more pronounced among parents of girls, and\nmothers’ of girls reported more symptoms of depression. Teachers, on the\nother hand, viewed the boys as less socially competent and more aggressive.\n In the meta‐analysis, the effect sizes (ES) indicated moderate reductions in\nchildren’s and adolescents’ conduct problems in studies with untreated control\ngroups, while in studies without untreated controls, the ESs in reductions in\naggressive behaviours were large. The changes in aggressive behaviours in daycare\nor school, alterations in social functioning and reductions in parental\ndistress were moderate in size. In the moderator analyses, the variable sample size was significant in studies with untreated controls, while the following\nvariables; age of the child, diagnostic assessment and mode of treatment, were\nall significant in studies without untreated comparisons.\n It is concluded that children’s and adolescents’ conduct problems can be\ntreated with positive results and that important additional treatment gains can\nbe achieved. However, factors such as parental stress and a child diagnosis of\nADHD can influence treatment effects negatively. Further steps to improve\ngeneralization effects may be needed, both in the treatment of conduct\nproblems in general and specifically when employing the Incredible Years in\nNorway.
Author: Sturla Fossum
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W1590816731