Nye C L, Zucker R A, Fitzgerald H E
Department of Psychology, Michigan State University, East Lansing, USA.
J Stud Alcohol Suppl. 1999 Mar;13:10-21. doi: 10.15288/jsas.1999.s13.10.
Risk for subsequent development of alcohol problems is not uniform across the population of alcoholic families, but varies with parental comorbidity and family history. Recent studies have also identified disruptive child behavior problems in the preschool years as predictive of alcoholism in adulthood. Given the quality of risk structure in highest risk families, prevention programming is more appropriately family based rather than individual.
A family-based intervention program for the prevention of conduct problems among preschool-age sons of alcoholic fathers was implemented to change this potential mediating risk structure. A population-based recruitment strategy enrolled 52 alcoholic families in a 10-month intervention involving parent training and marital problem solving. The study examined the interplay between parent treatment investment and parent and therapist expectations and satisfaction in predicting change in child behavior and authoritative parenting style during the program, and for 6 months afterward among the 29 families whose sustained involvement allowed these effects to be evaluated.
Parent expectations at pretreatment influenced their early investment in the program, which in turn predicted child and parenting outcomes. Parent and therapist satisfaction ratings during treatment were associated with one another and with expectations that the program would continue to promote changes in their child. Parent investment was a particularly salient influence on outcome, as higher investment throughout the program was associated with improvement in child behavior and authoritative parenting at termination.
Findings indicate that treatment process characteristics mediate the influence of baseline parent functioning on treatment success and that treatment changes themselves predict later child outcomes.
酒精问题后续发展的风险在酗酒家庭人群中并不一致，而是随父母共病情况和家族病史而变化。近期研究还发现，学龄前儿童的破坏性行为问题可预测成年后的酗酒问题。鉴于高风险家庭中风险结构的特点，预防项目更适合以家庭为基础而非针对个体。
实施了一项以家庭为基础的干预项目，以预防酗酒父亲的学龄前儿子出现行为问题，从而改变这种潜在的中介风险结构。一项基于人群的招募策略使52个酗酒家庭参与了为期10个月的干预，其中包括家长培训和婚姻问题解决。该研究考察了家长治疗投入与家长及治疗师期望和满意度之间的相互作用，以预测项目期间以及之后6个月内29个持续参与家庭中儿童行为和权威育儿方式的变化，这些家庭的持续参与使得能够评估这些效果。
治疗前的家长期望影响了他们对项目的早期投入，而这反过来又预测了儿童和育儿结果。治疗期间家长和治疗师的满意度评分相互关联，且与对项目将继续促进其孩子变化的期望相关。家长投入对结果有特别显著的影响，因为在整个项目中更高的投入与项目结束时儿童行为的改善和权威育儿方式相关。
研究结果表明，治疗过程特征介导了基线家长功能对治疗成功的影响，且治疗变化本身可预测后期儿童结果。
