Beauchaine Theodore P, Webster-Stratton Carolyn, Reid M Jamila
Department of Psychology.
School of Nursing.
J Consult Clin Psychol. 2005 Jun;73(3):371-388. doi: 10.1037/0022-006X.73.3.371.
Several child conduct problem interventions have been classified as either efficacious or well established. Nevertheless, much remains to be learned about predictors of treatment response and mechanisms of behavioral change. In this study, the authors combine data from 6 randomized clinical trials and 514 children, ages 3.0-8.5 years, to evaluate moderators, mediators, and predictors of outcome. Among other findings, latent growth curve models of mother-report and observational measures of child externalizing behaviors suggested that marital adjustment, maternal depression, paternal substance abuse, and child comorbid anxiety/depression each moderated treatment response. Moreover, critical, harsh, and ineffective parenting both predicted and mediated outcome, with the most favorable responses observed when parents scored relatively low on each construct at intake yet improved during treatment. Implications for treatment nonresponders are discussed.
几种儿童行为问题干预措施已被归类为有效或已确立。然而,关于治疗反应的预测因素和行为改变的机制仍有许多有待了解。在本研究中,作者合并了6项随机临床试验的数据以及514名3.0至8.5岁儿童的数据,以评估结果的调节因素、中介因素和预测因素。在其他研究结果中,母亲报告的潜在增长曲线模型和儿童外化行为的观察指标表明,婚姻调适、母亲抑郁、父亲药物滥用以及儿童共病焦虑/抑郁均调节了治疗反应。此外,批评、严厉和无效的养育方式既预测了结果又起到了中介作用,当父母在治疗开始时在这些指标上得分相对较低但在治疗期间有所改善时,观察到的反应最为有利。本文讨论了对治疗无反应者的启示。