Drugli May Britt, Larsson Bo
Section of Child & Adolescent Mental Health Dept. of Neuroscience, Norwegian University of Science and Technology, 7489 Trondheim, Norway.
Eur Child Adolesc Psychiatry. 2006 Oct;15(7):392-9. doi: 10.1007/s00787-006-0546-3. Epub 2006 Apr 13.
In this study, generalisation effects to day-care/school settings were examined in an outpatient clinic sample of 127 children aged 4-8 years treated because of oppositional conduct problems in the home with parent training (PT) and parent training combined with child therapy (CT) ("Incredible Years"). Before treatment all children scored above the 90th percentile on the Eyberg Child Behavior Inventory (ECBI) for home problems, and met criteria for a possible or a confirmed diagnosis of either an oppositional defiant (ODD) or a conduct (CD) disorder. Further, 83% of the children showed clinical levels of conduct problems both at home and in day-care/school before treatment. Although most children improved at home, the majority still showed clinical levels of conduct problems in day-care/school settings after treatment and 1-year later. Combined PT and CT produced the most powerful and significant generalisation effects across the treatment period, however these improvements were not maintained 1-year later for most areas. The results of the present study, therefore, underline the need to target conduct problems not only exhibited at home but also in day-care/school settings, and to develop strategies to maintain positive generalisation effects after treatment for this age and problem-group.
在本研究中，对127名4至8岁因在家中存在对立行为问题而接受家长培训（PT）以及家长培训与儿童治疗（CT）（“不可思议的岁月”）相结合治疗的儿童的门诊样本，考察了其在日托/学校环境中的泛化效应。治疗前，所有儿童在家庭问题的艾伯格儿童行为量表（ECBI）上的得分均高于第90百分位数，且符合对立违抗障碍（ODD）或品行障碍（CD）可能或确诊诊断的标准。此外，83%的儿童在治疗前在家中和日托/学校中均表现出临床水平的行为问题。尽管大多数儿童在家中有所改善，但大多数儿童在治疗后以及1年后在日托/学校环境中仍表现出临床水平的行为问题。在整个治疗期间，PT与CT相结合产生了最强大且显著的泛化效应，然而，对于大多数领域而言，这些改善在1年后并未持续。因此，本研究结果强调，不仅要针对在家中表现出的行为问题，还要针对在日托/学校环境中表现出的行为问题，并制定策略以维持该年龄组和问题组治疗后积极的泛化效应。
