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挪威幼儿对立违抗和品行问题的治疗:一项随机对照试验的结果

Treatment of oppositional defiant and conduct problems in young Norwegian children : results of a randomized controlled trial.

作者信息

Larsson Bo, Fossum Sturla, Clifford Graham, Drugli May Britt, Handegård Bjørn Helge, Mørch Willy-Tore

机构信息

Department of Neuroscience, NTNU, Regional Centre for Child and Adolescent Mental Health, N-7489, Trondheim, Norway.

出版信息

Eur Child Adolesc Psychiatry. 2009 Jan;18(1):42-52. doi: 10.1007/s00787-008-0702-z. Epub 2008 Jun 18.

DOI:10.1007/s00787-008-0702-z
PMID:18563473
Abstract

The efficacy of the Incredible Years parent training and child therapy programs was examined in a randomized controlled study including 127 Norwegian children aged 4-8 years. Children diagnosed with oppositional defiant disorder (ODD) or conduct disorder (CD) were randomized to parent training (PT), parent training combined with child therapy (PT + CT), or a waiting-list control condition (WLC). Assessments were carried out at baseline, posttreatment and at a one-year follow-up using standardized measures and a semi-structured interview. Both active treatment conditions reduced child conduct problems posttreatment as opposed to the WLC, while differences between the two treatment conditions were small and nonsignificant. About two thirds of the treated children functioned within normal variation after treatment, and the same proportion no longer received an ODD diagnosis at the one-year follow-up. Parental use of positive strategies increased after treatment, and the use of harsh and inconsistent discipline decreased as did mother experience of stress. The outcome of this study emphasizes the importance of offering parent training to young children with severe conduct problems exhibited at home. The findings and usefulness of the Incredible Years program in the present Norwegian replication study further support and extend positive outcomes of previous controlled trials conducted primarily in Anglo-Saxon countries.

摘要

在一项随机对照研究中,对127名4至8岁的挪威儿童进行了“不可思议的岁月”家长培训和儿童治疗项目的疗效评估。被诊断为对立违抗障碍(ODD)或品行障碍(CD)的儿童被随机分为家长培训组(PT)、家长培训与儿童治疗相结合组(PT + CT)或等待名单对照组(WLC)。在基线、治疗后和一年随访时,使用标准化测量方法和半结构化访谈进行评估。与WLC相比,两种积极治疗组在治疗后均减少了儿童的行为问题,而两种治疗组之间的差异较小且无统计学意义。约三分之二接受治疗的儿童在治疗后功能处于正常变异范围内,且在一年随访时相同比例的儿童不再被诊断为ODD。治疗后家长使用积极策略的情况增加,严厉和不一致的管教方式减少,母亲的压力体验也减少。这项研究的结果强调了为在家中表现出严重行为问题的幼儿提供家长培训的重要性。“不可思议的岁月”项目在本次挪威重复研究中的结果和实用性进一步支持并扩展了此前主要在盎格鲁-撒克逊国家进行的对照试验的积极结果。

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