Department of Psychology, Utrecht University, The Netherlands.
J Clin Child Adolesc Psychol. 2013;42(3):384-92. doi: 10.1080/15374416.2013.769169. Epub 2013 Mar 5.
Disadvantaged family socioeconomic status (SES) is often assumed to diminish parent training program effectiveness. In examining effects of SES, influences of initial problem severity have been largely ignored. In the present meta-analysis, we examined (a) whether there is a differential influence of SES on parent training effectiveness at immediate posttreatment and at 1-year follow-up-controlling for levels of initial problem severity--and (b) whether SES interacts with initial problem severity in its effect on program effectiveness. Seventy-five studies on parent training program effectiveness to reduce disruptive child behavior were included. Separate analyses were conducted for immediate posttreatment and approximately 1-year follow-up assessments. Immediately posttreatment, disadvantaged samples benefited less from parent training, but only when they had low levels of initial problem severity. At follow-up, disadvantaged samples benefited less from parent training regardless of initial problem severity. Initial problem severity was a strong predictor of effect sizes both immediately posttreatment and at follow-up. Parent training programs are equally effective for disadvantaged and nondisadvantaged families immediately posttreatment, at least when initial problems are severe. Maintenance of treatment gain, however, seems harder for disadvantaged families, suggesting that more sustained family support may be needed.
社会经济地位较低的家庭(SES)通常被认为会降低家长培训计划的效果。在研究 SES 的影响时,初始问题严重程度的影响在很大程度上被忽视了。在本荟萃分析中,我们检验了(a)在控制初始问题严重程度的情况下,SES 是否对家长培训效果在即时治疗后和 1 年随访中有不同的影响——以及(b)SES 是否在其对计划效果的影响上与初始问题严重程度相互作用。共纳入了 75 项关于家长培训计划效果的研究,以减少儿童的破坏性行为。分别对即时治疗后和大约 1 年随访评估进行了分析。即时治疗后,社会经济地位较低的样本从家长培训中获益较少,但只有在初始问题严重程度较低的情况下才会如此。在随访中,无论初始问题严重程度如何,社会经济地位较低的样本从家长培训中获益较少。初始问题严重程度是即时治疗后和随访时效应大小的一个强有力的预测因素。家长培训计划在即时治疗后对劣势和非劣势家庭同样有效,至少在初始问题严重时是这样。然而,维持治疗效果似乎对劣势家庭来说更难,这表明可能需要更持续的家庭支持。