Forehand Rex, Parent Justin, Sonuga-Barke Edmund, Peisch Virginia D, Long Nicholas, Abikoff Howard B
University of Vermont, 2 Colchester Ave., Burlington, VT, 05405, USA.
University of Southampton, Southampton, UK.
J Abnorm Child Psychol. 2016 Nov;44(8):1503-1513. doi: 10.1007/s10802-016-0138-8.
The present study examined whether the presence of comorbid ODD differentially moderated the outcome of two Behavioral Parent Training (BPT) programs in a sample of preschoolers with ADHD: One designed specifically for ADHD (NFPP: New Forest Parenting Programme) and one designed primarily for ODD (HNC: Helping the Noncompliant Child). In a secondary analysis, 130 parents and their 3-4 year-old children diagnosed with ADHD were assigned to one of the two programs. 44.6 % of the children also met criteria for ODD. Significant interactions between treatment conditions (NFPP vs. HNC) and child ODD diagnosis (presence vs. absence) indicated that based on some parent and teacher reports, HNC was more effective with disruptive behaviors than NFPP but only when children had a comorbid diagnosis. Further, based on teacher report, NFPP was more effective with these behaviors when children had a diagnosis of only ADHD whereas HNC was equally effective across ADHD only and comorbid ODD diagnoses. Comorbidity profile did not interact with treatment program when parent or teacher reported ADHD symptoms served as the outcome. Implications for clinical interventions are discussed and directions for future work are provided.
本研究探讨了对立违抗障碍（ODD）共病的存在是否会对多动症学龄前儿童样本中两种行为父母培训（BPT）项目的结果产生不同程度的调节作用：一种是专门为多动症设计的（NFPP：新森林育儿项目），另一种主要是为对立违抗障碍设计的（HNC：帮助不听话的孩子）。在一项二次分析中，130名被诊断为多动症的家长及其3至4岁的孩子被分配到这两个项目中的一个。44.6%的孩子也符合对立违抗障碍的标准。治疗条件（NFPP与HNC）和儿童对立违抗障碍诊断（存在与不存在）之间的显著交互作用表明，根据一些家长和教师的报告，HNC在处理破坏性行为方面比NFPP更有效，但前提是孩子患有共病诊断。此外，根据教师报告，当孩子仅被诊断为多动症时，NFPP在处理这些行为方面更有效，而HNC在仅患有多动症和共病对立违抗障碍的诊断中效果相同。当以家长或教师报告的多动症症状作为结果时，共病情况与治疗项目之间没有交互作用。文中讨论了对临床干预的启示，并提供了未来工作的方向。
