Katzmann Josepha, Hautmann Christopher, Greimel Lisa, Imort Stephanie, Pinior Julia, Scholz Kristin, Döpfner Manfred
Department of Psychiatry, Psychosomatics and Psychotherapy in Childhood and Adolescence, Medical Faculty, University of Cologne, Cologne, Germany.
School of Child and Adolescent Psychotherapy, University Hospital of Cologne, Cologne, Germany.
J Abnorm Child Psychol. 2017 May;45(4):719-730. doi: 10.1007/s10802-016-0195-z.
Parent training (PT) delivered as a guided self-help intervention may be a cost- and time-effective intervention in the treatment of children with externalizing disorders. In face-to-face PT, parenting strategies have repeatedly been identified as mediating mechanisms for the decrease of children's problem behavior. Few studies have examined possible mediating effects in guided self-help interventions for parents. The present study aimed to investigate possible mediating variables of a behaviorally oriented guided self-help program for parents of children with externalizing problems compared to a nondirective intervention in a clinical sample. A sample of 110 parents of children with externalizing disorders (80 % boys) were randomized to either a behaviorally oriented or a nondirective guided self-help program. Four putative mediating variables were examined simultaneously in a multiple mediation model using structural equation modelling. The outcomes were child symptoms of ADHD and ODD as well as child externalizing problems, assessed at posttreatment. Analyses showed a significant indirect effect for dysfunctional parental attributions in favor of the group receiving the behavioral program, and significant effects of the behavioral program on positive and negative parenting and parental self-efficacy, compared to the nondirective intervention. Our results indicate that a decrease of dysfunctional parental attributions leads to a decrease of child externalizing problems when parents take part in a behaviorally oriented guided self-help program. However, none of the putative mediating variables could explain the decrease in child externalizing behavior problems in the nondirective group. A change in dysfunctional parental attributions should be considered as a possible mediator in the context of PT.
作为一种指导性自助干预措施的家长培训（PT），在治疗外化障碍儿童方面可能是一种具有成本效益和时间效益的干预方法。在面对面的家长培训中，育儿策略一再被确定为儿童问题行为减少的中介机制。很少有研究考察指导性自助干预措施对家长可能产生的中介效应。本研究旨在调查与临床样本中的非指导性干预相比，针对有外化问题儿童的家长开展的行为导向型指导性自助项目可能的中介变量。110名有外化障碍儿童的家长（80%为男孩）被随机分配到行为导向型或非指导性指导性自助项目中。使用结构方程模型在多重中介模型中同时检验了四个假定的中介变量。结果变量是治疗后评估的儿童多动症和对立违抗性障碍症状以及儿童外化问题。分析表明，功能失调的父母归因对接受行为项目的组有显著的间接效应，与非指导性干预相比，行为项目对积极和消极育儿以及父母自我效能有显著影响。我们的结果表明，当父母参加行为导向型指导性自助项目时，功能失调的父母归因减少会导致儿童外化问题减少。然而，没有一个假定的中介变量能够解释非指导性组中儿童外化行为问题的减少。在家长培训的背景下，功能失调的父母归因的改变应被视为一种可能的中介因素。
