Department of Child and Adolescent Studies, Utrecht University, P.O. Box 80140, 3508 TC, Utrecht, The Netherlands.
Research Centre for Forensic Child and Youth Care Sciences, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, The Netherlands.
J Abnorm Child Psychol. 2017 Oct;45(7):1285-1295. doi: 10.1007/s10802-016-0242-9.
Multiple studies have shown that Multisystemic Therapy (MST) is, at group level, an effective treatment for adolescents showing serious externalizing problem behavior. The current study expands previous research on MST by, first, examining whether subgroups of participants who respond differently to treatment could be identified. Second, we investigated if the different trajectories of change during MST could be predicted by individual (hostile attributions) and contextual (parental sense of parenting competence and deviant and prosocial peer involvement) pre-treatment factors. Participants were 147 adolescents (mean age = 15.91 years, 104 (71%) boys) and their parents who received MST. Pre-treatment assessment of the predictors and 5 monthly assessments of externalizing behavior during treatment took place using both adolescent and parents' self-reports. Six distinct subgroups, showing different trajectories of change in externalizing problem behavior during MST, were identified. Two of the 6 trajectories of change showed a poor treatment response, as one class did not change in externalizing problem behavior and the other class even increased. The remaining 4 trajectories displayed a positive effect of MST, by showing a decrease in externalizing behavior. Most of these trajectories could be predicted by parental sense of parenting competence. Additionally, lower involvement with prosocial peers was a predictor of the group that appeared to be resistant to MST. Adolescents do respond differently to MST, which indicates the importance of personalizing treatment. Protective factors, such as parental sense of parenting competence and prosocial peers, seem to require additional attention in the first phase of MST.
多项研究表明，多系统治疗（MST）在群体层面上是一种针对表现出严重外化问题行为的青少年的有效治疗方法。本研究通过以下两个方面扩展了之前关于 MST 的研究：首先，检查是否可以识别出对治疗反应不同的参与者亚组；其次，我们研究了个体（敌意归因）和环境（父母养育效能感和偏差及亲社会同伴卷入）治疗前因素是否可以预测 MST 期间不同的变化轨迹。参与者为 147 名青少年（平均年龄 15.91 岁，104 名男孩，占 71%）及其接受 MST 的父母。使用青少年和父母的自我报告，在治疗前评估预测因素，并在治疗期间进行 5 次每月的外化行为评估。确定了 6 个不同的亚组，这些亚组在外化问题行为的 MST 期间表现出不同的变化轨迹。6 个变化轨迹中的 2 个显示出较差的治疗反应，因为一个轨迹在外化问题行为方面没有变化，另一个轨迹甚至增加了。其余 4 个轨迹显示出 MST 的积极效果，表现为外化行为减少。这些轨迹中的大多数可以通过父母的养育效能感来预测。此外，与亲社会同伴的较低卷入度是对似乎对 MST 有抵抗力的群体的一个预测因素。青少年对外化治疗确实有不同的反应，这表明个性化治疗的重要性。保护因素，如父母的养育效能感和亲社会同伴，在 MST 的第一阶段似乎需要额外的关注。
