Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia; and
Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia; and.
Pediatrics. 2017 Sep;140(3). doi: 10.1542/peds.2017-0352.
Parent-child interaction therapy (PCIT) is effective at reducing children's externalizing behavior. However, modifications are often made to PCIT, and it is not known whether these impact effectiveness.
To systematically review and meta-analyze the effects of PCIT on child externalizing behaviors, considering modifications, study design, and bias.
We searched PubMed, PsycINFO, Education Resources Information Center, Sociological Abstracts, and A+ Education.
We selected randomized controlled or quasi-experimental trials.
We analyzed child externalizing and internalizing behaviors, parent stress, parent-child interactions, PCIT format, and study design and/or characteristics.
We included 23 studies (1144 participants). PCIT was superior to control for reducing child externalizing (standardized mean difference [SMD]: -0.87, 95% confidence interval [CI]:-1.17 to -0.58). PCIT studies that required skill mastery had significantly greater reductions in externalizing behavior than those that did not (Mastery: SMD: -1.09, 95% CI: -1.44 to -0.73; Nonmastery: SMD: -0.51,95% CI: -0.85 to -0.17, = .02). Compared with controls, PCIT significantly reduced parent-related stress (mean difference [MD]: -6.98, 95% CI: -11.69 to -2.27) and child-related stress (MD: -9.87, 95% CI: -13.64 to -6.09). Children in PCIT were observed to be more compliant to parent requests (SMD: 0.89, 95% CI: 0.50 to 1.28) compared with controls. PCIT effectiveness did not differ depending on session length, location (academic versus community settings), or child problems (disruptive behaviors only compared with disruptive behavior and other problems).
Results for parent-child observations were inconsistently reported, reducing the ability to pool important data.
PCIT has robust positive outcomes across multiple parent-reported and observed parent-child interaction measures, and modifications may not be required even when implemented in diverse populations.
亲子互动疗法（PCIT）可有效减少儿童的外化行为。然而，PCIT 通常会进行修改，目前尚不清楚这些修改是否会影响其效果。
系统评价和荟萃分析 PCIT 对儿童外化行为的影响，同时考虑修改、研究设计和偏倚。
我们检索了 PubMed、PsycINFO、教育资源信息中心、社会学摘要和 A+ 教育。
我们选择了随机对照或准实验研究。
我们分析了儿童的外化和内化行为、父母压力、亲子互动、PCIT 形式以及研究设计和/或特征。
我们纳入了 23 项研究（1144 名参与者）。PCIT 组在减少儿童外化行为方面优于对照组（标准化均数差 [SMD]：-0.87，95%置信区间 [CI]：-1.17 至 -0.58）。需要掌握技能的 PCIT 研究组在减少外化行为方面的效果显著优于无需掌握技能的研究组（掌握：SMD：-1.09，95% CI：-1.44 至 -0.73；未掌握：SMD：-0.51，95% CI：-0.85 至 -0.17， =.02）。与对照组相比，PCIT 显著降低了父母相关压力（平均差 [MD]：-6.98，95% CI：-11.69 至 -2.27）和儿童相关压力（MD：-9.87，95% CI：-13.64 至 -6.09）。与对照组相比，接受 PCIT 的儿童对父母的请求更顺从（SMD：0.89，95% CI：0.50 至 1.28）。PCIT 的效果不受疗程长短、地点（学术与社区环境）或儿童问题（破坏性行为与破坏性行为和其他问题）的影响。
亲子观察结果的报告不一致，降低了汇总重要数据的能力。
PCIT 在多项父母报告和观察到的亲子互动测量中具有强大的积极结果，即使在不同人群中实施，也可能无需进行修改。
