Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Sweden.
Department of Psychology, University of Alabama, Tuscaloosa, AL, USA.
Behav Res Ther. 2018 Apr;103:43-52. doi: 10.1016/j.brat.2018.02.001. Epub 2018 Feb 5.
For children with oppositional defiant disorder (ODD), Parent Management Training (PMT) is a recommended treatment in addition to child Cognitive Behavioral Therapy (child-CBT). There is however a lack of studies investigating the additive effect of group-based child-CBT to PMT for children between 8 and 12 years. The current study investigated the incremental effect of group-based child-CBT, based on the Coping Power Program, when added to the Swedish group-based PMT program KOMET. Outcomes were child behavior problems, child prosocial behavior, parenting skills and the moderating effect of child characteristics. One hundred and twenty children 8-12 years with ODD or Disruptive Behavioral Disorder NOS and their parents were randomized either to combined child-CBT and PMT (n = 63) or to PMT only (n = 57) in Swedish Child- and Adolescent Psychiatric settings. Participants were assessed pre- and post-treatment using semi-structured interviews and child- and parent ratings. After treatment, behavior problems were reduced in both groups. Prosocial behavior were significantly more improved in the combined treatment. Parenting skills were improved in both groups. In moderator analyses, behavior problems and prosocial behavior improved significantly more in the combined treatment compared to PMT only in the group of children with high levels of ODD symptoms.
对于患有对立违抗性障碍(ODD)的儿童,除了儿童认知行为疗法(child-CBT)之外,父母管理培训(PMT)也是一种推荐的治疗方法。然而,目前缺乏研究调查基于群体的儿童-CBT 对 8 至 12 岁儿童 PMT 的附加效果。本研究调查了基于群体的儿童-CBT 在瑞典基于群体的 PMT 项目 KOMET 中的附加效果,该项目基于应对能力计划。结果是儿童行为问题、儿童亲社会行为、育儿技能以及儿童特征的调节作用。120 名 8-12 岁患有 ODD 或行为障碍NOS 的儿童及其父母在瑞典儿童和青少年精神病学环境中随机分为接受联合儿童-CBT 和 PMT(n=63)或仅接受 PMT(n=57)的治疗。参与者在治疗前和治疗后使用半结构化访谈和儿童和父母评分进行评估。治疗后,两组的行为问题均有所减少。亲社会行为在联合治疗中显著改善。育儿技能在两组中均得到改善。在调节分析中,与仅接受 PMT 相比,在 ODD 症状水平较高的儿童中,联合治疗组的行为问题和亲社会行为显著改善更多。