University of California, San Francisco.
University of California, San Francisco; University of California, Berkeley.
Behav Ther. 2018 Jul;49(4):567-579. doi: 10.1016/j.beth.2017.11.007. Epub 2017 Dec 5.
We investigated treatment effects on parenting self-efficacy and parent cognitive errors, and whether these parent cognitions are related to short- and long-term outcomes in parenting behaviors in psychosocial treatment for youth with attention-deficit/hyperactivity disorder, predominantly inattentive presentation (ADHD-I). In a randomized controlled trial across two sites (University of California, San Francisco, and University of California, Berkeley), 199 children between the ages of 7 and 11 were randomized to the Child Life and Attention Skills (CLAS; n = 74) program, parent-focused treatment (PFT; n = 74), or treatment as usual (TAU; n = 51). Parents reported on self-efficacy, cognitive errors, positive parenting, and negative parenting prior to treatment, immediately after treatment, and in the next school year at follow-up. Compared to TAU, CLAS and PFT had higher posttreatment parenting self-efficacy, and CLAS alone had lower posttreatment parent cognitive errors. At follow-up, only CLAS had improved parent cognitive errors compared to TAU. No other between-group differences were found in parenting self-efficacy or cognitive errors. Improved parenting self-efficacy was associated with improved posttreatment negative parenting outcomes for PFT and CLAS, and improved parent cognitive errors were also related to improvements in positive and negative posttreatment parenting outcomes for CLAS. Posttreatment parenting self-efficacy mediated follow-up negative parenting outcomes for CLAS and posttreatment parent cognitive errors mediated improved follow-up positive and negative parenting outcomes for CLAS. PFT and CLAS led to enhanced parenting self-efficacy, and CLAS appears especially robust in improving parent cognitive errors both in the short and long term. Pathways provide support for the possibility of parent cognitions as mediators of treatment effects on parenting; clinical focus on such cognitions may be useful.
我们研究了心理社会治疗对青少年注意缺陷多动障碍（主要为注意力不集中型 ADHD）父母养育自我效能感和父母认知错误的影响，以及这些父母认知是否与短期和长期养育行为结果相关。在加利福尼亚大学旧金山分校和加利福尼亚大学伯克利分校两个地点进行的一项随机对照试验中，199 名 7 至 11 岁的儿童被随机分配到儿童生活和注意力技能（CLAS；n = 74）项目、以父母为焦点的治疗（PFT；n = 74）或常规治疗（TAU；n = 51）。父母在治疗前、治疗后立即和随访的下一个学年报告自我效能感、认知错误、积极养育和消极养育。与 TAU 相比，CLAS 和 PFT 在治疗后具有更高的养育自我效能感，而仅 CLAS 在治疗后具有更低的父母认知错误。在随访中，仅 CLAS 与 TAU 相比改善了父母认知错误。在养育自我效能感或认知错误方面，没有发现其他组间差异。在 PFT 和 CLAS 中，提高养育自我效能感与治疗后消极养育结果的改善相关，而改善父母认知错误也与 CLAS 治疗后积极和消极养育结果的改善相关。治疗后养育自我效能感介导 CLAS 的随访消极养育结果，治疗后父母认知错误介导 CLAS 的随访积极和消极养育结果的改善。PFT 和 CLAS 导致养育自我效能感增强，而 CLAS 似乎在短期和长期内都特别有效地改善父母认知错误。这些途径为父母认知作为治疗对养育影响的中介的可能性提供了支持；临床关注这些认知可能是有用的。
