Booker Jordan A, Capriola-Hall Nicole N, Dunsmore Julie C, Greene Ross W, Ollendick Thomas H
Department of Psychology, Emory University.
Child Study Center, Department of Psychology, Virginia Tech.
J Child Fam Stud. 2018 Jul;27(8):2552-2561. doi: 10.1007/s10826-018-1089-1. Epub 2018 Apr 4.
Our objective was to predict change in maternal stress over the course of a randomized clinical trial comparing the efficacy of two interventions for Oppositional Defiant Disorder (ODD): Parent Management Training and Collaborative & Proactive Solutions. In a secondary analysis of data collected from this randomized clinical trial, we examined whether children's self-reported positive relations with their parents impacted responsiveness to treatment, which in turn impacted maternal stress. One hundred thirty-four children and their parents (38.1% female, ages 7-14, age = 9.51, = 1.77) were tracked across three time points: pre-treatment; one-week post-treatment; and six-month post-treatment. Hierarchical linear models tested change in children's reports of positive relations with parents, clinician reports of ODD severity, and maternal reports of parenting stress. Models then tested multilevel mediation from positive relations with parents, through ODD severity, onto maternal stress. Hypothesized indirect effects were supported such that children's reports of positive views toward parents uniquely predicted reductions in ODD severity over time, which in turn uniquely predicted reductions in maternal stress. Results highlight the promise of potential secondary benefits for parents following interventions for children with oppositional problems. Furthermore, results underscore the importance of the parent-child relationship as both a protective factor and as an additional target to complement interventions for child disruptive behaviors.
我们的目标是在一项随机临床试验过程中预测母亲压力的变化，该试验比较了两种针对对立违抗障碍（ODD）干预措施的疗效：家长管理培训和协作与积极应对方案。在对该随机临床试验收集的数据进行的二次分析中，我们研究了儿童自我报告的与父母的积极关系是否会影响对治疗的反应性，进而影响母亲的压力。134名儿童及其父母（女性占38.1%，年龄7 - 14岁，平均年龄 = 9.51岁，标准差 = 1.77）在三个时间点接受跟踪：治疗前；治疗后一周；治疗后六个月。分层线性模型测试了儿童报告的与父母的积极关系、临床医生报告的ODD严重程度以及母亲报告的育儿压力的变化。然后，模型测试了从与父母的积极关系，通过ODD严重程度，到母亲压力的多层次中介作用。假设的间接效应得到了支持，即儿童对父母的积极看法报告能够独特地预测ODD严重程度随时间的降低，这反过来又能独特地预测母亲压力的降低。结果突出了针对有对立问题儿童的干预措施对父母潜在附带益处的前景。此外，结果强调了亲子关系作为一种保护因素以及作为补充儿童破坏性行为干预措施的额外目标的重要性。
