McSilver Institute for Poverty Policy and Research, Silver School of Social Work, New York University, New York, NY, USA.
Ellis Evaluation & Consulting Services, Atlanta, GA, USA.
J Abnorm Child Psychol. 2019 Sep;47(9):1437-1454. doi: 10.1007/s10802-019-00525-6.
We examined the stability of and cross-influences between externalizing behaviors and intervention engagement among children participating in a randomized clinical trial of an intervention for disruptive behavioral youth. Analyses also accounted for the influence of caregiver depression, family relationship quality, and sociodemographic factors (race, income) on the relationship between behaviors and intervention engagement. Analyses were based on 118 children participating in the Coping Power intervention. Composite variables were created to represent externalizing behaviors and intervention engagement constructs. Associations between these composite variables were examined over 24 treatment sessions. Findings indicated a regressive relationship among externalizing behaviors, i.e., baseline externalizing behaviors were positively associated with immediate follow-up behaviors. There were also dynamic relationships observed among engagement constructs. Notably, engagement with in-session activities during sessions 1-8 was positively associated with out-of-session activity engagement during the same treatment time period. Engagement with out-of-session activities during sessions 1-8 was positively associated with in-session activity engagement during sessions 9-16, indicating a complete mediation between early and middle in-session engagement through the mechanism of early out-of-session engagement. A crosslag relationship was observed: middle in-session engagement was negatively associated with externalizing behaviors at immediate follow-up. Finally, an interaction of race by income on immediate follow-up externalizing behaviors was observed, such that Black children's externalizing behaviors remain static regardless of income level while White children's behaviors decreased with higher income. Our findings support the contention that focusing on intervention engagement may be especially important in prevention interventions.
我们考察了参加一项针对行为障碍青年的干预措施的随机临床试验的儿童的外化行为及其与干预参与之间的稳定性和交叉影响。分析还考虑了照顾者抑郁、家庭关系质量和社会人口因素（种族、收入）对行为与干预参与之间关系的影响。分析基于 118 名参加应对力量干预的儿童。创建了综合变量来代表外化行为和干预参与结构。在 24 次治疗会议期间检查了这些综合变量之间的关联。研究结果表明，外化行为之间存在回归关系，即基线外化行为与即时后续行为呈正相关。还观察到参与结构之间的动态关系。值得注意的是，在第 1-8 次会议期间参与课堂活动与同一治疗时间段内的课外活动参与呈正相关。在第 1-8 次会议期间参与课外活动与在第 9-16 次会议期间的课堂活动参与呈正相关，表明通过早期课外参与的机制，早期和中期课堂参与之间存在完全中介。观察到交叉滞后关系：中期课堂参与与即时随访时的外化行为呈负相关。最后，观察到种族与收入对即时随访时外化行为的交互作用，即无论收入水平如何，黑人儿童的外化行为保持不变，而白人儿童的行为随着收入的增加而减少。我们的研究结果支持这样一种观点，即关注干预参与可能在预防干预中尤为重要。
