Dedousis-Wallace Anna, Drysdale Sophia A, McAloon John, Ollendick Thomas H
The Kidman Centre, University of Technology Sydney, Randwick, NSW, 2031, Australia.
Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia.
Clin Child Fam Psychol Rev. 2021 Mar;24(1):92-119. doi: 10.1007/s10567-020-00330-4. Epub 2020 Oct 19.
Despite the established efficacy of Parent Management Training (PMT) for conduct problems in youth, evidence suggests that up to half of all treated youth still display clinical levels of disruptive behavior post-treatment. The reasons for these unsatisfactory outcomes are poorly understood. The aim of the present review was to provide an updated analysis of studies from the past 15 years that examined parental and familial predictors and moderators of improvement in PMT for conduct problems. A systematic literature review of indicated prevention (children with conduct problem symptoms) and intervention (children with clinical diagnoses) studies published between 2004 and 2019 was conducted. This 15-year time period was examined since the last systematic reviews were reported in 2006 and summarized studies completed through mid-2004 (see Lundahl et al. in Clin Psychol Rev 26(1):86-104, 2006; Reyno and McGrath in J Child Psychol Psychiatry 47(1):99-111, 2006). Risk of bias indices was also computed (see Higgins et al. in Revised Cochrane risk of bias tool for randomized trials (RoB 2.0), University of Bristol, Bristol, 2016) in our review. A total of 21 studies met inclusion criteria. Results indicated that a positive parent-child relationship was most strongly associated with better outcomes; however, little additional consistency in findings was evident. Future PMT research should routinely examine predictors and moderators that are both conceptually and empirically associated with treatment outcomes. This would further our understanding of factors that are associated with poorer treatment outcome and inform the development of treatment components or modes of delivery that might likely enhance evidence-based treatments and our clinical science. Protocol Registration Number: PROSPERO CRD42017058996.
尽管家长管理培训（PMT）对青少年行为问题已证实具有疗效，但有证据表明，接受治疗的青少年中仍有多达一半在治疗后表现出临床水平的破坏性行为。这些不尽人意的结果的原因尚不清楚。本综述的目的是对过去15年中研究家长和家庭预测因素以及PMT治疗行为问题改善的调节因素的研究进行更新分析。对2004年至2019年间发表的针对有行为问题症状儿童的指示性预防研究和针对临床诊断儿童的干预研究进行了系统的文献综述。之所以研究这15年的时间段，是因为上次系统综述报告于2006年，且总结的研究截至2004年年中（见Lundahl等人，《临床心理学评论》26(1):86 - 104，2006；Reyno和McGrath，《儿童心理学与精神病学杂志》47(1):99 - 111，2006）。在我们的综述中还计算了偏倚风险指数（见Higgins等人，《随机试验的修订Cochrane偏倚风险工具（RoB 2.0）》，布里斯托尔大学，布里斯托尔，2016）。共有21项研究符合纳入标准。结果表明，积极的亲子关系与更好的结果最密切相关；然而，研究结果几乎没有其他明显的一致性。未来的PMT研究应常规检查在概念和实证上与治疗结果相关的预测因素和调节因素。这将加深我们对与较差治疗结果相关因素的理解，并为可能增强循证治疗和临床科学的治疗组成部分或提供方式的发展提供信息。方案注册号：PROSPERO CRD42017058996。
