Björnsdotter Annika, Ghaderi Ata, Enebrink Pia
Department of Psychology, Uppsala University, Uppsala, Sweden.
Karolinska Institutet, Department of Clinical Neuroscience, Division of Psychology, Stockholm, Sweden.
J Pers Oriented Res. 2020 Dec 30;6(2):88-102. doi: 10.17505/jpor.2020.22403. eCollection 2020.
To explore whether children with various externalizing/prosocial behavior profiles benefit differently from face-to-face training than from an internet-based parent management training (PMT) programme.
A total of 231 families with children (aged 10 to 13 years) with externalizing behavior problems (EBP) were randomized to receive either the Family Check-Up, delivered by therapists in the community, or the internet-based PMT program (iComet). Person-oriented analysis was used for subtyping the children according to combinations of prosocial behavior and EBP.
The person-oriented analysis resulted in five significantly different clusters. There were no significant differences between the five clusters in relation to the total difficulties score of the Strengths and Difficulties Questionnaire, family warmth or family conflict, but the within-group effect sizes for the main outcome (total difficulties score) from baseline to post-treatment varied from Cohen's d of 0.52 to 2.56. There were no significant interaction effects between the clusters and type of intervention. However, for children high on symptoms of attention deficit hyperactivity disorder and moderate to high on oppositional defiant disorder, and low to relatively high on prosocial behaviors (Cluster 3 respectively 5), substantial residual EBP-symptomatology remained at post-treatment, although both interventions resulted in significant effects. The other three clusters were within the non-clinical EBP-range at post-intervention, irrespective of treatment condition. There were no significant differences between the clusters regarding treatment completion rate (ranging from 47.2% to 67.4%). This study illustrates the value of distinguishing between different profiles of children in the context of PMT for parents of children with EBP.
探讨具有不同外化/亲社会行为特征的儿童从面对面培训中获得的益处是否与基于互联网的家长管理培训（PMT）项目不同。
共有231个有外化行为问题（EBP）儿童（年龄10至13岁）的家庭被随机分为两组，一组接受由社区治疗师提供的家庭检查，另一组接受基于互联网的PMT项目（iComet）。采用以人为本的分析方法，根据亲社会行为和EBP的组合对儿童进行亚型分类。
以人为本的分析产生了五个显著不同的类别。在优势与困难问卷的总困难得分、家庭温暖或家庭冲突方面，这五个类别之间没有显著差异，但从基线到治疗后的主要结局（总困难得分）的组内效应大小从科恩d值0.52到2.56不等。类别与干预类型之间没有显著的交互作用。然而，对于注意力缺陷多动障碍症状高、对立违抗障碍中度至高、亲社会行为低至相对高的儿童（分别为类别3和5），尽管两种干预都产生了显著效果，但治疗后仍有大量残留的EBP症状。干预后，其他三个类别处于非临床EBP范围内，与治疗条件无关。在治疗完成率方面，类别之间没有显著差异（从47.2%到67.4%）。本研究说明了在为有EBP儿童的家长提供PMT的背景下区分不同儿童特征的价值。
