Department of Psychology, Simon Fraser University and British Columbia Children's Hospital Research Institute.
Department of Psychology, Louisiana State University.
J Clin Child Adolesc Psychol. 2021 Jul-Aug;50(4):525-533. doi: 10.1080/15374416.2021.1894566. Epub 2021 Mar 31.
: The purpose of this Brief Report is to synthesize the current evidence base examining moderators of psychosocial intervention response for children and adolescents with conduct problems (CP). We also provide directions for future research. We focused on four categories of psychosocial interventions for the prevention and/or treatment of CP: (1) parent management training (PMT) for children, (2) other family-based interventions for adolescents, (3) youth skills training, and (4) multicomponent interventions (i.e., family-based intervention plus skills training). Emphasis is placed on findings from meta-analyses. Moderation analyses have occurred more frequently for PMT than for other types of interventions. Variables for which there was consistent evidence for positive moderation included higher initial severity of CP, father engagement, higher maternal depressive symptoms, individual administration (vs. group), and treatment/targeted prevention approaches (vs. universal prevention). Variables where there was evidence for no moderation (demonstrating generalizability) included child diagnostic status and family risk in PMT, and diagnostic status and intervention setting for skills training. However, for some variables, evidence of moderation was dependent on intervention type. Future research should examine multiple moderators in combination; incorporate innovative techniques such as integrative data analyses, individual participant data, and class-based modeling, which may identify moderator effects that are undetected by more traditional variable-oriented moderation analyses; and conduct moderated mediation models for informing developmental theory on the interplay of risk and protective factors.
本简报旨在综合当前关于行为问题儿童和青少年心理社会干预反应的调节因素的证据基础。我们还为未来的研究提供了方向。我们关注了预防和/或治疗 CP 的四种心理社会干预措施:(1)针对儿童的父母管理培训(PMT),(2)针对青少年的其他家庭为基础的干预措施,(3)青年技能培训,以及(4)多组分干预(即家庭为基础的干预加技能培训)。重点放在荟萃分析的结果上。PMT 的调节分析比其他类型的干预更为频繁。有一致证据表明积极调节的变量包括 CP 的初始严重程度较高、父亲参与度较高、母亲抑郁症状较高、个体管理(与小组管理相比)以及治疗/针对性预防方法(与普遍预防方法相比)。没有调节证据(表现出普遍性)的变量包括 PMT 中的儿童诊断状况和家庭风险,以及技能培训中的诊断状况和干预设置。然而,对于一些变量,调节的证据取决于干预类型。未来的研究应该综合考虑多个调节因素;采用创新技术,如综合数据分析、个体参与者数据和基于类别的建模,这可能会发现传统变量导向的调节分析无法检测到的调节效应;并进行调节中介模型,以告知风险和保护因素相互作用的发展理论。