Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.
Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK.
Clin Child Fam Psychol Rev. 2021 Sep;24(3):542-552. doi: 10.1007/s10567-021-00349-1. Epub 2021 May 15.
Disruptive behavior disorders (DBDs) are among the primary reasons for child and youth referrals to mental health services and are linked to poor adult outcomes including antisocial behavior disorder. Research indicates a high incidence of internalizing problems in those with DBDs and those who have DBDs with cooccurring internalizing problems may have more severe later outcomes. Interventions targeted at internalizing symptoms have been found to also reduce comorbid externalizing problems. The impact of treatments for DBDs on comorbid internalizing disorders is not known. Databases PsycINFO, EMBASE and MEDLINE were systematically searched based on the Cochrane guidelines for systematic reviews. Records were independently reviewed by two reviewers. 12 papers were deemed eligible. A quality assessment of the selected studies was conducted independently by both reviewers. The 12 studies included 1334 young people with a mean age of 5 years. The parent training interventions assessed were the Incredible Years (6/12 studies), Triple-P (5/12) and Tuning In To Kids (1/12). 11 of the 12 studies reported significant reductions in primary externalizing behavior problems and DBDs. 7 studies reported significant reductions in internalizing symptoms. Mechanisms of change, clinical implications and directions for future research are discussed.
破坏性行为障碍(DBD)是儿童和青少年转介心理健康服务的主要原因之一,与包括反社会行为障碍在内的不良成人结局有关。研究表明,DBD 患者和同时存在内化问题的 DBD 患者内化问题的发生率较高,他们的后期结果可能更严重。针对内化症状的干预措施已被发现也可以减少共病外化问题。针对 DBD 的治疗对共病内化障碍的影响尚不清楚。根据 Cochrane 系统评价指南,系统地在 PsycINFO、EMBASE 和 MEDLINE 数据库中进行了检索。记录由两名评审员独立审查。有 12 篇论文被认为符合条件。两名评审员分别对选定研究进行了质量评估。这 12 项研究共纳入了 1334 名平均年龄为 5 岁的年轻人。评估的父母培训干预措施是不可思议的岁月(6/12 项研究)、三重-P(5/12)和 Tuning In To Kids(1/12)。12 项研究中的 11 项报告了主要外化行为问题和 DBD 的显著减少。7 项研究报告了内化症状的显著减少。讨论了变化的机制、临床意义和未来研究的方向。