Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany.
School for Child and Adolescent Cognitive Behavior Therapy (AKiP), Medical Faculty, University of Cologne, Cologne, Germany.
Child Psychiatry Hum Dev. 2024 Apr;55(2):453-466. doi: 10.1007/s10578-022-01400-0. Epub 2022 Sep 6.
The study examined potential mediating effects of therapist behaviors in the per-protocol sample (n = 108) of a randomized controlled trial comparing a behavioral and a nondirective guided self-help intervention for parents of children with externalizing disorders (4-11 years). Additionally, from an exploratory perspective, we analyzed a sequential model with parental adherence as second mediator following therapist behavior. Outcomes were child symptom severity of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder rated by blinded clinicians, and parent-rated child functional impairment. We found a significant indirect effect on the reduction of ADHD and functional impairment through emotion- and relationship-focused therapist behavior in the nondirective intervention. Additionally, we found limited support for an extended sequential mediation effect through therapist behavior and parental adherence in the models for these outcomes. The study proposes potential mediating mechanisms unique to the nondirective intervention and complements previous findings on mediator processes in favor of the behavioral group. Trial registration ClinicalTrials.gov NCT01350986.
该研究在一项比较行为和非指导性引导自助干预的随机对照试验中，对方案内样本（n=108）的治疗师行为进行了潜在的中介效应检验，该试验针对的是有外化障碍的儿童（4-11 岁）的家长。此外，从探索性的角度来看，我们分析了一个序列模型，以父母遵从来作为紧随治疗师行为的第二个中介。结局是由盲法临床医生评定的儿童注意缺陷多动障碍（ADHD）和对立违抗性障碍的症状严重程度，以及父母评定的儿童功能障碍。我们发现，在非指导性干预中，情绪和关系为重点的治疗师行为对 ADHD 和功能障碍的减少有显著的间接影响。此外，我们在这些结局的模型中发现，通过治疗师行为和父母遵从来进行扩展的序列中介效应的支持有限。该研究提出了非指导性干预特有的潜在中介机制，补充了以前支持行为组的中介过程的发现。试验注册ClinicalTrials.gov NCT01350986。
