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Journal of the American Academy of... Apr 2022Behavioral parent training is an evidence-based intervention for children with attention-deficit/hyperactivity disorder (ADHD), but it is unknown which of its components... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Behavioral parent training is an evidence-based intervention for children with attention-deficit/hyperactivity disorder (ADHD), but it is unknown which of its components are most effective. This meta-regression analysis investigated which specific behavioral techniques that parents learn in parent training are associated with effects on parental outcomes.
METHOD
A search was performed for randomized controlled trials on parent training for children with ADHD, with positive parenting, negative parenting, parenting sense of competence, parent-child relationship quality, and parental mental health as outcome measures. After screening 23,026 publications, 29 studies contributing 138 effect sizes were included (N = 2,345). For each study, the dosage of 39 behavioral techniques was derived from intervention manuals, and meta-regression determined which techniques were related to outcomes.
RESULTS
Parent training had robust small- to medium-sized positive effects on all parental outcomes relative to control conditions, both for unblinded and probably blinded measures. A higher dosage of techniques focusing on the manipulation of antecedents of behavior was associated with better outcomes on parenting sense of competence and parental mental health, and a higher dosage of techniques focusing on reinforcement of desired behaviors was related to larger decreases in negative parenting. Higher dosages of psychoeducation were negatively related to parental outcomes.
CONCLUSION
Although techniques were not investigated in isolation, the results suggested that manipulation of antecedents of behavior and reinforcement techniques are key components of parent training for children with ADHD in relation to parental outcomes. These exploratory findings may help to strengthen and tailor parent training interventions for children with ADHD.
Topics: Attention Deficit Disorder with Hyperactivity; Behavior Therapy; Humans; Parent-Child Relations; Parenting; Parents
PubMed: 34224837
DOI: 10.1016/j.jaac.2021.06.015 -
European Child & Adolescent Psychiatry Jun 2022Current forms of parent training for childhood attention deficit hyperactivity disorder (ADHD) are often insufficient. Many families drop out of the training, and... (Randomized Controlled Trial)
Randomized Controlled Trial
Current forms of parent training for childhood attention deficit hyperactivity disorder (ADHD) are often insufficient. Many families drop out of the training, and treatment gains are often not maintained. Nonviolent resistance parent training (NVR) focuses on helping parents resist the child's negative behaviors without escalating the problem. NVR helps parents to fulfill an anchoring function, supporting the child through presence, self-regulation, structure, and support network. This study is a randomized controlled trial designed to assess the efficacy of NVR in the treatment of childhood ADHD. Participants were Israeli parents of children with primary ADHD diagnosis (N = 101; 5-13 years old; 79% male participants) randomly assigned to either 12-session NVR (N = 50) or waiting list (N = 51). Measures were administered before and after treatment and at a 4-month follow-up. ADHD outcomes included the Conners and Child Behavior Checklist. Parenting outcomes included parental helplessness, emotional regulation, anchoring function, and family chaos. Participants in the NVR condition reported significant improvements in the child's internalizing, externalizing, and ADHD symptoms, as well as improvement in paternal and maternal helplessness and anchoring. Participants in the control condition did not report changes in the child's symptoms or the parents' condition. The results at follow-up revealed maintenance of change in the child's externalizing and internalizing symptoms, but failure to maintain gains in ADHD core symptoms. Maternal helplessness and anchoring, as well as family chaos continued to improve at follow-up. Dropout rates in the treatment group were low (5%), and fathers' engagement was close to 100%. NVR is an efficient treatment for childhood ADHD, with benefits extending beyond the child's symptoms to the entire family. NVR's special focus on parental distress may have contributed to low dropout, high paternal engagement, and maintenance of change.
Topics: Adolescent; Attention Deficit Disorder with Hyperactivity; Child; Child, Preschool; Female; Humans; Israel; Male; Outcome Assessment, Health Care; Parenting; Parents
PubMed: 33528659
DOI: 10.1007/s00787-021-01723-8 -
Clinical Psychology Review Jun 2014This systematic review and meta-analysis examined the effects of the multilevel Triple P-Positive Parenting Program system on a broad range of child, parent and family... (Meta-Analysis)
Meta-Analysis Review
This systematic review and meta-analysis examined the effects of the multilevel Triple P-Positive Parenting Program system on a broad range of child, parent and family outcomes. Multiple search strategies identified 116 eligible studies conducted over a 33-year period, with 101 studies comprising 16,099 families analyzed quantitatively. Moderator analyses were conducted using structural equation modeling. Risk of bias within and across studies was assessed. Significant short-term effects were found for: children's social, emotional and behavioral outcomes (d=0.473); parenting practices (d=0.578); parenting satisfaction and efficacy (d=0.519); parental adjustment (d=0.340); parental relationship (d=0.225) and child observational data (d=0.501). Significant effects were found for all outcomes at long-term including parent observational data (d=0.249). Moderator analyses found that study approach, study power, Triple P level, and severity of initial child problems produced significant effects in multiple moderator models when controlling for other significant moderators. Several putative moderators did not have significant effects after controlling for other significant moderators. The positive results for each level of the Triple P system provide empirical support for a blending of universal and targeted parenting interventions to promote child, parent and family wellbeing.
Topics: Adult; Child; Child Behavior Disorders; Female; Humans; Male; Parenting; Parents; Personal Satisfaction; Program Evaluation; Social Support
PubMed: 24842549
DOI: 10.1016/j.cpr.2014.04.003 -
Family Process Mar 2023Children and their families have been significantly impacted by the unfolding of the COVID-19 syndemic. We sought to identify (1) groups of families with distinct...
Children and their families have been significantly impacted by the unfolding of the COVID-19 syndemic. We sought to identify (1) groups of families with distinct profiles of joint trajectories of parental anxiety and child emotional distress and (2) protective and risk factors associated with these dual-trajectory profiles. A sample of 488 parents (65% White; 77% mothers) with 3- to 8-year-old children (M = 5.04, SD = 1.59) was followed from late March to early July in 2020. Survey data on parent (i.e., anxiety symptoms) and child (i.e., emotional distress) adjustment were collected at three time points. Using multivariate growth mixture modeling, we identified one group with low parental anxiety and child emotional distress (42.7%) and three other distinct groups with varying risk levels among parents and/or children. We also identified protective (e.g., positive parenting) and risk (e.g., child negative affect, negative parenting, perceived stress with racism) factors in predicting parent and child adjustment. It can be concluded that, overall, our sample (mostly middle- and high-socioeconomic status families) demonstrated family resilience amid COVID-19, consistent with prior disaster coping literature. At the same time, our findings also indicated the need to identify at-risk families and modifiable factors for post-disaster public health interventions.
Topics: Female; Child; Humans; Child, Preschool; Infant; Family Health; Syndemic; COVID-19; Resilience, Psychological; Parents; Parenting
PubMed: 35165887
DOI: 10.1111/famp.12761 -
Journal of Abnormal Child Psychology Oct 2020Specific phobias are among the most prevalent anxiety disorders in children and adolescents. Although brief and intensive treatments are evidence-based interventions...
Specific phobias are among the most prevalent anxiety disorders in children and adolescents. Although brief and intensive treatments are evidence-based interventions (Davis III et al. Annual Review of Clinical Psychology, 15, 233-256, 2019), up to one-third of youth do not show significant change in their symptoms following these interventions. Hence, consideration of additional factors influencing treatment response is necessary. Child-factors such as temperament and parent-factors such as parenting behaviors both contribute to the development of specific phobias and their maintenance over time. Specifically, we addressed child temperament (negative affectivity) and parenting behaviors (overprotection) that could uniquely predict clinical outcomes for specific phobias and that might interact to inform goodness-of-fit in the context of these interventions. We also considered whether child- and/or parent-gender shaped the effects of temperament or parenting on clinical outcomes. Participants were 125 treatment-seeking youth (M age = 8.80 years; age range = 6-15 years; 51.5% girls) who met criteria for specific phobia and their mothers and fathers. Mothers' reports of children's negative affectivity uniquely predicted poorer specific phobia symptom severity and global clinical adjustment at post-treatment. Interaction effects were supported between parental overprotection and child negative affectivity for post-treatment fearfulness. The direction of these effects differed between fathers and mothers, suggesting that goodness-of-fit is important to consider, and that parent gender may provide additional nuance to considerations of parent-child fit indices.
Topics: Adolescent; Affect; Child; Female; Humans; Male; Parent-Child Relations; Parenting; Parents; Phobic Disorders; Sex Factors; Temperament
PubMed: 32623544
DOI: 10.1007/s10802-020-00662-3 -
European Child & Adolescent Psychiatry Dec 2023Depression in early childhood increases risk of psychopathology and impairment across the lifespan. Parent-Child Interaction Therapy-Emotion Development (PCIT-ED)... (Randomized Controlled Trial)
Randomized Controlled Trial
Depression in early childhood increases risk of psychopathology and impairment across the lifespan. Parent-Child Interaction Therapy-Emotion Development (PCIT-ED) effectively treats depression and improves functioning in preschoolers. Parental depression has been associated with inconsistent parenting, depression onset and maintenance in offspring, and decreased treatment efficacy for youth. Given the intensity of parent involvement in PCIT-ED, this secondary data analysis aimed to evaluate parental depression severity (i.e., Beck Depression Inventory-II Total Score; BDI-II) as a moderator and predictor of child, parenting, and engagement outcomes, within the context of a randomized trial. Children (N = 229; ages 3-6.11) with early childhood depression and a consenting caregiver were randomly assigned to receive PCIT-ED or Waitlist (WL). Moderation results supported the superiority of PCIT-ED over WL on child and parenting outcomes, independent of parent-reported BDI-II at baseline (p ≥ 0.684 and p ≥ 0.476, respectively). BDI-II did not significantly predict child (p ≥ 0.836), parenting (p ≥ 0.114) or engagement (p ≥ 0.114) outcomes. Finally, BDI-II did not surpass chance in predicting whether children would maintain a depression diagnosis after PCIT-ED (AUC = 0.530) or prematurely terminate treatment (AUC = 0.545). Our results suggest that PCIT-ED is not contraindicated by minimal-to-moderate symptoms of depression in parents. Taken together with previous reports, PCIT-ED may indeed be a particularly beneficial treatment choice for this population. Further research in samples with more severe parental depression is needed. ClinicalTrials.gov identifier: NCT02076425.
Topics: Humans; Child, Preschool; Adolescent; Parenting; Depression; Psychotherapy; Emotions; Parents; Parent-Child Relations
PubMed: 36216984
DOI: 10.1007/s00787-022-02093-5 -
Journal of Adolescence Jul 2023Parental personality traits are predicted to influence offspring outcomes through parenting behavior and offspring personality traits. This study explored whether mother...
INTRODUCTION
Parental personality traits are predicted to influence offspring outcomes through parenting behavior and offspring personality traits. This study explored whether mother and father personality traits relate to offspring behavior problems in mid-late adolescence METHOD: In total, 3089 Australian adolescents (1576 boys, 1513 girls; M = 16.46 ± 0.50 years) and their parents completed questionnaires assessing personality, conduct problems, emotional and social functioning, antisocial and criminal behavior, cigarette smoking and drug use, at a single time-point.
RESULTS
After controlling for sociodemographic factors, results showed that problem behaviors in adolescence were most consistently related to mothers' scores on neuroticism and conscientiousness, and fathers' scores on neuroticism. Father personality traits were most important for antisocial and criminal behavior, whereas mother personality traits were most important for social and emotional functioning. Moderation analysis showed that associations between fathers' personality traits and some adolescent outcomes (cigarette smoking and drug use) were stronger for adolescent boys than for adolescent girls. Mediation models further demonstrated that adolescent personality traits mediated associations between parent personality and adolescent outcomes in almost all cases. Indirect effects expressed as a percentage showed that between 1.4% and 33.3% of the variance in the association between parent personality and adolescent outcomes was shared with the corresponding adolescent personality trait.
CONCLUSIONS
Overall, the findings of this study provide evidence that traits inherited (directly or indirectly) from parents might have an important role in shaping problem behavior in adolescence.
Topics: Male; Female; Adolescent; Humans; Problem Behavior; Australia; Parents; Personality; Mothers; Parenting; Adolescent Behavior
PubMed: 36942756
DOI: 10.1002/jad.12164 -
Infant Behavior & Development Nov 2023Infants experiencing homelessness face risk for developing mental health problems in the future. Parents residing in shelters experience adverse events at elevated rates...
Infants experiencing homelessness face risk for developing mental health problems in the future. Parents residing in shelters experience adverse events at elevated rates compared to non-homeless individuals, which can impact their infants during a time of rapid development depending on how the parent copes. For some, trauma linked to these events may manifest in an intrusive parenting style that interferes with the child's developing capacity for self-regulation. We utilized a sample of 60 parent-infant dyads recruited while residing in emergency homeless shelters to evaluate associations among parents' history of adversity, intrusive parenting behaviors, and infants' fearful distress. Observed parent intrusiveness during a free play interaction was significantly associated with infant fearfulness observed in a separate behavioral task during which infants viewed a series of masks. Furthermore, there was a moderating effect for parent history of adversity such that the association between parent intrusiveness and infant fearful distress was stronger among parents with more past experiences of adversity.
Topics: Child; Humans; Infant; Parents; Parenting; Fear; Ill-Housed Persons
PubMed: 37827010
DOI: 10.1016/j.infbeh.2023.101891 -
Journal of Youth and Adolescence Jan 2020Previous studies have found discrepancies between parent and child reports of parental favoritism. Some studies have also found that these discrepancies have unique...
Previous studies have found discrepancies between parent and child reports of parental favoritism. Some studies have also found that these discrepancies have unique effects on children's psychosocial adjustment. Nonetheless, much is still unknown about discrepancies between parent-reports and child-reports of parental favoritism and how they are associated with children's development. The current study examines discrepancies in multi-informant reports on parental favoritism in relation to children's internalizing and externalizing problems. The sample consisted of 556 mother-child dyads and 554 father-child dyads (46% boys, M = 12.52 years, SD = 1.18). Polynomial regression analyses and response surface analyses were used to disentangle the effects of parent-child discrepancies in perceived parental favoritism. The results indicate that children reported higher parental favoritism than their parents. And the highest internalizing and externalizing problems occurred when both the mother and the child reported high maternal favoritism, and when both the father and the child report high paternal favoritism. Therefore, these findings partly support the assumptions based on the operations triad model. The findings also highlight the importance of the discrepancy between child- and parent-reports on parental favoritism in the development of children's internalizing and externalizing problems.
Topics: Adolescent; Child; Conflict, Psychological; Defense Mechanisms; Fathers; Female; Humans; Male; Mothers; Object Attachment; Parent-Child Relations; Parenting; Parents; Siblings
PubMed: 31889229
DOI: 10.1007/s10964-019-01148-2 -
Clinical Psychology Review Dec 2013The present meta-analytic review examined effectiveness of the Incredible Years parent training (IYPT) regarding disruptive and prosocial child behavior, and aimed to... (Meta-Analysis)
Meta-Analysis Review
The present meta-analytic review examined effectiveness of the Incredible Years parent training (IYPT) regarding disruptive and prosocial child behavior, and aimed to explain variability in intervention outcomes. Fifty studies, in which an intervention group receiving the IYPT was compared to a comparison group immediately after intervention, were included in the analyses. Results showed that the IYPT is an effective intervention. Positive effects for distinct outcomes and distinct informants were found, including a mean effect size of d=.27 concerning disruptive child behavior across informants. For parental report, treatment studies were associated with larger effects (d=.50) than indicated (d=.20) and selective (d=.13) prevention studies. Furthermore, initial severity of child behavior revealed to be the strongest predictor of intervention effects, with larger effects for studies including more severe cases. Findings indicate that the IYPT is successful in improving child behavior in a diverse range of families, and that the parent program may be considered well-established.
Topics: Adult; Behavior Therapy; Child; Child Behavior; Child Behavior Disorders; Humans; Parenting; Parents
PubMed: 23994367
DOI: 10.1016/j.cpr.2013.07.006