The Impact of Parental Cognitions on Outcomes of Behavioral Parent Training for Children With Conduct Problems

IF 3.8 2区心理学 Q2 PSYCHIATRY

Behavior Therapy Pub Date : 2025-03-01 DOI:10.1016/j.beth.2025.02.004

Georgette E. Fleming, Vilas Sawrikar, Silvana Kaouar, Bryan Neo, Campbell McDonogh, Eva R. Kimonis

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引用次数: 0

Abstract

Despite decades of support for behavioral parent training, studies consistently comprise a proportion of families who do not experience sustained improvement in child conduct problems. Recent innovations to enhance treatment effects use predictors of treatment response to guide efforts to personalize treatment. We investigated whether baseline parental cognitions predicted response to Parent-Child Interaction Therapy (PCIT) in a sample of N = 61 children (M = 4.78 years, SD = 1.23, 74% boys) with conduct problems. Families received PCIT at an Australian urban university-based clinic. Parental positive and negative relational schemas were coded from baseline 5-minute speech samples. Linear mixed-effects models showed that mothers’ unhelpful cognitions predicted significantly less improvement in child conduct problems and internalizing problems, parenting stress, and observed parenting behaviors from baseline to follow-up. In contrast, children of fathers with unhelpful cognitions began treatment with more severe problems than other children, but experienced similar or greater magnitude of improvement in child conduct problems, paternal parenting stress, and observed paternal negative parenting behaviors during treatment relative to other children. Findings suggest that PCIT may be a useful alternative to parent-only behavioral parent training for fathers with unhelpful cognitions. We also discuss methods for tailoring PCIT for mothers with unhelpful cognitions to enhance treatment effects.

These trials were registered with the Australian and New Zealand Clinical Trial Registry (ACTRN12616000280404; ACTRN12616000221459).

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父母认知对行为问题儿童行为训练效果的影响

尽管行为父母训练得到了几十年的支持，但研究始终包含了一部分家庭，他们在儿童行为问题上没有持续改善。最近提高治疗效果的创新使用治疗反应的预测因子来指导个性化治疗的努力。我们调查了N = 61名有行为问题的儿童（M = 4.78岁，SD = 1.23,74%的男孩）的基线父母认知是否能预测对亲子互动治疗（PCIT）的反应。家庭在澳大利亚城市大学诊所接受PCIT治疗。父母积极和消极的关系图式从基线5分钟的语音样本编码。线性混合效应模型显示，母亲的无用认知对儿童行为问题和内化问题、父母压力以及从基线到随访观察到的父母行为的改善的预测显著降低。相比之下，父亲有消极认知的孩子在治疗开始时比其他孩子有更严重的问题，但在儿童行为问题、父亲养育压力和治疗期间观察到的父亲消极养育行为方面的改善程度与其他孩子相似或更大。研究结果表明，对于认知不良的父亲来说，PCIT可能是一种有效的替代父母行为训练的方法。我们还讨论了针对认知不良的母亲量身定制PCIT的方法，以提高治疗效果。这些试验已在澳大利亚和新西兰临床试验登记处注册（ACTRN12616000280404; ACTRN12616000221459）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Behavior Therapy Multiple-

CiteScore

7.40

自引率

2.70%

发文量

113

审稿时长

121 days

期刊介绍： Behavior Therapy is a quarterly international journal devoted to the application of the behavioral and cognitive sciences to the conceptualization, assessment, and treatment of psychopathology and related clinical problems. It is intended for mental health professionals and students from all related disciplines who wish to remain current in these areas and provides a vehicle for scientist-practitioners and clinical scientists to report the results of their original empirical research. Although the major emphasis is placed upon empirical research, methodological and theoretical papers as well as evaluative reviews of the literature will also be published. Controlled single-case designs and clinical replication series are welcome.