MAINTENANCE TREATMENTS FOR CONDUCT DISORDERED CHILDREN

行为障碍儿童的维持治疗

• 批准号: 6625431
• 负责人: SHEILA M EYBERG
• 金额: $ 46.24万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-12-01 至 2004-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6625431
• 关键词: African American; behavior test; behavior therapy; behavioral /social science research tag; caucasian American; clinical research; conduct disorder; culture; functional ability; gender difference; human subject; human therapy evaluation; interview; longitudinal human study; mental disorder diagnosis; middle childhood (6-11); oppositional defiant disorder; outcomes research; parent offspring interaction; patient care management; preschool child (1-5); psychological models; psychopathology; psychotherapy; racial /ethnic difference; relapse /recurrence; social psychology

Conduct-disordered behavior in preschool-age children represents the single most important behavioral risk factor for later antisocial behavior and can be reliably identified in children as young as 3 years. Early intervention may be critical. Without treatment, conduct-disordered behavior is highly persistent and worsens with time. Evidence indicates that the short-term effects of interventions at preschool age are highly effective, may be more effective than treatments when children are older, and may prevent many of the associated academic and peer difficulties that require multiple interventions only a few years later. Evidence of the long-term effects of treatment (beyond 1 year), however, are limited. The few studies that exist suggest that beyond the first follow-up year, as many as 50 percent of treated children may return to pretreatment levels. Lack of information about the course of child and family functioning after treatment hinders our understanding of factors associated with treatment failure, and studies of psychosocial maintenance treatments for children are almost nonexistent. This project will test the continuing care model of maintenance treatment that assumes that conduct disorder is a chronic condition requiring monitoring and booster treatment at times of incipient relapse during childhood. Participants will be 100 families of children ages 3 to 6 with Oppositional Defiant Disorder referred to one of two clinics for treatment. Families will be randomly assigned to the standard treatment group (parent-child interaction therapy; PCIT) or to the maintenance treatment group (standard treatment followed by a two-year period of monitoring and treatment-as- needed). We predict significant differences at 2-year follow-up favoring the maintenance treatment group in child and parent functioning assessed by multiple method/multiple informant measures across settings. We expect responsiveness to treatment in both groups to be influenced most strongly by parent psychological variables. Predictors of outcome will be examined separately for the African American subgroup to inform the development of a culture specific treatment protocol.

学龄前儿童中的行为行为是后来反社会行为的最重要的行为风险因素，可以在3岁​​以下的儿童中可靠地识别。 早期干预可能至关重要。 没有治疗，行为序的行为是高度持久的，并且随着时间的流逝而恶化。 证据表明，学龄前年龄的干预措施的短期影响非常有效，可能比儿童年龄更大的治疗更有效，并且可能会阻止几年后仅需要多次干预措施的许多相关学术和同伴困难。 但是，治疗长期影响（超过1年）的证据是有限的。 存在的少数研究表明，超过第一个随访年，多达50％的受过治疗儿童可能会恢复到预处理水平。 缺乏有关儿童和家庭在治疗后的过程的信息，这阻碍了我们对与治疗失败有关的因素的理解，以及对儿童的社会心理维持治疗的研究几乎不存在。 该项目将测试维护治疗的持续护理模型，该模型假定行为障碍是一种慢性病，需要在儿童期初期复发时进行监测和助推器治疗。 参与者将是100个3至6岁儿童的家庭，患有反对反抗疾病，指的是两个诊所之一进行治疗。 家族将被随机分配到标准治疗组（亲子互动疗法； PCIT）或维护治疗组（标准治疗组，然后进行两年的监测和治疗期间）。 我们预测，在两年的随访中有显着差异，有利于通过多种方法/多个线人跨环境评估的儿童维护治疗组和父母功能的差异。 我们希望两组对治疗的反应能够受到父母心理变量的最大影响。 结果将分别检查非裔美国人亚组的预测因素，以告知特定培养治疗方案的发展。