RESUMO
OBJECTIVES: The COVID-19 related lockdowns and distancing measures have presented families with unprecedented challenges. A UK-wide cohort study tracking changes in families' mental health since early lockdown (Co-SPACE) found a significant rise in primary school-aged children's behaviour problems and associated family-related stress. Three-quarters of parents in Co-SPACE also reported wanting extra support. In SPARKLE, we will examine whether providing Co-SPACE families with a smartphone application delivering information and parenting support, Parent Positive, can reverse the negative effects of the pandemic on children and parents. The efficacy on child and parent outcomes and cost-effectiveness of Parent Positive will be examined. We will also test whether the effects are moderated by pre-existing levels of child conduct problems and usage of Parent Positive. Exploratory analyses will examine whether other baseline characteristics or lockdown circumstances moderate the effects of Parent Positive. TRIAL DESIGN: SPARKLE is a two-arm superiority parallel group randomised controlled trial embedded in an existing large UK-wide self-selected community cohort - Co-SPACE. Those who consent to SPARKLE will be randomised 1:1 to either Parent Positive or Follow-up As Usual (FAU). PARTICIPANTS: Co-SPACE (a UK-wide longitudinal cohort study) parents aged ≥18 who have children aged 4-10 years will be eligible for SPARKLE. INTERVENTION AND COMPARATOR: Parent Positive: is a digital public health intervention that can be delivered rapidly at scale to support parents in managing their children's behaviour to reduce conduct problems and levels of family conflict, which were exacerbated during the first lockdown, and which may increase further in future months as families need to cope with continuous uncertainty and further disruption to their daily lives. Co-designed with parents and based on decades of parenting research, Parent Positive consists of three elements: (i) Parenting Boosters: where advice, delivered in the form of narrated animations, videos, graphics and text is provided to help parents with eight common parenting challenges; (ii) Parenting Exchange: a facilitated parent-to-parent communication and peer support platform and; (iii) Parent Resources: giving access to carefully selected high-quality, evidence-based online parenting resources. Follow-up as Usual: FAU was selected as a comparator because the public health nature meant that an active comparator was not appropriate due to the pragmatic, rapid implementation of the trial. Individuals randomised to FAU will receive no intervention for the first two months while the data for baseline (T1), T2 and T3 are collected. They will then be given full access to the app until 30th November 2021. MAIN OUTCOMES: Outcome measures will be collected remotely through Qualtrics according to the Co-SPACE schedule at baseline (T1), which will be the Co-SPACE survey data obtained immediately prior to randomisation, and then at one month (T2) and two months (T3) post-randomisation. Measures will be collected to assess group differences in child and parent outcomes, costs and service utilisation, and adverse events. Usage of Parent Positive will also be tracked. The primary outcome is parent-reported child conduct problems at one-month post-randomisation measured using the Strengths and Difficulties Questionnaire conduct problems subscale. RANDOMISATION: Enrolled participants will be allocated to Parent Positive or FAU at the ratio of 1:1 by simple randomisation using the Randomizer function within the Qualtrics programme. Neither blocking nor stratification will be used. BLINDING (MASKING): It is not possible to blind parents enrolled in the study and Qualtrics will automatically inform parents of their group allocation. Blinded members of the research team and the senior statistician will not be given access to the Qualtrics system or the data in order to remain blinded until after the analysis is complete. We do not anticipate any serious harms associated with taking part in the intervention, therefore there will be no need to unblind any blinded staff during the study. The junior statistician will be unblinded throughout. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): A total of 616 will be recruited into the trial with 308 consenting parents randomised to each treatment arm. TRIAL STATUS: V1.0; 15.03.2021. Not yet recruiting. Anticipated start date: 1st April 2021. Anticipated end date for recruitment: 31st July 2021. TRIAL REGISTRATION: Clinicaltrial.gov: NCT04786080 . The trial was prospectively registered on 8 March 2021. FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).
Assuntos
COVID-19 , Comportamento Infantil , Aplicativos Móveis , Poder Familiar , Estresse Psicológico/prevenção & controle , Criança , Pré-Escolar , Controle de Doenças Transmissíveis , Transtorno da Conduta/prevenção & controle , Humanos , Estudos Longitudinais , Pandemias , Pais , Ensaios Clínicos Controlados Aleatórios como Assunto , Smartphone , Resultado do TratamentoRESUMO
Individuals with the combination of psychopathy and severe conduct disorder often get in a lot of trouble from their early childhood, and can cause great suffering and problems for other people and their immediate environment. Their antisocial behaviour has a tendency to develop into a chronic pattern early in life, and the treatment prognosis in adulthood is poor. A large proportion of serious violent crimes in society can be attributed to this group of perpetrators. Until recently, it has been unclear whether traits of this type can be prevented or changed, so that these individuals and their surroundings can benefit from targeted treatments at an early stage. To reduce serious crime in a society, it is very important to develop effective measures for this particular group. A lack of empathy, indifference to others, and a lack of concern about their own performance appear to be key early signs in children and adolescents with persistent behavioural problems and more serious norm violations who continue into a criminal career upon reaching adulthood. These characteristics have been termed callous-unemotional (CU) traits, and they are considered to be a precursor to psychopathic traits in adulthood. In recent years, several studies have evaluated the degree to which treatments that have been proved effective for children and adolescents with severe behavioural problems also show effectiveness for children and adolescents with CU traits. Interventions specifically tailored to children with CU traits have also been developed with the aim of directly changing the ongoing development of this precursor to psychopathy. In this paper, we will address the extent to which current evidence-based treatment methods developed for children and adolescents with behavioural difficulties are equally effective when a child has CU traits. We will also take a closer look at the effects of interventions designed to change this trait. There will be a discussion regarding what seems relevant for a change in the trait itself, as well as a change in their antisocial behaviour.
Assuntos
Transtorno da Conduta , Criminosos , Adolescente , Adulto , Transtorno da Personalidade Antissocial/prevenção & controle , Pré-Escolar , Transtorno da Conduta/prevenção & controle , Emoções , Empatia , HumanosRESUMO
Conduct problems can develop into behavior disorders and put children at risk for other mental health problems. Parenting interventions have been shown to successfully reduce conduct problems and are often expected to prevent the development of broader mental health problems. Few studies have evaluated the longer-term and broader effects of these interventions. To what extent are parenting intervention effects sustained in the years after the intervention? And do effects pertain to conduct problems specifically, or do they also affect broader aspects of children's mental health? We used a randomized controlled trial to assess the longer-term (2.5 years) effects of the Incredible Years parenting intervention on children's conduct problems in an indicated prevention setting (N = 387; 79% retention rate). Using a multi-method (survey and computerized tasks) and multi-informant (parents, teachers, and children) approach, we tested whether initial effects on conduct problems were sustained, and whether Incredible Years had broader effects on children's peer problems, emotional problems, attention-deficit/hyperactivity disorder (ADHD) symptoms, attention and inhibition deficits, and service use. Incredible Years, relative to control (no intervention), led to sustained reductions in parent-reported conduct problems (Cohen's d = 0.31), but not teacher- and child-reported conduct problems. There were no broader benefits: Incredible Years did not reduce children's peer problems, emotional problems, ADHD-symptoms, attention and inhibition deficits, or their service use. Improvements in parents' perceptions of child conduct problems sustained until 2.5 years later. Our findings do not show benefits of Incredible Years as a preventive intervention for children's broader mental health.
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Transtorno do Deficit de Atenção com Hiperatividade , Transtorno da Conduta , Poder Familiar , Comportamento Problema , Transtorno do Deficit de Atenção com Hiperatividade/prevenção & controle , Transtorno da Conduta/prevenção & controle , Humanos , PaisRESUMO
Models of positive youth development suggest that athletes may be influenced by parent education programmes; however, there is little research examining the impact of such programmes on athlete outcomes. This study examined the impact of the Respect in Sport Parent Program on athlete outcomes among minor hockey players over three years. This study consisted of cross-sectional and longitudinal online surveys measuring athletes' positive and negative developmental experiences, prosocial and antisocial behaviours, parental support and pressure, and sport enjoyment and commitment. Athletes completed at least one online survey during the study period (N = 366; 84.2% males; 14-19 years of age; M = 15.4 years), and 83 athletes completed multiple surveys for longitudinal analyses. Cross-sectional results comparing athletes in leagues adopting the programme at different time points indicated significant differences in prosocial behaviours towards teammates. Multilevel longitudinal analyses revealed improvements in athletes' antisocial behaviours towards opponents, initiative, goal setting, and cognitive skills over time, regardless of whether they were in a league that implemented the programme. However, athletes in leagues that implemented the programme during the study reported greater improvements in antisocial behaviours towards opponents, and there were trends with respect to improved personal and social skills. These findings provide suggestions to improve the delivery and impact of parent education programmes in youth sport.
Assuntos
Atletas/psicologia , Hóquei/psicologia , Pais/educação , Avaliação de Programas e Projetos de Saúde , Respeito , Adolescente , Desenvolvimento do Adolescente , Transtorno da Conduta/prevenção & controle , Estudos Transversais , Feminino , Objetivos , Humanos , Relações Interpessoais , Masculino , Prazer , Estudos Prospectivos , Comportamento Social , Habilidades Sociais , Inquéritos e Questionários , Esportes de Equipe , Adulto Jovem , Esportes JuvenisRESUMO
The prevention of externalizing disturbances Abstract. Objectives: Externalizing disturbances (attention deficit-hyperactivity disorders, oppositional defiant disorders, conduct disorders) in children and adolescents have a high prevalence, are stable over time, and precipitate a high individual and economic burden. Method: This review article presents the state of research based on selected current meta-analyzes and systematic reviews. Additionally, evidenced-based German-language prevention programs are discussed. Results: As in treatment, a multimodal approach to prevention is recommended which aims at reducing externalizing symptoms in specific settings. Interventions that focus on the specific environment in the family and the (pre-)school are preferable. Child-focused interventions are especially important in the context of peer-related problematic behavior because parent-based or teacher-based interventions may be less able to affect peer interactions. Conclusions: Comprehensive parent-based and (pre-)school-based preventive interventions of externalizing disturbances should be implemented. These should also include child-based approaches and additional parent-based group interventions. The effects of these interventions should be tested in large-scale studies.
Assuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/prevenção & controle , Transtornos do Comportamento Infantil/prevenção & controle , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/prevenção & controle , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/terapia , Criança , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/terapia , Transtorno da Conduta/epidemiologia , Transtorno da Conduta/prevenção & controle , Transtorno da Conduta/terapia , Humanos , Relações InterpessoaisRESUMO
BACKGROUND: The terms affective dysregulation (AD) and irritability describe transdiagnostic dimensions and are characterized by an excessive reactivity to negative emotional stimuli with an affective (anger) and a behavioral component (aggression). Due to early onset, high prevalence and persistence, as well as developmental comorbidity, AD in childhood is one of the most psychosocially impairing and cost-intensive mental health conditions. AD is especially prevalent in children in the youth welfare service. Despite continuous research, there remains a substantial need for diagnostic approaches and optimization of individualized treatment strategies in order to improve outcomes and reduce the subjective and economic burden. METHODS: The ADOPT (Affective Dysregulation - Optimizing Prevention and Treatment) Consortium integrates internationally established, highly experienced and interdisciplinary research groups. The work program encompasses (a) epidemiology, including prevalence of symptoms and disorders, (b) development and evaluation of screening and assessment tools, (c) stepped care approaches for clinically useful personalized medicine, (d) evaluation of an easily accessible and cost-effective online intervention as indicated prevention (treatment effects, moderation/mediation analysis), and (e) evaluation of an intensive personalized modular outpatient treatment in a cohort of children with AD who live with their parents and in a cohort of children with AD who live in out-of-home care (treatment effects, moderation/mediation analysis). DISCUSSION: The results will lead to significant recommendations for improving treatment within routine clinical care in two cohorts of children with AD and coexisting conditions, especially oppositional-defiant disorder, conduct disorder and disruptive mood dysregulation disorder. TRIAL REGISTRATION: Trial registration ADOPT Online: German Clinical Trials Register (DRKS) DRKS00014963 . Registered 27 June 2018. Trial registration ADOPT Treatment: German Clinical Trials Register (DRKS) DRKS00013317 . Registered 27 September 2018. Trial registration ADOPT Institution: German Clinical Trials Register (DRKS) DRKS00014581 . Registered 04 July 2018.
Assuntos
Terapia Comportamental/métodos , Transtornos do Humor/prevenção & controle , Transtornos do Humor/terapia , Adolescente , Agressão , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/prevenção & controle , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/terapia , Terapia Comportamental/economia , Criança , Comorbidade , Transtorno da Conduta/epidemiologia , Transtorno da Conduta/prevenção & controle , Transtorno da Conduta/terapia , Análise Custo-Benefício , Emoções , Feminino , Humanos , Masculino , Transtornos do Humor/epidemiologia , Pais/psicologia , Prevalência , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do TratamentoRESUMO
The Fast Track (FT) intervention was a multimodal preventive intervention addressing antisocial development across 10 years of childhood and early adolescence. The intervention included parent management training, child social-cognitive skills training, peer coaching and mentoring, academic skills tutoring, and a classroom social-emotional learning program. While not specifically designed to target psychosis symptoms (e.g., social withdrawal, thought abnormalities), the present study aimed to examine whether the FT intervention prevented psychosis symptoms through childhood and adolescence and into adulthood. Participants included the FT intervention and high-risk control samples (N = 891; 69% male; M age = 6.58 years, SD = .48). Psychosis symptoms were assessed using the "thought problems" subscale of the parent-report Child Behavior Checklist during grades 1, 2, 4, 5, and 7, and the self-report Adult Behavior Checklist at age 25 years, in line with prior research using this measure. Growth models included the FT condition and covariates (i.e., initial risk screen score, cohort, socioeconomic status, rural/urban status, race, and sex) as predictors; and child, adolescent, and adult psychosis symptoms as outcomes. Intervention status was not significantly associated with the slope of psychosis symptoms; however, after controlling for concurrent cannabis use, intervention participants reported lower levels of psychosis symptoms over time. Findings suggest that interventions targeting antisocial behavior may prevent psychosis symptoms in the long term.
Assuntos
Transtorno da Personalidade Antissocial/prevenção & controle , Comportamento Infantil/psicologia , Transtorno da Conduta/prevenção & controle , Intervenção Educacional Precoce/métodos , Agressão/psicologia , Transtorno da Personalidade Antissocial/terapia , Criança , Serviços de Saúde da Criança/organização & administração , Estudos de Coortes , Transtorno da Conduta/terapia , Feminino , Humanos , Masculino , Pais/psicologia , Psicologia da Criança , Ajustamento SocialRESUMO
School-based psychosocial interventions are a widely used approach to prevent or reduce externalising behaviour. However, evaluating the effects of such interventions is complicated by the fact that the interventions may not only change the target behaviour, but also the way that informants report on that behaviour. For example, teachers may become more aware of bullying behaviour after delivering lessons on the topic, resulting in increased teacher reports of the behaviour. In this study, we used multi-group confirmatory factor analysis to evaluate whether teachers exposed to the Promoting Alternative Thinking Strategies (PATHS) intervention changed the way they reported on child externalising behaviour. Using data from the z-proso study (802 participants; 51% male; 69 teachers), teacher reports of aggressive behaviour, attention deficit hyperactivity disorder and non-aggressive conduct disorder symptoms were compared pre- and post- intervention and across the intervention and control conditions. There was no evidence that teacher reporting was affected by exposure to the intervention. This helps bolster the interpretation of intervention effects as reflecting changes in child behaviour, rather than in the manner of informant reporting.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/prevenção & controle , Transtornos do Comportamento Infantil/prevenção & controle , Transtorno da Conduta/prevenção & controle , Serviços de Saúde Escolar/organização & administração , Professores Escolares/psicologia , Agressão , Criança , Comportamento Infantil/psicologia , Currículo , Feminino , Humanos , MasculinoRESUMO
OBJECTIVES: To (a) explore the preferences of Mexican parents and Spanish-speaking professionals working with migrant Latino families in Minnesota regarding the Mexican-adapted brief model versus the original conduct problems intervention and (b) identifying the potential challenges, and preferred solutions, to implementation of a conduct problems preventive intervention. METHOD: The core practice elements of a conduct problems prevention program originating in the United States were adapted for prevention efforts in Mexico. Three focus groups were conducted in the United States, with Latino parents (n = 24; 2 focus groups) and professionals serving Latino families (n = 9; 1 focus group), to compare and discuss the Mexican-adapted model and the original conduct problems prevention program. Thematic analysis was conducted on the verbatim focus group transcripts in the original language spoken. RESULTS: Participants preferred the Mexican-adapted model. The following key areas were identified for cultural adaptation when delivering a conduct problems prevention program with Latino families: recruitment/enrollment strategies, program delivery format, and program content (i.e., child skills training, parent skills training, child-parent activities, and child-parent support). For both models, strengths, concerns, barriers, and strategies for overcoming concerns and barriers were identified. CONCLUSIONS: We summarize recommendations offered by participants to strengthen the effective implementation of a conduct problems prevention model with Latino families in the United States. This project demonstrates the strength in binational collaboration to critically examine cultural adaptations of evidence-based prevention programs that could be useful to diverse communities, families, and youth in other settings. (PsycINFO Database Record
Assuntos
Transtorno da Conduta/prevenção & controle , Assistência à Saúde Culturalmente Competente/métodos , Prática Clínica Baseada em Evidências/métodos , Hispânico ou Latino/psicologia , Avaliação de Programas e Projetos de Saúde/métodos , Adulto , Criança , Feminino , Grupos Focais , Hispânico ou Latino/estatística & dados numéricos , Humanos , Masculino , México/etnologia , Pessoa de Meia-Idade , Minnesota , Modelos Psicológicos , Pais , Reprodutibilidade dos TestesRESUMO
OBJECTIVE: To evaluate associations between iron supplementation and iron deficiency in infancy and internalizing, externalizing, and social problems in adolescence. STUDY DESIGN: The study is a follow-up of infants as adolescents from working-class communities around Santiago, Chile who participated in a preventive trial of iron supplementation at 6 months of age. Inclusionary criteria included birth weight ≥3.0 kg, healthy singleton term birth, vaginal delivery, and a stable caregiver. Iron status was assessed at 12 and 18 months of age. At 11-17 years of age, internalizing, externalizing, and social problems were reported by 1018 adolescents with the Youth Self Report and by parents with the Child Behavior Checklist. RESULTS: Adolescents who received iron supplementation in infancy had greater self-reported attention-deficit/hyperactivity disorder but lower parent-reported conduct disorder symptoms than those who did not (Ps < .05). Iron deficiency with or without anemia at 12 or 18 months of age predicted greater adolescent behavior problems compared with iron sufficiency: more adolescent-reported anxiety and social problems, and parent-reported social, post-traumatic stress disorder, attention-deficit/hyperactivity disorder, oppositional defiant, conduct, aggression, and rule breaking problems (Ps < .05). The threshold was iron deficiency with or without anemia for each of these outcomes. CONCLUSIONS: Iron deficiency with or without anemia in infancy was associated with increased internalizing, externalizing, and social problems in adolescence.
Assuntos
Anemia Ferropriva/prevenção & controle , Ansiedade/etiologia , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Transtorno da Conduta/etiologia , Suplementos Nutricionais , Ferro/uso terapêutico , Oligoelementos/uso terapêutico , Adolescente , Anemia Ferropriva/psicologia , Ansiedade/diagnóstico , Ansiedade/prevenção & controle , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/prevenção & controle , Criança , Transtorno da Conduta/diagnóstico , Transtorno da Conduta/prevenção & controle , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Lactente , Masculino , Pais , Fatores de Risco , Autorrelato , Resultado do TratamentoRESUMO
This study investigated whether a school-based pilot prevention program is effective in reducing Conduct Disorder (CD) symptoms and callous unemotional (CU) traits (i.e., lack of empathy and guilt) in a community sample of children. A total of 304 children from three schools in Cyprus were randomly assigned at school level to either a prevention group that received a skill building training program (N = 94; M age = 7.91, SD = .74; 52.1% female) or a control group that received no training (N = 210; M age = 7.82, SD = .81; 50.5% female). To evaluate the effectiveness of the program, CD symptoms and CU traits were assessed before the implementation of the training program and at 3 and 9 months after training. Additionally, the child's impulsivity, parental involvement and friend support were assessed pre- and post-prevention. Significant post-training reductions in CU traits were identified for the prevention, but not the control, group at both 3-month and 9-month follow-ups and in CD symptoms at the 9 month follow-up. Furthermore, children in the prevention group scored lower on impulsivity and higher on paternal involvement and friend support compared to the control group after participating in the training program. This study provides preliminary evidence that child focused training delivered in the school setting can provide lasting benefits by preventing the development of CU traits, impulsivity, and CD. The program was also successful in improving the child's social relationships with peers and parents. These findings emphasize the importance of school based prevention efforts.
Assuntos
Transtorno da Conduta/prevenção & controle , Comportamento Impulsivo , Relações Interpessoais , Pais , Grupo Associado , Psicoterapia/métodos , Instituições Acadêmicas , Apoio Social , Criança , Chipre , Feminino , Seguimentos , Humanos , Masculino , Projetos Piloto , Resultado do TratamentoRESUMO
Prevention programs that strengthen parenting and family functioning have been found to reduce poor behavioral outcomes in adolescents, including substance use, HIV risk, externalizing and internalizing problems. However, there is evidence that not all youth benefit similarly from these programs. Familias Unidas is a family-focused intervention designed to prevent substance use and sexual risk among Hispanic youth and has recently demonstrated unanticipated reductions in internalizing symptoms for some youth. This paper examines variation in intervention response for internalizing symptoms using individual-level data pooled across four distinct Familias Unidas trials: (1) 266 eighth grade students recruited from the general school population; (2) 160 ninth grade students from the general school population; (3) 213 adolescents with conduct, aggression, and/or attention problems; and (4) 242 adolescents with a delinquency history. Causal inference growth mixture modeling suggests a three-class model. The two largest classes represent youth with low (60 %) and medium (27 %) internalizing symptoms at baseline, and both intervention and control participants show reductions in internalizing symptoms. The third class (13 %) represents youth with high levels of baseline internalizing symptoms who remain at steady levels of internalizing symptoms when exposed to the intervention, but who experience an increase in symptoms under the control condition. Female gender, low baseline levels of parent-adolescent communication, and older age were associated with membership in the high-risk class. These synthesis analyses involving a large sample of youth with varying initial risk levels represent a further step toward strengthening our knowledge of preventive intervention response and improving preventive interventions.
Assuntos
Ansiedade/prevenção & controle , Depressão/prevenção & controle , Promoção da Saúde , Hispânico ou Latino/psicologia , Poder Familiar , Avaliação de Programas e Projetos de Saúde , Adolescente , Transtorno da Conduta/prevenção & controle , Feminino , Humanos , Delinquência Juvenil/prevenção & controle , Masculino , Serviços Preventivos de SaúdeRESUMO
Psychopathy is an adult condition that incurs substantial societal and individual costs. Here we review neurocognitive and genetically informative studies that shed light on how and why this condition emerges. Children cannot present with psychopathy. However, the presence of callous-unemotional (CU) traits can distinguish a group of children who are at elevated risk of psychopathy in adulthood. These children display diminished empathy and guilt and show attenuated brain activation to distress cues in others. Genetically informative studies indicate that individual differences in CU traits show moderate-to-strong heritability, but that protective environmental factors can counter heritable risk. On the basis of the extant research findings, we speculate on what might represent the priorities for research over the next decade. We also consider the clinical implications of these research findings. In particular, we consider the importance of delineating what precisely works for children with CU traits (and their parents) and the ways in which intervention and prevention programs may be optimized to improve engagement as well as clinical outcomes.
Assuntos
Transtorno da Personalidade Antissocial/psicologia , Transtorno da Conduta/psicologia , Emoções , Pais/psicologia , Adulto , Transtorno da Personalidade Antissocial/prevenção & controle , Criança , Transtorno da Conduta/prevenção & controle , Empatia , Culpa , HumanosRESUMO
Although parenting is one of the most commonly studied predictors of child problem behavior, few studies have examined parenting as a multidimensional and dynamic construct. This study investigated different patterns of developmental trajectories of two parenting dimensions (harsh discipline [HD] and parental warmth [PW]) with a person-oriented approach and examined the associations between different parenting patterns and child externalizing problems and callous-unemotional traits. Data were drawn from the combined high-risk control and normative sample (n = 753) of the Fast Track Project. Parent-reported HD and observer-reported PW from kindergarten to grade 2 were fit to growth mixture models. Two subgroups were identified for HD (low decreasing, 83.0 %; high stable, 17.0 %) and PW (high increasing, 78.7 %; low increasing, 21.3 %). The majority of parents (67.0 %) demonstrated the low decreasing HD and high increasing PW pattern, while the prevalence of the high stable HD and low increasing PW pattern was the lowest (6.8 %). Parenting satisfaction, parental depression, family socioeconomic status, and neighborhood safety predicted group memberships jointly defined by the two dimensions. Children from the high stable HD and low increasing PW pattern showed the highest levels of externalizing problems in grades 4 and 5. Children from the low decreasing HD and low increasing PW pattern showed the highest levels of callous-unemotional traits in grade 7. These findings demonstrate the utility and significance of a person-oriented approach to measuring parenting as a multidimensional and dynamic construct and reveal the interplay between HD and PW in terms of their influences on child developmental outcomes.
Assuntos
Relações Pais-Filho , Poder Familiar/psicologia , Criança , Pré-Escolar , Transtorno da Conduta/prevenção & controle , Feminino , Humanos , Modelos Logísticos , Masculino , Observação , Inquéritos e Questionários , Estados UnidosRESUMO
Callous-unemotional (CU) traits and effortful control (EC) are personality and temperament traits implicated in early-onset antisocial trajectories. This secondary analysis of Hitkashrut's randomized controlled trial first tested parent training's effects on EC and CU traits while controlling for more general treatment effects on conduct problems (CP), and subsequently tested mediation by parenting. Prekindergarten teachers in three Israeli cities identified 209 3-5 year-old (163 boys; 46 girls) preschoolers with subclinical-clinical range conduct problems. All participants were Jewish ranging from ultra-orthodox to secular. They were assigned to 14-session co-parent training groups (n = 140 couples), or to minimal intervention control groups with referral to local services as necessary (n = 69 couples). We employed averaged indices of pre- and post-intervention questionnaires completed by both parents. The testing of all hypothesized models controlled for treatment effects on CP in order to strengthen the robustness of the analyses. We found significant concurrent treatment effects on CP and on either CU traits or EC. All effects were mediated by ineffective parenting (IP): a latent variable that was indicated by negative/inconsistent practices and perceived parenting inefficacy. This is the first demonstration of parenting mediated treatment effects on both EC and CU traits in a randomized controlled study conducted in everyday practice contexts. This finding supports a disruption model of change: the reduction of IP facilitates a caregiving environment that affects children's behavior and developing personality. The changing of personality and temperament characteristics implicated in early-onset pathways suggests an innovative prevention strategy for disruptive behavior disorders.
Assuntos
Transtornos do Comportamento Infantil/psicologia , Transtorno da Conduta/psicologia , Educação não Profissionalizante/métodos , Poder Familiar/psicologia , Autocontrole/psicologia , Transtornos do Comportamento Infantil/prevenção & controle , Pré-Escolar , Transtorno da Conduta/prevenção & controle , Feminino , Humanos , Masculino , Resultado do TratamentoRESUMO
BACKGROUND AND OBJECTIVES: Kangaroo mother care (KMC) is a multifaceted intervention for preterm and low birth weight infants and their parents. Short- and mid-term benefits of KMC on survival, neurodevelopment, breastfeeding, and the quality of mother-infant bonding were documented in a randomized controlled trial (RCT) conducted in Colombia from 1993 to 1996. The aim of the present study was to evaluate the persistence of these results in young adulthood. METHODS: From 2012 to 2014, a total of 494 (69%) of the 716 participants of the original RCT known to be alive were identified; 441 (62% of the participants in the original RCT) were re-enrolled, and results for the 264 participants weighing ≤1800 g at birth were analyzed. The KMC and control groups were compared for health status and neurologic, cognitive, and social functioning with the use of neuroimaging, neurophysiological, and behavioral tests. RESULTS: The effects of KMC at 1 year on IQ and home environment were still present 20 years later in the most fragile individuals, and KMC parents were more protective and nurturing, reflected by reduced school absenteeism and reduced hyperactivity, aggressiveness, externalization, and socio-deviant conduct of young adults. Neuroimaging showed larger volume of the left caudate nucleus in the KMC group. CONCLUSIONS: This study indicates that KMC had significant, long-lasting social and behavioral protective effects 20 years after the intervention. Coverage with this efficient and scientifically based health care intervention should be extended to the 18 million infants born each year who are candidates for the method.
Assuntos
Cuidado do Lactente/tendências , Recém-Nascido de Baixo Peso , Recém-Nascido Prematuro , Método Canguru/tendências , Adolescente , Aleitamento Materno , Criança , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/prevenção & controle , Pré-Escolar , Colômbia , Transtorno da Conduta/epidemiologia , Transtorno da Conduta/prevenção & controle , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Inteligência , Estudos Longitudinais , Masculino , Relações Mãe-Filho , Transtornos do Neurodesenvolvimento/epidemiologia , Transtornos do Neurodesenvolvimento/prevenção & controle , Apego ao Objeto , Ajustamento Social , Análise de Sobrevida , Adulto JovemAssuntos
Cannabis/efeitos adversos , Transtorno da Conduta/prevenção & controle , Depressão/terapia , Esquizofrenia/etiologia , Prevenção do Suicídio , Telemedicina/métodos , Adulto , Criança , Terapia Cognitivo-Comportamental/métodos , Humanos , Abuso de Maconha/epidemiologia , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
This randomized controlled trial tested a widely used general parent training program, Common Sense Parenting (CSP), with low-income 8th graders and their families to support a positive transition to high school. The program was tested in its original 6-session format and in a modified format (CSP-Plus), which added 2 sessions that included adolescents. Over 2 annual cohorts, 321 families were enrolled and randomly assigned to either the CSP, CSP-Plus, or minimal-contact control condition. Pretest, posttest, 1-year follow-up, and 2-year follow-up survey data on parenting as well as youth school bonding, social skills, and problem behaviors were collected from parents and youth (94% retention). Extending prior examinations of posttest outcomes, intent-to-treat regression analyses tested for intervention effects at the 2 follow-up assessments, and growth curve analyses examined experimental condition differences in yearly change across time. Separate exploratory tests of moderation by youth gender, youth conduct problems, and family economic hardship also were conducted. Out of 52 regression models predicting 1- and 2-year follow-up outcomes, only 2 out of 104 possible intervention effects were statistically significant. No statistically significant intervention effects were found in the growth curve analyses. Tests of moderation also showed few statistically significant effects. Because CSP already is in widespread use, findings have direct implications for practice. Specifically, findings suggest that the program may not be efficacious with parents of adolescents in a selective prevention context and may reveal the limits of brief, general parent training for achieving outcomes with parents of adolescents. (PsycINFO Database Record
Assuntos
Transtornos do Comportamento Infantil/prevenção & controle , Transtorno da Conduta/prevenção & controle , Educação não Profissionalizante , Comportamento Problema/psicologia , Adolescente , Criança , Transtornos do Comportamento Infantil/psicologia , Estudos de Coortes , Transtorno da Conduta/psicologia , Inteligência Emocional , Relações Familiares/psicologia , Feminino , Seguimentos , Humanos , Masculino , Apego ao Objeto , Relações Pais-FilhoRESUMO
A broad-span, six-stage translational prevention model is presented, extending from the basic sciences-taking a multi-level systems approach, including the neurobiological sciences-through to globalization. The application of a very wide perspective of translation research from basic scientific discovery to international policy change promises to elicit sustainable, population-level reductions in behavioral health disorders. To illustrate the conceptualization and actualization of a program of translational prevention research, we walk through each stage of research to practice and policy using an exemplar, callous-unemotional (CU) traits. Basic science has identified neurobiological, psychophysiological, behavioral, contextual, and experiential differences in this subgroup, and yet, these findings have not been applied to the development of more targeted intervention. As a result, there are currently no programs considered especially effective for CU traits, likely because they do not specifically target underlying mechanisms. To prevent/reduce the prevalence of conduct disorder, it is critical that we transfer existing knowledge to subsequent translational stages, including intervention development, implementation, and scaling. And eventually, once resulting programs have been rigorously evaluated, replicated, and adapted across cultural, ethnic, and gender groups, there is potential to institutionalize them as well as call attention to the special needs of this population. In this paper, we begin to consider what resources and changes in research perspectives are needed to move along this translational spectrum.
Assuntos
Transtorno da Conduta/prevenção & controle , Pesquisa Translacional Biomédica/métodos , Animais , HumanosRESUMO
Research has shown a connection between negative parenting practices and child conduct problems. One of the most commonly used measures to assess parenting practices is the Alabama parenting questionnaire (APQ). The current study aimed to culturally adapt and assess the psychometric properties of a short version of the APQ for use in Arabic cultures, using a sample of 251 Qatari parents of children ages 4-12. An exploratory factor analysis proposed a five-model solution that corresponds to the original proposed model in the full version of the APQ. The five constructs of the APQ correlated in the expected direction with the Conduct Problem Subscale from the Strength and Difficulties Questionnaire. This study provides support for the utility of the 15-item short version of the APQ in Arabic cultures. More studies are needed to validate the performance of the short version of APQ in clinical settings.