START NOW: a cognitive behavioral skills training for adolescent girls with conduct or oppositional defiant disorder - a randomized clinical trial.
J Child Psychol Psychiatry
; 65(3): 316-327, 2024 Mar.
Article
in En
| MEDLINE
| ID: mdl-37814906
ABSTRACT
BACKGROUND:
Conduct disorder (CD) and oppositional defiant disorder (ODD) both convey a high risk for maladjustment later in life and are understudied in girls. Here, we aimed at confirming the efficacy of START NOW, a cognitive-behavioral, dialectical behavior therapy-oriented skills training program aiming to enhance emotion regulation skills, interpersonal and psychosocial adjustment, adapted for female adolescents with CD or ODD.METHODS:
A total of 127 girls were included in this prospective, cluster randomized, multi-center, parallel group, quasi-randomized, controlled phase III trial, which tested the efficacy of START NOW (n = 72) compared with standard care (treatment as usual, TAU, n = 55). All female adolescents had a clinical diagnosis of CD or ODD, were 15.6 (±1.5) years on average (range 12-20 years), and were institutionalized in youth welfare institutions. The two primary endpoints were the change in number of CD/ODD symptoms between (1) baseline (T1) and post-treatment (T3), and (2) between T1 and 12-week follow-up (T4).RESULTS:
Both treatment groups showed reduced CD/ODD symptoms at T3 compared with T1 (95% CI START NOW = -4.87, -2.49; TAU = -4.94, -2.30). There was no significant mean difference in CD/ODD symptom reduction from T1 to T3 between START NOW and TAU (-0.056; 95% CI = -1.860, 1.749; Hedge's g = -0.011). However, the START NOW group showed greater mean symptom reduction from T1 to T4 (-2.326; 95% CI = -4.274, -0.378; Hedge's g = -0.563). Additionally, secondary endpoint results revealed a reduction in staff reported aggression and parent-reported irritability at post assessment.CONCLUSIONS:
Although START NOW did not result in greater symptom reduction from baseline to post-treatment compared with TAU, the START NOW group showed greater symptom reduction from baseline to follow-up with a medium effect size, which indicates a clinically meaningful delayed treatment effect.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Attention Deficit Disorder with Hyperactivity
/
Conduct Disorder
Type of study:
Clinical_trials
Limits:
Adolescent
/
Adult
/
Child
/
Female
/
Humans
Language:
En
Journal:
J Child Psychol Psychiatry
Year:
2024
Document type:
Article
Affiliation country:
Switzerland