Social support and treatment outcome in behavioral family therapy for child conduct problems.

Assessed the role of social support in the outcome of child management training (CMT) for single parents of conduct problem children and assessed the impact of adjunctive ally support training (AST) on treatment outcome. 22 single parents with a child diagnosed as oppositional or conduct-disordered received CMT or CMT plus AST. Each group received the same 6-wk parent training program and the AST group received an extra social support intervention. Measures of parent behavior, child deviance, social support (SS), and parental depression were obtained at pre- and posttreatment and at 6-mo follow-up. Both groups improved, and changes maintained at follow-up. AST produced no extra gains. Responders from either group were more likely than nonresponders to report high levels of SS from friends. Results emphasize the importance of SS and the difficulty of incorporating changes in SS into treatment programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Specific and nonspecific factors in the effectiveness of a behavioral approach to the treatment of marital discord.

Compared 2 behavioral treatments for marital discord with a nonspecific control and a waiting-list control. The behavioral treatments combined training in problem-solving skills with training in contingency management procedures, differing only with respect to the contracting form: One group learned to form good faith contracts, and the other, quid pro quo contracts. 32 couples were randomly assigned to 1 of these 2 treatment conditions and 1 of 3 therapists. Improvement was assessed by 2 observational measures and by 2 self-report questionnaires, Marital Adjustment and Marital Happiness Scales. On all measures, both behavioral groups improved significantly more than waiting-list couples. On 3 of the 4 measures, behavioral couples improved significantly more than nonspecific couples. The 2 behavioral groups did not differ from one another on any of the measures. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of knowledge of social learning principles on enhancing treatment outcome and generalization in a parent training program.

Examined the efficacy of incorporating formal training in social learning principles into a behavioral parent training program as a means of enhancing treatment outcome and generalization. Two groups of parents (n?=?20) received behavioral skill training designed to modify child noncompliance. One group also received formal training in social learning principles throughout the program. Children had a mean age of 61.75 mo. Outcome measures collected prior to and after treatment and at a 2-mo follow-up included home observations by independent observers, parents' perceptions of child adjustment, and a parent consumer-satisfaction measure. Results indicate that after treatment, the group receiving social learning principles tended to perceive their children as better adjusted and tended to be more satisfied with treatment. At follow-up, parents in this group perceived their children as better adjusted and rewarded their children more. Furthermore, their children were significantly more compliant. Results suggest that temporal and setting generality are enhanced by the inclusion of social learning principles into parent training procedures. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of water pipelines on the quality of drinking water

Examined whether marital discord over childrearing contributes to child behavior problems after taking into account general marital adjustment, and if child age moderates associations between child behavior problems and either general marital adjustment or marital discord over childrearing. Participants were 146 two-parent families seeking services for their child's (4 to 9 years of age) conduct problems. Data on marital functioning and child behavior problems were collected from both parents. Mothers' and fathers' reports of marital discord over childrearing related positively to child externalizing problems after accounting for general marital adjustment. Child age moderated associations between fathers' reports of general marital adjustment and both internalizing and externalizing child problems, with associations being stronger in families with younger children. The discussion highlights the role that developmental factors may play in understanding the link between marital and child behavior problems in clinic-referred families.     

Complex language and comprehension monitoring: Teaching child witnesses to recognize linguistic confusion.

The authors investigated the efficacy of 2 child witness preparation programs: task demand training (TDT) and comprehension-monitoring training (CMT) with task demand training (CMT + TDT). Preschool (M?=?60.8 months), kindergarten (M?=?76.0 months) and 2nd-grade (M?=?98.1 months) children participated. All children participated in either TDT (n?=?56), or TDT + CMT (n?=?43). After training, participants were interviewed about a video they watched. Questions contained either simple or complex language. Results suggest TDT + CMT better prepares witnesses of all ages for complex-language questions. When faced with complex-language questions, the TDT + CMT group averaged more requests for rephrasings than the TDT group. These data suggest even the very young children in this investigation benefited from the court preparation protocol including TDT and CMT. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interspousal aggression, marital discord, and child problems.

The association between interspousal aggression and child problems was assessed after controlling for parent's general marital discord. Participants were 87 couples requesting marital therapy who had children between 5 and 12 years old. Spouses completed measures of marital aggression, marital discord, child problems, and family demographics. Marital aggression contributed unique variance to the prediction of conduct disorder, personality disorder, inadequacy-immaturity, and clinical levels of problematic child behavior after marital discord, child's age, child's sex, and Marital Discord?×?Child's Sex interaction were controlled. The theoretical implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early intervention in the path to alcohol problems through conduct problems: Treatment involvement and child behavior change.

A program for the prevention of conduct problems among preschool-age sons of alcoholic fathers was implemented to interrupt what is likely to be a major mediating factor in the development of alcoholism in later years. A population-based sample of 42 families participated in a 10-month intervention involving parent training and marital problem solving. Differences in treatment outcome were examined, with the expectation that level of treatment involvement—entailing both level of participation and level of investment—would account for variability in child outcome at termination. Significant changes in positive and negative child behaviors were observed only within the group of families who completed the program and where the mothers demonstrated a higher level of treatment investment. When pretreatment child, parent, and family predictors of child behavior change were accounted for, subsequent analyses identified maternal treatment investment as a significant predictor of child outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Outpatient group treatment of chronic pain: Effects of spouse involvement.

Evaluated the efficacy of outpatient group treatment of chronic pain and the effect of spouse involvement in treatment in chronic pain patients ranging in age from 23 to 69 yrs who were randomly assigned to couples group treatment (n?=?17), patient-only group treatment (n?=?14), or waiting-list controls (n?=?12). 29 Ss had low back pain; the remaining Ss reported pain in the knee, arm, leg, hip, head, and phantom limb. The Ss completed the MMPI—168 and measures of health-related psychosocial and physical dysfunction and marital satisfaction. Results indicate that the 16-hr cognitive-behavioral program produced reductions in pain, somatization, spouse-observed pain behavior, physical and psychosocial dysfunction, spouse-rated dysfunction, and utilization of health care resources. Depression was not affected by treatment. Spouse involvement did not facilitate response to treatment on any variables. Also, Ss in the individual condition only showed improved marital satisfaction. All treatment gains were maintained at 3-mo to 7-mo follow-ups. Results indicate that brief outpatient treatment can significantly ameliorate chronic pain problems, and spouse involvement is not essential for a positive response to treatment. (39 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrative behavioral couple therapy: An acceptance-based, promising new treatment for couple discord.

Although traditional behavioral couple therapy (TBCT) has garnered the most empirical support of any marital treatment, concerns have been raised about both its durability and clinical significance. Integrative behavioral couple therapy (IBCT) was designed to address some of these limitations by combining strategies for fostering emotional acceptance with the change-oriented strategies of TBCT. Results of a preliminary clinical trial, in which 21 couples were randomly assigned to TBCT or IBCT, indicated that therapists could keep the 2 treatments distinct, that both husbands and wives receiving IBCT evidenced greater increases in marital satisfaction than couples receiving TBCT, and that IBCT resulted in a greater percentage of couples who either improved or recovered on the basis of clinical significance data. Although preliminary, these findings suggest that IBCT is a promising new treatment for couple discord. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of parent training on infant sleeping patterns, parents' stress, and perceived parental competence.

First-time parent couples from childbirth classes were randomly assigned to a 4-session training group (n?=?29) or a control group (n?=?31). Members of the training group were taught behavioral strategies to promote healthy, self-sufficient sleep patterns in their infants, whereas the control group received the same amount of personal contact without the behavioral training. Six sleep variables were derived from a daily infant sleep diary completed by parents at 2 time points. Results show that at age 6–9 wks, infants in the training group displayed significantly better sleeping patterns than did control infants. Training group parents awakened and responded less often to infant signaling and reported greater parental competence. By contrast, control group parents indicated increased stress over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The legacy of parents' marital discord: Consequences for children's marital quality.

Drawing on a national longitudinal study of 297 parents and their married offspring, the authors found that parents' marital discord was negatively related to offspring's marital harmony and positively related to offspring's marital discord. The transmission of marital quality was not mediated by parental divorce, life-course variables, socioeconomic attainment, retrospective measures of parent–child relationships, or psychological distress. Offspring's recollections of parental discord, however, mediated about half of the association between parents' reports of marital discord and offspring's reports of discord in their own marriages. Parental behaviors most likely to predict problematic marriages among offspring included jealousy, being domineering, getting angry easily, being critical, being moody, and not talking to the spouse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An evaluation of modeling and experiential procedures for self-disclosure training.

Attempted (a) to adapt and implement an interpersonal-skills training paradigm for training married individuals to exhibit increased self-disclosive behavior in their marital relationships, and (b) to determine the efficacy of experiential and modeling procedures in such training. 27 university-affiliated married couples (mean age 24.5 yrs, mean length of marriage 3.1 yrs) were randomly assigned to 1 of 3 groups: a communication-skills training group, a modeling group, and a control group. Frequency, duration, and quality of self-disclosive behavior were analyzed for pre- to posttraining changes by means of the Hill Interaction Matrix and the Facilitative Self-Disclosure Scale. Results indicate that (a) the communication-skills training group demonstrated a significant increase on 4 of the 5 self-disclosure measures, (b) the modeling group demonstrated an increase on 3 of the self-disclosure variables, and (c) the controls did not change on any of the variables. Implications of integrating both modeling and experiential methods into interpersonal-skills training programs are discussed. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Supplementing behavioral marital therapy with cognitive restructuring and emotional expressiveness training: An outcome investigation.

The current study investigated whether the effectiveness of behavioral marital therapy (BMT) would be increased by the addition of cognitive restructuring (CGR) and/or emotional expressiveness training (EET) for maritally distressed couples. Sixty such couples were randomly assigned to 1 of 3 therapists and 1 of 5 treatment conditions (BMT Alone, CGR?+?BMT, BMT?+?EET, CGR?+?BMT?+?EET, or waiting list) for 12 weeks of conjoint marital therapy. Within each treatment condition, couples typically improved on the variables focused on in treatment. However, comparisons among active treatment conditions showed few significant differences among treatments; the treatments were equally effective in increasing marital adjustment. Thus, the addition of CGR and EET did not appear to increase the overall effectiveness of treatment. Possible reasons for the current findings are provided, and suggestions for future marital outcome investigations are outlined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Commitment to treatment goals in prediction of group cognitive–behavioral therapy treatment outcome for women with bulimia nervosa.

The purpose of this study was to investigate potential client variables that predict favorable response to group cognitive–behavioral therapy in a sample of women (N?=?143) seeking treatment for bulimia nervosa. Similar to findings of previous studies, bulimic symptom remission at end of treatment was predicted by baseline degree of bulimic symptom severity but not by depressive symptomatology or perfectionism. After these variables were controlled for, both pretreatment ratings of desire to discontinue bulimic behaviors and expected success significantly added to prediction of treatment outcome. The primary variable found to predict longer term outcome was symptom remission at the end of treatment and at the 1-month follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Outcome of parent-mediated treatment of preschoolers with attention deficit disorder with hyperactivity.

Despite the early onset of attention deficit disorder with hyperactivity (ADDH), there is a dearth of treatment studies with preschoolers with this disorder. Forty-six families with ADDH preschoolers were randomly assigned to either an immediate or a delayed group parent training program aimed at improving child compliance. Groups were balanced on demographic variables. Treatment outcome was evaluated by comparing the groups at pre- and posttreatment and 3-month follow-up on measures of parent–child interactions during free play, a compliance task, and parent-supervised activities, as well as on parent-completed Conners Hyperkinesis Index (C. H. Goyette et al; see record 1980-22450-001) scores. Positive treatment effect was obtained on measures of compliance, parental style of interaction, and management skills. These improvements were maintained at 3-month follow-up. Evaluation of treatment effects on nontargeted child behaviors indicated no generalization. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Level of social-cognitive development, adaptive functioning, and DSM-III diagnoses in adolescent offspring of parents with affective disorders: Implications of the development of the capacity for mutuality.

This study examines the relation between the developmental social-cognitive capacity for interpersonal negotiation and both parental-risk and adolescent-outcome variables in 172 adolescents 11 to 19 years of age. The sample was divided into two groups: those at risk because of affective disorder in one or both of their parents and a comparison group whose parents have never experienced affective illness. Adolescents' interpersonal negotiation strategy (INS) levels were negatively associated with the duration of parental affective illness (and with associated lower socioeconomic status and marital discord). INS level significantly predicted adolescents' adaptive social functioning (AFR) even after controlling for age, sex, intelligence, number of adolescent diagnoses, and parental-risk factors. Two additional patterns were found in the risk group: adolescents with both high AFR and high INS, and adolescents who have disturbed functioning despite high INS. These findings are consistent with a risk model in which social-cognitive capacity mediates between parental disorder and adaptive child behavior, and they suggest the importance of assessing children at risk with a developmental measure of relational capacity to complement the more traditional diagnostic and behavioral outcome measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mediators, Moderators, and Predictors of 1-Year Outcomes Among Children Treated for Early-Onset Conduct Problems: A Latent Growth Curve Analysis.

Several child conduct problem interventions have been classified as either efficacious or well established. Nevertheless, much remains to be learned about predictors of treatment response and mechanisms of behavioral change. In this study, the authors combine data from 6 randomized clinical trials and 514 children, ages 3.0-8.5 years, to evaluate moderators, mediators, and predictors of outcome. Among other findings, latent growth curve models of mother-report and observational measures of child externalizing behaviors suggested that marital adjustment, maternal depression, paternal substance abuse, and child comorbid anxiety/depression each moderated treatment response. Moreover, critical, harsh, and ineffective parenting both predicted and mediated outcome, with the most favorable responses observed when parents scored relatively low on each construct at intake yet improved during treatment. Implications for treatment nonresponders are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rate and predictors of divorce among parents of youths with ADHD.

Numerous studies have asserted the prevalence of marital conflict among families of children with attention-deficit/hyperactivity disorder (ADHD), but evidence is surprisingly less convincing regarding whether parents of youths with ADHD are more at risk for divorce than are parents of children without ADHD. Using survival analyses, the authors compared the rate of marital dissolution between parents of adolescents and young adults with and without ADHD. Results indicated that parents of youths diagnosed with ADHD in childhood (n = 282) were more likely to divorce and had a shorter latency to divorce compared with parents of children without ADHD (n = 206). Among a subset of those families of youths with ADHD, prospective analyses indicated that maternal and paternal education level; paternal antisocial behavior; and child age, race/ethnicity, and oppositional-defiant/conduct problems each uniquely predicted the timing of divorce between parents of youths with ADHD. These data underscore how parent and child variables likely interact to exacerbate marital discord and, ultimately, dissolution among families of children diagnosed with ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral versus insight-oriented marital therapy: Effects on individual and interspousal functioning.

Compared the effects of behavioral marital therapy (BMT) and insight-oriented marital therapy (IOMT) on both interspousal and intrapersonal functioning in a controlled outcome study. A total of 79 couples seeking treatment for relationship distress were randomly assigned to BMT, IOMT, or a treatment-on-demand (TOD) waiting-list control group. Results indicated the significance and general equivalence of behavioral and insight-oriented therapies in producing positive changes in individual and relationship functioning. Both treatment approaches produced significant effects from intake to termination that were substantially maintained at the 6-month follow-up. Behavioral and insight-oriented therapies resulted in significant improvements in self-reports of global marital accord and, to a lesser extent, in the reduction of overall psychological distress and in the enhancement of self-concept, with no significant differences between treatment conditions. The magnitude of these effects in comparison with those reported in previous marital outcome studies and in more general psychotherapy research is discussed, and possible mechanisms for the equivalence of these technically divergent treatment approaches are explored. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relapse prevention training and problem-solving therapy in the long-term management of obesity.

This study compared 2 extended therapy programs for weight management with standard behavioral treatment (BT) without additional therapy contacts. Participants were 80 obese women who completed 20 weekly group sessions of BT and achieved a mean initial weight loss of 8.74 kg. Participants were randomly assigned to a no-further-contact condition (BT only) or to one of two extended interventions consisting of relapse prevention training (RPT) or problem-solving therapy (PST). No significant overall weight-change differences were observed between RPT and BT or between RPT and PST. However, participants who completed the PST intervention had significantly greater long-term weight reductions than BT participants, and a significantly larger percentage of PST participants achieved clinically significant losses of 10% or more in body weight than did BT participants (35% vs 6%). (PsycINFO Database Record (c) 2010 APA, all rights reserved)