Callous-Unemotional Traits and Delinquent Peer Affiliation.

Association with a deviant peer group is a robust correlate of juvenile antisocial behavior. The current study focused on whether this association differed for antisocial youth with and without callous-unemotional (CU) traits and whether potential mediators of this association differed for the 2 groups. Deviant peer group association was examined in a community sample (N = 98) of high-risk youth. The sample was assessed at 4 yearly intervals. Across all assessment points, children with conduct problems and CU traits showed the highest level of affiliation with deviant peers. At the first 2 assessment points, this effect was largely mediated by dysfunctional parenting and problems in the child's social relationships. In contrast, the mediational role of these variables was much weaker at the last 2 assessment points. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individual Behavioral Profiles and Predictors of Treatment Effectiveness for Children With Autism.

Differential responsiveness to intervention programs suggests the inadequacy of a single treatment approach for all children with autism. One method for reducing outcome variability is to identify participant characteristics associated with different outcomes for a specific intervention. In this investigation, an analysis of archival data yielded 2 distinct behavioral profiles for responders and nonresponders to a widely used behavioral intervention, pivotal response training (PRT). In a prospective study, these profiles were used to select 6 children (3 predicted responders and 3 predicted nonresponders) who received PRT. Children with pretreatment responder profiles evidenced positive changes on a range of outcome variables. Children with pretreatment nonresponder profiles did not exhibit improvements. These results offer promise for the development of individualized treatment protocols for children with autism. (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)     

Parenting Behaviors and the Occurrence and Co-Occurrence of Depressive Symptoms and Conduct Problems Among African American Children.

The occurrence and co-occurrence of depressive symptoms and conduct problems were examined in the context of parenting behaviors in a community-based sample of 897 African American children and their primary caregivers using a multi-informant, longitudinal design. Parenting behaviors and clinical symptoms were assessed in 2 waves, when the children averaged 10.5 and 12.3 years of age. Parenting behaviors differed significantly according to a child's symptomatology; (a) that is, when a child exhibited no depressive or conduct problems, (b) depressive problems only, (c) conduct problems only, or (d) co-occurring depressive and conduct problems. When parenting behaviors were examined according to changes in children's symptom levels, children whose symptoms increased over time reported increases in hostility and harsh-inconsistent parenting and decreases in warmth and nurturant-involved parenting. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Positive Association of Child Involvement and Treatment Outcome Within a Manual-Based Cognitive-Behavioral Treatment for Children With Anxiety.

Ratings of child involvement in manual-based cognitive-behavioral treatment for anxiety were associated with the absence of primary anxiety diagnosis and reductions in impairment ratings at posttreatment for 59 children with anxiety (ages 8-14 years). Good-to-excellent interrater reliability was established for the independent ratings of 237 therapy sessions, and strong psychometrics were established for the involvement measure. Child involvement at midtreatment, just prior to in vivo exposures, was positively associated with treatment gains but earlier involvement was not. Increased involvement during therapy (positive involvement shifts) may provide a useful index of change and may also predict outcomes. Involvement was not associated with client demographics or diagnostic category. Implications for treatment and measurement of psychotherapy process within manual-based treatments are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Contributions of Ineffective Discipline and Parental Hostile Attributions of Child Misbehavior to the Development of Conduct Problems at Home and School.

Data were collected in a longitudinal study of 134 boys and 132 girls and their families during kindergarten and first grade. Four hours of parent-child interaction were coded to ascertain parent discipline practices. A structured interview assessed maternal attributions about child behavior. Maternal ratings of child conduct problems at kindergarten entry reliably predicted the mother's subsequent hostile attributions concerning child misbehavior and use of ineffective discipline tactics. Ineffective maternal discipline and the interaction of ineffective discipline and hostile attribution predicted growth in child conduct problems at home during kindergarten and first grade. Changes in teacher-reported and observed child conduct problems at school during kindergarten and first grade were predicted by growth in conduct problems at home and by the interaction of ineffective discipline and hostile attribution. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disentangling the Underlying Dimensions of Psychopathy and Conduct Problems in Childhood: A Community Study.

The psychometric and predictive validity of callous-unemotional (CU) traits as an early precursor of conduct disorder and antisocial behavior were assessed. A community sample of children (4-9 years of age) were tested 12 months apart with the Antisocial Process Screening Device (APSD; P. J. Frick & R. D. Hare, 2002), a measure of early signs of psychopathy in children. Factor analysis supported the structure of the APSD. Given controversy surrounding construct overlap between psychopathy and conduct problems, a factor analysis was conducted on pooled items from the Strengths and Difficulties Questionnaire and APSD. A 5-factor solution resulted: antisocial, hyperactivity, CU traits, anxiety, and peer problems. CU traits added small but significant improvements in the 12-month prediction of antisocial behavior for boys and older girls, after controlling for Time 1 measures. These results indicate that although the dimensions of the APSD overlap with dimensions of the disruptive behavior disorders, CU traits have unique predictive validity in childhood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment effectiveness of parent management training in Norway: A randomized controlled trial of children with conduct problems.

This study was a randomized control trial (RCT) of Parent Management Training--The Oregon Model (PMTO) in Norway. A sample representing all health regions of Norway and consisting of 112 children with conduct problems and their families participated in the study. Families were randomly assigned to either PMTO or a regular services comparison group. PMTO was delivered via existing children's services, and families were recruited using the agencies' regular referral procedures, making this the first effectiveness study of PMTO and the first RCT of PMTO conducted outside of the United States. Using a multiagent-multimethod approach, results showed that PMTO was effective in reducing parent-reported child externalizing problems, improving teacher-reported social competence, and enhancing parental discipline. Age level and gender modified the effects of PMTO treatment on other outcomes. In a path model, participation in PMTO was associated with improved parental discipline, and effective discipline predicted greater child compliance, fewer child-initiated negative chains, and lower levels of child externalizing problems. Findings are presented along with a discussion of the implications for practice and research and the challenges accompanying effectiveness trials. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Treatment of Dissociation in Sexually Abused Children From a Family/Attachment Perspective.

This article outlines an approach to treatment of sexually abused children with dissociative symptoms. Dissociated self-states are seen as competing interpersonal approaches to handling the many emotional sequela of abuse, including anger, fear, and regressive needs. Parents' responses to their sexually abused children, complicated by guilt and their own histories of trauma, can promote dissociative coping in the children as they have difficulty processing their own real feelings of anger, fear, and responsibility. Children and parents may alternatively take victimizer, victim, and rescuer roles, thus mutually reinforcing a dissociative style of coping with these events. This article illustrates how sensitivity to these family dynamics, along with a problem-solving approach to the child's symptoms, can treat dissociative psychopathology in these children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Iatrogenic Effects of Group Treatment for Antisocial Youths.

It has been argued that group treatment of antisocial adolescents may increase rather than decrease conduct problems. One mechanism that has been suggested to underlie this effect is "deviancy training," wherein during group sessions deviant peers reinforce each other's antisocial actions and words. These 2 hypotheses have important implications and warrant close review at conceptual and empirical levels. In this article, the authors present such a review. Conceptually, deviancy training potential of treatment sessions appears less significant than the more extensive peer influences outside treatment. Empirical findings previously cited in support of iatrogenic effects appear on close examination to provide little support. Finally, 17 of 18 new meta-analytic tests produced results not supportive of iatrogenic or deviancy training effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-Behavioral and Humanistic Group Treatment for Children With Learning Disabilities: A Comparison of Outcomes and Process.

The authors of this study examined the outcomes and processes of 2 types of group treatment--cognitive-behavioral treatment groups (CBTG) and humanistic group therapy (HGT)--offered to 200 elementary schoolchildren in a center for students with learning disabilities in Israel. Results indicated that the addition of either type of group treatment to individual academic assistance was more effective than the latter alone on most measures. In fact, on the majority of measures, group treatment without academic assistance was more effective than just individual assistance. Finally, HGT was more effective than CBTG on most measures. Most of the outcomes were sustained at follow-up, and some even increased from termination to follow-up, although effect sizes were quite low. Process measures included the Client Behavior System and the therapist Helping Skills System, which were measured at 5 points in time. Differences between the 2 treatment types were revealed on both process measures, including differences in the growth curve of these behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Efficacy of the RECAP intervention program for children with concurrent internalizing and externalizing problems.

The authors evaluated the efficacy of RECAP, a psychosocial intervention developed to treat concurrent internalizing and externalizing problem in children. Participants included 93 4th-grade children assigned to the treatment group or a no-treatment control group. The school-based program, which lasts the 9-month academic year, provides individual, group, classroom, teacher, and parent training in the RECAP skills-development curriculum, which was derived from empirically supported treatment programs for nonconcurrent internalizing and externalizing problems. Outcome assessments included parent-, teacher-, self-, and peer reports. A mixed hierarchical linear models analysis indicated that, overall, treatment children's rate of improvement in both internalizing and externalizing problems was significantly greater than that for control participants. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotional and Behavioral Problems of Children Living With Drug-Abusing Fathers: Comparisons With Children Living With Alcohol-Abusing and Non-Substance-Abusing Fathers.

Although the effects of paternal alcoholism on the psychosocial adjustment of children are well documented, the impact of fathers' illicit drug abuse on their children is poorly understood. The purpose of this study was to compare the adjustment of children living in families with drug-abusing fathers (n = 40) with that of children with fathers who abused alcohol (n = 40) and children with non-substance-abusing fathers (n = 40). Children with drug-abusing fathers experienced more internalizing and externalizing symptoms than children with alcoholic or non-substance-abusing fathers. Interparental conflict and parenting behavior mediated the relationship between family type and children's adjustment. Interventions to improve fathers' parenting behavior and reduce partner conflict may lead to better adjustment among custodial children of drug-abusing fathers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Transdermal Methylphenidate, Behavioral, and Combined Treatment for Children With ADHD.

Stimulant medication and behavioral treatments are evidence-based for children with attention-deficit/hyperactivity disorder, but the combination of the 2 treatments has been understudied. In this investigation, methylphenidate (MPH) was crossed with 2 levels of behavior modification (BMOD) in a summer treatment program. Twenty-seven children with attention-deficit/hyperactivity disorder, aged 6-12, participated. Children received placebo and 3 doses of transdermal MPH (12.5 cm2, 25.0 cm2, and 37.5 cm2). BMOD was implemented on alternating weeks. Both treatments produced large and significant effects. Combined treatment was superior to either treatment alone. The effects of transdermal MPH were comparable to those found in this setting in previous studies with multiple stimulant medications and formulations. Consistent with other research, low doses of MPH--even lower than in previous studies--yielded enhanced effects in combination with behavior modification. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effectiveness of Collaborative Problem Solving in Affectively Dysregulated Children With Oppositional-Defiant Disorder: Initial Findings.

Oppositional-defiant disorder (ODD) refers to a recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures. Research has shown that children with ODD and comorbid mood disorders may be at particular risk for long-term adverse outcomes, including conduct disorder. In this study, the authors examined the effectiveness of a cognitive-behavioral model of intervention--called collaborative problem solving (CPS)--in comparison with parent training (PT) in 47 affectively dysregulated children with ODD. Results indicate that CPS produced significant improvements across multiple domains of functioning at posttreatment and at 4-month follow-up. These improvements were in all instances equivalent, and in many instances superior, to the improvements produced by PT. Implications of these findings for further research on and treatment selection in children with ODD are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the Independence of Ratings of Hyperactivity, Conduct Problems, and Attention Deficits in Children: A Multiple Regression Analysis: Correction to Lahey, Green, and Forehand.

Reports an error in the original article by Benjamin B. Lahey, Kenneth D. Green, and Rex Forehand (Journal of Consulting and Clinical Psychology, 1980, Vol. 48, No. 5, pp. 566-574). It was incorrectly stated on page 571 that Loney, Langhorne, and Paternite derived factor scores from the product of all factor loadings and teacher ratings. Instead, they used normalized z scores derived from ratings of only those items that loaded most strongly on each factor. Differences in results between the two studies, therefore, are probably not due to differences in the methods of calculating factor scores. (The following abstract of this article originally appeared in record 1980-33426-001.) Teacher ratings, direct observational measures, and peer evaluations were obtained on 109 3rd-grade children. Factor scores on the Conners Teacher Rating Scale were correlated with the following measures: observation of time on task; frequency of teacher interaction; positive and negative peer interactions; peer ratings of acceptance, rejection, and dislike; and 3 measures of academic performance. Arguments are made for combining hyperactivity and conduct problem scales in rating child behavior problems. A factor resembling the attention deficit disorder without hyperactivity (inattentive-passive) was found to account for a substantial portion of independent variance in the multiple regression analyses and should, therefore, be considered as a separate rating scale factor. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of Children With Complicated Posttraumatic Stress Reactions.

Complicated or complex posttraumatic stress reactions in children typically indicate a history of protracted trauma and often include both a greater number of symptoms with heightened severity as compared with children experiencing single-incident traumas. Complicated traumatic stress responses in childhood are usually more difficult to treat than less complex ones. Characteristics of the traumatic event as well as mediating and moderating variables, which can render the child susceptible to a complicated trauma reaction, are delineated in this article. Interventions are presented to address the diverse difficulties presented by children with a complicated trauma reaction, including safety planning, grief work, family therapy, cognitive-behavioral individual treatment, and utilization of various systems of childhood (e.g., school). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Investigation of the Heterogeneity of Disruptive Behaviour in Elementary-Age Children.

We evaluated parent and teacher ratings of a large sample (N=1579) of elementary-school children in Canada to determine how different conceptualizations of disruptive behaviour are co-related and related to other measures of functioning. Parent and teacher ratings were consistent, and suggested three separate but correlated aspects of disruptive behaviour in children: (1) reactive/oppositional behaviour, (2) proactive/callous behaviour; and (3) inattention-impulsive-overactive behaviour. These were uniquely and significantly related to DSM-IV diagnostic scores and to other measure of impairment, indicating that they measure distinct aspects of disruptive behaviour in children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reducing conduct problems among children of battered women.

This study was an experimental evaluation of an intervention designed to reduce conduct problems among children of battered women. Participants were 36 families (mothers and children) in which the mother had sought shelter because of relationship violence and had at least 1 child (4-9 years old) with clinical levels of conduct problems. The intervention consisted of 2 primary components: (a) providing instrumental and emotional support and (b) teaching child management skills to mothers. Families were randomly assigned to either the intervention condition or the existing services comparison condition and were assessed on 5 occasions over 16 months after shelter departure. Compared with families receiving existing services, children in the intervention condition improved at a faster rate, the proportion of children displaying clinical levels of conduct problems was greatly diminished, and mothers displayed greater improvements in child management skills. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Efficacy of Play Therapy With Children: A Meta-Analytic Review of Treatment Outcomes.

The efficacy of psychological interventions for children has long been debated among mental health professionals; however, only recently has this issue received national attention, with the U.S. Public Health Service (2000) emphasizing the critical need for early intervention and empirically validated treatments tailored to children's maturational needs. Play therapy is a developmentally responsive intervention widely used by child therapists but often criticized for lacking an adequate research base to support its growing practice. A meta-analysis of 93 controlled outcome studies (published 1953-2000) was conducted to assess the overall efficacy of play therapy and to determine factors that might impact its effectiveness. The overall treatment effect for play therapy interventions was 0.80 standard deviations. Further analysis revealed that effects were more positive for humanistic than for nonhumanistic treatments and that using parents in play therapy produced the largest effects. Play therapy appeared equally effective across age, gender, and presenting issue. (PsycINFO Database Record (c) 2010 APA, all rights reserved)