Side effects of parent counseling on marital satisfaction.

In a study with 27 mothers and their clinic-referred children, mothers were divided into 3 groups based on their pretreatment level of marital satisfaction (Locke Marital Adjustment Test). Child compliance and deviant behavior as measured by independent observers, parent perceptions of child adjustment, and parent marital satisfaction were assessed before treatment, after treatment, and at a 2-mo follow-up. Parent counseling consisted of teaching mothers to reward appropriate behavior and use a time-out procedure for deviant behavior. All groups changed significantly from pre- to posttreatment on the child behavior measures and on parent perceptions of child adjustment. These changes were maintained at follow-up for child compliance and parent perceptions of child adjustment. The group of mothers with low marital satisfaction reported an increase in marital adjustment from pretreatment to posttreatment, but this effect was not maintained at the 2-mo follow-up. Groups with medium or high marital satisfaction reported no change in marital adjustment. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early intervention for parents at risk of child abuse and neglect: A preliminary investigation.

An early intervention program for young parents and children who have been identified as being at risk of child maltreatment was evaluated. Thirty mother–child dyads were randomly assigned to one of two conditions: (a) an information group offered by the child protection agency (which served as a control condition) or (b) a special program of behavioral parent training in addition to the agency group. Self-report measures indicated that significant improvements in parenting risk and child behavior problems at posttest and at 3-month follow-up were evident only for mothers who received parent training in addition to information groups. Home observation data were inconclusive, possibly due to the limited opportunities to observe behaviors of interest. Both groups showed improvements in their child-rearing environments and in their children's adaptive behaviors at follow-up. Caseworker ratings of clients' risks of maltreatment and abilities to manage their families at 1-year follow-up significantly favored the families who received parent training in addition to information. Methodological and treatment issues arising from this preliminary investigation of early intervention with diverse population of high-risk parents and children are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Randomized controlled trial of a family cognitive-behavioral preventive intervention for children of depressed parents.

A family cognitive-behavioral preventive intervention for parents with a history of depression and their 9–15-year-old children was compared with a self-study written information condition in a randomized clinical trial (n = 111 families). Outcomes were assessed at postintervention (2 months), after completion of 4 monthly booster sessions (6 months), and at 12-month follow-up. Children were assessed by child reports on depressive symptoms, internalizing problems, and externalizing problems; by parent reports on internalizing and externalizing problems; and by child and parent reports on a standardized diagnostic interview. Parent depressive symptoms and parent episodes of major depression also were assessed. Evidence emerged for significant differences favoring the family group intervention on both child and parent outcomes; strongest effects for child outcomes were found at the 12-month assessment with medium effect sizes on most measures. Implications for the prevention of adverse outcomes in children of depressed parents are highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Teacher ratings predict peer ratings of aggression at 3-year follow-up in boys with attention deficit disorder with hyperactivity.

Compared initial and 3-yr follow-up peer ratings of 19 boys, who were in Grades 1–3 at the beginning of the study, who had attention deficit disorder with hyperactivity (ADDH). When the entire group was considered, nominations on the Aggression and Likability factors of a pupil evaluation inventory improved. Subgroups were created using teacher ratings on an aggression scale. Peer ratings of Aggression improved for Ss whom teachers rated below the median on the aggression scale but not for Ss rated above the median. Subgroups reflecting other teacher and peer ratings were less effective in predicting differential change in peer ratings of ADDH Ss. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Three- and 6-Month Follow-Up of EMDR Treatment of PTSD in an HMO Setting.

Eye movement desensitization and reprocessing (EMDR) treatment was found to maintain superiority to newly initiated standard Kaiser Care, which consisted of individual therapy plus variations of medication and group therapy. A 3- and 6-month follow-up of individuals randomly assigned to either EMDR treatment or standard care (SC) treatment for posttraumatlc stress disorder (PTSD) indicates that significantly greater improvements found with EMDR at posttreatment in an earlier article (S. Marcus, P. Marquis, & C. Sakai, 1997) were maintained on measures of PTSD, depression, anxiety, and general symptoms. Of the original 67 participants in this large HMO study, 44 were assessed at 3-month follow-up and 36 were assessed at 6-month follow-up by an independent assessor. The study indicates that a relatively small number of EMDR treatment sessions result in substantial benefits that are maintained over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treating children with early-onset conduct problems: A comparison of child and parent training interventions.

Families of 97 children with early-onset conduct problems, 4–8 yrs old, were randomly assigned to 1 of 4 conditions: a parent training treatment group (PT), a child training group (CT), a combined child and parent training group (CT?+?PT), or a waiting-list control group (CON). Posttreatment assessments indicated that all 3 conditions had resulted in significant improvements in comparison with controls. Comparisons of the 3 treatment conditions indicated that CT and CT?+?PT children showed significant improvements in problem solving as well as conflict management skills, as measured by observations of their interactions with a best friend; differences among treatments on these measures consistently favored the CT over the PT condition. As for parent and child behavior at home, PT and CT?+?PT parents and children had significantly more positive interactions, compared with CT parents and children. One-yr follow-up assessments indicated that all the significant changes noted immediately posttreatment had been maintained over time. Moreover, child conduct problems at home had lessened over time. Analyses of the clinical significance of the results suggested that the combined CT?+?PT condition produced the most significant improvements in child behavior at 1-yr follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral therapy for anxiety disordered youth: A randomized clinical trial evaluating child and family modalities.

This randomized clinical trial compared the relative efficacy of individual (child) cognitive-behavioral therapy (ICBT), family cognitive-behavioral therapy (FCBT), and a family-based education/support/ attention (FESA) active control for treating anxiety disordered youth ages 7-14 years (M = 10.27). Youth (N = 161; 44% female; 85% Caucasian, 9% African American, 3% Hispanic, 3% other/mixed) with a principal diagnosis of separation anxiety disorder, social phobia, or generalized anxiety disorder and their parents participated. Outcome analyses were conducted using hierarchical linear models on the intent-to-treat sample at posttreatment and 1-year follow-up using diagnostic severity, child self-reports, parent reports, and teacher reports. Chi-square analyses were also conducted on diagnostic status at post and 1-year follow-up. Children evidenced treatment gains in all conditions, although FCBT and ICBT were superior to FESA in reducing the presence and principality of the principal anxiety disorder, and ICBT outperformed FCBT and FESA on teacher reports of child anxiety. Treatment gains, when found, were maintained at 1-year follow-up. FCBT outperformed ICBT when both parents had an anxiety disorder. Implications for treatment and suggestions for research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Efferent projection from the rostral ventrolateral medulla to the area postrema in rats

Describes interim results of a study examining the effectiveness of parent-child interaction therapy (PCIT) with families of preschool-age children with oppositional defiant disorder. Following an initial assessment, 64 clinic-referred families were randomly assigned to an immediate treatment (i.t.) or a wait-list control (WL) condition. Results indicated that parents in the IT condition interacted more positively with their child and were more successful in gaining their child's compliance than parents in the WL condition. In addition, parents who received treatment reported decreased parenting stress and a more internal locus of control. Parents in the IT group reported statistically and clinically significant improvements in their child's behavior following PCIT. All families who received treatment reported high levels of satisfaction with both the content and process of PCIT. Preliminary 4-month follow-up data showed that parents maintained gains on all self-report measures.     

Brief cognitive therapy for panic disorder: A randomized controlled trial.

Cognitive therapy (CT) is a specific and highly effective treatment for panic disorder (PD). Treatment normally involves 12–15 1-hr sessions. In an attempt to produce a more cost-effective version, a briefer treatment that made extensive use of between-sessions patient self-study modules was created. Forty-three PD patients were randomly allocated to full CT (FCT), brief CT (BCT), or a 3-month wait list. FCT and BCT were superior to wait list on all measures, and the gains obtained in treatment were maintained at 12-month follow-up. There were no significant differences between FCT and BCT. Both treatments had large (approximately 3.0) and essentially identical effect sizes. BCT required 6.5 hr of therapist time, including booster sessions. Patients' initial expectation of therapy success was negatively correlated with posttreatment panic-anxiety. Cognitive measures at the end of treatment predicted panic-anxiety at 12-month follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital discord and treatment outcome in behavioral treatment of child conduct disorders.

Research assessing the role of marital variables in the treatment of childhood conduct disorders is scarce. The aim of this study was (a) to assess the role of marital discord in the overall outcome of a program training parents in behavioral techniques (behavioral parent training) and (b) to assess the effects of an adjunctive treatment (partner support training [PST]) on outcome. The latter treatment focused on marital conflict, communication, and problem solving. Twenty-four families with a child diagnosed as oppositional or conduct disordered were assigned to either a marital-discord group (n?=?12) or a no-marital-discord group (n?=?12). Families within each group were then randomly assigned to either child management training (CMT) alone or CMT with PST. Measures of child deviance, parenting behavior, and marital satisfaction were collected at pre- and posttraining and at a 6-month follow-up. Results indicated a significant interaction between marital discord and treatment type on most measures at follow-up but not at posttraining. Although PST added little to the maintenance of change for the nondiscordant group, it produced significant gains over those who received CMT only for the discordant group. Further results highlighting the interaction of marital and treatment variables are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of parent training on parenting stress and sense of competence.

Examined the effects of behavioral parent training groups on parenting stress and sense of competence. Ss, parents of 91 clinically diagnosed hyperactive preschoolers (aged 3–6 yrs), were randomly assigned to an immediate treatment group (experimental) or a delayed treatment group (control). Results indicate that group parent training yielded benefits beyond changes in parent and child behavior. Compared with controls, experimental Ss reported less parenting stress and increased sense of competence following treatment and 3 mo later. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological treatment of chronic posttraumatic stress disorder in victims of sexual aggression

The aim of this research was to test the comparative effectiveness of two therapeutic modalities in the treatment of chronic posttraumatic stress disorder in victims of sexual aggression: (a) self-exposure and cognitive restructuring and (b) progressive relaxation training. The sample consisted of 20 patients (victims of rape in adulthood or adult victims of childhood sexual abuse) selected according to DSM-III-R criteria. A multigroup experimental design with repeated measures (pretreatment, posttreatment, and 1-, 3-, 6-, and 12-month follow-up) was used. Most treated patients improved, but the success rate was higher in all measures in the exposure and cognitive restructuring group immediately on posttreatment and at follow-up. Implications of this study for clinical practice and future research in this field are commented on.     

Comparative analysis of attentional deficits in hyperactive and learning-disabled children.

Compared 14 boys (aged 7–9 yrs) with attention deficit disorder with hyperactivity (ADDH), 12 with learning disability (LD), 12 with ADDH-LD, and 13 normal boys on measures of sustained attention, selective attention, and span of apprehension. Unique patterns of attentional deficits were associated with each of the diagnostic groups. The ADDH Ss with and without learning disabilities exhibited sustained attention deficits. The LD Ss evidenced selective attention deficits on a speeded classification task. The LD and ADDH-LD Ss evidenced recall difficulties on a paired-associate task, regardless of distractor presence. The 3 clinical groups performed more poorly than did the normal group on the span of apprehension measure. Although attentional deficits were most pervasive in the ADDH-LD group, multivariate composites of attentional variables were sensitive to the ADDH and LD dimensions. (34 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parent-child interaction therapy: A comparison of standard and abbreviated treatments for oppositional defiant preschoolers.

Families of 54 behaviorally disturbed preschool-aged children (3 to 5 years) were randomly assigned to 1 of 3 treatment conditions: standard parent-child interaction therapy (PCIT; STD); modified PCIT that used didactic videotapes, telephone consultations, and face-to-face sessions to abbreviate treatment, and a no-treatment waitlist control group (WL). Twenty-one nondisturbed preschoolers were recruited as a social validation comparison condition. Posttreatment assessment indicated significant differences in parent-reported externalizing behavior in children, and parental stress and discipline practices from both treatment groups on most measures compared with the WL group. Clinical significance testing suggested a superior effect for the STD immediately after intervention, but by 6-month follow-up, the two groups were comparable. The findings indicate that abbreviated PCIT may be of benefit for families with young conduct problem children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of child noncompliant behavior in the home.

Conducted a study with 18 mothers and their clinic-referred 2–9 yr olds to examine which data (parent behavior, child behavior, or parent reports) obtained in a clinic setting would be the best indicators of child noncompliance in the home. Results show that (a) 2 maternal behaviors, beta commands and total rewards, displayed in the clinic were the best predictors of child compliance in the home; and (b) the traditionally accepted parent report measures and child behavior in the clinic were not significant predictors of compliance in the home. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child negative emotionality and parenting from infancy to preschool: A meta-analytic review.

This meta-analytic review (k = 62 studies; N = 7,613 mother-child dyads) shows that effect sizes for the association between child negative emotionality and parenting were generally small and were moderated by sample and measurement characteristics. The association between more child negative emotionality and less supportive parenting was relatively strong in lower socioeconomic status families, reversed in higher socioeconomic status families, and limited to studies with relatively high percentages of participants from ethnic minorities and studies using parent report to assess negative emotionality. Higher levels of child negative emotionality were associated with more restrictive control in samples with less than 75% 1st-born children, as well as in infants and preschoolers, and in studies using parent report or composite measures to assess both negative emotionality and restrictive parenting. Finally, more child negative emotionality was associated with less inductive control. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comorbidity, case complexity, and effects of evidence-based treatment for children referred for disruptive behavior.

Comorbidity and complexity of cases seen in clinical work form a basis for discounting the applicability and generality of evidence-based treatments (EBTs). The authors evaluated treatment outcomes in 2 samples of clinically referred children who met criteria for oppositional defiant disorder (n = 183; 42 girls, 141 boys; ages 3-14) or conduct disorder (n = 132; 35 girls, 97 boys; ages 7-14) but varied in comorbidity (up to 5 additional disorders). In addition to comorbidity, 4 domains of case complexity were evaluated: scope and severity of child dysfunction, socioeconomic disadvantage, parent and family functioning, and barriers that emerged during treatment. Comorbidity was associated with greater therapeutic change. Children who varied in comorbidity did not differ on outcome measures at the end of treatment. Complexity was either unrelated or positively related to therapeutic change. As an exception, perceived barriers were associated with less child improvement, but, even with high barriers, effect sizes for these children were large. The findings suggest that comorbidity or complexity of cases does not necessarily influence outcome or limit the applicability of EBTs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treating anxiety disorders in children: Results of a randomized clinical trial.

Investigated a psychosocial treatment for 47 Ss (aged 9–13 yrs) with anxiety disorders. A 16-session cognitive-behavioral treatment was compared with a wait-list condition. Outcome was evaluated using child self-report, parent report, teacher report, cognitive assessment, and behavioral observations. Pretreatment–posttreatment changes and maintenance of gains at 1-yr follow-up were examined. Results revealed that many treated Ss were found to be without a diagnosis at posttest and at follow-up and to be within normal limits on many measures. The child's perception of the therapeutic relationship and the therapist's perception of parental involvement were measured but were not related to outcome. Discussion focuses on characteristics of effective child therapy and the need for further research on treatment components and alternative treatment methods. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapy for youths with anxiety disorders: A second randomized clincal trial.

Ninety-four children (aged 9-13 years) with anxiety disorders were randomly assigned to cognitive behavioral treatment or waiting-list control. Outcomes were evaluated using diagnostic status, child self-reports, parent and teacher reports, cognitive assessment and behavioral observation; maintenance was examined using l-year follow-up data. Analyses of dependent measures indicated significant improvements over time, with the majority indicating greater gains for those receiving treatment. Treatment gains returned cases to within nondeviant limits (i.e., normative comparisons) and were maintained at l-year follow-up. Client age and comorbid status did not moderate outcomes. A preliminary examination of treatment segments suggested that the enactive exposure (when it follows cognitive-educational training) was an active force in beneficial change. Discussion includes suggestions for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)