Top

Published in:

Open Access 01-05-2018

Understanding Who Benefits from Parenting Interventions for Children’s Conduct Problems: an Integrative Data Analysis

Authors: Patty Leijten, Maartje Raaijmakers, Leoniek Wijngaards, Walter Matthys, Ankie Menting, Maud Hemink-van Putten, Bram Orobio de Castro

Published in: Prevention Science | Issue 4/2018

Abstract

Parenting interventions are an effective strategy to reduce children’s conduct problems. For some families, that is, not all families benefit equally. Individual trials tend to be underpowered and often lack variability to differentiate between families how benefit less or more. Integrating individual family level data across trials, we aimed to provide more conclusive results about often presumed key family (parental education and ethnic background) and child characteristics (problem severity, ADHD symptoms and emotional problems) as putative moderators of parenting intervention effects. We included data from 786 families (452 intervention; 334 control) from all four trials on the Incredible Years parenting intervention in The Netherlands (three randomized; one matched control). Children ranged between 2 and 10 years (M = 5.79; SD = 1.66). Of the families, 31% had a lower educational level and 29% had an ethnic minority background. Using multilevel regression, we tested whether each of the putative moderators affected intervention effects. Incredible Years reduced children’s conduct problems (d = − .34). There were no differential effects by families’ educational or ethnic background, or by children’s level of ADHD symptoms. Children with more severe conduct problems and those with more emotional problems benefited more. Post hoc sensitivity analyses showed that for the two trials with longer-term data, moderation effects disappeared at 4 or 12 months follow-up. Often assumed moderators have some, but limited abilities to explain who benefits from parenting interventions. This suggests the need for studying theoretically more precise moderators in prevention research, other than relatively static family characteristics alone.

Abrahamse, M. E., Junger, M., Leijten, P., Boer, F., & Lindauer, R. J. L. (2015). Identifying behavioural problems in a community sample and a multi-ethnic clinical sample of young children: Psychometric properties of the Dutch Eyberg Child Behavior Inventory (ECBI). Journal of Psychopathology and Behavioral Assessment, 37, 679–691. https://doi.org/10.1007/s10862-015-9482-1.CrossRefPubMedPubMedCentral

Achenbach, T. M., & Rescorla, L. A. (2000). Manual for the ASEBA preschool forms and profiles. Burlington: University of Vermont, Research Center for Children, Youth, and Families.

Belsky, J., Bakermans-Kranenburg, M. J., & Van IJzendoorn, M. H. (2007). For better and for worse differential susceptibility to environmental influences. Current Directions in Psychological Science, 16, 300–304. https://doi.org/10.1111/j.1467-8721.2007.00525.x.CrossRef

Bjørknes, R., & Manger, T. (2013). Can parent training alter parent practice and reduce conduct problems in ethnic minority children? A randomized controlled trial. Prevention Science, 14, 52–63. https://doi.org/10.1007/s11121-012-0299-9.CrossRefPubMed

Bjørnebekk, G., Kjøbli, J., & Ogden, T. (2015). Children with conduct problems and co-occurring ADHD: Behavioral improvements following parent management training. Child & Family Behavior Therapy, 37, 1–19. https://doi.org/10.1080/07317107.2015.1000227.CrossRef

Brown, C. H., Sloboda, Z., Faggiano, F., Teasdale, B., Keller, F., Burkhart, G., et al. (2013). Methods for synthesizing findings on moderation effects across multiple randomized trials. Prevention Science, 14, 144–156. https://doi.org/10.1007/s11121-011-0207-8.CrossRefPubMedPubMedCentral

Burns, G. L., & Patterson, D. R. (2001). Normative data on the Eyberg child behavior inventory and Sutter–Eyberg student behavior inventory: Parent and teacher rating scales of disruptive behavior problems in children and adolescents. Child & Family Behavior Therapy, 23, 15–28. https://doi.org/10.1300/J019v23n01_02.CrossRef

Conger, R. D., Conger, K. J., Elder, G. H., Lorenz, F. O., Simons, R. L., & Whitbeck, L. B. (1992). A family process model of economic hardship and adjustment of early adolescent boys. Child Development, 63, 526–541. https://doi.org/10.1111/j.1467-8624.1992.tb01644.x.CrossRefPubMed

Curran, P. J., & Hussong, A. M. (2009). Integrative data analysis: The simultaneous analysis of multiple data sets. Psychological Methods, 14, 81–100. https://doi.org/10.1037/a0015914.CrossRefPubMedPubMedCentral

Deković, M., Slagt, M. I., Asscher, J. J., Boendermaker, L., Eichelsheim, V. I., & Prinzie, P. (2011). Effects of early prevention programs on adult criminal offending: A meta-analysis. Clinical Psychology Review, 31, 532–544. https://doi.org/10.1016/j.cpr.2010.12.003.CrossRefPubMed

Dwan, K., Altman, D. G., Arnaiz, J. A., Bloom, J., Chan, A. W., Cronin, E., et al. (2008). Systematic review of the empirical evidence of study publication bias and outcome reporting bias. PLoS One, 3, e3081. https://doi.org/10.1371/journal.pone.0003081.CrossRefPubMedPubMedCentral

Eyberg, S. M., & Ross, A. W. (1978). Assessment of child behavior problems: The validation of a new inventory. Journal of Clinical Child Psychology, 7, 113–116. https://doi.org/10.1080/15374417809532835.CrossRef

Gardner, F., Connell, A., Trentacosta, C. J., Shaw, D. S., Dishion, T. J., & Wilson, M. N. (2009). Moderators of outcome in a brief family-centered intervention for preventing early problem behavior. Journal of Consulting and Clinical Psychology, 77, 543–553. https://doi.org/10.1037/a0015622.CrossRefPubMedPubMedCentral

Gardner, F., Hutchings, J., Bywater, T., & Whitaker, C. (2010). Who benefits and how does it work? Moderators and mediators of outcome in an effectiveness trial of a parenting intervention. Journal of Clinical Child & Adolescent Psychology, 39, 568–580. https://doi.org/10.1080/15374416.2010.486315.CrossRef

Goodman, R. (1997). The strengths and difficulties questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38, 581–586. https://doi.org/10.1111/j.1469-7610.1997.tb01545.x.CrossRefPubMed

Goodman, R., & Scott, S. (1999). Comparing the strengths and difficulties questionnaire and the child behavior checklist: Is small beautiful? Journal of Abnormal Child Psychology, 27, 17–24. https://doi.org/10.1023/A:1022658222914.CrossRefPubMed

Halldorsdottir, T., & Ollendick, T. H. (2016). Long-term outcomes of brief, intensive CBT for specific phobias: The negative impact of ADHD symptoms. Journal of Consulting and Clinical Psychology, 84, 465–471. https://doi.org/10.1037/ccp0000088.CrossRefPubMed

Hinshaw, S. P., Lahey, B. B., & Hart, E. L. (1993). Issues of taxonomy and comorbidity in the development of conduct disorder. Development and Psychopathology, 5, 31–49. https://doi.org/10.1017/S0954579400004247.CrossRef

Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19. https://doi.org/10.1037/0022-006X.59.1.12.CrossRefPubMed

Jacobson, N. S., Follette, W. C., & Revenstorf, D. (1984). Psychotherapy outcome research: Methods for reporting variability and evaluating clinical significance. Behavior Therapy, 15, 336–352. https://doi.org/10.1016/S0005-7894(84)80002-7.CrossRef

Jarrett, M., Siddiqui, S., Lochman, J., & Qu, L. (2014). Internalizing problems as a predictor of change in externalizing problems in at-risk youth. Journal of Clinical Child & Adolescent Psychology, 43, 27–35. https://doi.org/10.1080/15374416.2013.764823.CrossRef

Kaehler, L. A., Jacobs, M., & Jones, D. J. (2016). Distilling common history and practice elements to inform dissemination: Hanf-model BPT programs as an example. Clinical Child and Family Psychology Review, 19, 236–258. https://doi.org/10.1007/s10567-016-0210-5.CrossRefPubMedPubMedCentral

Kazdin, A. E., & Wassell, G. (2000). Therapeutic changes in children, parents, and families resulting from treatment of children with conduct problems. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 414–420. https://doi.org/10.1097/00004583-200004000-00009.CrossRefPubMed

Kivlighan Jr., D. M., Marmarosh, C. L., & Hilsenroth, M. J. (2014). Client and therapist therapeutic alliance, session evaluation, and client reliable change: A moderated actor–partner interdependence model. Journal of Counseling Psychology, 61, 15–23. https://doi.org/10.1037/a0034939.CrossRefPubMed

Leijten, P., Overbeek, G., & Janssens, J. M. A. M. (2012). Effectiveness of a parent training program in (pre)adolescence: Evidence from a randomized controlled trial. Journal of Adolescence, 35, 833–842. https://doi.org/10.1016/j.adolescence.2011.11.009.CrossRefPubMed

Leijten, P., Raaijmakers, M. A. J., Orobio de Castro, B., & Matthys, W. (2013). Does socioeconomic status matter? A meta-analysis on parent training effectiveness for disruptive child behavior. Journal of Clinical Child & Adolescent Psychology, 42, 384–392. https://doi.org/10.1080/15374416.2013.769169.CrossRef

Leijten, P., Dishion, T. J., Thomaes, S., Raaijmakers, M. A. J., Orobio de Castro, B., & Matthys, W. (2015). Bringing parenting interventions back to the future: How randomized controlled microtrials may benefit parenting intervention efficacy. Clinical Psychology: Science and Practice, 22, 47–57. https://doi.org/10.1111/cpsp.12087.

Leijten, P., Raaijmakers, M. A., Orobio de Castro, B., van den Ban, E., & Matthys, W. (2017). Effectiveness of the incredible years parenting program for families with socioeconomically disadvantaged and ethnic minority backgrounds. Journal of Clinical Child & Adolescent Psychology, 46, 59–73. https://doi.org/10.1080/15374416.2015.1038823.

Lipsey, M. W. (2003). Those confounded moderators in meta-analysis: Good, bad, and ugly. The Annals of the American Academy of Political and Social Science, 587, 69–81. https://doi.org/10.1177/0002716202250791.CrossRef

Lundahl, B., Risser, H. J., & Lovejoy, M. C. (2006). A meta-analysis of parent training: Moderators and follow-up effects. Clinical Psychology Review, 26, 86–104. https://doi.org/10.1016/j.cpr.2005.07.004.CrossRefPubMed

MacKenzie, E. P., Fite, P. J., & Bates, J. E. (2004). Predicting outcome in behavioral parent training: Expected and unexpected results. Child & Family Behavior Therapy, 26, 37–53. https://doi.org/10.1300/J019v26n02_03.CrossRef

Matthys, W., Vanderschuren, L. J., Schutter, D. J., & Lochman, J. E. (2012). Impaired neurocognitive functions affect social learning processes in oppositional defiant disorder and conduct disorder: Implications for interventions. Clinical Child and Family Psychology Review, 15, 234–246. https://doi.org/10.1007/s10567-012-0118-7.CrossRefPubMed

Menting, A. T. A., Orobio de Castro, B., & Matthys, W. (2013). Effectiveness of the Incredible Years parent training to modify disruptive and prosocial child behavior: A meta-analytic review. Clinical Psychology Review, 33, 901–913. https://doi.org/10.1016/j.cpr.2013.07.006.CrossRefPubMed

Menting, A. T. A., Orobio de Castro, B., Wijngaards-de Meij, L., & Matthys, W. (2014). A trial of parent training for mothers being released from incarceration and their children. Journal of Clinical Child & Adolescent Psychology, 43, 381–396. https://doi.org/10.1080/15374416.2013.817310.CrossRef

Miranda, J., Bernal, G., Lau, A., Kohn, L., Hwang, W. C., & LaFromboise, T. (2005). State of the science on psychosocial interventions for ethnic minorities. Annual Review of Clinical Psychology, 1, 113–142. https://doi.org/10.1146/annurev.clinpsy.1.102803.143822.CrossRefPubMedPubMedCentral

Moffitt, T. E., & Caspi, A. (2001). Childhood predictors differentiate life-course persistent and adolescence-limited antisocial pathways among males and females. Development and Psychopathology, 13, 355–375. https://doi.org/10.1017/S0954579401002097.CrossRefPubMed

National Health Interview Survey [NHIS] (2001). Centers for Disease Control and Prevention National Center for Health Statistics. Available at: http://www.cdc.gov/nchs/nhis.htm. Accessed 1 March 2015.

Ng, M. Y., & Weisz, J. R. (2016). Annual research review: Building a science of personalized intervention for youth mental health. Journal of Child Psychology and Psychiatry, 57, 216–236. https://doi.org/10.1111/jcpp.12470.CrossRefPubMed

Ollendick, T. H., Jarrett, M. A., Grills-Taquechel, A. E., Hovey, L. D., & Wolff, J. C. (2008). Comorbidity as a predictor and moderator of treatment outcome in youth with anxiety, affective, attention deficit/hyperactivity disorder, and oppositional/conduct disorders. Clinical Psychology Review, 28, 1447–1471. https://doi.org/10.1016/j.cpr.2008.09.003.CrossRefPubMed

Pelham, W. E., Dishion, T. J., Tein, J. Y., Shaw, D. S., & Wilson, M. N. (2017). What doesn’t work for whom? Exploring heterogeneity in responsiveness to the family check-up in early childhood using a mixture model approach. Prevention Science, 18, 911–922. https://doi.org/10.1007/s11121-017-0805-1.

Posthumus, J. A., Raaijmakers, M. A. J., Maassen, G. H., Van Engeland, H., & Matthys, W. (2012). Sustained effects of incredible years as a preventive intervention in preschool children with conduct problems. Journal of Abnormal Child Psychology, 40, 487–500. https://doi.org/10.1007/s10802-011-9580-9.

Raudenbush, S. W., Bryk, A. S., & Congdon, R. (2004). HLM 6 for Windows [computer software]. Skokie: Scientific Software International, Inc..

Reid, M. J., Webster-Stratton, C., & Beauchaine, T. P. (2001). Parent training in head start: A comparison of program response among African American, Asian American, Caucasian, and Hispanic mothers. Prevention Science, 2, 209–227. https://doi.org/10.1023/A:1013618309070.CrossRefPubMed

Riosa, P. B., McArthur, B. A., & Preyde, M. (2011). Effectiveness of psychosocial intervention for children and adolescents with comorbid problems: A systematic review. Child and Adolescent Mental Health, 16, 177–185. https://doi.org/10.1111/j.1475-3588.2011.00609.x.CrossRef

Rutter, M., & Pickles, A. (2016). Annual research review: Threats to the validity of child psychiatry and psychology. Journal of Child Psychology and Psychiatry, 57, 398–416. https://doi.org/10.1111/jcpp.12461.CrossRefPubMed

Rutter, M., Kim-Cohen, J., & Maughan, B. (2006). Continuities and discontinuities in psychopathology between childhood and adult life. Journal of Child Psychology and Psychiatry, 47, 276–295. https://doi.org/10.1111/j.1469-7610.2006.01614.x.CrossRefPubMed

Sagatun, Å., Lien, L., Søgaard, A. J., Bjertness, E., & Heyerdahl, S. (2008). Ethnic Norwegian and ethnic minority adolescents in Oslo, Norway. Social Psychiatry and Psychiatric Epidemiology, 43, 87–95. https://doi.org/10.1007/s00127-007-0275-z.CrossRefPubMed

Scott, S., Webster-Stratton, C., Spender, Q., Doolan, M., Jacobs, B., & Aspland, H. (2001). Multicentre controlled trial of parenting groups for childhood antisocial behaviour in clinical practice. Commentary: Nipping conduct problems in the bud. British Medical Journal, 323, 194–197. https://doi.org/10.1136/bmj.323.7306.194.CrossRefPubMedPubMedCentral

Shelleby, E. C., & Shaw, D. S. (2014). Outcomes of parenting interventions for child conduct problems: A review of differential effectiveness. Child Psychiatry & Human Development, 45, 628–645. https://doi.org/10.1007/s10578-013-0431-5.CrossRef

Sonuga-Barke, E. J., Brandeis, D., Cortese, S., Daley, D., Ferrin, M., Holtmann, M., et al. (2013). Nonpharmacological interventions for ADHD: Systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. American Journal of Psychiatry, 170, 275–289. https://doi.org/10.1176/appi.ajp.2012.12070991.CrossRefPubMed

Van Widenfelt, B. M., Goedhart, A. W., Treffers, P. D., & Goodman, R. (2003). Dutch version of the strengths and difficulties questionnaire (SDQ). European Child & Adolescent Psychiatry, 12, 281–289. https://doi.org/10.1007/s00787-003-0341-3.CrossRef

Webster-Stratton, C. (2001). The incredible years: Parents and children videotape series: A parenting course (BASIC). Seattle: Incredible Years.

Webster-Stratton, C. (2002). The incredible years: Parents and children videotape series: A parenting course (ADVANCE). Seattle: Incredible Years.

Webster-Stratton, C. (2006). The incredible years: A trouble-shooting guide for parents of children aged 3–8. Toronto: Umbrella press.

Webster-Stratton, C. (2009). Affirming diversity: Multi-cultural collaboration to deliver the incredible years parent programs. International Journal of Child Health and Human Development, 2, 17–32.

Webster-Stratton, C., Hollinsworth, T., & Kolpacoff, M. (1989). The long-term effectiveness and clinical significance of three cost-effective training programs for families with conduct-problem children. Journal of Consulting and Clinical Psychology, 57, 550–553. https://doi.org/10.1037/0022-006X.57.4.550.CrossRefPubMed

Weeland, J., Chhangur, R. R., van der Giessen, D., Matthys, W., de Castro, B. O., & Overbeek, G. (2017). Intervention effectiveness of the incredible years: New insights into sociodemographic and intervention-based moderators. Behavior Therapy, 48, 1–18. https://doi.org/10.1016/j.beth.2016.08.002.

Weisz, J. R., & Kazdin, A. E. (2010). Evidence-based psychotherapies for children and adolescents (2nd ed.). New York: Guilford Press.

Title: Understanding Who Benefits from Parenting Interventions for Children’s Conduct Problems: an Integrative Data Analysis
Authors: Patty Leijten
Maartje Raaijmakers
Leoniek Wijngaards
Walter Matthys
Ankie Menting
Maud Hemink-van Putten
Bram Orobio de Castro
Publication date: 01-05-2018
Publisher: Springer US
Published in: Prevention Science / Issue 4/2018
Print ISSN: 1389-4986
Electronic ISSN: 1573-6695
DOI: https://doi.org/10.1007/s11121-018-0864-y

At a glance: The STEP trials

Springer Medicine

Understanding Who Benefits from Parenting Interventions for Children’s Conduct Problems: an Integrative Data Analysis

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2018

A Cluster-Randomized Trial of Getting To Outcomes’ Impact on Sexual Health Outcomes in Community-Based Settings

Predicting the Emergence of Sexual Violence in Adolescence

Effects of a Program to Promote High Quality Parenting by Divorced and Separated Fathers

Visit Attendance Patterns in Nurse-Family Partnership Community Sites

Longitudinal Predictors of Behavioral Intentions and HIV Service Use Among Men Who Have Sex with Men

For Whom Do Parenting Interventions to Prevent Adolescent Substance Use Work?