父母行为训练对注意力缺陷/多动障碍儿童的持续改善:对长期儿童和父母结果的荟萃分析综述。

JCPP advances Pub Date : 2023-09-04 DOI:10.1002/jcv2.12196
Dominique P. A. Doffer, Tycho J. Dekkers, Rianne Hornstra, Saskia van der Oord, Marjolein Luman, Patty Leijten, Pieter J. Hoekstra, Barbara J. van den Hoofdakker, Annabeth P. Groenman
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引用次数: 5

摘要

背景:行为父母培训是一种针对注意力缺陷/多动障碍(ADHD)儿童的循证干预措施,但对最初的益处在多大程度上得以维持知之甚少。目的:这项荟萃分析综述调查了多动症儿童行为父母训练的长期(即干预后2个月以上)儿童和父母结果。材料和方法:我们搜索随机对照试验,检查了多动症症状、行为问题、积极育儿、消极育儿、育儿能力感,亲子关系质量和父母心理健康作为结果。我们纳入了27项研究(31项干预措施;217个效应大小),使用多水平随机效应荟萃分析进行组间和组内比较(干预前与随访和干预后与随访),并探讨了12个变化预测因素。结果:在干预前和随访期间(M=5.3个月),我们发现干预对多动症症状、行为问题、积极育儿、育儿能力感和亲子关系质量的组间影响具有显著的小到中等程度。组内研究结果显示,所有结果领域的干预条件都得到了持续改善。从干预后到随访,几乎没有显著变化。此外,绝大多数个体效应大小表明从干预后到随访的持续结果。有七个显著的儿童结果变化预测因素,包括女孩多动症症状和年幼儿童行为问题的显著减少。与一些关于短期影响的荟萃分析相比,我们发现在随访中,多动症症状的掩盖和未掩盖结果之间没有差异。讨论和结论:我们得出结论,行为父母培训对儿童的多动症症状和行为问题以及积极的育儿行为有着长期的益处,父母的能力感和亲子关系的质量。
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Sustained improvements by behavioural parent training for children with attention-deficit/hyperactivity disorder: A meta-analytic review of longer-term child and parental outcomes

Background

Behavioural parent training is an evidence-based intervention for children with attention-deficit/hyperactivity disorder (ADHD), but little is known about the extent to which initial benefits are maintained.

Aims

This meta-analytic review investigated longer-term (i.e., more than 2 months post-intervention) child and parental outcomes of behavioural parent training for children with ADHD.

Materials & Methods

We searched for randomized controlled trials and examined ADHD symptoms, behavioural problems, positive parenting, negative parenting, parenting sense of competence, parent-child relationship quality, and parental mental health as outcomes. We included 27 studies (31 interventions; 217 effect sizes), used multilevel random-effects meta-analyses for between- and within-group comparisons (pre-intervention to follow-up and post-intervention to follow-up), and explored twelve predictors of change.

Results

Between pre-intervention and follow-up (M = 5.3 months), we found significant small-to-moderate between-group effects of the intervention on ADHD symptoms, behavioural problems, positive parenting, parenting sense of competence and parent-child relationship quality. Within-group findings show sustained improvements in the intervention conditions for all outcome domains. There were few significant changes from post-intervention to follow-up. Additionally, the large majority of the individual effect sizes indicated sustained outcomes from post-intervention to follow-up. There were seven significant predictors of change in child outcomes, including stronger reductions in ADHD symptoms of girls and behaviour problems of younger children. In contrast with some meta-analyses on short-term effects, we found no differences between masked and unmasked outcomes on ADHD symptoms at follow-up.

Discussion & Conclusion

We conclude that behavioural parent training has longer-term benefits for children's ADHD symptoms and behavioural problems, and for positive parenting behaviours, parenting sense of competence and quality of the parent-child relationship.

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Issue Information Implementing open science and reproducible research practices in mental health research through registered reports Special educational needs provision and academic outcomes for children with teacher reported language difficulties at school entry Examining the association of neighborhood conditions on attention‐deficit/hyperactivity disorder symptoms in autistic youth using the child opportunity index 2.0 The trajectory of anxiety symptoms during the transition from childhood to young adulthood is predicted by IQ and sex, but not polygenic risk scores
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