Effect of Comorbid Psychopathology and Conduct Problem Severity on Response to a Multi-component Intervention for Childhood Disruptive Behavior

Overview

Journal Child Psychiatry Hum Dev

Specialties Pediatrics
Psychiatry

Date 2018 Mar 30

PMID 29594940

Citations 2

Authors

Madison Aitken

Jordana A Waxman

Katie Macdonald

Brendan F Andrade

Affiliations

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Abstract

This study examined the effects of comorbid ADHD symptoms, internalizing psychopathology, Callous-Unemotional (CU) Traits, and conduct problem severity on children's response to an evidence-based psychosocial intervention. Clinic-referred children with DBD ages 8-12 years (N = 76) participated in a 15-week multi-component intervention. Parents provided weekly ratings of children's oppositionality-defiance, peer problems, and impairment. Oppositionality-defiance, peer problems, and impairment decreased significantly over the course of the intervention; however, there was considerable variability in weekly ratings. Baseline ADHD symptoms, internalizing psychopathology, CU traits, and conduct problem severity were unrelated to rate of change across treatment. However, ADHD symptoms uniquely predicted more oppositionality-defiance, peer problems, and impairment averaged across the 15 weeks of treatment. Follow-up analyses suggested this was driven by hyperactivity-impulsivity rather than inattention. Children with DBD and comorbid symptoms appear to benefit from a multi-component intervention, but those with ADHD symptoms may require additional support to address social and behavioral challenges.

Citing Articles

The Relationship Between Frontal Cortical Thickness and Externalizing Psychopathology is Associated with Treatment Outcomes in Children with Externalizing Problems: A Preliminary Pilot Study: La relation entre l'épaisseur du cortex frontal et les....

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References

Hawes S, Byrd A, Henderson C, Gazda R, Burke J, Loeber R . Refining the parent-reported inventory of callous-unemotional traits in boys with conduct problems. Psychol Assess. 2013; 26(1):256-266. DOI: 10.1037/a0034718. View

Ollendick T, Jarrett M, Grills-Taquechel A, Hovey L, Wolff J . Comorbidity as a predictor and moderator of treatment outcome in youth with anxiety, affective, attention deficit/hyperactivity disorder, and oppositional/conduct disorders. Clin Psychol Rev. 2008; 28(8):1447-71. DOI: 10.1016/j.cpr.2008.09.003. View

Andrade B, Wade M . Latent Profiles of Externalizing Psychopathology and Their Relation to Children's Aggression and Social Behavior. J Dev Behav Pediatr. 2016; 37(6):442-50. DOI: 10.1097/DBP.0000000000000304. View

Waschbusch D . A meta-analytic examination of comorbid hyperactive-impulsive-attention problems and conduct problems. Psychol Bull. 2002; 128(1):118-50. DOI: 10.1037/0033-2909.128.1.118. View

Muthen B, Muthen L . Integrating person-centered and variable-centered analyses: growth mixture modeling with latent trajectory classes. Alcohol Clin Exp Res. 2000; 24(6):882-91. View

Muratori P, Milone A, Manfredi A, Polidori L, Ruglioni L, Lambruschi F . Evaluation of Improvement in Externalizing Behaviors and Callous-Unemotional Traits in Children with Disruptive Behavior Disorder: A 1-Year Follow Up Clinic-Based Study. Adm Policy Ment Health. 2015; 44(4):452-462. DOI: 10.1007/s10488-015-0660-y. View

Bjornebekk G, Kjobli J . Observed callousness as a predictor of treatment outcomes in parent management training. Clin Child Psychol Psychiatry. 2016; 22(1):59-73. DOI: 10.1177/1359104515621961. View

Goodman R . The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry. 1997; 38(5):581-6. DOI: 10.1111/j.1469-7610.1997.tb01545.x. View

Frick P, Ray J, Thornton L, Kahn R . Can callous-unemotional traits enhance the understanding, diagnosis, and treatment of serious conduct problems in children and adolescents? A comprehensive review. Psychol Bull. 2013; 140(1):1-57. DOI: 10.1037/a0033076. View

10.

Lochman J, Wells K, Qu L, Chen L . Three year follow-up of coping power intervention effects: evidence of neighborhood moderation?. Prev Sci. 2012; 14(4):364-76. DOI: 10.1007/s11121-012-0295-0. View

11.

Kurtz B, Borkowski J . Development of strategic skills in impulsive and reflective children: a longitudinal study of metacognition. J Exp Child Psychol. 1987; 43(1):129-48. DOI: 10.1016/0022-0965(87)90055-5. View

12.

Chase R, Eyberg S . Clinical presentation and treatment outcome for children with comorbid externalizing and internalizing symptoms. J Anxiety Disord. 2007; 22(2):273-82. DOI: 10.1016/j.janxdis.2007.03.006. View

13.

Dadds M, Cauchi A, Wimalaweera S, Hawes D, Brennan J . Outcomes, moderators, and mediators of empathic-emotion recognition training for complex conduct problems in childhood. Psychiatry Res. 2012; 199(3):201-7. DOI: 10.1016/j.psychres.2012.04.033. View

14.

Andrade B, Sorge G, Na J, Wharton-Shukster E . Clinical Profiles of Children with Disruptive Behaviors Based on the Severity of Their Conduct Problems, Callous-Unemotional Traits and Emotional Difficulties. Child Psychiatry Hum Dev. 2014; 46(4):567-76. DOI: 10.1007/s10578-014-0497-8. View

15.

Bierman K, Coie J, Dodge K, Greenberg M, Lochman J, McMahon R . Using the Fast Track randomized prevention trial to test the early-starter model of the development of serious conduct problems. Dev Psychopathol. 2003; 14(4):925-43. PMC: 2775439. DOI: 10.1017/s0954579402004133. View

16.

Fabiano G, Pelham Jr W, Waschbusch D, Gnagy E, Lahey B, Chronis A . A practical measure of impairment: psychometric properties of the impairment rating scale in samples of children with attention deficit hyperactivity disorder and two school-based samples. J Clin Child Adolesc Psychol. 2006; 35(3):369-85. DOI: 10.1207/s15374424jccp3503_3. View

17.

Costin J, Chambers S . Parent management training as a treatment for children with oppositional defiant disorder referred to a mental health clinic. Clin Child Psychol Psychiatry. 2007; 12(4):511-24. DOI: 10.1177/1359104507080979. View

18.

Hawes D, Price M, Dadds M . Callous-unemotional traits and the treatment of conduct problems in childhood and adolescence: a comprehensive review. Clin Child Fam Psychol Rev. 2014; 17(3):248-67. DOI: 10.1007/s10567-014-0167-1. View

19.

Bakker M, Greven C, Buitelaar J, Glennon J . Practitioner Review: Psychological treatments for children and adolescents with conduct disorder problems - a systematic review and meta-analysis. J Child Psychol Psychiatry. 2016; 58(1):4-18. DOI: 10.1111/jcpp.12590. View

20.

Eyberg S, Nelson M, Boggs S . Evidence-based psychosocial treatments for children and adolescents with disruptive behavior. J Clin Child Adolesc Psychol. 2008; 37(1):215-37. DOI: 10.1080/15374410701820117. View