Article

Behavioral parent training as an adjunct to routine care in children with attention-deficit/hyperactivity disorder: Moderators of treatment response

University Center of Child and Adolescent Psychiatry, P.O. Box 660, 9700 AR Groningen, The Netherlands.
Journal of Pediatric Psychology (Impact Factor: 2.91). 08/2009; 35(3):317-26. DOI: 10.1093/jpepsy/jsp060
Source: PubMed

ABSTRACT To investigate predictors and moderators of outcome of behavioral parent training (BPT) as adjunct to ongoing routine clinical care (RCC), versus RCC alone.
We randomly assigned 94 referred children (4-12 years) with attention-deficit/hyperactivity disorder (ADHD) to BPT plus RCC or RCC alone. Outcome was based on parent-reported behavioral problems and ADHD symptoms. Predictor/moderator variables included children's IQ, age, and comorbidity profile, and maternal ADHD, depression, and parenting self-efficacy.
Superior BPT treatment effects on behavioral problems and ADHD symptoms were present in children with no or single-type comorbidity-anxiety/depression or oppositional defiant disorder (ODD)/conduct disorder (CD)-and when mothers had high parenting self-efficacy, but absent in children with broad comorbidity (anxiety/depression and ODD/CD) and when mothers had low parenting self-efficacy. In older children ADHD symptoms tended to decrease more through BPT than in younger children.
Adjunctive BPT is most useful when mothers have high parenting self-efficacy and in children with no or single-type comorbidity.

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    • "Behavioral treatments and medication have been shown to be effective in the treatment of ADHD, but have several limitations (Van der Oord et al. 2008). First, although behavioral parent management training has been shown to be effective, a diagnosis of ADHD in parents predicts nonresponse to this treatment (Sonuga-Barke et al. 2002; Van den Hoofdakker et al. 2010). Moreover, parent management training has been investigated predominantly in preadolescent children, and effects for adolescents seem lower (Barkley 2004; Chronis et al. 2004). "
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    • "However , ADHD is highly heritable and a diagnosis of ADHD of parents is a predictor of non-response to this behavioral parent training (e.g. Sonuga-Barke et al. 2002; Van den Hoofdakker et al. 2010). Cognitive behavioral treatments for ADHD are focused on learning the child skills or coping methods to handle their ADHD or associated problems. "
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