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12-06-2020

Internet-Delivered Parent Training for Preschoolers with Conduct Problems: Do Callous-Unemotional Traits Moderate Efficacy and Engagement?

Auteurs: Georgette E. Fleming, Eva R. Kimonis, Jami M. Furr, Jonathan S. Comer

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 9/2020

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Abstract

Recent efforts to improve access to evidence-based parent training programs using online delivery have largely neglected findings that young children with callous-unemotional (CU)-type conduct problems receive less benefit from parent training than children with conduct problems alone. The current study aimed to examine the moderating effect of child CU traits on efficacy and engagement outcomes associated with Internet-delivered Parent-Child Interaction Therapy (iPCIT) versus standard, clinic-based PCIT. Forty families (57.6% non-Hispanic Caucasian) with a 3–5 year-old (M = 3.95 years, SD = 0.9; 83.5% boys) child with a disruptive behavior disorder were randomized to either iPCIT or clinic-based PCIT. Families participated in four assessments across time; child conduct problems, global functioning and treatment responder status, and parent-rated treatment satisfaction were measured. Analyses revealed that the negative influence of CU traits on functional gains was not uniform across treatment formats. Specifically, the detrimental effect of CU traits on functional gains was significantly more pronounced among children treated with iPCIT than clinic-based PCIT. CU traits also predicted lower parental treatment satisfaction across delivery formats, but this effect was more pronounced among iPCIT parents. In contrast, CU traits did not moderate differential effects across iPCIT and clinic-based PCIT for conduct problem severity or treatment response status. Findings suggest that iPCIT is a promising treatment option for early conduct problems, particularly when access-to-care barriers exist, but that further research is needed to determine whether strategic adaptations to online programs can more optimally address the distinct needs of children with clinically significant CU traits.
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Voetnoten
1
All analyses were replicated using the 5-item CU screening measure proposed by Willoughby et al. (2011) that excludes “cruel to animals”. The direction and patterns of significance remain unchanged for all outcome variables.
 
2
Since CU traits scores were continuous, model estimated means corresponding with low and high CU traits groups were generated by estimating the mean of each outcome variable at ±1 standard deviation above/below the sample mean of baseline CU traits scores (M = 3.4, SD = 1.9).
 
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Metagegevens
Titel
Internet-Delivered Parent Training for Preschoolers with Conduct Problems: Do Callous-Unemotional Traits Moderate Efficacy and Engagement?
Auteurs
Georgette E. Fleming
Eva R. Kimonis
Jami M. Furr
Jonathan S. Comer
Publicatiedatum
12-06-2020
Uitgeverij
Springer US
Gepubliceerd in
Research on Child and Adolescent Psychopathology / Uitgave 9/2020
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI
https://doi.org/10.1007/s10802-020-00660-5