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01-10-2010 | Uitgave 7/2010

Journal of Abnormal Child Psychology 7/2010

Trajectories of Symptom Reduction and Engagement During Treatment for Childhood Behavior Disorders: Differences Across Settings

Research on Child and Adolescent Psychopathology > Uitgave 7/2010
Oliver Lindhiem, David J. Kolko
Belangrijke opmerkingen
This study was supported by a grant to the second author from the National Institute of Mental Health (MH57727) and by a T32 Fellowship to the first author (MH18951; PI: David Brent, MD). The authors acknowledge the research and clinical staff of the Resources to Enhance the Adjustment of Children (REACH) program. Reprints may be obtained from Dr. Kolko, WPIC, 3811 O’Hara St., Pittsburgh, PA 15213.


In this study, we examined trajectories of symptom reduction and family engagement during the modular treatment phase of a clinical trial for early-onset disruptive behavior disorders that was applied either in community settings or a clinic. Participants (N = 139) were 6–11 year-old children with diagnoses of Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD). Symptoms of ODD/CD and level of engagement were assessed at every session during the course of treatment. Overall, symptom reduction was characterized by a gradual decline in symptoms over the first 11 sessions followed by a flatter slope beginning with session 12. Clinic participants evidenced a greater decline in symptoms after session 11 compared to participants in community settings. Overall, engagement remained stable during the course of treatment. However, clinic participants had higher levels of engagement throughout treatment compared to participants in the community settings. These setting differences in level of engagement did not account for the differences in trajectories of symptom reduction across the treatment settings.

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