Randomized controlled trial of the evidence-based therapy based on behavioral parent training group in alleviating Chinese children with symptoms of externalized behavior problems

doi:10.11852/zgetbjzz2022-1039

Abstract

Abstract: Objective To analyze the effect of the evidence-based therapy based on Behavioral Parent Training (BPT) on alleviating the symptoms of common externalizing behavior problems in Chinese children by a randomized controlled trial. Methods From Nov.2019 to Apr.2020,a total of 141 children aged 6-12 and their parents were randomly divided into intervention group (n=72) and control group (n=69). Parents in the intervention group received BPT for 10 times, while the control group was given no intervention procedure. The Eyberg Child Behavior Inventory (ECBI) was used to assess children's behavior at baseline and after the intervention. Results Finally 114 children finished assessment before and after intervention, of whom 62 children were in the intervention group, and 52 children were in the control group. Post-test scores of ECBI, oppositional defiant behavior (ODB), attention deficit hyperactivity disorder behavior and unnamed factor in the intervention group were significantly lower thanthose of the control group(F=6.13, 4.34, 4.17, 7.41, P＜0.05), but there was no significant difference in the score of conduct problem behavior between the two groups (P＞0.05). After intervention, the scores of ECBI and four specific dimensions of children in the intervention group were significantly lower than those before intervention, but there was no significant difference in the ECBI score between pre-test and post-test for the control group (P＞0.05). Except for conduct problem, the pre-test and post-test difference scores of ECBI and other 3 dimensions in the intervention group were significantly higher than those in the control group (t=2.76, 2.05, 2.44, 3.12, P＜0.05). Conclusion BPT can effectively alleviate common externalized behavior problems of children, which may provide useful reference for taking evidence-based intervention, reducing the occurrence and development of children's externalizing behavior problems.

Key words: externalized behavior problems, attention deficit hyperactivity disorder, parental skills, children, parental intervention

摘要： 目的采用随机对照试验考察基于父母行为训练(BPT)的循证疗法对缓解中国儿童常见外化行为问题症状的效果。方法 2019年11月—2020年4月,选取北京市某小学141名6~12岁儿童及其父母,将其随机分成干预组(n=72)和对照组(n=69)。干预组父母进行10次父母行为训练小组治疗,对照组不给予干预程序。采用Eyberg儿童行为量表(ECBI)在干预前及干预后进行评估。结果 114名儿童完成了干预前后的测量,其中干预组62人,对照组52人。组间比较结果显示,干预后干预组儿童在行为问题总分(F=6.13)、对立违抗行为(F=4.34)、注意缺陷多动冲动障碍行为(F=4.17)以及其他不良行为(F=7.41)后测得分均显著低于对照组,差异有统计学意义(P<0.05),在品行问题维度两组得分差异无统计学意义(P>0.05);组内前后测结果显示,干预组在后测的行为问题总分及4个具体纬度得分均显著低于前测得分,对照组前后测得分差异无统计学意义(P>0.05);两组前后测差值的比较结果显示,除品行问题外,干预组在行为问题总分及其他3个维度差值均高于对照组(t=2.76、2.05、2.44、3.12),差异有统计学意义(P<0.05)。结论 BPT小组疗法可有效缓解中国儿童常见的外化行为问题症状,为我国积极开展循证干预、减少儿童行为问题的发生和发展提供了有益参考。

关键词: 外化行为问题, 注意缺陷多动障碍, 教养技能, 儿童, 父母干预

CLC Number:

R749.94

GAO Liru, QIN Yiming, QU Zhiyong. Randomized controlled trial of the evidence-based therapy based on behavioral parent training group in alleviating Chinese children with symptoms of externalized behavior problems[J]. Chinese Journal of Child Health Care, 2023, 31(9): 957-962.

高丽茹, 秦一铭, 屈智勇. 基于父母行为训练小组的循证疗法缓解儿童外化行为问题症状的随机对照试验[J]. 中国儿童保健杂志, 2023, 31(9): 957-962.

References

[1] American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-Ⅴ[M].Washington DC:American Psychiatric Association, 2013.
[2] Ishii T, Takahashi O,KawamuraY,et al. Comorbidity in attention deficit-hyperactivity disorder[J]. Psychiatry Clin Neurosci, 2003, 57 (5): 457-463.
[3] Wichstrom L, Berg-Nielsen TS, Angold A, et al. Prevalence of psychiatric disorders in prescholers[J]. J Child Psychol Psychiatry, 2012, 53 (6): 695-705.
[4] 黄广文,苏林雁,马敏,等.对立违抗性障碍儿童行为特征及伙伴关系初步研究[J].中国儿童保健杂志,2006,14(4):341-343.
Huang GW, Su LY, Ma M,et al. Study of the behavior problems and companion relationships in children with oppositional defiant disorder[J]. Chin J Child Health Care, 2006,14(4): 341-343.(in Chinese)
[5] 潘雯. 辽宁省儿童青少年精神障碍的流行病学调查分析[D]. 沈阳:中国医科大学, 2008.
Pan W. Epidemiology study of mental disorder of childern and adolescents in Liaoning Province[D]. Shenyang: China Medical University, 2008.(in Chinese)
[6] 韦臻,罗学荣,叶海森,等. 长沙市中小学生对立违抗性障碍的流行病学调查[C].中华医学会精神病学分会第七届学术年会,2006: 110-111.
[7] 陶文凤. 武汉市某小学儿童注意缺陷多动障碍和破坏性行为障碍的影响因素分析[D]. 武汉:华中科技大学, 2018.
Tao WF. Analysis of the influencing factors of attention deficit hyperactivity disorder and disruptive behavior disorder in a primary school children inWuhan[D]. Wuhan: Huazhong University of Science and Technology, 2018.(in Chinese)
[8] 徐改玲,王长虹,杨桂伏,等.河南苍台镇儿童注意和破坏性行为障碍调查[J].临床精神医学杂志,2011,21(4):255-257.
Xu GL, Wang CH, Yang GF, et al. Investigation of children with attention and disruptive behavior disorder in Cangtai town, Henan province[J]. Journal of Clinical Psychiatry, 2011,21(4): 255-257.(in Chinese)
[9] Leung P, Hung SF, Ho TP, et al. Prevalence of DSM-Ⅳ disorders in Chinese adolescents and the effects of an impairment criterion[J].Eur Child Adolesc Psychiatry, 2008, 17(7): 452-461.
[10] 童连, 史慧静, 臧嘉捷. 中国儿童ADHD流行状况Meta分析[J]. 中国公共卫生, 2013, 29(9): 1279-1283.
Tong L, Shi HJ, Zang JJ. Prevalence of ADHD in children of China:A systematic review andmeta analysis[J]. Chinese Journal of Public Health, 2013, 29(9): 1279-1283.(in Chinese)
[11] 李福轮, 杨静, 谢晴牧, 等. 中国儿童注意缺陷多动障碍患病率的Meta分析[J]. 临床荟萃, 2017, 32(12): 1079-1083.
Li FL, Yang J,Xie QM, et al. Current prevalence of attention deficit hyperactivity disorder among children:A meta-analysis[J]. Clinical Focus, 2017, 32(12): 1079-1083.(in Chinese)
[12] Hoeve M, Dubas JS, Eichelsheim VI, et al. The relationship between parenting and delinquency: A Meta-analysis[J]. J Abnorm Child Psychol, 2009, 37(6): 749-775.
[13] Forehand R, Jones DJ, Parent J. Behavioral parenting interventions for child disruptive behaviors and anxiety:What's different and what's the same[J]. Clin Psychol Rev, 2013, 33(1): 133-145.
[14] Pelham WE, Fabiano GA. Evidence-based psychosocial treatments for attention-deficit/hyperactivity disorder[J]. J Clin Child Adolesc Psychol, 2008, 37(1): 184-214.
[15] Patterson GR,Debaryshe BD, Ramsey E. A developmental perspective on antisocial behavior[J]. Am Psychol, 1989, 44(2): 329-335.
[16] Pearl ES. Parent management training for reducing oppositional and aggressive behavior in preschoolers[J]. Aggress Violent Beh, 2009, 14(5): 295-305.
[17] Eyberg SM, Nelson MM, Boggs SR. Evidence-based psychosocial treatments for children and adolescents with disruptive behavior[J]. J Clin Child Adolesc Psychol, 2008, 37(1): 215-237.
[18] Charach A, Carson P, Fox S, et al. Interventions for preschool children at high risk for ADHD: A comparative effectiveness review[J]. Pediatrics, 2013, 131(5): 1584-1604.
[19] Forehand R,Lafko N, Parent J, et al. Is parenting the mediator of change in behavioral parent training for externalizing problems of youth?[J]. Clin Psychol Rev, 2014, 34(8): 608-619.
[20] Evans SW, Owens, JS,Wymbs BT, et al. Evidence-based psychosocial treatments for children and adolescents with attention deficit/hyperactivity disorder[J]. J Clin Child Adolesc Psychol, 2018, 53, 47(2): 157-198.
[21] 苏炳华,金丕焕,陈峰,等. 临床试验统计学[M]. 北京:人民卫生出版社, 2018.
[22] Eyberg SM, Pincus D. Eyberg child behavior inventory and sutter-Eyberg student behavior inventory-revised: Professional manual[M]. Odessa, FL: Psychological Assessment Resources, 1999.
[23] Leung C, Tsang S, Sin T, et al. The efficacy of parent-child interaction therapy with chinese families: Randomized controlled trial[J]. Res Soc Work Pract, 2015, 25(1): 117-128.
[24] Chen YC, Fortson BL,Tiano JD. Establishing norms on the eyberg child behavior inventory to identify disruptive behaviors in Taiwanese children[J]. Child Fam Behav Ther, 2018, 40(4):306-319.
[25] Fisher PA, Gilliam KS. Research into theory into practice: An overview of family based interventions for child antisocial behavior developed at the Oregon social learning center[J]. Clin Salud, 2012, 23(3): 247-259.
[26] Brestan EV, Eyberg SM. Effective psychosocial treatments of conduct-disordered children and adolescents: 29 years, 82 studies, and 5,272 kids[J]. J Clin Child Psychol, 1998, 27(2): 180-189.
[27] Owens JS, Evans SW,Bunford N. Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder[J]. J Clin Child Adolesc Psychol, 2014, 43(4): 527-551.