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Originalarbeit

Pilotstudie zur Wirksamkeit einer multimodalen Gruppenbehandlung für Kinder mit einer Störung des Sozialverhaltens mit oppositionellem, aufsässigem Verhalten in der klinischen Grundversorgung

Published Online:May 18, 2016https://doi.org/10.1024/1422-4917/a000424

Abstract

Zusammenfassung.Fragestellung: Die Störung des Sozialverhaltens mit oppositionellem, aufsässigem Verhalten (SSV/OAV) ist eine häufige Störung des Kindesalters und oft Zuweisungsgrund an kinderpsychiatrische Kliniken. Die SSV/OAV zeigt sich in Form von erhöhter Reizbarkeit, Dickköpfigkeit und boshaften Verhaltensweisen. In dieser Pilotstudie sollen Hinweise auf die Wirksamkeit von kombinierten kognitiv-verhaltenstherapeutischen Gruppeninterventionen – bei den Kindern das Baghira-Gruppentraining und bei deren Eltern das Triple P-Elterntraining – im Kontext der ambulanten kinderpsychiatrischen Grundversorgung geprüft werden. Methodik: 42 Kinder mit SSV/OAV erhielten die kombinierte Behandlung und wurden mit 26 unbehandelten Probanden einer Wartelistekontrollgruppe verglichen. Externalisierendes Problemverhalten sowie aggressives und regelverletzendes Verhalten wurden bei Behandlungsbeginn und -ende sowie nach sechs Monaten Katamnesezeitraum mittels der Fragebogenmethode bei Kindern, Eltern und Lehrpersonen erhoben. Ergebnisse: Im Vergleich zur Wartelistekontrollgruppe ergab sich bei den Kindern der Behandlungsgruppe zwischen Prä- und Posterhebung eine signifikante Abnahme der von den Eltern beurteilten externalisierenden Probleme und eine tendenziell signifikante Abnahme des von den Lehrpersonen berichteten regelverletzenden Verhaltens. Es wurden mittelgroße Effektstärken gefunden und die Effekte blieben über den Katamnesezeitraum stabil. Schlussfolgerungen: In dieser Pilotstudie zeigten sich die kombinierten Interventionen für die Behandlung von SSV/OAV in der ambulanten kinderpsychiatrischen Grundversorgung als wirksam und hilfreich. Zur Beurteilung der spezifischen Wirksamkeit des Baghira-Gruppentrainings sind weitere, umfangreichere Studien erforderlich.


Pilot study on the effectiveness of a multimodal group treatment for children with oppositional defiant disorder in clinical primary care

Abstract. Pilot study on the effectiveness of a multimodal group treatment for children with oppositional defiant disorder in clinical primary care. Objective: Oppositional defiant disorder (ODD) is a frequent disorder in children and a common cause for referral to child psychiatric services. ODD consists of irritability, headstrongness and hurtful behaviours. The aim of the pilot study was to assess the effectiveness of combined cognitive-behavioural group interventions – the Baghira group training for the children and the Positive Parenting Program Triple P – in an outpatient child psychiatric service. Method: 42 children with ODD who attended the combined interventions were compared to 26 untreated probands in a waiting list control group. Externalizing problem behaviour, aggression and delinquency were assessed at treatment begin, treatment end and at the 6-month follow-up with questionnaires for the children, parents and teachers. Results: In comparison to the waiting list control group in the treatment group parent-reported externalizing problems decreased significantly between pre- and posttreatment assessment. A trend to significance was found for the decrease of teacher reported delinquency. Medium effect sizes were found and all effects were stable at follow-up. Conclusions: In this pilot study the combined interventions have shown to be effective in clinical primary care for the treatment of ODD and beneficial for the children and their families. For the assessment of the specific effectiveness of the Baghira group training further and larger studies are required.

Literatur

  • Achenbach, T. M. (1991a). Manual for the Child Behavior Check List/4-18 and 1991 Profile. Burlington, VT: Department of Psychiatry, University of Vermont. First citation in articleGoogle Scholar

  • Achenbach, T. M. (1991b). Manual for the Teacher Report Form and 1991 Profile. Burlington, VT: Department of Psychiatry, University of Vermont. First citation in articleGoogle Scholar

  • Aebi, M., Perriard, R., Stiffler Scherrer, B. & Wettach, R. (2012). Kinder mit oppositionellem und aggressivem Verhalten. Das Baghira Training. Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Aebi, M., Plattner, B., Winkler Metzke, C., Bessler, C. & Steinhausen, H. C. (2013). Parent- and self-reported dimensions of oppositionality in youth: Construct validity, comorbidity and criminal outcomes in adulthood. Journal of Child Psychology and Psychiatry, 54, 941–949. First citation in articleCrossref Medline, Google Scholar

  • Benjamini, Y. & Hochberg Y. (1995). Controlling the false discovery rate: a practical and powerful approach to multiple testing. Journal of the Royal Statistical Society: Series B, 57, 289–300. First citation in articleGoogle Scholar

  • Bingham, C. R., Stemmler, M., Petersen, A. C. & Graber, J. (1998). Imputing missing data values in repeated measurement within-subjects designs. Methods of Psychological Research, 3, 131–155. First citation in articleGoogle Scholar

  • Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences. Hillsdale: Lawrence Erlbaum Association. First citation in articleGoogle Scholar

  • de Graaf, I., Speetjens, P., Smit, F., de Wolff, M. & Tavecchio, L. (2008). Effectiveness of the Triple P Positive Parenting Program on behavioral problems in children: a meta-analysis. Behavior Modification, 32, 714–735. First citation in articleCrossref Medline, Google Scholar

  • De Los Reyes, A. & Kazdin, E. A. (2005). Informant discrepancies in the assessment of childhood psychopathology: A critical review, theoretical framework and recommendations for further study. Psychological Bulletin, 131, 483–509. First citation in articleCrossref Medline, Google Scholar

  • Frick, P. J., Ray, J. V., Thornton, L. C. & Kahn, R. E. (2014). Can callous-unemotional traits enhance the understanding, diagnosis, and treatment of serious conduct problems in children and adolescents? A comprehensive review. Psychological Bulletin, 140, 1–57. First citation in articleGoogle Scholar

  • Knapp, P., Chait, A., Pappadopulos, E., Crystal, S., Jensen, P. S. & Group, T. M. S. (2012). Treatment of maladaptive aggression in youth: CERT guidelines I. Engagement, assessment, and management. Pediatrics, 129, e1562–1576. First citation in articleCrossref, Google Scholar

  • Kolko, D. J. & Pardini, D. A. (2010). ODD dimensions, ADHD, and callous-unemotional traits as predictors of treatment response in children with disruptive behavior disorders. Journal of Abnormal Psychology, 119, 713–725. First citation in articleCrossref Medline, Google Scholar

  • Larson, B., Fossum, S., Clifford, G., Drugli, M. B., Handegard, B. H. & Morch, W.-T. (2009). Treatment of oppositional defiant and conduct problems in young Norwegian children. Results of a randomized controlled trial. European Journal of Child and Adolescent Psychiatry, 18, 42–52. First citation in articleGoogle Scholar

  • Litschge, C. M., Vaughn, M. G. & McCrea, C. (2010). The Empirical Status of Treatments for Children and Youth with Conduct Problems. An Overview of Meta-Analytic Studies. Research on Social Work Practice, 20, 21–35. First citation in articleCrossref, Google Scholar

  • Lochman, J. E. & Pardini, D. A. (2008). Cognitive behavioural therapies. In M. Rutter, D. Bishop, D. Pine, S. Scott, J. Stevenson, E. Tayloret al. (Eds.), Rutter’s child and adolescent psychiatry (pp. 1026–1045). Oxford: Blackwell. First citation in articleGoogle Scholar

  • Luengo, M. A., Carrillo-de-la-Pena, M. T., Otero, J. M. & Romero, E. (1994). A short-term longitudinal study of impulsivity and antisocial behavior. Journal of Personality and Social Psychology, 66, 542–548. First citation in articleCrossref Medline, Google Scholar

  • Margraf, J. (2009). Übertragbarkeit der Forschungsergebnisse auf die Routinepraxis. In J. Margraf (Hrsg.), Kosten und Nutzen der Psychotherapie (S. 119–125). Heidelberg: Springer. First citation in articleCrossref, Google Scholar

  • Maughan, B., Rowe, R., Messer, J., Goodman, R. & Meltzer, H. (2004). Conduct disorder and oppositional defiant disorder in a national sample: developmental epidemiology. Journal of Child Psychology and Psychiatry, 45, 609–621. First citation in articleCrossref, Google Scholar

  • McCart, M. R., Priester, P. E., Davies W. H. & Azen, R. (2006). Differential effectiveness of behavioral parent-training and cognitiv-behavioral therapy for antisocial youth: a meta-analysis. Journal of Abnormal Child Psychology, 34, 527–543. First citation in articleCrossref Medline, Google Scholar

  • Menting, A. T. A., de Castro, B. O. & Matthys, W. (2013). Effectiveness of the Incredible Years parent training to modify disruptive and prosocial child behavior: A meta-analytic review. Clinical Psychology Review, 33, 901–913. First citation in articleCrossref Medline, Google Scholar

  • Petermann, F. & Koglin, U. (2015). Therapie aggressiven Verhaltens. In F. Petermann & U. Koglin (Hrsg.), Aggressive Kinder und Jugendliche (S. 19–31). Heidelberg: Springer. First citation in articleGoogle Scholar

  • Petermann, F. & Petermann, U. (2008). Wechsler Intelligenz Test für Kinder. Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Ralph, A. & Sanders, M. R. (2006). The ‘Teen Triple P’ Positive Parenting Program: A preliminary evaluation. Youth Studies Australia, 25, 41–48. First citation in articleGoogle Scholar

  • Sanders, M. R. (1999). Triple P-Positive Parenting Program: Towards an empirically validated multilevel parenting and family support strategy for the prevention of behavior and emotional problems in children. Clinical Child and Family Psychology Review, 2, 71–90. First citation in articleCrossref Medline, Google Scholar

  • Sanders, M. R. & Ralph, A. (2002). Practitioner’s Manual for Primary Care Teen Triple P. Münster: PAG Institute für Psychology. First citation in articleGoogle Scholar

  • Sanders, M. R., Kirby, J. N., Tellegen, C. L. & Day, J. J. (2014). The Triple P-Positive Parenting Program: A systematic review and meta-analysis of a multi-level system of parenting support. Clinical Psychological Review, 34, 337–357. First citation in articleMedline, Google Scholar

  • Scotto Rosato, N., Correll, C. U., Pappadopulos, E., Chait, A., Crystal, S. & Jensen, P. S.et al. (2012). Treatment of maladaptive aggression in youth: CERT guidelines II. Treatments and ongoing management. Pediatrics, 129, e1577–e1586. First citation in articleCrossref Medline, Google Scholar

  • Stadler, C., Janke, W. & Schmeck, K. (2004). Inventar zur Erfassung von Impulsivität, Risikoverhalten und Empathie. Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Steiner, H. & Remsing, L. (2007). Practice parameter for the assessment and treatment of children and adolescents with oppositional defiant disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 126–141. First citation in articleCrossref, Google Scholar

  • Stringaris, A. & Goodman, R. (2009a). Longitudinal outcome of youth oppositionality: irritable, headstrong, and hurtful behaviors have distinctive predictions. Journal of the American Academy of Child and Adolescent Psychiatry, 48, 404–412. First citation in articleCrossref Medline, Google Scholar

  • Stringaris, A. & Goodman, R. (2009b). Three dimensions of oppositionality in youth. Journal of Child Psychology and Psychiatry, 50, 216–223. First citation in articleCrossref Medline, Google Scholar

  • Sukhodolsky, D. G., Kassinove, H. & Gorman, B. S. (2004). Cognitive-behavioral therapy for anger in children and adolescents: a meta-analysis. Aggression and Violent Behavior, 9, 247–269. First citation in articleCrossref Medline, Google Scholar

  • Swiss Federal Institute for Statistics. (1992). Swiss Health Survey (Schweizerische Gesundheitsbefragung). Retrieved from http://www.bfs.admin.ch/bfs/portal/de/index/infothek/erhebungen__quellen/blank/blank/ess/01.html First citation in articleGoogle Scholar

  • Tewes, U., Schallberger, P. & Rossmann, U. (1999). Hamburg-Wechsler-Intelligenztest für Kinder III. Bern: Huber. First citation in articleGoogle Scholar

  • Turner, K. M. T., Markie-Dadds, C. & Sanders, M. R. (2002). Manual for Triple P group program. Münster: PAH Institute for Psychology. First citation in articleGoogle Scholar

  • Webster-Stratton, C., Reid, M. J. & Hammond, M. (2004). Treating children with early-onset conduct problems: intervention outcomes for parent, child, and teacher training. Journal of Clinical Child and Adolescent Psychology, 33, 105–124. First citation in articleCrossref, Google Scholar

  • Wilson, P., Rush, R., Hussey, S., Puckering, C., Sim, F. & Allely, C. S.et al. (2012). How evidence-based is an ‘evidence-based parenting program’? A PRISMA systematic review and meta-analysis of Triple P. BMC Medicine, 10, 130. First citation in articleCrossref, Google Scholar