EARLY PRIMARY PREVENTION OF CONDUCT PROBLEMS

总的目标是评价一级预防方案， 有可能出现品行问题的幼儿， 后来的反社会行为这项调查是由1） 儿童期行为问题严重; 2）他们的不良长期- 长期预后; 3）他们对治疗的抵抗; 4）缺乏 针对高危幼儿的预防干预研究; 5）缺乏针对市中心的干预计划 家庭预防实验的时机是理想的，因为 他们的设计现在可以建立在理性的基础上， 目前对行为问题风险因素的了解， 反社会行为一项随机对照临床试验， 对高风险家庭的多系统强化干预 学龄前儿童的建议。96个市中心的学龄前儿童 有法庭记录的反社会历史的哥哥姐姐 行为将被随机分配到一个为期一年的家庭为基础的 干预组或无接触对照组。干预 将包括诊所和以家庭为基础的育儿技能培训。 接受治疗的儿童的近期和长期（1年）结果 将比较干预和对照。结果变量， 包括父母的做法、儿童行为问题和儿童 社会能力，将通过盲法观察进行评估， 多种设置，以及家长和教师的评级，以及 结构化诊断访谈这项研究的独特之处在于：（1） 预防性干预是真正的首要目标 学龄前儿童谁是在发展行为问题的高风险 以及后来的反社会行为，但他们还没有表现出这些 （2）它评估了一个密集的，家庭的功效- 预防性干预，以减少 行为问题-养育子女的方法不足; 3） 干预措施针对市中心的家庭; 4）招募， 评估和干预程序已经过测试， 可行性; 5）预防方案已经手册化。

The overall goal is to evaluate a program of primary prevention in young children at high risk for developing conduct problems and later antisocial behavior. This investigation is prompted by 1) the serious nature of childhood conduct problems; 2) their poor long- term prognosis; 3) their resistance to treatment; 4) the absence of preventive interventions studies for very young high-risk children; and 5) the paucity of intervention programs tailored to inner-city families. The timing for prevention experiments is ideal, since their design can now rest on rational bases derived from our current knowledge about risk factors for conduct problems and antisocial behavior. A randomized controlled clinical trial of a multisystemic, intensive intervention for families of high-risk preschoolers is proposed. Ninety-six inner-city preschoolers who have older siblings with court-documented histories of antisocial behavior will be randomly assigned to a year-long family-based intervention or to a no contact control group. The intervention will consist o clinic and home-based parenting skills training. Immediate and long-term (1 year) outcome of children receiving intervention and controls will be compared. Outcome variables, including parenting practices, child conduct problems and child social competence, will be assessed with blind observations in multiple settings, as well as by parent and teacher ratings, and structured diagnostic interviews. This study is unique in that 1) the preventive intervention is truly primary-it targets preschoolers who are at high risk for developing conduct problems and later antisocial behaviors but who do not yet display these behaviors; 2) it assesses the efficacy of an intensive, family- based preventive intervention for reducing a key risk factor for conduct problems-inadequate parenting practices; 3) the intervention is tailored to inner-city families; 4) recruitment, assessment and intervention procedures have been tested for feasibility; and 5) the prevention program has been manualized.