Moderators and Mediators of Therapy for Conduct Disorder

行为障碍治疗的调节者和调解者

• 批准号: 6815067
• 负责人: ALAN KAZDIN
• 金额: $ 52.06万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-12-01 至 2006-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6815067
• 关键词: Moderators; Mediators; Therapy; Conduct; Disorder

EXCEED THE SPACE PROVIDED. This is a revised application for a Competing Continuation. The prior version received a priority score of 193 in October 2001. The revised application addresses issues raised by the 6 reviewers. The overarching goal of this study is to improve the effectiveness of treatment of children referred for Conduct Disorder. The study focuses on understanding how treatment produces changes (mediators) and factors that contribute to outcome (moderators). The model underlying the study is that therapeutic change is influenced by characteristics that children, parents, and families "bring with" them to treatment, by characteristics that emerge during the treatment process (e.g., alliance, adherence), and by the intervention and associated features (e.g., therapist behavior, characteristics). The proposed study focuses on the first two components and will: 1) identify child, parent, and family factor s that contribute to therapeutic change and 2) test key processes during the course of treatment that explain therapeutic change. Children (N=200, ages 6-12, including European and African American families) referred to outpatient treatment and who meet diagnostic criteria for Conduct Disorder will participate. All children and parents well receive problem-solving skills training and parent management training as a combined treatment. The central predictions are that: 1) responsiveness to treatment will be influenced by child dysfunction and impairment, parent dysfunction and stress, and adverse family relations in the home and by initial parent expectancies about treatment processes and outcome, and 2) therapeutic change will be mediated by a positive parent-therapist relationship, few perceived parent barriers to treatment during treatment, and parent and child adherence and compliance with treatment. The study will also permit evaluation of the predictions across the two ethnicities. Apart from improving the effectiveness of treatment for Conduct Disorder, the study is intended to advance a heuristic model for child therapy research more generally. The model conceptualizes antecedents, emerging processes, and interventions as sources of influence on outcome, Also, the design of the study permits evaluation of processes and causal models to help explain the processes of change. PERFORMANCE KEY PERSONNEL ========================================Section End===========================================

超出所提供的空间。 这是一份修改后的竞争延续申请。2001年10月，前一个版本获得了193分的优先级。修订后的申请解决了6名审评员提出的问题。本研究的总体目标是提高治疗行为障碍儿童的有效性。这项研究的重点是了解治疗如何产生变化（介质）和影响结果的因素（调节剂）。这项研究的基础模型是，治疗变化受到儿童、父母和家庭“带来”治疗的特征的影响，受到治疗过程中出现的特征的影响（例如，联盟、遵守），以及通过干预和相关特征（例如，治疗师行为，特征）。拟议的研究侧重于前两个组成部分，并将：1）确定有助于治疗变化的儿童，父母和家庭因素，2）在治疗过程中测试解释治疗变化的关键过程。 儿童（N=200，6-12岁，包括欧洲和非洲裔美国家庭）转诊到门诊治疗，并符合行为障碍的诊断标准将参与。所有儿童和家长都接受解决问题技能培训和家长管理培训，作为一种综合治疗。核心预测是：1）对治疗的反应性将受到儿童功能障碍和损伤、父母功能障碍和压力、家庭中不利的家庭关系以及父母对治疗过程和结果的最初期望的影响，以及2）治疗变化将由积极的父母-治疗师关系介导，在治疗期间很少感知到父母对治疗的障碍，以及父母和孩子对治疗的依从性。这项研究还将允许对两个种族的预测进行评估。 除了提高行为障碍治疗的有效性外，这项研究还旨在为更普遍的儿童治疗研究提出一个启发式模型。该模型将前因、新兴过程和干预措施概念化为对结果的影响来源，此外，研究的设计允许评估过程和因果模型，以帮助解释变化的过程。性能关键人员=