Moderators and Mediators of Therapy for Conduct Disorder

超出所提供的空间。这是一份修改后的竞争延续申请。之前的版本在2001年10月获得了193分的优先级分数。修订后的申请解决了6位审稿人提出的问题。本研究的首要目标是提高对品行障碍儿童的治疗效果。该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（调节因子）。该研究的基础模型是，治疗改变受到儿童、父母和家庭“带来”治疗的特征、治疗过程中出现的特征（如联盟、依从性）、干预和相关特征（如治疗师行为、特征）的影响。建议的研究将集中在前两个组成部分，并将：1)确定有助于治疗变化的儿童，父母和家庭因素；2)测试治疗过程中解释治疗变化的关键过程。接受门诊治疗并符合品行障碍诊断标准的儿童（N=200，年龄6-12岁，包括欧洲和非洲裔美国家庭）将参与研究。所有的孩子和家长都将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。主要预测是：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；2)治疗改变将受到积极的父母-治疗师关系、治疗过程中很少感知到的父母障碍以及父母和儿童对治疗的依从性和依从性的调节。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，本研究旨在为更广泛的儿童治疗研究提供启发式模型。该模型将前因、新过程和干预作为影响结果的来源进行了概念化。此外，研究的设计允许对过程和因果模型进行评估，以帮助解释变化的过程。性能关键人员 ======================================== 节结束 ===========================================

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===========================================