Preventing Problems Among Children of Substance Abusers

描述（由申请人提供）：R21项目的目的是开发和试验一种干预措施，以改善滥用药物的父母的养育和家庭沟通技巧，从而减少其子女不良后果的风险。药物滥用者的孩子有行为问题的风险。父母培训在减少儿童行为问题方面是有效的，但父母药物滥用预示着父母培训试验的不良结果。这些发现表明，对于滥用药物的父母来说，单独的父母培训效果较差，对于这一人群来说，创新的策略是必要的。该项目将扩展斯坦格博士目前的流行病学研究结果，表明父母药物滥用与儿童结局之间的关系是由父母精神病理、家庭冲突和养育问题介导的。我们将开发一种新的干预措施，将韦伯斯特-斯特拉顿针对行为问题的经验验证的育儿治疗与基于激励的、针对物质依赖父母的应急管理干预相结合。我们假设，激励措施将增强对育儿干预的依从性（每天监测父母和孩子的行为，完成小组间的家庭作业），并增加治疗强度和保留（参加的会议数量，完成治疗的家庭数量）。

DESCRIPTION (provided by applicant): The aim of this R21 project is to develop and pilot test an intervention to improve parenting and family communication skills among substance-abusing parents, thereby reducing the risk of poor outcomes among their children. Children of substance abusers are at risk for conduct problems. Parent training is effective in reducing children's conduct problems, but parental substance abuse predicts poor outcomes in parent training trials. These findings suggest that parent training alone is less effective for substance abusing parents and that innovative strategies will be necessary for this population. This project will extend findings from Dr. Stanger's current epidemiologic research indicating that relations between parental substance abuse and children's outcomes are mediated by parental psychopathology, family conflict, and parenting problems. We will develop a new intervention integrating Webster-Stratton's empirically validated parenting treatment for conduct problems with an incentive-based, contingency-management intervention for substance dependent parents. We hypothesize that incentives will enhance compliance with the parenting intervention (daily monitoring of parenting and children's behavior, completion of between-group homework assignments) and increase treatment strength and retention (number of sessions attended, number of families completing treatment). Forty mothers with substance abuse histories and their partners will be randomly assigned to either: (1) behavioral parent training plus contingency management, or (2) parent training without contingency management. PTI and PT groups will be randomly assigned to receive either immediate or delayed treatment. Primary outcome measures will include: positive and negative parenting, family problems, and children's aggressive and delinquent behavior. We will also assess important mediators of treatment outcome, including parent substance use and psychopathology. An innovative telephone computer assisted interview system will collect daily ratings of parenting and children's aggressive and delinquent behavior in order to test the impact of daily variations in parenting on children's conduct problems. This study will provide an initial test of the efficacy of an innovative multicomponent intervention targeting parenting in a high-risk sample of substance abusing parents. Findings will advance understanding of developmental psychopathology by linking epidemiologic research on relations between parenting and children's problems to intervention research.