Preventing Problems Among Children of Substance Abusers

描述（由申请人提供）：这个R21项目的目的是开发和试点测试的干预措施，以改善父母之间的物质滥用和家庭沟通技巧，从而减少他们的孩子之间的不良结果的风险。药物滥用者的子女有行为问题的风险。家长培训是有效的，在减少儿童的行为问题，但家长药物滥用预测家长培训试验结果不佳。这些研究结果表明，家长培训本身是不太有效的药物滥用的父母，创新的战略将是必要的，这一人口。Stanger的当前流行病学研究表明，父母滥用药物和儿童的结果之间的关系是由父母的精神病理学，家庭冲突和养育问题介导的。我们将开发一种新的干预整合韦伯斯特-斯特拉顿的经验验证的育儿治疗行为问题的激励为基础的，应急管理干预物质依赖的父母。我们假设，激励措施将提高依从性的养育干预（日常监测养育和儿童的行为，完成组间作业），并增加治疗强度和保留（参加会议的数量，完成治疗的家庭数量）。 40名有药物滥用史的母亲及其伴侣将被随机分配到：（1）行为父母培训加应急管理，或（2）没有应急管理的父母培训。PTI和PT组将随机分配接受立即或延迟治疗。主要的结果测量将包括：积极和消极的父母，家庭问题，儿童的攻击性和犯罪行为。我们还将评估治疗结果的重要介质，包括母体物质的使用和精神病理学。一个创新的电话计算机辅助访谈系统将收集父母和儿童的攻击性和犯罪行为的日常评级，以测试日常变化的父母对儿童的行为问题的影响。这项研究将提供一个创新的多成分干预的有效性的初步测试，针对父母的高风险样本的药物滥用的父母。研究结果将通过将流行病学研究与干预研究联系起来，促进对父母养育和儿童问题之间关系的理解。

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.