A Family Affair: Parent Management of Children's Disruptive Behavior Disorders

描述（由申请人提供）：儿童破坏性行为障碍（DBDs）是一种严重的情绪、注意力和行为综合症，包括注意缺陷/多动障碍、对立违抗性障碍和行为障碍。dbd非常普遍，是严重的公共卫生问题，保健费用巨大，对儿童的社会、学业和情感发展产生持续影响。dbd与药物滥用、犯罪和同伴排斥的风险较高有关。儿童dbd是在家庭背景下发生和管理的，与母亲抑郁、离婚、严厉的纪律和家庭内部冲突有关。父母是孩子进入看护中心的看门人；治疗取决于父母如何看待和定义孩子的症状性行为。家庭管理风格框架（FMSF）的发展是为了描述有慢性病儿童的家庭的独特管理风格。使用FMSF可以解决儿童dbd管理方面的知识差距。这项初步混合方法研究的目的是利用FMSF从三个维度来描述父母对dbd日常管理的复杂性：父母对行为的定义和管理，以及感知到的后果。这项创新研究支持了国家心理研究中心的一项核心战略目标：确定开发促进和维持家庭心理和情感健康的预测模型和干预措施所需的基础知识。我们将对爱荷华大学的50名3-16岁被诊断为dbd的父母进行两次半结构化的家长访谈。过采样策略将用于招募反映诊所客户的不同样本的父母。访谈1将安排在诊断后7天内，访谈2将安排在治疗后30天，以探讨管理维度如何变化或保持稳定。此外，53项李克特问卷的数据将用于三角测量和扩展访谈数据。本研究将采用持续比较的方法进行系统迭代的数据收集、编码和分析。将在每个家庭单位内和跨病例分析数据，以制定dbd家庭管理的类型。目标1：探索诊断后7天内患有dbd的儿童家庭中FMSF的组成部分。目的2：探讨dbd患儿家庭FMSF成分在诊断后30天随时间的变化。本研究的长期目标是发展以理论为导向、以家庭为中心和个性化的干预措施，以改善儿童、父母和家庭的功能。

DESCRIPTION (provided by applicant): Childhood disruptive behavior disorders (DBDs) are serious emotional, attentional and behavioral syndromes including attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder. DBDs are highly prevalent, significant public health problems with enormous health care costs and persistent effects on children's social, academic and emotional development. DBDs are associated with higher risks for substance abuse, delinquency, and peer rejection. Childhood DBDs occur and are managed within the context of the family and are associated with maternal depression, divorce, harsher discipline, and intra familial conflict. Parents are gatekeepers to a child's entry into care; treatment is dependent on how parents perceive and define a child's symptomatic behaviors. The Family Management Style Framework (FMSF) was developed to describe the unique management styles of families with chronically ill children. Use of the FMSF can address the knowledge gap about management of childhood DBDs. The purpose of this preliminary mixed methods study is to use the FMSF to describe the complexity of parents' day-to-day management of DBDs across three dimensions: parent definition and management of the behavior, and perceived consequences. This innovative study supports a core NINR strategic goal: to identify foundational knowledge necessary for development of predictive models and interventions that promote and sustain the mental and emotional health of families. Two semi-structured parent interviews will be conducted with a purposeful sample of 50 partnered and single parents of children aged 3-16 years diagnosed with DBDs at the University of Iowa. Oversampling strategies will be used to recruit a diverse sample of parents reflective of the clinic clientele. Interview 1 will be scheduled within 7 days of diagnosis, and Interview 2 after 30 days of treatment to explore how dimensions of management changed or remained stable. In addition data from a 53-item Likert questionnaire will be used to triangulate and expand on interview data. This study will use constant comparison methods for systematic iterative data collection, coding, and analysis. Data will be analyzed within each family unit and across cases to develop a typology of family management of DBDs. Specific aims are: Aim 1: To explore the components of the FMSF in families of children with DBDs within 7 days of diagnosis. Aim 2: To explore the changes over time in the components of the FMSF in families of children with DBDs at = 30 days after diagnosis. The long-term goal of this research is to develop theory-driven, family-focused and individualized interventions for families of children with DBDs to improve child, parent and family function.