Intervention Effects of the Family Check-Up: Moderators and Moderated Mediation

描述（由申请人提供）：大量关于行为问题（CP）出现的研究表明，在儿童早期表现出较高水平的CP的幼儿在整个发展过程中有持续出现问题行为的风险（Broidy等人，2003;Campbell, 2002）。养育子女的许多方面都与CP的出现有关，包括积极方面，如温暖（Pettit, Bates, & Dodge, 1997）和消极方面，如拒绝（Trentacosta & Shaw, 2008）；因此，许多广泛实施的针对CP的早期干预针对育儿方面也就不足为奇了（Lundahl, Risser, & Lovejoy, 2006; Reyno & McGrath, 2006）。虽然总体上发现父母干预在减少CP方面产生了小到中等的效果（Lundahl et al., 2006; Piquero et al., 2009），但并不是对所有儿童都有效（Webster-Stratton, 1990; Webster-Stratton & Hammond, 1997）。因此，对有效性调节因子的调查对于告知改进干预措施和推进理论的方法至关重要。研究表明，父母干预效果最可靠的预测因素之一是CP的初始水平（Lundahl et al., 2006; Reyno & McGrath, 2006）。此外，改变父母干预的动机中最重要的一个方面是父母希望孩子改变行为的愿望（Nock & Kazdin, 2005）。在儿童CP基线的背景下，如果孩子的行为处于“可容忍”的水平，即使与规范相比有所提高，父母可能不太愿意改变或参与干预；只有当行为变得难以控制时，动机才会大大增加。目前的研究将检查儿童的初始CP水平作为家庭检查（FCU）育儿干预效果的调节因子。此外，在一个有调节的中介框架中，本研究将检验儿童的初始CP水平是否会调节FCU已被证明有效的中介途径——通过改善父母教养和父母抑郁——以确定中介效应的强度是否会随着初始CP水平的变化而变化。据推测，对于初始CP水平较高的儿童，CP和FCU影响CP的中介途径的改善将会更大。建议的培训计划包括高级分析技术的正式课程，特定研究领域的指导阅读，以及与定量方法、临床和发展心理学以及公共政策领域的专家合作。这项工作旨在解决NIMH的战略目标，即开发新的和更好的干预措施，以结合CP个体的不同需求，并通过使用轨迹建模来绘制精神疾病的轨迹，以检查干预组和对照组中高危儿童CP病程的差异。这项研究的发现将帮助研究者进一步了解不同儿童对父母干预的反应，并改进干预措施，以最好地解决CP儿童的需求。

DESCRIPTION (provided by applicant): A wealth of research on the emergence of conduct problems (CP) has shown that young children who demonstrate elevated levels of CP in early childhood are at risk for persisting in problematic behavior across development (Broidy et al., 2003; Campbell, 2002). Numerous aspects of parenting have been linked to the emergence of CP, including positive dimensions such as warmth (Pettit, Bates, & Dodge, 1997) and negative dimensions such as rejection (Trentacosta & Shaw, 2008); therefore, it is not surprising that many widely implemented early interventions for CP target aspects of parenting (Lundahl, Risser, & Lovejoy, 2006; Reyno & McGrath, 2006). Although parenting interventions on the whole have been found to produce small to moderate effects in reducing CP (Lundahl et al., 2006; Piquero et al., 2009), they are not effective for all children (Webster-Stratton, 1990; Webster-Stratton & Hammond, 1997).Therefore, the investigation into moderators of effectiveness is of utmost importance to inform ways to refine interventions and to advance theory. Research has shown that one of the most robust predictors of parenting intervention effects is initial level of CP (Lundahl et al., 2006; Reyno & McGrath, 2006). Further, one of the most important aspects of motivation for change in parenting interventions is the parents' desire for behavioral change in their children (Nock & Kazdin, 2005). In the context of baseline child CP, parents might be less motivated to change or to engage in an intervention if a child's behavior is at a level that is "tolerable," even if it is elevated compared to norms; only when behavior becomes more unmanageable would motivation increase to a great degree. The current study will examine children's initial level of CP as a moderator of the effectiveness of th Family Check-Up (FCU) parenting intervention. Further, in a moderated mediation framework, the current study will examine whether children's initial level of CP moderates the mediational pathways through which the FCU has been shown to be effective - through improving parenting and parental depression - to determine if the strength of the mediated effect changes as initial level of CP changes. It is hypothesized that improvements in CP and mediational pathways through which the FCU influences CP will be greater for children with higher initial levels of CP. The proposed training program includes formal coursework in advanced analytic techniques, directed readings on specific areas of research, and collaboration with experts in the fields of quantitative methods, clinical and developmental psychology, and public policy. This work is intended to address the NIMH strategic objective of developing new and better interventions to incorporate the diverse needs of individuals with CP and the objective of charting trajectories of mental illnesses by use of trajectory modeling to examine differences in the course of CP in high-risk children in the intervention and control groups. Findings from the proposed research will aid researchers in further understanding differential responsiveness to parenting interventions and refining interventions to best address the needs of children with CP.