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

描述(申请人提供)：儿童破坏性行为障碍(DBDS)是一种严重的情绪、注意力和行为综合征，包括注意力缺陷/多动障碍、对立违抗障碍和品行障碍。DBDS是一种非常普遍的重大公共卫生问题，具有巨大的医疗保健成本，并对儿童的社会、学业和情感发展产生持续影响。DBD与药物滥用、青少年犯罪和同伴排斥的风险更高。儿童DBD在家庭环境中发生和管理，并与母亲抑郁、离婚、更严厉的纪律和家庭内部冲突有关。父母是孩子进入托儿所的看门人；治疗取决于父母如何看待和定义孩子的症状行为。家庭管理风格框架(FMSF)是用来描述有慢性病儿童的家庭独特的管理风格的。FMSF的使用可以解决有关儿童DBD管理的知识差距。这项初步的混合方法研究的目的是使用FMSF从三个维度描述父母对DBD日常管理的复杂性：父母对行为的定义和管理，以及感知的后果。这项创新研究支持了NINR的一个核心战略目标：确定开发预测模型和干预措施所需的基础知识，以促进和维持家庭的心理和情绪健康。两个半结构化的家长访谈将在爱荷华大学进行，有目的的样本包括50名3-16岁被诊断患有DBDS的儿童的伴侣和单亲父母。过度抽样策略将被用来招募反映诊所客户的不同样本的父母。面谈1将安排在诊断后7天内，面谈2将安排在治疗30天后，以探索管理维度如何变化或保持稳定。此外，来自53个项目的利克特调查问卷的数据将被用来三角测量和扩展面试数据。本研究将使用恒定比较法进行系统的迭代数据收集、编码和分析。将在每个家庭单位内和跨案例分析数据，以制定DBDS的家庭管理类型学。具体目标是：目标1：在诊断为DBDS的7天内，探索家庭中的FMSF的组成部分。目的：探讨诊断后30天DBDS患儿家庭FMSF各成分随时间的变化。这项研究的长期目标是为患有DBD的儿童家庭开发理论驱动的、以家庭为中心的个性化干预措施，以改善儿童、父母和家庭功能。

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.