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Meta-meta-analysis on the effectiveness of parent-based interventions for the treatment of child externalizing behavior problems.

ABSTRACT: OBJECTIVE:The aim of this study is to perform the first meta-meta-analysis on the effectiveness of parent-based interventions for children with externalizing behavior problems. Even though parent-based interventions are considered as effective treatments the effects reported in meta-analyses are heterogeneous and the implementation in clinical practice is suboptimal. Recapitulative valid effect predictions are required to close the still existing gap between research findings and clinical practice. The meta-meta-analytic results on changes in child behavior shall result in a clear signal for clinical practice. METHODS:This meta-meta-analysis encompasses 26 meta-analyses identified via search in electronic databases (PsycINFO, Medline, PubMed). Meta-analyses had to report effects of parent-based interventions on child behavior and focus on children under the age of 13 years with externalizing behavior problems in a clinical setting. Analyses were based on random-effects models. To combine results, the effect estimates of the meta-analyses were transformed to SMD and weighted to correct for primary study overlap. The meta-meta-analysis is registered on PROSPERO, registration number CRD42016036486 and was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement (PRISMA). RESULTS:The results indicate a significant moderate overall effect for child behavior (SMD = 0.46) as well as for parent reports (SMD = 0.51) and observational data (SMD = 0.62). Further analyses focusing on child externalizing behavior yielded significant and moderate effects (SMD = 0.45). All effects remained stable to follow-up. Considerable heterogeneity was observed within results. CONCLUSION:Parent-based interventions are shown to be effective in improving behavior in children with externalizing behavior problems, as assessed using parent reports and observational measures. The present results should encourage health care providers to apply evidence-based parent-based interventions.

SUBMITTER: Mingebach T

PROVIDER: S-EPMC6157840 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Meta-meta-analysis on the effectiveness of parent-based interventions for the treatment of child externalizing behavior problems.

Mingebach Tanja T Kamp-Becker Inge I Christiansen Hanna H Weber Linda L

PloS one 20180926 9

<h4>Objective</h4>The aim of this study is to perform the first meta-meta-analysis on the effectiveness of parent-based interventions for children with externalizing behavior problems. Even though parent-based interventions are considered as effective treatments the effects reported in meta-analyses are heterogeneous and the implementation in clinical practice is suboptimal. Recapitulative valid effect predictions are required to close the still existing gap between research findings and clinica ...[more]

PMID: 30256794

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Project description:ObjectiveThe aim of the present investigation was to compare the effectiveness of Parent-Child Interaction Therapy (PCIT) with treatment as usual (TAU) in young children who were referred to regular child and adolescent mental health clinics for behavior problems.MethodEighty-one Norwegian families with two- to seven-year-old children (52 boys) who had scored ≥ 120 on the Eyberg Child Behavior Inventory (ECBI) were randomly assigned to receive either PCIT or TAU. The families were assessed 6 and 18 months after beginning treatment. Parenting skills were measured using the Dyadic Parent-Child Interaction Coding System (DPICS), and child behavior problems were measured using the ECBI and the Child Behavior Checklist (CBCL).ResultsLinear growth curve analyses revealed that the behavior problems of children receiving PCIT improved more compared with children receiving TAU according to mother reports (ECBI d = .64, CBCL d = .61, both p < .05) but not according to father report. Parents also improved with regard to Do and Don't skills (d = 2.58, d = 1.46, respectively, both p ≤ .001). At the 6-month assessment, which often occurred before treatment was finished, children who had received PCIT had lower father-rated ECBI and mother-rated CBCL-scores (p = .06) compared with those who had received TAU. At the 18-month follow-up, the children who had received PCIT showed fewer behavior problems compared with TAU according to mother (d = .37) and father (d = .56) reports on the ECBI and mother reports on the CBCL regarding externalizing problems (d = .39). Parents receiving PCIT developed more favorable Do Skills (6-month d = 1.81; 18-month d = 1.91) and Don't Skills (6-month d = 1.46; 18-month d = 1.42) according to observer ratings on the DPICS compared with those receiving TAU.ConclusionChildren receiving PCIT in regular clinical practice exhibited a greater reduction in behavior problems compared with children receiving TAU, and their parents' parenting skills improved to a greater degree compared with those receiving TAU.Trial registrationClinicalTrials.gov NTC01085305.

Project description:Young maternal age at birth has been consistently recognized as a factor contributing to externalizing behavior. However, estimates of the magnitude of this association across existing studies are inconsistent. Such inconsistencies cloud the interpretation of the literature and highlight the need for a systematic synthesis of existing empirical evidence. Further, the roles of possible moderators in the association remain to be revealed. Moderation analyses will enhance the field's capacity to evaluate needs and locate a subgroup of children born to teen mothers with particularly heightened vulnerabilities. To address these gaps, the present study had two primary aims. First, a meta-analysis was conducted to quantify the magnitude of the association between being born to young mothers and children's externalizing behavior across existing studies. Second, moderation meta-analyses were conducted to evaluate whether the influence of being born to teen mothers on children's externalizing behavior is stronger during specific developmental periods, for a specific gender, for a specific race, or across contexts with varying teen pregnancy rates at a societal level. The current study followed the PRISMA guidelines. The search utilized multiple electronic databases including Web of Science, ProQuest, PubMed, and Ovid MEDLINE through July 2019. Standardized mean difference, Cohen's d, was used as a summary estimate of effect size. A random-effects model was conducted. Moderating effects were evaluated. Twenty-one effect sizes from 18 independent samples (n = 133,585) were included in the meta-analysis. The main meta-analysis and sensitivity analysis suggested a small yet robust association between teenage motherhood and children's externalizing behavior problems. The relevant moderation analyses detected no statistically significant moderating effect for a specific gender, for racial and ethnic minority groups, during a specific developmental period, or across varying contexts. The current meta-analysis findings suggest that the impact of young maternal age on children's externalizing behavior is small, yet independent. Further, such impacts of young maternal age were similar for girls and boys, in different racial and ethnic groups, across developmental periods, and across different contexts with varying teen pregnancy rates. Prevention efforts seeking to curb the emergence of youth's externalizing behavior should focus on parenting teens, regardless of their child's gender, race, age, or contexts. Further, the current findings suggest that prevention strategies for this specific group may benefit from a hybrid approach that combines universal, selective, and indicated prevention strategies.

Dataset Information

Meta-meta-analysis on the effectiveness of parent-based interventions for the treatment of child externalizing behavior problems.

Publications

Meta-meta-analysis on the effectiveness of parent-based interventions for the treatment of child externalizing behavior problems.

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