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Perceived Parent–Child Relations, Conduct Problems, and Clinical Improvement Following the Treatment of Oppositional Defiant Disorder

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Abstract

Our objective in this study was to examine the moderating influence of parent–child relationship quality (as viewed by the child) on associations between conduct problems and treatment responses for children with oppositional defiant disorder (ODD). To date, few studies have considered children’s perceptions of relationship quality with parents in clinical contexts even though extant studies show the importance of this factor in children’s behavioral adjustment in non-clinical settings. In this study, 123 children (ages 7–14 years, 61.8 % male, 83.7 % white) who fulfilled DSM-IV criteria for ODD received one of two psychosocial treatments: Parent Management Training or Collaborative and Proactive Solutions. In an earlier study, both treatments were found to be effective and equivalent in treatment outcomes. In the current study, pre-treatment maternal reports of conduct problems and pre-treatment child reports of relations with parents were used to predict outcomes in ODD symptoms and their severity following treatment. Elevated reports of children’s conduct problems were associated with attenuated reductions in both ODD symptoms and their severity. Perceived relationship quality with parents moderated the ties between conduct problems and outcomes in ODD severity but not the number of symptoms. Mother reports of elevated conduct problems predicted attenuated treatment response only when children viewed relationship quality with their parents as poorer. When children viewed the relationship as higher quality, they did not show an attenuated treatment response, regardless of reported conduct problems. The current findings underscore the importance of children’s perspectives in treatment response and reductions in externalizing child behaviors.

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Acknowledgments

Funding was provided by R01 MH59308 from NIMH and by the Institute for Society, Culture, and Environment at Virginia Tech. We wish to express appreciation to the graduate students and research scientists who assisted us with various aspects of this project, including data reduction, assessment, and treatment of these youth. We also wish to extend thanks to the many undergraduate students at Virginia Tech who assisted us with data coding, entry, and verification. Finally, we are grateful to the youth and families who participated in this clinical research.

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Authors and Affiliations

  1. Family Narratives Lab, Department of Psychology, Emory University, 36 Eagle Row, Psychology and Interdisciplinary Sciences Building, Atlanta, GA, 30322, USA

    Jordan A. Booker

  2. Child Study Center, Department of Psychology, Virginia Tech, Blacksburg, VA, USA

    Thomas H. Ollendick & Ross W. Greene

  3. Social Development Lab, Department of Psychology, Virginia Tech, Blacksburg, VA, USA

    Julie C. Dunsmore

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  1. Jordan A. Booker
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  2. Thomas H. Ollendick
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  3. Julie C. Dunsmore
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  4. Ross W. Greene
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Booker, J.A., Ollendick, T.H., Dunsmore, J.C. et al. Perceived Parent–Child Relations, Conduct Problems, and Clinical Improvement Following the Treatment of Oppositional Defiant Disorder. J Child Fam Stud 25, 1623–1633 (2016). https://doi.org/10.1007/s10826-015-0323-3

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