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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References
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington DC: American Psychiatric Association.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington DC: American Psychiatric Association.
Andersen, S. M., & Chen, S. (2002). The relational self: An interpersonal social-cognitive theory. Psychological Review, 109, 619–645. doi:10.1037//0033-295X.109.4.619.
Anderson, S. R., & Ollendick, T. H. (2012). Diagnosing oppositional defiant disorder using the anxiety disorders interview schedule for DSM-IV: Parent version and the diagnostic interview schedule for children. Psychopathology and Behavioral Assessment, 34, 467–475.
Angold, A., Costello, E., & Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry, 40, 57–97.
Arbunkle, J. L. (1996). Full information estimation in the presence of incomplete data. In G. A. Marcoulides & R. E. Schumacker (Eds.), Advanced structural equation modeling (pp. 243–277). Mahwah, NJ: Erlbaum.
Barkley, R. A. (1997). Defiant children: A clinician’s manual for parent training (2nd ed.). New York: Guilford Press.
Bauer, D. J., & Curran, P. J. (2005). Probing interactions in fixed and multilevel regression: Inferential and graphical techniques. Multivariate Behavioral Research, 40, 373–400.
Beauchaine, T. P., Webster-Stratton, C., & Reid, M. J. (2005). Mediators, moderators, and predictors of 1-year outcomes among children treated for early-onset conduct problems: A latent growth curve analysis. Journal of Consulting and Clinical Psychology, 73, 371–388. doi:10.1037/0022-006X.73.3.371.
Beiderman, J., Faraone, S. V., Milberger, S., Jetton, J. G., Chen, L., Mick, E., et al. (1996). Is childhood oppositional defiant disorder a precursor to adolescent conduct disorder? Findings from a four-year follow-up study of children with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 1193–1204. doi:10.1097/00004583-199609000-00017.
Brestan, E. V., & Eyberg, S. M. (1998). Effective psychosocial treatments of conduct-disordered children and adolescents: 29 years, 82 studies, and 5,272 kids. Journal of Clinical Child Psychology, 27, 180–189.
Burke, J. D., Loeber, R., & Birmaher, B. (2000). Oppositional defiant disorder and conduct disorder: A review of the past 10 years, part II. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1275–1293.
Burt, S. A., McGue, M., Krueger, R. F., & Iacono, W. G. (2005). How are parent-child conflict and childhood externalizing symptoms related over time? Results from a genetically informative cross-lagged study. Developmental Psychopathology, 17, 145–165.
Cooley, C. H. (1902). Human nature and the social order. New York: Scribner.
Crick, N. R., & Dodge, K. A. (1996). Social information-processing mechanisms in reactive and proactive aggression. Child Development, 67, 993–1002.
Dodge, K. A., Lansford, J. E., Burks, V. S., Bates, J. E., Pettit, G. S., Fontaine, R., & Price, J. M. (2003). Peer rejection and social information-processing factors in the development of aggressive behavior problems in children. Child Development, 74, 374–393.
Edens, J. F., Cavell, T. A., & Hughes, J. N. (1999). The self-systems of aggressive children: A cluster-analytic investigation. Journal of Child Psychology and Psychiatry, 40, 441–453.
Edwards, G., Barkley, R. A., Laneri, M., Fletcher, K., & Metevia, L. (2001). Parent–adolescent conflict in teenagers with ADHD and ODD. Journal of Abnormal Child Psychology, 29, 557–572.
Eisenberg, N., Zhou, Q., Spinrad, T. L., Valiente, C., Fabes, R. A., & Liew, J. (2005). Relations among positive parenting, children’s effortful control, and externalizing problems: A three-wave longitudinal study. Child Development, 76, 1055–1071.
Enders, C. K., & Bandalos, D. L. (2001). The relative performance of full information maximum likelihood estimation for missing data in structural equation mdoels. Structural Equation Modeling, 8, 430–457.
Epstein, T., & Saltzman-Benaiah, J. (2010). Parenting children with disruptive behaviors: Evaluation of a collaborative problem solving pilot program. Journal of Clinical Psychology Practice, 2010, 27–40. doi:10.1023/A:1021803005547.
Eyberg, S. M., Nelson, M. M., & Boggs, S. R. (2008). Evidence-based psychosocial treatments for children and adolescents with disruptive behavior. Journal of Clinical Child & Adolescent Psychology, 37, 215–237. doi:10.1080/15374410701820117.
Fergusson, D. M., John Horwood, L., & Ridder, E. M. (2005). Show me the child at seven: The consequences of conduct problems in childhood for psychosocial functioning in adulthood. Journal of Child Psychology and Psychiatry, 46, 837–849. doi:10.1111/j.1469-7610.2004.00387.x.
Frick, P. J., Cornell, A. H., Barry, C. T., Bodin, S. D., & Dane, H. E. (2003). Callous-unemotional traits and conduct problems in the prediction of conduct problem severity, aggression, and self-report of delinquency. Journal of Abnormal Child Psychology, 31, 457–470.
Frick, P. J., & Ellis, M. (1998). Callous-unemotional traits and subtypes of conduct disorder. Clinical Child and Family Psychology Review, 2, 149–168.
Frick, P. J., & Loney, B. R. (1999). Outcomes of children and adolescents with oppositional defiant disorder and conduct disorder. In H. C. Quay & A. Hogan (Eds.), Handbook of disruptive behavior disorders (pp. 507–524). New York: Plenum.
Frick, P. J., & McMahon, R. J. (2008). Child and adolescent conduct problems. In J. Hunsley & E. J. Mash (Eds.), A Guide to assessments that work (pp. 41–66). New York: Oxford University Press.
Frick, P. J., Stickle, T. R., Dandreaux, D. M., Farrell, J. M., & Kimonis, E. R. (2005). Callous-unemotional traits in predicting the severity and stability of conduct problems and delinquency. Journal of Abnormal Child Psychology, 33, 471–487. doi:10.1007/s10648-005-5728-9.
Gilman, R., Huebner, E. S., & Laughlin, J. E. (2000). A first study of the multidimensional students’ life satisfaction scale with adolescents. Social Indicators Research, 52, 135–160.
Greene, R. W. (1998). The explosive child. New York: Harper Collins.
Greene, R. W. (2010). Collaborative problem solving. In R. C. Murrihy, A. D. Kidman, & T. H. Ollendick (Eds.), Clinical handbook of assessing and treating conduct problems in youth (pp. 193–220). doi:10.1007/978-1-4419-6297-3_8
Greene, R. W., Biederman, J., Zerwas, S., Monuteaux, M. C., Goring, J. C., & Faraone, S. V. (2002). Psychiatric comorbidity, family dysfunction, and social impairment in referred youth with oppositional defiant disorder. American Journal of Psychiatry, 159, 1214–1224.
Greene, R. W., & Ollendick, T. H. (2000). Behavioral assessment of children. In G. Goldstein & M. Hersen (Eds.), Handbook of psychological assessment (3rd ed., pp. 453–470). Oxford: Elsevier Science Ltd.
Hoza, B., Pelham, W. E, Jr, Dobbs, J., Owens, J. S., & Pillow, D. R. (2002). Do boys with attention-deficit/hyperactivity disorder have positive illusory self-concepts? Journal of Abnormal Psychology, 111, 268–278. doi:10.1037//0021-843X.111.2.268.
Ingoldsby, E. M., Shaw, D. S., Winslow, E., Schonberg, M., Gilliom, M., & Criss, M. M. (2006). Neighborhood disadvantage, parent-child conflict, neighborhood peer relationships, and early antisocial behavior problem trajectories. Journal of Abnormal Child Psychology, 34, 293–309. doi:10.1007/s10802-006-9026-y.
Kamphaus, R. W., & Frick, P. J. (2005). Clinical assessment of children and adolescent personality and behavior. Boston: Allyn & Bacon.
Kazdin, A. E. (2005). Parent management training: Treatment for oppositional, aggressive, and antisocial behavior in children and adolescents. New York: Oxford University Press.
Kimonis, E. R., & Frick, P. J. (2010). Oppositional defiant disorder and conduct disorder grown-up. Journal of Developmental and Behavioral Pediatrics, 31, 244–254.
Laursen, B., & Mooney, K. S. (2008). Relationship network quality. Adolescent adjustment and perceptions of relationships with parents and friends. American Journal of Orthopsychiatry, 78, 47–53. doi:10.1037/0002-9432.78.1.47.
Maughan, B., Rowe, R., Messer, J., Goodman, R., & Meltzer, H. (2004). Conduct disorder and oppositional defiant disorder in a national sample: Developmental epidemiology. Journal of Child Psychology and Psychiatry, 45, 609–621. doi:10.1111/j.1469-7610.2004.00250.x.
Mead, G. H. (1934). Mind, self, and society. Chicago: University of Chicago Press.
Murrihy, R. C., Kidman, A. D., & Ollendick, T. H. (2010). Clinical handbook of assessing and treating conduct problems in youth. New York: Springer.
Nixon, R. D. V., Sweeney, L., Erickson, D. B., & Touyz, S. W. (2003). Parent-child interaction therapy: A comparison of standard and abbreviated treatments for oppositional defiant preschoolers. Journal of Counseling and Clinical Psychology, 71, 251–260. doi:10.1037/0022-006X.71.2.251.
Olinsky, A., Chen, S., & Harlow, L. (2003). The comparative efficacy of imputation methods for missing data in structural equation modeling. European Journal of Operational Research, 151, 53–79.
Ollendick, T. H., Greene, R. W., Austin, K. E., Fraire, M. G., Halldorsdottir, T., Allen, K. B., et al. (in press). Parent management training and collaborative & proactive solutions: A randomized control trial for oppositional youth. Journal of Clinical Child and Adolescent Psychology. doi:10.1080/15374416.2015.1004681
Pasalich, D. S., Dadds, M. R., Vincent, L. C., Cooper, F. A., Jawes, D. J., & Brennan, J. (2012). Emotional communication in families of conduct problem children with high and low callous-unemotional traits. Journal of Clinical Child and Adolescent Psychology, 41, 302–313.
Pelham, W. E., Gnagy, E. M., Greenslade, K., & Milich, R. (1992). Teacher ratings of DSM-III-R symptoms for the disruptive behavior disorders. Journal of American Academy of Child and Adolescent Psychiatry, 31, 210–218. doi:10.1097/00004583-199203000-00006.
Preacher, K. J., Curran, P. J., & Bauer, D. J. (2006). Computational tools for probing interactions in multiple linear regression, multilevel modeling, and latent curve analysis. Journal of Educational and Behavioral Statistics, 31, 437–448.
Rapee, R. M., & Lim, L. (1992). Discrepancy between self- and observer ratings of performance in social phobics. Journal of Abnormal Psychology, 101, 728–731.
Reid, M. J., Webster-Stratton, C., & Hammond, M. (2003). Follow-up of children who received the incredible years intervention for oppositional-defiant disorder: Maintenance and prediction of 2-year outcome. Behavior Therapy, 34, 471–491.
Reynolds, C. R., & Kamphaus, R. W. (2000). Behavior assessment system for children (2nd ed.). Circle Pines, MN: American Guidance Service.
Rhodes, T. E., & Dadds, M. R. (2010). Assessment of conduct problems using an integrated, process-oriented approach. In R. C. Murrihy, A. D. Kidnman, & T. H. Ollendick (Eds.), Clinical handbook of assessing and treating conduct problems in youth (pp. 77–116). New York: Springer.
Rosseel, Y. (2012). lavaan: An R package for structural equation modeling. Journal of Statistics Software, 48, 1–36.
Scott, S., Briskman, J., & O’Connor, T. G. (2014). Early prevention of antisocial personality: Long-term follow-up of two randomized controlled trials comparing indicated and selective approaches. American Journal of Psychiatry, 171, 649–657.
Shrauger, J. S., & Schoeneman, T. J. (1979). Symbolic interactionist view of self-concept: Through the looking glass darkly. Psychological Bulletin, 86, 549–573.
Silver, R. B., Measelle, J. R., Armstrong, J. M., & Essex, M. J. (2011). The impact of parents, child care providers, teachers, and peers on early externalizing trajectories. Journal of School Psychology, 48, 555–583. doi:10.1016/j.jsp.2010.08.003.
Silverman, W. K., & Albano, A. M. (1996). The anxiety disorders interview schedule for children for DSM-IB: Child and parent versions. San Antonio: Psychological Corporation.
South, S. C., Oltmanns, T. F., Johnson, J., & Turkheimer, E. (2011). Level of agreement between self and spouse in the assessment of personality pathology. Assessment, 18, 217–226. doi:10.1177/1073191110394772.
Stringaris, A., Maufhan, B., & Goodman, R. (2010). What’s in a disruptive disorder? Temperamental antecedents of oppositional defiant disorder: Findings from the Avon Longitudinal Study. Journal of the American Academy of Child and Adolescent Psychiatry, 49, 474–483.
Tesser, A. (2002). Constructing a niche for the self: A bio-social, PDP approach to understanding lives (special issue: Self-concept, self-regulation, and psychological vulnerability). Self and Identity, 1, 185–190.
Urquiza, A. J., & Timmer, S. (2012). Parent-child interaction therapy: Enhancing parent-child relationships. Psychosocial Intervention, 21, 145–156. doi:10.5093/in2012a16.
van Aken, M. A. G., & Asendorpf, J. B. (1997). Support by parents, classmates, friends and siblings in preadolescence: Covariation and compensation across relationships. Journal of Social and Personal Relationships, 14, 79–93.
Vickers, A. J., & Altman, D. G. (2001). Analyzing controlled trials with baseline and follow-up measurements. British Medical Journal, 323, 1123–1124. doi:10.1136/bmj.323.7321.1123.
Webster-Stratton, C., Reid, M. J., & Hammond, M. (2004). Treating children with early-onset conduct problems: Intervention outcomes for parent, child, and teacher-training. Journal of Clinical Child and Adolescent Psychology, 33, 105–124. doi:10.1207/S15374424JCCP3301-11.
White, B. A., Jarrett, M. A., & Ollendick, T. H. (2013). Self-regulation deficits explain the deficits between reactive aggression and internalizing and externalizing behavior problems. Journal of Psychopathology and Behavioral Assessment, 35, 1–9.
Wolke, D., & Samara, M. M. (2004). Bullied by siblings: Association with peer victimization and behaviour problems in Israeli lower secondary children. Journal of Child Psychology and Psychiatry, 45, 1015–1029.
Wolke, D., Woods, S., Bloomfield, L., & Karstadt, L. (2000). The association between direct and relational bullying and behavior problems among primary school children. Journal of Child Psychology and Psychiatry, 41, 989–1002. doi:10.1111/1469-7610.00687.
Woodworth, M., & Waschbusch, D. (2007). Emotional processing in children with conduct problems and callous/unemotional traits. Child: Care Health, and Development, 34, 234–244. doi:10.1111/j.1365-2214.2007.00792.x.
Wootton, J. M., Frick, P. J., Shelton, K. K., & Silverthorn, P. (1997). Ineffective parenting and childhood conduct problems: The moderating role of callous-unemotional traits. Journal of Consulting and Clinical Psychology, 65, 301–308.
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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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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DOI: https://doi.org/10.1007/s10826-015-0323-3