Change in Maternal Stress for Families in Treatment for their Children with Oppositional Defiant Disorder
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Our objective was to predict change in maternal stress over the course of a randomized clinical trial comparing the efficacy of two interventions for Oppositional Defiant Disorder (ODD): Parent Management Training and Collaborative & Proactive Solutions. In a secondary analysis of data collected from this randomized clinical trial, we examined whether children’s self-reported positive relations with their parents impacted responsiveness to treatment, which in turn impacted maternal stress. One hundred thirty-four children and their parents (38.1% female, ages 7–14, M age = 9.51, SD = 1.77) were tracked across three time points: pre-treatment; one-week post-treatment; and six-month post-treatment. Hierarchical linear models tested change in children’s reports of positive relations with parents, clinician reports of ODD severity, and maternal reports of parenting stress. Models then tested multilevel mediation from positive relations with parents, through ODD severity, onto maternal stress. Hypothesized indirect effects were supported such that children’s reports of positive views toward parents uniquely predicted reductions in ODD severity over time, which in turn uniquely predicted reductions in maternal stress. Results highlight the promise of potential secondary benefits for parents following interventions for children with oppositional problems. Furthermore, results underscore the importance of the parent–child relationship as both a protective factor and as an additional target to complement interventions for child disruptive behaviors.
KeywordsOppositional defiant disorder Parent–child relationship Maternal stress
Funding was provided by R01 MH076141 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.
J.A.B.: Conducted the data analyses and contributed to writing the paper. N.N.C.-H.: Contributed to data analyses and writing the paper. J.C.D.: Contributed to the study design and editing the paper. R.W.G.: Co-designed the study, contributed to editing the paper. T.H.O.: PI of the grant supporting this research, co-designed and executed the study, contributed to writing and editing the paper.
Compliance with Ethical Standards
Conflict of Interest
R.W.G.: Received royalties related to work concerning Collaborative and Proactive Solutions. The remaining authors declare that they have no conflict of interest.
All procedures performed in this study were in accordance with the ethical standards of the overseeing institutional review board and with the 1964 Helsinki declaration and its later amendments.
All participating families completed informed consent and informed assent before participating.
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