Abstract
The present study evaluates the implementation of the Coping Power Program (CPP)-Child Component in a group of patients with attention deficit/hyperactivity disorder (ADHD), and explores the effects of this treatment on changes in the primary and associated symptoms of ADHD. A clinical sample of 50 children and preadolescents (8–13 years) with ADHD was involved. The clinical sample was split into a treatment group (TG; N = 26), which was included in the child training program (CPP), and a control group (CG; N = 24), which was placed on a waiting list. The Clinical Global Impression-Severity (CGI-S) and the Child Behavior Checklist 6–18 (CBCL 6–18) were assessed at baseline and at the end of treatment. The outcomes were assessed as a CBCL-subscale response rate and a CGI-S shift. Our results showed a significant improvement in children’s global functioning and in emotional and behavioral symptoms. The children in the TG were more likely to shift from a more severe functional impairment class to a less severe one (69.2% of TG vs. 20.8% of CG). Further, the CGI-S scores diminished significantly in the TG (p < 0.01). There were significant differences in the changes in Social Problems (p < 0.05), Attention Problems (p < 0.05) and Rule-Breaking Behavior Scales (p < 0.05). CPP seemed to be effective in children and adolescents with ADHD without comorbidity for ODD or CD. Our study revealed an improved outcome, not only in the core symptoms of ADHD, but also in global functioning and social adjustment. Possible improvements to the present formulation of CPP-C are discussed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school-age forms and profiles. Burlington: University of Vermont, Department of Psychiatry.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. 5th edn Arlington, VA: American Psychiatric Publishing.
Barbaresi, W. J., Katusic, S. K., Colligan, R. C., Weaver, A. L., & Jacobsen, S. J. (2007). Long-term school outcomes for children with attention-deficit/hyperactivity disorder: a population-based perspective. Journal of Developmental & Behavioral Pediatrics, 28(4), 265–273.
Biederman, J., Monuteaux, M. C., Kendrick, E., Klein, K. L., & Faraone, S. V. (2005). The CBCL as a screen for psychiatric comorbidity in paediatric patients with ADHD. Archives of Disease in Childhood, 90, 1010–1015.
Conners, C. K. (1997). Conners’ rating scales–revised (technical manual). Toronto, Ontario, Canada: Multi-Health Systems.
Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied behavior analysis. 2nd Edn. Upper Saddle River, NJ: Pearson.
Douglas, V. I. (1983). Attentional and cognitive problems. In M. Rutter (Ed.) Developmental neuropsychiatry. (pp. 280–329). New York, NY: Guilford Press.
Evans, S., Ling, M., Hill, B., Rinehart, N., Austin, D., Sciberras, E. (2017). Systematic review of meditation-based interventions for children with ADHD, European Child and Adolescent Psychiatry, 27(1) 1–19.
Geeraerts, S. B., Deutz, M. H. F., Deković, M., Bunte, T., Schoemaker, K., & Espy, K. A. et al. (2015). The child behavior checklist dysregulation profile in preschool children: a broad dysregulation syndrome. Journal of the American Academy of Child and Adolescent Psychiatry, 54, 595–602.
Goodman, R., Ford, T., Richards, H., Gatward, R., & Meltzer, H. (2000). The development and well-being assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. Journal of Child Psychology and Psychiatry, 41, 645–655.
Guy, W. (1976). Clinical global impressions. In W. Guy (Ed.), ECDEU assessment manual for psychopharmacology (pp. 218–222). Rockville, MD: National Institute for Mental Health. Revised DHEW Pub. (ADM).
Hetlinger, C. A., Simpkins, C. G., & Combs-Orme, T. (2000). Using the CBCL to Determine the Clinical Status of Children in State Custody. Children and Youth Services Review, 22, 55–73.
Hollingshead, A. A. (1975). Four-factor index of social status. New Haven, CT: Yale University.
Keng, S. L., Smoski, M. J., & Robins, C. J. (2011). Effects of mindfulness on psychological health: a review of empirical studies. Clinical Psychology Review, 31(6), 1041–1056.
Lochman, J.E., Wells, K.C., & Lenhart, L.A. (2008). Coping power: child group facilitator’s guide (Vol. 2). New York, NY: Oxford University Press.
Lochman, J. E., & Wells, K. C. (2004). The coping power program for preadolescent aggressive boys and their parents: outcome effects at the 1-year follow-up. Journal of Consulting and Clinical Psychology, 72, 571–578.
Lochman, J. E., & Wells, K. C. (2003). Effectiveness of the coping power program and of classroom intervention with aggressive children: outcomes at a 1-year follow-up. Behavior Therapy, 34, 493–515.
Lochman, J. E., & Wells, K. C. (2002a). Contextual social-cognitive mediators and child outcome: a test of the theoretical model in the Coping Power Program. Development and Psychopathology, 14, 945–967.
Lochman, J. E., & Wells, K. C. (2002). The Psychology of Addictive Behaviors, 16, S40–S54.
Lochman, J. E., Nelson, W. M., & Sims, J. P. (1981). A cognitive behavioral program for use with aggressive children. Journal of Clinical Child Psychology, 10, 146–148.
Masi, G., Milone, A., Paciello, M., Lenzi, F., Muratori, P., & Manfredi, A. et al. (2014). Efficacy of a multimodal treatment for disruptive behaviour disorders in children and adolescents: focus on internalizing problems. Psychiatry Research, 219, 617–624.
Masi, G., Muratori, P., Manfredi, A., Lenzi, F., Polidori, L., & Ruglioni, L. et al. (2013). Response to treatments in youth with disruptive behavior disorders. Comprehensive Psychiatry, 54, 1009–1015.
Muratori, P., Bertacchi, I., Giuli, C., Lombardi, L., Bonetti, S., & Nocentini, A. et al. (2015). First adaptation of coping power program as a classroom-based prevention intervention on aggressive behaviors among elementary school children. Prevention Science, 16, 432–439.
Muratori, P., Polidori, L., Lambruschi, F., Lenzi, F., Manfredi, A., & Ruglioni, L. et al. (2013). Un modello di trattamento in setting di gruppo per i Disturbi da Comportamento Dirompente in età evolutiva: Il pisa coping power program. Psicologia Clinica dello Sviluppo, 17, 411–428.
Pelham, W. E., & Milich, R. (1984). Peer relations in children with hyperactivity/attention deficit disorder. Journal of Learning Disabilities, 17, 560–567.
Peyre, H., Speranza, M., Cortese, S., Wohl, M., & Purper-Ouakil, D. (2015). Do ADHD children with and without child behavior checklist–dysregulation profile have different clinical characteristics, cognitive features, and treatment outcomes? Journal of Attention Disorders, 19, 63–71.
Piazza, C. C., Fisher, W. W., Hanley, G. P., Remick, M. L., Contrucci, S. A., & Aitken, T. L. (1997). The use of positive and negative reinforcement in the treatment of escape-maintained destructive behavior. Journal of Applied Behavior Analysis, 30(2), 279–298.
Pourat, N., Zima, B.T., & Marti, A.L.C. (2016). Standardized outcome measures literature scans. UCLA Standardized Outcome Measures Report.
Rohde, L. A., & Halpern, R. (2004). Recent advances on attention deficit/hyperactivity disorder. Jornal Délelőtt Pediatria, 80(2), 61–70.
Sagvolden, T., Russell, V. A., Aase, H., Johansen, E. B., & Farshbaf, M. (2005). Rodent models of attention-deficit/hyperactivity disorder. Biological Psychiatry, 57, 1239–1247.
SINPIA Linee-guida per la diagnosi e la terapia farmacologica del Disturbo da Deficit Attentivo con Iperattività (ADHD) in età evolutiva. (24 giugno 2002). http://www.sinpia.eu/atom/allegato/149.pdf. Accessed November 1, 2013.
Smith, B. H., Waschbusch, D. A., Willoughby, M. T., & Evans, S. (2000). The efficacy, safety, and practicality of treatments for adolescents with attention-deficit/hyperactivity disorder. Clinical Child and Family Psychology Review, 3, 243–267
Strine, T. W., Lesesne, C. A., Okoro, C. A., McGuire, L. C., Chapman, D. P., & Balluz, L. S., et al. (2006). Peer reviewed: emotional and behavioral difficulties and impairments in everyday functioning among children with a history of attention-deficit/hyperactivity disorder. Preventing Chronic Disease, 3(2), A52.
Van De Wiel, N. M., Matthys, W., Cohen-Kettenis, P. T., Maassen, G. H., Lochman, J. E., & Van Engeland, H. (2007). The effectiveness of an experimental treatment when compared to care as usual depends on the type of care as usual. Behavior Modification, 31, 298–312.
Van De Wiel, N. M., Matthys, W., Cohen-Kettenis, P., & Van Engeland, H. (2003). Application of the Utrecht coping power program and care as usual to children with disruptive behavior disorders in outpatient clinics: a comparative study of cost and course of treatment. Behavior Therapy, 34(4), 421–436.
Walcott, C. M., & Landau, S. (2004). The relation between disinhibition and emotion regulation in boys with attention deficit hyperactivity disorder. Journal of Clinical Child and Adolescent Psychology, 33, 772–782.
Wells, K., Lochman, J. E. & Lenhart, L. (2008). Coping power: parent group facilitator’s guide. New York, NY: Oxford University Press.
Zonnevylle-Bender, M. J. S., Matthys, W., Van De Wiel, N. M. H., & Lochman, J. (2007). Preventive effects of treatment of disruptive behavior disorder in middle childhood on substance use and delinquent behavior. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 33–39.
Author Contributions
L.V. and P.C. are the persons who wrote the first draft of the manuscript, and contributed equally to this work. L.V., A.V. and V.M. participated and coordinated all the phases of the present research, they have full access to data and they have the right to publish such data. A.V. and V.M. conducted all sessions as experienced therapists; L.V. supervised weekly as expert cognitive behavioral psychotherapist. P.C., S.B.C. and M.N. participated in designing the study and writing the protocol, in data collection, in literature search and in the discussion of the final manuscript. M.M. and M.P. participated in article preparation and revision.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
There are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Institutional Review Board (IRB) approval was obtained from Ethics Committee of Scientific Institute E. Medea (Bosisio Parini, LC).
Informed Consent
Informed consent was obtained from parents of all participants included in the study.
Additional information
These authors contributed equally: Vanzin L, Colombo P.
Rights and permissions
About this article
Cite this article
Vanzin, L., Colombo, P., Valli, A. et al. The Effectiveness of Coping Power Program for ADHD: An Observational Outcome Study. J Child Fam Stud 27, 3554–3563 (2018). https://doi.org/10.1007/s10826-018-1207-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10826-018-1207-0