Aggression is a characteristic feature of many psychiatric disorders. To address the scarceness for evidence-based interventions for behavioral problems in Pakistan, we evaluated the effectiveness of culturally adapted version of Coping Power Program. The purpose of the study was to determine the extent to which Coping Power Program is capable of reducing aggressive behavior and improving competent behavior, when delivered in a different culture, i.e., Pakistan. With randomized control trial (RCT) of pre- and post-testing, 112 fourth grade boys were allocated to Coping Power intervention condition and waitlist control condition. The intervention group showed significant reduction in aggression at post assessment, in comparison to control group. Boys who received Coping Power intervention also showed improvements in behavior, social skills, and social cognitive processes, with better anger control and problem solving strategies, in comparison to the control group. The results of the study provide preliminary evidence, supporting the effectiveness of Coping Power Program for Pakistani children. Despite its limitations, the results of this study are promising and suggest that Coping Power is an effective intervention to reduce behavioral problems and promote healthy and positive behaviors in children, even when implemented in different contexts with greater potential for violence exposure.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Azam, S., & Aftab, R. (2012). Social problem solving styles, acting-out tendencies, and aggression in boys and girls. Pakistan Journal of Psychological Research, 27, 121–134.
Barrera, M., Jr., & Castro, F. G. (2006). A heuristic framework for the cultural adaptation of interventions. Clinical Psychology: Science and Practice, 13, 311–316.
Bruckner, T. A., Scheffler, R. M., Shen, G., Yoon, J., Chisholm, D., Morris, J., Fulton, B. D., Dal Poz, M. R., & Saxena, S. (2011). The mental health workforce gap in low- and middle-income countries: A needs-based approach. Bulletin of the World Health Organization, 89, 184–194.
Capaldi, D. M., & Rothbart, M. K. (1992). Development and validation of an early adolescent temperament measure. Journal of Early Adolescence, 12, 153–173.
Caspi, A., Henry, B., McGee, R. O., Moffitt, T. E., & Silva, P. A. (1995). Temperamental origins of child and adolescent behavior problems: From age three to fifteen. Child Development, 66, 55–68.
Coie, J. D., & Dodge, K. A. (1988). Multiple sources of data on social behavior and social status in the school: A cross-age comparison. Child Development, 59, 815–829.
Conduct Problems Prevention Research Group. (1999). Initial impact of the fast track prevention trial for conduct problems: I. The high-risk sample. Journal of Consulting and Clinical Psychology, 67, 631–647.
Coy, K., Speltz, M. L., DeKlyen, M., & Jones, K. (2001). Social-cognitive processes in preschool boys with and without oppositional defiant disorder. Journal of Abnormal Child Psychology, 29, 107–119.
Crick, N. R., & Dodge, K. A. (1994). A review and reformulation of social information-processing mechanisms in children’s social adjustment. Psychological Bulletin, 115, 74–101.
Dodge, K. A. (2006). Translational science in action: Hostile attributional style and the development of aggressive behavior problems. Development and Psychopathology, 18, 791–814.
Dodge, K. A., & Coie, J. D. (1987). Social information processing factors in reactive and proactive aggression in children’s peer groups. Journal of Personality and Social Psychology, 53, 1146–1158.
Dodge, K. A., Pettit, G. S., McClaskey, C. L., & Brown, M. M. (1986). Social competence in children. Monographs of the Society for Research in Child Development, 51, 1–85.
Dunn, S. E., Lochman, J. E., & Colder, C. (1997). Social problem-solving skills in boys with conduct and oppositional defiant disorders. Aggressive Behavior, 23, 457–469.
Gadit, A. A. M. (2009). Terrorism and mental health: The issue of psychological fragility. Journal of Pakistan Medical Association, 59, 725–726.
Frazzetto, G., Di Lorenzo, G., Carola, V., Proietti, L., Sokolowska, A., Gross, C., & Troisi, A. (2007). Early trauma and increased risk for physical aggression during adulthood: The moderating role of MAOA genotype. PLoS One, 2, e486.
Guerra, N. G., Huesman, L. R., & Spindler, A. (2003). Community violence exposure, social cognition, and aggression among urban elementary school children. Child Development, 74, 1561–1576.
Haselager, G. J. T., Cillessen, A. H. N., Van Lieshout, C. F. M., Riksen-Walraven, J. M. A., & Hartup, W. W. (2002). Heterogeneity among peer-rejected boys across middle childhood: Developmental pathways of social behavior. Developmental Psychology, 38, 446–456.
Hewitt, J. K., Silbert, J. L., Neale, M. C., Eaves, L. J., & Erickson, M. (1992). The analysis of parental ratings of children’s behavior using LISREL. Behavior Genetics, 22, 293–317.
Hill, L. G., Lochman, J. E., Coie, J. D., Greenberg, M. T., & Conduct Problems Prevention Research Group. (2004). Effectiveness of early screening for externalizing problems: Issues of screening accuracy and utility. Journal of Consulting and Clinical Psychology, 72, 809–820.
Holmbeck, G. N., Greenley, R. N., & Franks, E. A. (2003). Developmental issues and considerations in research and practice. In A. Kazdin & J. Weisz (Eds.), Evidence-based psychotherapies for children and adolescents (pp. 21–40). New York: Guilford Press.
Horton, C. (2003). Protective factors literature review: Early care and education programs and the prevention of child abuse and neglect. Washington, DC: Center for the Study of Social Policy.
Huesman, L. R., Eron, L. D., Lefkowitz, M. M., & Walder, L. O. (1984). Stability of aggression over time and generations. Developmental Psychology, 20, 1120–1134.
Kazdin, A. E. (1995). Child, parent, and family dysfunction as predictors of outcome in cognitive-behavioral treatment of antisocial children. Behaviour Research and Therapy, 33, 271–281.
Lahey, B. B., Loeber, R., Quay, H. C., Applegate, B., Shaffer, D., Waldman, I., Hart, E. L., McBurnett, K., Frick, P. J., Jensen, P. S., Dulcan, M. K., Canino, G., & Bird, H. (1998). Validity of DSM-IV subtypes of conduct disorder based on age of onset. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 435–442.
Laird, R. D., Jordan, K. Y., Dodge, K. A., Pettit, G. S., & Bates, J. E. (2001). Peer rejection in childhood, involvement with antisocial peers in early adolescence, and the development of externalizing behavior problems. Development and Psychopathology, 13, 337–354.
Lochman, J. E. (2006). School-based programs for prevention of aggression. In N. Heinrichs, K. Hahlweg, & M. Dopner (Eds.), Strengthening families: Evidence-based approaches to support child mental health (pp. 221–254). Germany: Verlag: Munster.
Lochman, J. E., Baden, R. E., Boxmeyer, C. L., Powell, N. P., Qu, L., Salekin, K. L., & Windle, M. (2014). Does a booster intervention augment the preventive effects of an abbreviated version of the Coping Power Program for aggressive children? Journal of Abnormal Child Psychology, 42, 367–381.
Lochman, J.E., Barry, T.D., Barth, J., Wells, K.C. (2001). The influence of neighborhood context on children’s aggressive and academic behaviors. Paper presented at the Life History Research Society Meeting, St. Michaels, Maryland.
Lochman, J. E., Burch, P. R., Curry, J. F., & Lampron, L. B. (1984). Treatment and generalization effects of cognitive-behavioral and goal-setting interventions with aggressive boys. Journal of Consulting and Clinical Psychology, 52, 915–916.
Lochman, J. E., & The Conduct Problems Prevention Research Group (CPPRG). (1995). Screening of child behavior problems for prevention programs at school entry. Journal of Consulting and Clinical Psychology, 6, 549–559.
Lochman, J. E., Dishion, T. J., Powell, N. P., Boxmeyer, C. L., Qu, L., & Sallee, M. (2015). Evidence-based preventive intervention for preadolescent aggressive children: One-year outcomes following randomization to group versus individual delivery. Journal of Consulting and Clinical Psychology, 83, 728–735.
Lochman, J. E., & Dodge, K. A. (1994). Social-cognitive processes of severely violent, moderately aggressive, and nonaggressive boys. Journal of Consulting and Clinical Psychology, 62, 366–374.
Lochman, J. E., Dunn, S. E., & Wagner, E. E. (1997). Anger. In G. Bear, K. Minke, & A. Thomas (Eds.), Children’s needs II (pp. 149–160). Washington, DC: National Association of School Psychology.
Lochman, J. E., & Gresham, F. E. (2009). Intervention development, assessment, planning, and adaptation: The importance of developmental models. In M. J. Mayer, R. Van Acker, J. E. Lochman, & F. M. Gresham (Eds.), Cognitive behavioral interventions for emotional and behavioral disorders (pp. 3–28). New York: Guilford Press.
Lochman, J. E., Powell, N. P., Boxmeyer, C. L., Qu, L., Wells, K. C., & Windle, M. (2009). Implementation of a school-based prevention program: Effects of counselor and school characteristics. Professional Psychology: Research & Practice, 40, 476–482.
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. (2002b). The Coping Power Program at the middle school transition: Universal and indicated prevention effects. Psychology of Addictive Behaviors, 16, S40–S54.
Lopez, A., Mathers, C., Ezzati, M., Jamison, D., & Murray, C. (2006). Global burden of disease and risk factors. Washington, DC: Oxford University Press and the World Bank.
Moffitt, T. E. (1993). Adolescence-limited and life course persistent antisocial behavior: A developmental taxonomy. Psychological Review, 100, 674–701.
Muratori, P., Bertacchi, I., Giuli, C., Lombardi, L., Bonetti, S., Nocentini, A., Manfredi, A., Polidori, L., Ruglioni, L., Milone, A., & Lochman, J. E. (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.
Mushtaq, A. (2007). Aggressive children’s status among peers and their social information processing styles. Unpublished M.Phil. Dissertation. National Institute of Psychology, Quaid-i-Azam University. Islamabad. Pakistan.
Mushtaq, M., & Kayani, M. M. (2013). Exploring the factors causing aggression and violence among students and its impact on our social attitude. Educational Research International, 2, 10–18.
Mytton, J. A., DiGuiseppi, C., Gough, D., Taylor, R. S., & Logan, S. (2006). School-based secondary prevention programmes for preventing violence. Cochrane Database of Systematic Reviews, 3, CD004606.
O’Donnell, S. L., Jurecska, D. E., & Dyer, R. (2012). Effectiveness of the coping power program in a Mexican-American sample: Distinctive cultural considerations. International Journal of Culture and Mental Health, 5, 30–39.
Orobio de Castro, B., Veerman, J. W., Koops, W., Bosch, J. D., & Monshouwer, H. J. (2002). Hostile attribution of intent and aggressive behavior: A meta-analysis. Child Development, 73, 916–934.
Patterson, G. R., DeBaryshe, B. D., & Ramsey, E. (1989). A developmental perspective on antisocial behavior. American Psychologist, 44, 329–335.
Perry, D. G., Perry, L. C., & Rasmussen, P. (1986). Cognitive social learning mediators of aggression. Child Development, 57, 700–711.
Powell, N. P., Boxmeyer, C. L., Baden, R., Stromeyer, S., Minney, J. A., Mushtaq, A., et al. (2011). Assessing and treating aggression and conduct problems in schools: Implications from the Coping Power Program. Psychology in the Schools, 48, 3–12.
Sharan, P., Gallo, C., Gureje, O., Lamberte, E., Mari, J. J., Mazzotti, G., Patel, V., Swartz, L., Olifson, S., Levav, I., de Francisco, A., Saxena, S., & Mental Health Research Maping Project Group. (2009). Mental health research priorities in low- and middle-income countries of Africa, Asia, Latin America and the Caribbean. British Journal of Psychiatry, 195, 354–363.
Syed, E. U., Hussein, S. A., & Haidry, S. E. (2009). Prevalence of emotional and behavioral problems among primary school children in Karachi, Pakistan-multi informant study. Indian Journal of Pediatrics, 76, 623–627.
Wang, P. S., Aguilar-Gaxiola, S., Alonso, J., Angermeyer, M. C., Borges, G., Bromet, E. J., Bruffaerts, R., de Girolamo, G., de Graaf, R., Gureje, O., Haro, J. M., Karam, E. G., Kessler, R. C., Kovess, V., Lane, M. C., Lee, S., Levinson, D., Ono, Y., Petukhova, M., Posada-Villa, J., Seedat, S., & Wells, J. E. (2007). Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. The Lancet, 370, 841–850.
Weisz, J. R., & Kazdin, A. E. (Eds.). (2010). Evidence based psychotherapies for children and adolescents (2nd ed.). New York: Guilford Press.
Wilson, S. J., & Lipsey, M. W. (2007). School-based interventions for aggressive and disruptive behavior: Update of a meta-analysis. American Journal of Preventive Medicine, 33, 130–143. doi:10.1016/j.amepre.2007.04.011.
World Health Organization. (2005). Child and adolescent Atlas: Resources for child and adolescent mental health. Geneva, Switzerland: Author.
World Health Organization. (2011). Mental health atlas. Pakistan Profile.
Zonnevylle-Bender, M. J. S., Matthys, W., van de Wiel, N. M. H., & Lochman, J. E. (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.
Conflict of Interest
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. John Lochman is the co-developer of the Coping Power program and receives royalties from the Oxford University Press for the Coping Power Implementation Guides for the Child Group Program and the Parent Group Program. He is also the Principal Investigator on grants from NICHD and NIDA which provide funding for intervention research on the Coping Power program.
All procedures performed in study 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. It is the Doctoral research of the First Author (Asia Mushtaq) and approved by the Syndicate/Advanced Studies and Research Board (SAS&RB) of Quaid-i-Azam University, Islamabad, Pakistan.
Informed consent was obtained from all concerned parties, i.e., school authorities, class teachers, parents, and participants (boys).
About this article
Cite this article
Mushtaq, A., Lochman, J.E., Tariq, P.N. et al. Preliminary Effectiveness Study of Coping Power Program for Aggressive Children in Pakistan. Prev Sci 18, 762–771 (2017). https://doi.org/10.1007/s11121-016-0721-9
- Coping Power Program
- Aggressive behavior
- Cultural adaptation
- Indicated intervention
- Pakistani school children