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Detecting Effects of the Indicated Prevention Programme for Externalizing Problem Behaviour (PEP) on Child Symptoms, Parenting, and Parental Quality of Life in a Randomized Controlled Trial

Published online by Cambridge University Press:  08 December 2009

Charlotte Hanisch*
Affiliation:
University of Applied Sciences Düsseldorf, Germany
Inez Freund-Braier
Affiliation:
University of Cologne, Germany
Christopher Hautmann
Affiliation:
University of Cologne, Germany
Nicola Jänen
Affiliation:
University of Cologne, Germany
Julia Plück
Affiliation:
University of Cologne, Germany
Gabriele Brix
Affiliation:
University of Cologne, Germany
Ilka Eichelberger
Affiliation:
University of Cologne, Germany
Manfred Döpfner
Affiliation:
University of Cologne, Germany
*
Reprint requests to Charlotte Hanisch, University of Applied Sciences, Department of Psychology, Universitaetsstraße, Düsseldorf 40225, Germany. E-mail: charlotte.hanisch@fh-duesseldorf.de

Abstract

Background: Behavioural parent training is effective in improving child disruptive behavioural problems in preschool children by increasing parenting competence. The indicated Prevention Programme for Externalizing Problem behaviour (PEP) is a group training programme for parents and kindergarten teachers of children aged 3–6 years with externalizing behavioural problems. Aims: To evaluate the effects of PEP on child problem behaviour, parenting practices, parent-child interactions, and parental quality of life. Method: Parents and kindergarten teachers of 155 children were randomly assigned to an intervention group (n = 91) and a nontreated control group (n = 64). They rated children's problem behaviour before and after PEP training; parents also reported on their parenting practices and quality of life. Standardized play situations were video-taped and rated for parent-child interactions, e.g. parental warmth. Results: In the intention to treat analysis, mothers of the intervention group described less disruptive child behaviour and better parenting strategies, and showed more parental warmth during a standardized parent-child interaction. Dosage analyses confirmed these results for parents who attended at least five training sessions. Children were also rated to show less behaviour problems by their kindergarten teachers. Conclusions: Training effects were especially positive for parents who attended at least half of the training sessions. Abbreviations: CBCL: Child Behaviour Checklist; CII: Coder Impressions Inventory; DASS: Depression anxiety Stress Scale; HSQ: Home-situation Questionnaire; LSS: Life Satisfaction Scale; OBDT: observed behaviour during the test; PCL: Problem Checklist; PEP: prevention programme for externalizing problem behaviour; PPC: Parent Problem Checklist; PPS: Parent Practices Scale; PS: Parenting Scale; PSBC: Problem Setting and Behaviour checklist; QJPS: Questionnaire on Judging Parental Strains; SEFS: Self-Efficacy Scale; SSC: Social Support Scale; TRF: Caregiver-Teacher Report Form

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2009

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References

Achenbach, T. M. and Rescorla, L. A. (2000). Manual for the ASEBA Preschool Forms and Profiles. Burlington, VT: University of Vermont Department of Psychiatry.Google Scholar
Arbeitsgruppe Deutsche Child Behavior Checklist (1998). Elternfragebogen über das Verhalten von Kindern und Jugendlichen; deutsche Bearbeitung der Child Behavior Checklist (CBCL/4-18). Einführung und Anleitung zur Handauswertung. 2. Auflage mit deutschen Normen, bearbeitet von M. Döpfner, J. Plück, S. Bölte, P. Melchers and K. Heim. Köln: Arbeitsgruppe Kinder-, Jugend- und Familiendiagnostik (KJFD).Google Scholar
Arbeitsgruppe Deutsche Child Behavior Checklist (2002a). Elternfragebogen für Klein- und Vorschulkinder (CBCL 1½ -5). Köln: Arbeitsgruppe Kinder-, Jugend- und Familiendiagnostik (KJFD).Google Scholar
Arbeitsgruppe Deutsche Child Behavior Checklist (2002b). Fragebogen für Erzieherinnen von Klein- und Vorschulkinder (C-TRF 1½ – 5). Köln: Arbeitsgruppe Kinder-, Jugend- und Familiendiagnostik (KJFD).Google Scholar
Arnold, D. S., O'Leary, S. G., Wolff, L. S. and Acker, M. M. (1993). The parenting scale: a measure of dysfunctional parenting in discipline situations. Psychological Assessment, 5, 137144.CrossRefGoogle Scholar
Barkley, R. A. (1990). Attention-Deficit Hyperactivity Disorder: a handbook for diagnosis and treatment. New York: Guilford Press.Google Scholar
Bodenmann, G., Cina, A., Ledermann, T. and Sanders, M. R. (2008). The efficacy of the Triple P-Positive Parenting Program in improving parenting and child behavior: a comparison with two other treatment conditions. Behaviour Research and Therapy, 46, 411427.CrossRefGoogle ScholarPubMed
Bongers, I., Koot, H. M., Van Der Ende, J. and Verhulst, F. C. (2004). Developmental trajectories of externalizing behaviors in childhood and adolescence. Child Development, 75, 15231537.CrossRefGoogle ScholarPubMed
Bor, W., Sanders, M. R. and Markie-Dadds, C. (2002). The effect of the Triple P- positive parenting program on preschool children with co-occurring disruptive behavior and attentional/hyperactive difficulties. Journal of Abnormal Child Psychology, 30, 571587.CrossRefGoogle ScholarPubMed
Breuer, D. and Döpfner, M. (1997). Die Erfassung von problematischen Situationen in der Familie. Praxis der Kinderpsychologie und Kinderpsychiatrie, 46, 583596.Google Scholar
Brotman, L. M., Gouley, K. K., Chesir-Teran, D., Dennis, T., Klein, R. G. and Shrout, P. (2005). Prevention for preschoolers at high risk for conduct problems: immediate outcomes on parenting practices and social competence. Journal Child and Adolescent Psychology, 34, 724734.CrossRefGoogle ScholarPubMed
Chronis, A. M., Jones, H. A. and Raggi, V. L. (2006). Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder. Clinical Psychology Review, 26, 486502.CrossRefGoogle ScholarPubMed
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). New York: Academic Press.Google Scholar
Coleman, P. K. and Karraker, K. H. (1997). Self-efficacy and parenting quality: findings and future applications. Developmental Review, 18, 4785.CrossRefGoogle Scholar
Conduct Problems Prevention Research Group (1999). Initial impact of the Fast Track Prevention Trial for conduct problems: 1. the high-risk sample. Journal of Consulting and Clinical Psychology, 67, 631647.CrossRefGoogle Scholar
Conduct Problems Prevention Research Group (2002). Evaluation of the first 3 years of the Fast Track Prevention Trial with children at high risk for adolescent conduct problems. Journal of Abnormal Child Psychology, 30, 1935.CrossRefGoogle Scholar
Conduct Problems Prevention Research Group (2004). The effects of the Fast Track Program and serious problem outcomes at the end of elementary school. Journal of Clinical Child and Adolescent Psychology, 33, 650661.CrossRefGoogle Scholar
Conduct Problems Prevention Research Group (2007). Fast Track randomized controlled trial to prevent externalizing psychiatric disorders: findings from grades 3 to 9. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 12501262.CrossRefGoogle Scholar
Connor, D. F., Carlson, G. A., Chang, K. D., Daniolos, P. T., Ferziger, R., Findling, R. L., Hutchinson, J. G., Malone, R. P., Halperin, J. M., Plattner, B., Post, R. M., Reynolds, D. L., Rogers, K. M., Saxena, K. and Steiner, H. (2006). Juvenile maladaptive aggression: a review of prevention, treatment, and service configuration and a proposed research agenda. Journal of Clinical Psychiatry, 67, 808820.CrossRefGoogle Scholar
Côté, S., Vaillancourt, T., LeBlanc, J. C., Nagin, D. S. and Tremblay, R. E. (2006). The development of physical aggression from toddlerhood to pre-adolescence: a nation wide longitudinal study of Canadian children. Journal of Abnormal Child Psychology, 34, 7185.CrossRefGoogle ScholarPubMed
Dadds, M. R. and Powell, M. B. (1991). The relationship of interparental conflict and global marital adjustment to aggression, anxiety, and immaturity in aggressive and nonclinic children. Journal of Abnormal Child Psychology, 19, 553567.CrossRefGoogle ScholarPubMed
Daly, B. P., Creed, T., Xanthopoulos, M. and Brown, R. T. (2007). Psychosocial treatments for children with attention deficit/hyperactivity disorder. Neuropsychology Review, 17, 7389.CrossRefGoogle ScholarPubMed
Dirscherl, T., Hahlweg, K., Sanders, M. R. and von Wulfen, Y. (2007). Triple P: ein Public Health Ansatz zur Förderung der seelischen Gesundheit von Kindern und Jugendlichen durch Stärkung der elterlichen Erziehungskompetenz. Münster: PAG Institut für Psychologie AG.Google Scholar
Dodge, K. A. and Pettit, G. S. (2003). A biopsychosocial model of the development of chronic conduct problems in adolescence. Developmental Psychology, 39, 349371.CrossRefGoogle ScholarPubMed
Döpfner, M., Berner, W., Schmeck, K., Lehmkuhl, G. and Poustka, F. (1995). Internal consistencies and validity of the CBCL and the TRF in a German sample: a cross cultural comparison. In Sergeant, J. (Ed.), Eunethydis: European approaches to hyperkinetic disorder (pp. 5181). Zürich: Fotorotar, Egg.Google Scholar
Döpfner, M., Breuer, D., Schürmann, S., Wolf Metternich, T. and Lehmkuhl, G. (2004). Effectiveness of an adaptive multimodal treatment in children with attention-deficit hyperactivity disorder: global outcome. European Child and Adolescent Psychiatry, Suppl. 1, 117–129.Google Scholar
Döpfner, M. and Lehmkuhl, G. (2000). Diagnostik- System für psychische Störungen im Kinders- und Jugendalter nach ICD-10 und DSM-IV (DISYPS-KJ) (2nd ed.). Bern: Huber.Google Scholar
Döpfner, M., Schürmann, S. and Frölich, J. (2002). Therapieprogramm für Kinder mit hyperkinetischem und oppositionellem Problemverhalten (THOP) (3rd ed.). Weinheim: Beltz, Psychologie Verlags Union.Google Scholar
Dretzke, J., Frew, E., Davenport, C., Barlow, J., Stewart-Brown, S., Sandercock, J., Bayliss, S., Raftery, J., Hyde, C. and Taylor, R. (2005). The effectiveness and cost-effectiveness of parent training/education programmes for the treatment of conduct disorder, including oppositional defiant disorder, in children. Health Technology Assessment, 9, 1253.CrossRefGoogle Scholar
Drugli, M. B. and Larsson, B. (2006). Children aged 4–8 years treated with parent training and child therapy because of conduct problems: generalization effects to day-care and school settings. European Child and Adolescent Psychiatry, 15, 392399.CrossRefGoogle ScholarPubMed
Eyberg, S. M., Nelson, M. and Boggs, S. R. (2008). Evidence-based psychosocial treatments for children and adolescents with disruptive behavior. Journal of Clinical Child and Adolescent Psychology, 37, 215237.CrossRefGoogle ScholarPubMed
Farmer, E. M., Compton, S. N., Bums, B. J. and Robertson, E. (2002). Review of the evidence base for treatment of childhood psychopathology: externalizing disorders. Journal of Consulting and Clinical Psychology, 70, 12671302.CrossRefGoogle ScholarPubMed
Fydrich, T., Geyer, M., Hessel, A., Sommer, G. and Brähler, E. (1999). Fragebogen zur sozialen Unterstützung (F-SozU): Normierung an einer repräsentativen Stichprobe. Diagnostica, 45, 212216.CrossRefGoogle Scholar
Greenberg, M. T., Domitrovich, C. and Bumbarger, B. (2001). The prevention of mental disorders in school-aged children: current state of the field. Prevention and Treatment, 4, 139.CrossRefGoogle Scholar
Hahlweg, K., Heinrichs, N., Kuschel, A. and Feldmann, M. (2008). Therapist-assisted, self-administered bibliotherapy to enhance parental competence: short- and long-term effects. Behavior Modification, 32, 659681.CrossRefGoogle ScholarPubMed
Hautmann, C., Hanisch, C., Mayer, I., Plück, J. and Döpfner, M. (2008) Effectiveness of the prevention program for externalizing problem behaviour (PEP) in children with symptoms of attention-deficit/hyperactivity disorder and oppositional defiant disorder – generalization to the real world. Journal of Neural Transmission, 115, 363370.CrossRefGoogle ScholarPubMed
Heinrichs, N., Hahlweg, H., Naumann, S., Kuschel, A., Bertram, H. and Ständer, D. (2009). Universelle Prävention kindlicher Verhaltensstörungen mithilfe einer elternzentrierten Maßnahme. Zeitschrift für Klinische Psychologie und Psychotherapie, 38, 7988.CrossRefGoogle Scholar
Heinrichs, N., Bertram, H., Kuschel, A. and Hahlweg, K. (2005). Parent recruitment and retention in a universal prevention program for child behavior and emotional problems: barriers to research and program participation. Prevention Science, 6, 275286.CrossRefGoogle Scholar
Henrich, G. and Herschbach, P. (1996). Fragen zur Lebenszufriedenheit (FLZ)- ein Gewichtsmodell. In Schwarz, R., Bernhard, J., Flechtner, H., Küchler, T. and Hürny, C. (Eds.), Lebensqualität in der Onkologie (Vol. II, pp. 7793). München: Zuckschwerdt.Google Scholar
Jester, J. M., Nigg, J. T., Adams, K., Fitzgerald, H. E., Puttler, L. I., Wong, M. M. and Zucker, R. A. (2005) Inattention/hyperactivity and aggression from early childhood to adolescence: heterogeneity of trajectories and differential influence of family environment characteristics. Development and Psychopathology, 17, 99125.CrossRefGoogle ScholarPubMed
Johnston, C. and Mash, E. J. (1989). A measure of parenting satisfaction and efficacy. Journal of Clinical Child Psychology, 18, 167175.CrossRefGoogle Scholar
LeMarquand, D., Tremblay, R. E. and Vitaro, F. (2001). The prevention of conduct disorder: a review of successful and unsuccessful experiments. In Hill, J. and Maughan, B. (Eds.), Conduct Disorders in Childhood and Adolescence (pp. 449477). Cambridge: Cambridge UniversityPress.Google Scholar
Loeber, R. and Farrington, D. P. (2000). Young children who commit crime: epidemiology, developmental origins, risk factors, early interventions, and policy implications. Development and Psychopathology, 12, 737762.CrossRefGoogle ScholarPubMed
Lovibond, S. H. and Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scale (2nd ed.). Sydney, New South Wales, Australia: Psychology Foundation of Australia.Google Scholar
Lundahl, B., Risser, H. J. and Lovejoy, M. C. (2006). A meta-analysis of parent training: moderators and follow-up effects. Clinical Psychology Review, 26, 86104.CrossRefGoogle ScholarPubMed
Majoros, K. (2001). Belastung ohr Ende? Die Entwicklung eines Belastungsfragebogens für Eltern mit hyperaktiven Kindern. Unpublished Diploma, Julius-Maximillians Universität, Würzburg.Google Scholar
McMahon, R. J. and Langua, L. J. (1996). Scale Construction for the Coder Impressions Inventory. Technical report.Google Scholar
Miller Brotman, L., Klein, R. G., Kamboukos, D., Brown, E. J., Coard, S. I. and Sosinsky, L. S. (2003). Preventive intervention for urban, low-income preschoolers at familial risk for conduct problems: a randomized pilot study. Journal of Clinical Child and Adolescent Psychology, 32, 246257.CrossRefGoogle ScholarPubMed
Miller, Y. (2001). Erziehung von Kindern im Kindergartenalter: Erziehungsverhalten und Kompetenzüberzeugungen von Eltern und der Zusammenhang zu kindlichen Verhaltensstörungen. TU Braunschweig, Braunschweig.Google Scholar
Moffitt, T. E. (1993). Adolescent-limited and life-course-persistent antisocial behavior: a developmental taxonomy. Psychological Review, 100, 674701.CrossRefGoogle Scholar
Nelson, G., Westhues, A. and MacLeod, J. (2003). A meta-analysis of longitudinal research on preschool prevention programs for children. Prevention and Treatment, 6, 31.CrossRefGoogle Scholar
Nixon, R. D. V., Sweeney, L., Erickson, D. B. and Touyz, S. W. (2004). Parent-child interaction therapy: one- and two year follow-up of standard and abbreviated treatments for oppositional preschoolers. Journal of Abnormal Child Psychology, 32, 263271.CrossRefGoogle ScholarPubMed
Nowak, C. and Heinrichs, N. (2008). A comprehensive meta-analysis of Triple P-Positive Parenting Program using hierarchical linear modeling: effectiveness and moderating variables. Clinical Child and Family Psychology Review, 11, 114144.CrossRefGoogle ScholarPubMed
Patterson, G. R., DeGarmo, D. and Forgatch, M. S. (2004). Systematic change in families following prevention trials. Journal of Abnormal Child Psychology, 32, 621633.CrossRefGoogle ScholarPubMed
Plück, J., Wieczorrek, E., Wolff Metternich, T. and Döpfner, M. (2006). Präventionsprogramm für Expansives Problemverhalten (PEP). Ein Manual für Eltern- und Erziehergruppen. Göttingen: Hogrefe.Google Scholar
Plück, J., Hautmann, C, Brix, G, Freund-Braier, I., Hahlweg, K. and Döpfner, M. (2008). Screening von Expansivem Problemverhalten bei Kindern im Kindergartenalter für Eltern und Erzieherinnen (PEP-Screen). Diagnostika, 54, 138149.CrossRefGoogle Scholar
Rubin, K. H. and Burgess, K. B. (2002). Parents of aggressive and withdrawn children. In Bornstein, M. H. (Ed.), Handbook of Parenting (Vol. 1, pp. 383418). Mahwah, NJ: Lawrence Erlbaum Associates, Inc.Google Scholar
Sanders, M. R. (1999). Triple P-Positive Parenting Program: towards an empirically validated multilevel parenting and family support strategy for the prevention of behavior and emotional problems in children. Clinical Child and Family Psychology Review, 2, 7190.CrossRefGoogle ScholarPubMed
Sanders, M. R., Markie-Dadds, C., Tully, L. A. and Bor, W. (2000). The Triple P-Positive parenting program: a comparison of enhanced, standard, and self-directed behavioral family intervention for parents of children with early onset conduct problems. Journal of Consulting and Clinical Psychology, 68, 624640.CrossRefGoogle Scholar
Sanders, M. R., Bor, W. and Morawska, A. (2007). Maintenance of treatment gains: a comparison of enhanced, standard, and self-directed Triple P-Positive Parenting Program. Journal of Abnormal Child Psychology, 35, 983998.CrossRefGoogle Scholar
Serketich, W. J. and Dumas, J. E. (1996). The effectiveness of behavioral parent training to modify antisocial behavior in children: a meta-analysis. Behavior Therapy, 27, 171186.CrossRefGoogle Scholar
Shaw, D. S., Dishion, T. J., Supplee, L., Gardner, F. and Arnds, K. (2006). Randomized trial of a family-centered approach to the prevention of early conduct problems: 2-year effects of the family check-up in early childhood. Journal of Consulting and Clinical Psychology, 74, 19.CrossRefGoogle Scholar
Sonuga-Barke, E. (2004). On the reorganization of incentive structure to promote delay tolerance: a therapeutic possibility for AD/HD? Neural Plasticity, 11, 2328.CrossRefGoogle ScholarPubMed
Strayhorn, J. M. and Weidmann, C. S. (1988). A parent practices scale and its relation to parent and child mental health. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 613618.CrossRefGoogle ScholarPubMed
Tabachnick, B. G. and Fidell, L. F. (1996). Using Multivariate Statistics (3rd ed.). New York: Harper Collins.Google Scholar
Webster-Stratton, C. (1998). Preventing conduct problems in Head Start children strengthening parenting competencies. Journal of Consulting and Clinical Psychology, 66, 715730.CrossRefGoogle ScholarPubMed
Webster-Stratton, C., Reid, M. J. and 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, 105124.CrossRefGoogle ScholarPubMed
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