Designing a Novel Behavioral Treatment Protocol for Children Characterized by Conduct Problems and Callous-unemotional Traits
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 48
- 试验地点
- 1
- 主要终点
- Conduct Problems
研究概览
简要总结
The purpose of this study is to modify behavior therapy so that it is optimized for children with conduct problems and callous-unemotional traits by emphasizing reward components and de-emphasizing punishment components.
详细描述
Several studies have demonstrated that standard behavioral treatments do not appear to be sufficient for children with conduct problems (CP) and callous-unemotional (CU) traits. Other research suggests that children with CPCU are less responsive to punishments as evaluated using controlled laboratory tasks. Based on these two sets of findings, it was hypothesized that behavioral treatment modified to emphasize reward and de-emphasize punishments would be advantageous when used to treat children with CPCU. This hypothesis was tested in a treatment development study that had three phases. During phase 1, which occurred in 2010, the intervention was planned and treatment procedures and manuals were developed. During phase 2, which occurred in 2011, a pilot study was conducted in which the intervention was tested in an iterative manner in a group of 12 children with conduct problems and callous-unemotional traits. In phase 3, a larger trial was conducted using a cross over design, with one-half of participants getting standard behavioral treatment for four weeks followed by modified behavioral treatment for four weeks and remaining participants receiving treatments in the reverse order.Treatments were evaluated using parent ratings, counselor ratings, and frequency counts of behavior during treatments.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 7 Years 至 12 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Clinical diagnosis of oppositional defiant disorder or conduct disorder
- •Ages 7 to 12 years old
- •t-score of 65 or above on CU scale of Antisocial Process Screening Device as rated by parents or teacher
- •at least parent/caregiver fluent in English
- •able to participate in vigorous outdoor activities
- •parent/caregiver agreement to keep psychoactive medication treatment constant throughout the study
排除标准
- •Full scale intelligence quotient (IQ) of less than 75
- •medical conditions that contra-indicate participation in treatment
- •current or past clinical diagnosis of pervasive developmental disorder, schizophrenia or other psychotic disorders, sexual disorder, organic mental disorder, or eating disorder
- •lack of functional impairment
- •current or past seizures or other neurological disorders
研究组 & 干预措施
Reward-Emphasized treatment
This treatment consisted of behavior therapy modified to match the unique learning styles of children with CPCU. This was accomplished by emphasizing rewards and de-emphasizing punishments. This treatment was administered using a summer treatment program.
干预措施: Reward-Emphasized Treatment (Behavioral)
Standard treatment
This treatment consisted of standard behavior therapy, in which reward and punishment components were used in a balanced manner, as is typically done in outpatient settings. This treatment was administered using a summer treatment program.
干预措施: Standard Treatment (Behavioral)
结局指标
主要结局
Conduct Problems
时间窗: Weekly
Counselors recorded each instance of conduct problems, defined as lying, stealing, intentional destruction of property, and intentional aggression. The average number per day was computed for each week of treatment.
Negative Verbalizations
时间窗: Weekly
Counselors recorded each instance of negative verbalizations, defined as verbal abuse to staff, teasing peers, and swearing. The average number per day was computed for each week of treatment.
Complaining
时间窗: Weekly
Counselors recorded each instance of complaining. The average number per day was computed for each week of treatment.
Interruption
时间窗: Weekly
Counselors recorded each instance of interrupting. The average number per day was computed for each week of treatment.
Noncompliance
时间窗: Weekly
Counselors recorded each instance of noncompliance. The average number per day was computed for each week of treatment.
Rule Violations
时间窗: Weekly
Counselors recorded each instance of rule violations. The average number per day was computed for each week of treatment.
Positive Peer Behavior
时间窗: Weekly
Counselors recorded each instance of positive behavior with peers, defined as helping, sharing and ignoring teasing. The average number per day was computed for each week of treatment.
Minutes in Time Out
时间窗: Weekly
Counselors recorded the total number of minutes children were in Time Out due to intentional aggression, intentional destruction of property, or repeated noncompliance. The average number per day was computed for each week of treatment.
Number of Time Outs
时间窗: Weekly
Counselors recorded the total number of Time Outs children served due to intentional aggression, intentional destruction of property, or repeated noncompliance. The average number per day was computed for each week of treatment.
Minutes of Physical Management
时间窗: Weekly
Counselors recorded the total number of minutes children had to be physically managed due to behavior dangerous to themselves or others. The average number per day was computed for each week of treatment.
次要结局
- WPRF Rule Following Problems - Parent(Weekly)
- WPRF Overall Problems - Counselor(Weekly)
- WPRF Overall Problems - Parent(Weekly)
- How Much Did Your Child Benefit From Treatment?(End of each treatment, at weeks 4 and 8)
- How Much Did You (the Parent) Benefit From Treatment?(End of each treatment, at weeks 4 and 8)
- How Much Did Your Child Enjoy the Treatment?(End of each treatment, at weeks 4 and 8)
- Would You Send Your Child to This Treatment Again?(End of each treatment, at weeks 4 and 8)
- Recommend Treatment?(End of each treatment, at weeks 4 and 8)
- Overall Satisfaction(End of each treatment, at weeks 4 and 8)
- Overall Effectiveness(End of each treatment, at weeks 4 and 8)
- Overall Treatment Recommendation - Counselor(End of all treatment, at week 8)
- Overall Treatment Recommendation - Parent(End of all treatment, at week 8)
- IOWA Inattentive/Overactive Scale - Counselor(Weekly)
- IOWA Inattentive/Overactive Scale - Parent(Weekly)
- IOWA Oppositional-defiant Scale - Counselor(Weekly)
- IOWA Oppositional-defiant Scale - Parent(Weekly)
- WPRF Serious Conduct Problems Scale - Counselor(Weekly)
- WPRF Serious Conduct Problems Scale - Parent(Weekly)
- WPRF Rule Following Problems - Counselor(Weekly)