Designing a Novel Behavioral Treatment Protocol for Children Characterized by Conduct Problems and Callous-unemotional Traits
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Conduct Disorder
- Sponsor
- Florida International University
- Enrollment
- 48
- Locations
- 1
- Primary Endpoint
- Conduct Problems
- Status
- Completed
- Last Updated
- 10 years ago
Overview
Brief Summary
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.
Detailed Description
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.
Investigators
Eligibility Criteria
Inclusion Criteria
- •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
Exclusion Criteria
- •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
Outcomes
Primary Outcomes
Conduct Problems
Time Frame: 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
Time Frame: 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
Time Frame: Weekly
Counselors recorded each instance of complaining. The average number per day was computed for each week of treatment.
Interruption
Time Frame: Weekly
Counselors recorded each instance of interrupting. The average number per day was computed for each week of treatment.
Noncompliance
Time Frame: Weekly
Counselors recorded each instance of noncompliance. The average number per day was computed for each week of treatment.
Rule Violations
Time Frame: Weekly
Counselors recorded each instance of rule violations. The average number per day was computed for each week of treatment.
Positive Peer Behavior
Time Frame: 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.
Number of Time Outs
Time Frame: 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 in Time Out
Time Frame: 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.
Minutes of Physical Management
Time Frame: 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.
Secondary Outcomes
- 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)