Behavioural and nondirective parent training for children with externalising disorders: First steps towards personalised treatment recommendations

Christopher Hautmann; Christina Dose; Martin Hellmich; Kristin Scholz; Josepha Katzmann; Julia Pinior; Stephanie Gebauer; Lisa Nordmann; Tanja Wolff Metternich-Kaizman; Stephanie Schürmann; Manfred Döpfner

doi:10.1016/j.brat.2023.104271

Behavioural and nondirective parent training for children with externalising disorders: First steps towards personalised treatment recommendations

Behav Res Ther. 2023 Apr:163:104271. doi: 10.1016/j.brat.2023.104271. Epub 2023 Feb 1.

Affiliations

¹ Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; School for Child and Adolescent Psychotherapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. Electronic address: christopher.hautmann@uk-koeln.de.
² School for Child and Adolescent Psychotherapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
³ Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
⁴ Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
⁵ Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; School for Child and Adolescent Psychotherapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.

PMID: 36931110
DOI: 10.1016/j.brat.2023.104271

Abstract

For children with externalising disorders, parent training programmes with different theoretical foundations are available. Currently, there is little knowledge concerning which programme should be recommended to a family based on their individual needs (e.g., single parenthood). The personalised advantage index (PAI) indicates the predicted treatment advantage of one treatment over another. The aim of the present study was to examine the usefulness of this score in providing individualised treatment recommendations. The analysis considered 110 parents (per-protocol sample) of children (4-11 years) with attention-deficit/hyperactivity (ADHD) or oppositional defiant disorder (ODD), randomised to either a behavioural or a nondirective telephone-assisted self-help parent training. In multiple moderator analyses with four different regression algorithms (linear, ridge, k-nearest neighbors, and tree), the linear model was preferred for computing the PAI. For ODD, families randomised to their PAI-predicted optimal intervention showed a treatment advantage of d = 0.54, 95% CI [0.17, 0.97]; for ADHD, the advantage was negligible at d = 0.35, 95% CI [-0.01, 0.78]. For children with conduct problems, it may be helpful if the PAI includes the treatment moderators single parent status and ODD baseline symptoms when providing personalised treatment recommendations for the selection of behavioural versus nondirective parent training. TRIAL REGISTRATION: The study was registered prospectively with ClinicalTrials.gov (Identifier NCT01350986).

Keywords: Attention-deficit/hyperactivity disorder; Behavioural; Nondirective; Oppositional defiant disorder; Parent training; Personalised therapy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Attention Deficit Disorder with Hyperactivity* / therapy
Attention Deficit and Disruptive Behavior Disorders / therapy
Child
Humans
Parents / education
Precision Medicine

Associated data

ClinicalTrials.gov/NCT01350986