Parent training for disruptive behavior symptoms in attention deficit hyperactivity disorder: a randomized clinical trial

Gabrielle Chequer de Castro Paiva; Jonas Jardim de Paula; Danielle de Souza Costa; Antônio Alvim-Soares; Daniel Augusto Ferreira E Santos; Julia Silva Jales; Marco Aurélio Romano-Silva; Débora Marques de Miranda

doi:10.3389/fpsyg.2024.1293244

Parent training for disruptive behavior symptoms in attention deficit hyperactivity disorder: a randomized clinical trial

Front Psychol. 2024 Feb 16:15:1293244. doi: 10.3389/fpsyg.2024.1293244. eCollection 2024.

Authors

Affiliations

¹ Programa de Pós-Graduação em Medicina Molecular da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
² Faculty of Medicine, Research Center of Impulsivity and Attention, Federal University of Minas Gerais, Belo Horizonte, Brazil.
³ Departamento de Saúde Mental, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
⁴ Departamento de Pediatria, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

Abstract

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) affects 5% of children and 2.5% of adults worldwide. Comorbidities are frequent, and Oppositional Defiant Disorder (ODD) reaches 50%. Family environment is crucial for the severity of behaviors and for prognosis. In middle-income countries, access to treatment is challenging, with more untreated children than those under treatment. Face-to-face behavioral parent training (PT) is a well-established intervention to improve child behavior and parenting.

Method: A clinical trial was designed to compare PT-online and face-to-face effects to a waiting list group. Outcomes were the ADHD and ODD symptoms, parental stress and styles, and quality of life. Families were allocated into three groups: standard treatment (ST), ST + PT online, and ST + Face-to-Face PT. We used repeated measures ANOVA for pre × post treatment analysis corrected for multiple comparisons.

Results and discussion: Parent training was effective in reducing symptoms of ADHD (p = 0.030) and ODD (p = 0.026) irrespective of modality (p = 1.000). The combination of ST and PT was also associated with better quality of life in the physical domain for patients (p = 0.009) and their parents (p = 0.050). In addition to preliminary data, online intervention seems effective for parenting and improving social acceptance of children. The potential to reach many by an online strategy with a self-directed platform may imply effectiveness with a low cost for public health to support parents' symptoms management.

Keywords: ODD; attention-deficit/hyperactivity disorder; digital interventions; oppositional defiant disorder; parent training.

Grants and funding

The authors declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ) - Grant 406935/2022-0.