Journal of Pediatric Psychology Advance Access originally published online on October 23, 2007
Journal of Pediatric Psychology 2008 33(5):462-472; doi:10.1093/jpepsy/jsm075
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Predictor and Moderator Effects in the Treatment of Oppositional Defiant Disorder in Pediatric Primary Care
1Children's Memorial Hospital, 2Feinberg School of Medicine, Northwestern University, and 3Mary Ann and J. Milburn Smith, Child Health Research Program, Children's Memorial Research Center
All correspondence concerning this article should be addressed to John V. Lavigne, PhD, Department of Child and Adolescent Psychiatry (#10), Children's Memorial Hospital, 2300 Children's Plaza, Chicago, IL 60614, USA. E-mail: jlavigne{at}childrensmemorial.org
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Objective To examine predictors and moderators of parent-training outcomes for treatment of Oppositional Defiant Disorder (ODD) in pediatric primary care. Methods Parents of 117 children with ODD, ages 3–6 years, seen in primary care received either a minimal intervention bibliotherapy treatment (MIT), or a 12-session parenting program led by a nurse or psychologist. Results More initial total life stress, parenting distress, internalizing problems, functional impairment, and difficult temperament were associated with more improvement, but families scoring lower on those variables had fewer behavior problems at posttreatment and follow-up. Gender was a significant moderator, with more improvement for girls than boys in the nurse-led group but more improvement for boys than girls in the MIT group. Less well-educated mothers treated by psychologists showed the greatest change. Conclusions Predictors and moderators may play a role in deciding, which families receive a particular form of treatment for ODD in primary care.
Key words: parent training; predictors; primary care; moderators; Oppositional Defiant Disorder.
Received May 9, 2007; revision received July 13, 2007; accepted August 11, 2007