What works in the psychological treatment of child conduct problems? An umbrella review of meta-analytic studies

• Estrella Romero ^[1] ; María Álvarez-Voces ^[1] ; Beatriz Díaz-Vázquez ^[1] ; Laura López-Romero ^[1]
  1. [1] Universidade de Santiago de Compostela

     Universidade de Santiago de Compostela

     Santiago de Compostela, España

     
• Localización: Revista de Psicología Clínica con Niños y Adolescentes, ISSN-e 2340-8340, Vol. 10, Nº. 1 (Enero 2023), 2023 (Ejemplar dedicado a: Estado de los tratamientos psicológicos infanto-juveniles)
• Idioma: inglés
• Enlaces
  • Texto completo  1    2 (pdf) 
• Resumen
  • español

    ¿Qué funciona en el tratamiento psicológico de los problemas de conducta en niños? Revisión umbrella de estudios meta-analíticos. Los problemas de conducta (PC) son un foco prioritario de atención en la psicología clínica infantil. Este estudio presenta una revisión umbrella de meta-análisis sobre la eficacia del tratamiento/prevención indicada de los PC infantiles (rango de edad media hasta 12 años). Siguiendo un protocolo registrado, se buscaron meta-análisis (enero 2002 a marzo 2022) en Web of Science, PsycINFO, PROSPERO y The Cochrane Library. Nueve meta-análisis cumplieron con los criterios requeridos y sus características y hallazgos fueron descritos sistemáticamente; además, con RStudio se calcularon los tamaños del efecto (TEs) ponderados. Se realizaron análisis de heterogeneidad, sesgo de publicación, calidad (AMSTAR-2) y credibilidad. El entrenamiento parental fue la intervención más estudiada, con un TE medio ponderado de d = -.49 (IC del 95%: -.67 a -.32), y se identificaron diversos moderadores de eficacia, incluyendo características individuales (gravedad de los PC), familiares (desventaja económica) y de intervención (formato de administración). También se analizaron los resultados de la terapia de juego centrada en el niño, d = -.34 (IC del 95%:

    -.40 a -.28), pero el reducido número de meta-análisis y la debilidad detectada por la evaluación de la calidad sugieren la necesidad de considerar con cautela los efectos agrupados. En general, la evidencia es sugestiva de eficacia del tratamiento de los PC, específicamente del entrenamiento parental. No obstante, la eficacia parece ser moderada, los índices de heterogeneidad elevados y las evaluaciones de calidad de los meta-análisis no suelen ser óptimas. Este estudio sugiere varias vías para reforzar el conocimiento en este campo.

  • English

    Conduct problems (CP) constitute a major field for child clinical psychology, in terms of not only prevalence, but also developmental, social, and clinical relevance. This study carried out an umbrella review of meta-analyses on the efficacy of treatment/indicated prevention of child CP (mean age range up to 12 years). Following a registered protocol, several databases (i.e., Web of Science, PsycINFO, PROSPERO, and The Cochrane Library) were searched for meta-analyses published from January 2002 to March 2022. Nine meta-analytic publications met the required criteria, and the main characteristics and findings of the studies were systematically described. Weighted effect sizes (ESs) were calculated through RStudio program. Analyses of heterogeneity, publication bias, quality (AMSTAR-2), and credibility were also conducted. Results indicate that parent training has been the most studied intervention, with a weighted ES of d = -0.49 (95% CI -.67 to -.32). The reviewed studies identified several moderators for the efficacy of parent training, including individual (severity of CP), family (financial disadvantage), and intervention (delivery format) characteristics. Results from child-centered play therapy were also analyzed, d = -.34 (95% CI -.40 to -.28), but the reduced number of meta-analyses and the weakness detected by quality assessment suggest the need of cautiously considering the pooled effects. In general, evidence seems to be suggestive of the efficacy of treatment of CP, particularly for parent training. Nevertheless, efficacy seems to be moderate, heterogeneity indexes are high, and quality assessments of meta-analyses are often suboptimal. This study suggests several avenues to strengthen knowledge in this field

• Referencias bibliográficas
  • Allen, D., Gillen, E., & Rixson, L. (2009). Systematic review of the effectiveness of integrated care pathways: what works, for whom,...
  • Aromataris, E., Fernandez, Ritin., Godfrey, C. M., Holly, C., Khalil, H., & Tungpunkom, P. (2015). Summarizing systematic reviews: methodological...
  • Bakker, M. J., Greven, C. U., Buitelaar, J. K., & Glennon, J. C. (2017). Practitioner Review: Psychological treatments for children and...
  • Battagliese, G., Caccetta, M., Luppino, O. I., Baglioni, C., Cardi, V., Mancini, F., & Buonanno, C. (2015). Cognitive-behavioural therapy...
  • Belbasis, L., Bellou, V., Evangelou, E., Ioannidis, J. P., & Tzoulaki, I. (2015). Environmental risk factors and multiple sclerosis: an...
  • Bellou, V., Belbasis, L., Tzoulaki, I., Evangelou, E., & Ioannidis, J. P. (2016). Environmental risk factors and Parkinson’s disease:...
  • Brinkmeyer, M. Y., & Eyberg, S. M. (2003). Parent-child interaction therapy for oppositional children. In A. E. Kazdin & J. R. Weisz...
  • Broidy, L. M., Nagin, D. S., Tremblay, R. E., Bates, J. E., Brame, B., Dodge, K. A., Fergusson, D., Horwood, J. L., Loeber, R., Laird, R.,...
  • *Burkey, M. D., Hosein, M., Morton, I., Purgato, M., Adi, A., Kurzrok, M., Kohrt, B. A., & Tol, W. A. (2018). Psychosocial interventions...
  • Cicchetti, D. (Ed.) (2016). Developmental psychopathology (Vol. 3, Maladaptation and Psychopathology, 3rd ed.). Wiley.
  • Cicchetti, D., Rogosch, F. A., Lynch, M., & Holt, K. D. (1993). Resilience in maltreated children: Processes leading to adaptive outcome....
  • Cohen, J. (1988). Statistical power analysis for the behavioural sciences, 2nd ed. Erlbaum.
  • *Comer, J. S., Chow, C., Chan, P. T., Cooper-Vince, C., & Wilson, L. A. S. (2013). Psychosocial treatment efficacy for disruptive behaviour...
  • Florean, I. S., Dobrean, A., Păsărelu, C. R., Georgescu, R. D., & Milea, I. (2020). The Efficacy of internet-based parenting programs...
  • Furlong, M., & McGilloway, S. (2012). The Incredible Years Parenting program in Ireland: A qualitative analysis of the experience of disadvantaged...
  • Fusar-Poli, P., & Radua, J. (2018). Ten simple rules for conducting umbrella reviews. Evidence-Based Mental Health, 21(3), 95–100. https://doi....
  • Ghandour, R. M., Sherman, L. J., Vladutiu, C. J., Ali, M. M., Lynch, S. E., Bitsko, R. H., & Blumberg, S. J. (2019). Prevalence and treatment...
  • Girard, L. C., Tremblay, R. E., Nagin, D., & Côte, S. M. (2019). Development of aggression subtypes from childhood to adolescence: A group-based...
  • Glenn, A. L., Lochman, J. E., Dihsion, T., Powell, N. P., Boxmeyer, C., Kassing, F., Qu, L., & Romero, D. (2019). Toward tailored interventions:...
  • Gordon, R. (1987). An operational classification of disease prevention. In J. A. Steinberg & M. M. Silverman (Eds.), Preventing mental...
  • Gutman, L. M., Joshi, H., & Schoon, I. (2019). Developmental trajectories of conduct problems and cumulative risk from early childhood...
  • Guyatt, G. H., Oxman, A. D., Schünemann, H. J., Tugwell, P., & Knottnerus, A. (2011). GRADE guidelines: A new series of articles in the...
  • Hackworth, N. J., Matthews, J., Westrupp, E. M., Nguyen, C., Phan, T., Scicluna, A., Cann, W., Bethelsen, D., Bennetts, S. K., & Nicholson,...
  • Harley, M., Murtagh, A., & Cannon, M. (2008). Conduct disorder–psychiatry’s greatest opportunity for prevention: A commentary on ‘From...
  • Higgins, J. P., & Thompson, S. G. (2002). Quantifying heterogeneity in a meta‐analysis. Statistics in Medicine, 21(11), 1539–1558. https://doi....
  • Higgins, J. P., Altman, D. G., Gøtzsche, P. C., Jüni, P., Moher, D., Oxman, A. D., Savović, J., Schulz, K. F., Weeks, L., & Sterne, J....
  • Higgins, J. P., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J., & Welch, V. A. (eds). (2019) Cochrane handbook for systematic...
  • Higgins, J. P., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta-analyses. Bmj, 327(7414), 557–560....
  • Hunter, J. E., & Schmidt, F. L. (2004). Methods of meta-analysis: Correcting error and bias in research findings. Sage.
  • Lahey, B. B., Van Hulle, C. A., Waldman, I. D., Rodgers, J. L., D’Onofrio, B. M., Pedlow, S., Rathouz, P. & Keenan, K. (2006). Testing...
  • Landreth, G. L. (2012). Play Therapy. The Art of the Relationship. Routledge. Lebrun-Harris, L. A., Sappenfield, O. R., & Warren, M. D....
  • Leflot, G., van Lier, P. A. C., Onghena, P., & Colpin, H. (2010). The role of teacher behavior management in the development of disruptive...
  • Leijten, P., Gardner, F., Melendez-Torres, G. J., Van Aar, J., Hutchings, J., Schultz, S., Knerr, W., & Overbeek, G. (2018). What to teach...
  • Leijten, P., Raaijmakers, M. A., de Castro, B. O., & Matthys, W. (2013). Does socioeconomic status matter? A meta-analysis on parent training...
  • Lochman, J. E., & Wells, K. C. (2002). Contextual social–cognitive mediators and child outcome: A test of the theoretical model in the...
  • López-López, J. A., Rubio-Aparicio, M., & Sánchez-Meca, J. (2022). Overviews of reviews: Concept and Development. Psicothema, 34(2), 175–181....
  • Lundahl, B., Risser, H. J., & Lovejoy, M. C. (2006). A meta-analysis of parent training: Moderators and follow-up effects. Clinical Psychology...
  • McHugh, M. L. (2012). Interrater reliability: the kappa statistic. Biochemia Medica, 22(3), 276–282.
  • Masten, A., & Cicchetti, D. (2010). Developmental cascades. Development and Psychopathology, 22(3), 491–495. https://doi.org/10.1017/...
  • McMahon, R. J., Goulter, N., & Frick, P. J. (2021). Moderators of psychosocial intervention response for children and adolescents with...
  • Menting, A. T. A., de Castro, B. O., & Matthys, W. (2013). Effectiveness of the incredible years parent training to modify disruptive...
  • Merikangas, K. R., Nakamura, E. F., & Kessler, R. C. (2022). Epidemiology of mental disorders in children and adolescents. Dialogues in...
  • Moffit, T. E. (2003). Life-course-persistent and adolescence-limited antisocial behaviour: A 10-year research review and a research agenda....
  • Moffitt, T. E. (1993). Adolescence-limited and life-course-persistent antisocial behaviour: A developmental taxonomy. Psyhological Review,...
  • Munder, T., Brütsch, O., Leonhart, R., Gerger, H., & Barth, J. (2013). Researcher allegiance in psychotherapy outcome research: An overview...
  • Nix, R. L., Bierman, K. L., McMahon, R. J., & The Conduct Problems Prevention Research Group. (2009). How attendance and quality of participation...
  • Nock, M. K., & Ferriter, C. (2005). Parent management of attendance and adherence in child and adolescent therapy: A conceptual and empirical...
  • Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan,...
  • Parker, M. M., Hunnicutt Hollenbaugh, K. M., & Kelly, C. T. (2021). Exploring the impact of child-centered play therapy for children exhibiting...
  • Patterson, G. R. (1982). Coercitive family process: A social learning approach to family intervention (vol. 3). Castalia Publishing Company.
  • Ray, D. C., Armstrong, S. A., Balkin, R. S., & Jayne, K. M. (2015). Child-centered play therapy in the schools: review and meta-analysis....
  • Rissanen, E., Kuvaja‐Köllner, V., Elonheimo, H., Sillanmäki, L., Sourander, A., & Kankaanpää, E. (2022). The long‐term cost of childhood...
  • Romero, E., Gómez-Fraguela, X. A., Villar, P., & Rodríguez, C. (2019). Prevención indicada de los problemas de conducta: entrenamiento...
  • Romero, E., López-Romero, L., Domínguez-Álvarez, B., Villar, P., & GómezFraguela, J. A. (2020). Testing the effects of COVID-19 confinement...
  • Romero, E., Rodríguez, C., Villar, P., & Gómez-Fraguela, X. A. (2017). Intervention on early-onset conduct problems as indicated prevention...
  • Schaeffer, C. M., Petras, H., Ialongo, N., Masyn, K. E., Hubbard, S., Poduska, J., & Kellam, S. (2006). A comparison of girls’ and boys’...
  • Schardt, C., Adams, M. B., Owens, T., Keitz, S., & Fontelo, P. (2007). Utilization of the PICO framework to improve searching PubMed for...
  • Shea, B. J., Reeves, B. C., Wells, G., Thuku, M., Hamel, C., Moran, J., Moher, D., Tugwell, P., Welch, V., Kristjansson, E., & Henry,...
  • Tausendfreund, T., Knot-Dickscheit, J., Schulze, G. C., Knorth, E. J., & Grietens, H. (2016). Families in multi-problem situations: Backgrounds,...
  • van IJzendoorn, M. H., Schuengel, C., Wang, Q., & Bakermans-Kranenburg, M. J. (2022). Improving parenting, child attachment, and externalizing...
  • Veenman, B., Luman, M., & Oosterlaan, J. (2018). Efficacy of behavioural classroom programs in primary school. A meta-analysis focusing...
  • Waller, R., Gardner, F., & Hyde, L. W. (2013). What are the associations between parenting, callous–unemotional traits, and antisocial...