Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 16:15:1293244.
doi: 10.3389/fpsyg.2024.1293244. eCollection 2024.

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

Gabrielle Chequer de Castro Paiva  1   2 , Jonas Jardim de Paula  1   3 , Danielle de Souza Costa  2   3 , Antônio Alvim-Soares  2   3 , Daniel Augusto Ferreira E Santos  1 , Julia Silva Jales  2 , Marco Aurélio Romano-Silva  1   3 , Débora Marques de Miranda  1   2   4
Affiliations

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

Gabrielle Chequer de Castro Paiva et al. Front Psychol. .

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.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Participants enrolment, allocation, follow-up and analysis according to CONSORT guidelines.
Figure 2
Figure 2
Comparisons of ADHD symptoms pre and post-treatment, stratified by group (repeated measures ANOVA). The upper panel shows the mean MTA-SNAP-IV scores for each subscale between baseline and follow-up assessments, while the following panels report individual and group data for each comparison. All treatment groups showed a significant reduction in ADHD symptoms between the two time points (p < 0.001). We found interactions between treatment modality and time-point for symptoms of inattention (p < 0.030) and oppositional-defiant behavior (p = 0.026). For inattention, Standard Treatment (ST) in addition to face-to-face parent training (PT) showed a significant improvement between the two assessments (p < 0.001) when compared to ST alone. For oppositional-defiant behavior, the addition of face-to-face PT (p = 0.033) or online PT (p = 0.009) was associated with a significant reduction in symptoms, while ST alone wasn’t (p = 1.000).
See this image and copyright information in PMC

References

    1. Altafim E. R. P., McCoy D. C., Linhares M. B. M. (2018). Relations between parenting practices, socioeconomic status, and child behavior in Brazil. Child Youth Serv. Rev. 89, 93–102. doi: 10.1016/j.childyouth.2018.04.025 - DOI
    1. American Psychiatric Association (APA) (2014). DSM-5: Manual Diagnóstico e Estatístico de Transtornos Mentais. Porto Alegre: Artmed Editora.
    1. American Psychiatric Association . (2014). Diagnostic and statistical manual of mental disorders: DSM-5. Available at: https://www.academia.edu/download/38718268/csl6820_21.pdf (Accessed March 26, 2023).
    1. Anastopoulos A. D., Sommer J. L., Schatz N. K. (2009). ADHD and family functioning. Curr. Atten. Disord. Rep. 1, 167–170. doi: 10.1007/s12618-009-0023-2 - DOI
    1. Anastopoulos A. D., Smith T. F., Garrett M. E., Morrissey-Kane E., Schatz N. K., Sommer J. L., et al. (2011). Self-regulation of emotion, functional impairment, and comorbidity among children with AD/HD. J. Atten. Disord. 15, 583–592. doi: 10.1177/1087054710370567, PMID: - DOI - PMC - PubMed

LinkOut - more resources