Article Text

Effects of behavioural parent training for children with attention-deficit/hyperactivity disorder on parenting behaviour: a protocol for an individual participant data meta-analysis
  1. Laura Steenhuis1,
  2. Annabeth P Groenman1,
  3. Pieter J Hoekstra1,
  4. Rianne Hornstra1,
  5. Marjolein Luman2,3,
  6. Saskia van der Oord4,
  7. Barbara J van den Hoofdakker1
  1. 1Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
  2. 2Dept. Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
  3. 3Bascule, academic centre for child and adolescent psychiatry, Amsterdam, the Netherlands
  4. 4Clinical Psychology, KU Leuven, Leuven, Flanders, Belgium
  1. Correspondence to Dr Annabeth P Groenman; a.groenman{at}


Introduction Behavioural parent training (BPT) is a well-established treatment for children with attention-deficit/hyperactivity disorder (ADHD). BPT is based on the hypothesis that improvements in parenting are mediators of improvements in children’s behaviours. However, meta-analyses show considerate heterogeneity in effects of BPT on child outcomes, and meta-analyses on parenting outcomes are scarce. Also, few studies have investigated parenting factors as mediators of child outcomes. This study aims to examine the effects and moderators of BPT on parenting outcomes and whether improvements in parenting mediate amelioration of behaviour and impairment in children with ADHD.

Methods and analyses We will conduct an individual participant data meta-analysis (IPDMA), making use of individual data of existing trials, and giving the opportunity for highly powered moderator analyses. This IPDMA will be performed by the Psychosocial ADHD INTervention (PAINT) collaboration. We will include randomised controlled trials of BPT, for individuals with ADHD below 18 years old. Systematic searches have been performed to locate relevant papers. Authors are currently contacted to share their data with the PAINT-IPDMA project. We will examine effects of BPT on parenting outcomes (eg, positive and negative parenting, management of affect, perceived parenting competence, parenting stress), moderators of these effects (eg, parental depression, parenting stress, severity of the child’s ADHD symptoms) and subsequently perform mediation analyses where parenting outcomes are modelled as mediators of child outcomes (eg, symptoms and severity of ADHD, comorbid psychopathology and impairment).

Ethics and dissemination We will include data from randomised control trials for which ethical approval has been received and consent forms have been signed. Deidentified data will be provided by the original investigators. We aim to disseminate our findings through peer-reviewed scientific journals, presentations at (inter)national scientific meetings, newsletters, the website of our project and the Dutch academic workspace ADHD.

PROSPERO registration number CRD42017069877.

  • child & adolescent psychiatry
  • mental health
  • paediatrics
  • psychiatry

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  • LS and APG are joint first authors.

  • LS and APG contributed equally.

  • Contributors BJvdH is the guarantor. APG wrote the first draft of the manuscript, and LS wrote a revised and final version. APG, RH and LS are performing the systematic search and data extraction. PJH, ML, SvdO and BJvdH acquired funding for the PAINT-IPDMA project; an international database including individual participant data from RCTs examining psychosocial interventions for the treatment of ADHD in children. The current study is a part of the PAINT-IPDMA project. PJH, ML, SvdO, BJvdH and APG setup the initial design for the IPDMA. All authors worked together to design this IPDMA, contributed to the intellectual content of the current manuscript and approved the final version.

  • Funding This research was funded by The Dutch Organization for Health Research and Development (ZonMw) under grant number 729300013.

  • Disclaimer The funder had no role in the design of this protocol. The funder will have no input on the collection of data, the data analysis or the interpretation or publication of the study results.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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