Abstract
This study examined cognitive/academic functioning and severity of clinical dysfunction as moderators of treatment outcome of cognitively based treatment among children (N = 120, ages 7 to 13 years) referred for aggressive and antisocial behavior. We predicted that more favorable treatment outcome would be evident among children higher in intellectual functioning, reading achievement, and level of school functioning, and with less severe and chronic symptoms of antisocial behavior and fewer symptoms across a range of diagnoses. The predictions were evaluated in relation to posttreatment behavioral problems and prosocial functioning at home and at school. Reading achievement, academic and school dysfunction, and number of symptoms across all diagnoses predicted treatment outcome. Additional analyses indicated that parent, family, and contextual factors (socioeconomic disadvantage, parent dysfunction, and adverse child-rearing practices) were related to child predictors, as well as to treatment outcome. The results convey the importance of child moderators of cognitive-behavioral treatment, as well as broader parent, family, and contextual influences in which these are embedded.
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REFERENCES
Abidin, R. R. (1990). Parenting Stress Index clinical manual. Charlottesville, VA: Pediatric Psychology Press.
Achenbach, T. M. (1991a). Manual for the Child Behavior Checklist/4–18 and 1991 Profile. Burlington: University of Vermont, Department of Psychiatry.
Achenbach, T. M. (1991b). Manual for the Teacher's Report Form and 1991 Profile. Burlington: University of Vermont, Department of Psychiatry.
Adler, N. E., Boyce, T., Chesney, M. A., Cohen, S., Folkman, S., Kahn, R. L., & Syme, S. L. (1994). Socioeconomic status and health: The challenge of the gradient. American Psychologist, 49, 15–24.
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed. rev.). Washington, DC: Author.
Baer, R. A., & Nietzel, M. T. (1991). Cognitive and behavioral treatment of impulsivity in children: A meta-analytic review of the outcome literature. Journal of Clinical Child Psychology, 20, 400–412.
Brofenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press.
Chambers, W. J., Puig-Antich, J., Hirsch, M., Paez, P., Ambrosini, P. J., Tabrizi, M. A., & Davies, M. (1985). The assessment of affective disorders in children and adolescents by semistructured interview: Test-retest reliability. Archives of General Psychiatry, 42, 696–702.
Derogatis, L. R., & Cleary, P. A. (1977). Confirmation of the dimensional structure of the SCL-90: A study in construct validation. Journal of Clinical Psychology, 33, 981–989.
Dumas, J. E., & Wahler, R. G. (1983). Predictors of treatment outcome in parent training: Mother insularity and socioeconomic disadvantage. Behavioral Assessment, 5, 301–313.
Durlak, J. A., Fuhrman, T., & Lampman, C. (1991). Effectiveness of cognitive-behavioral therapy for maladapting children: A meta-analysis. Psychological Bulletin, 110, 204–214.
Dush, D. M., Hirt, M. L., & Schroeder, J. E. (1989). Self-statement modification in the treatment of child behavior disorders: A meta-analysis. Psychological Bulletin, 106, 97–106.
Hinshaw, S. P., Lahey, B. B., & Hart, E. L. (1983). Issues of taxonomy and comorbidity in the development of conduct disorder. Development and Psychopathology, 5, 31–49.
Hollingshead, A. B., & Redlich, F. C. (1958). Social class and mental illness. New York: Wiley.
Jastak, J. E., & Jastak, S. R. (1978). The Wide Range Achievement Test (rev. ed.). Wilmington, DE: Guidance Associates.
Kazdin, A. E. (1989). Hospitalization of antisocial children: Clinical course, follow-up status, and predictors of outcome. Advance in Behaviour Research and Therapy, 11, 1–67.
Kazdin, A. E. (1995). Conduct disorders in childhood and adolescence (2nd ed.). Thousand Oaks, CA: Sage.
Kazdin, A. E. (1996). Problem solving and parent management in treating aggressive and antisocial behavior. In E. D. Hibbs & P. S. Jensen (Eds.), Psychosocial treatment research of child and adolescent disorders (pp. 377–408). Washington, DC: American Psychological Association.
Kazdin, A. E., Bass, D., Ayers, W. A., & Rodgers, A. (1990). Empirical and clinical focus of child and adolescent psychotherapy research. Journal of Consulting and Clinical Psychology, 58, 729–740.
Kazdin, A. E., Bass, D., Siegel, T., & Thomas, C. (1989). Cognitive-behavioral treatment and relationship therapy in the treatment of children referred for antisocial behavior. Journal of Consulting and Clinical Psychology, 57, 522–535.
Kazdin, A. E., Mazurick, J. L., & Bass, D. (1993). Risk for attrition in treatment of antisocial children and families. Journal of Clinical Child Psychology, 22, 2–16.
Kazdin, A. E., Mazurick, J. L., & Siegel, T. (1994). Treatment outcome among children with externalizing disorder who terminate prematurely versus those who complete psychotherapy. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 549–557.
Kazdin, A. E., Siegel, T., & Bass, D. (1992). Cognitive problem-solving skills training and parent management training in the treatment of antisocial behavior in children. Journal of Consulting and Clinical Psychology, 60, 733–747.
Kendall, P. C. (Ed.). (1991). Child and adolescent therapy: Cognitive-behavioral procedures. New York: Guilford Press.
Kendall, P. C., & Braswell, L. (1985). Cognitive-behavioral therapy for impulsive children. New York: Guilford Press.
Kendall, P. C., Reber, M., McLeer, S., Epps, J., & Ronan, K. R. (1990). Cognitive-behavioral treatment of conduct-disordered children. Cognitive Therapy and Research, 14, 279–297.
Kopp, C. (1982). Antecedents of self-regulation: A developmental perspective. Developmental Psychology, 18, 199–214.
Lerner, R. M. (1991). Changing organism-context relations as the basic process of development: A developmental contextual perspective. Developmental Psychology, 27, 27–32.
Luria, A. R. (1961). The role of speech in the regulation of normal and abnormal behavior. New York: Basic Books.
Moffitt, T. E. (1993). The neuropsychology of conduct problems. Development and Psychopathology, 5, 135–151.
Patterson, G. R., Capaldi, D., & Bank, L. (1991). An early starter model for predicting delinquency. In D. J. Pepler & K. H. Rubin (Eds.), The development and treatment of childhood aggression (pp. 139–168). Hillsdale, NJ: Erlbaum.
Robins, L., & Rutter, M. (Eds.). (1990). Straight and devious pathways from childhood to adulthood. Cambridge, England: Cambridge University Press.
Rutter, M., & Giller, H. (1983). Juvenile delinquency: Trends and perspectives. New York: Penguin Books.
Sattler, J. M. (1986). Assessment of children (3rd. ed.). San Diego, CA: Author.
Spivack, G., Platt, J. J., & Shure, M. B. (1976). The problem solving approach to adjustment. San Francisco: Jossey-Bass.
Wechsler, D. (1974). Manual for the Wechsler Intelligence Scale for Children—Revised. New York: Psychological Corporation.
Werner, E. E., & Smith, R. S. (1992). Overcoming the odds: High risk children from birth to adulthood. Ithaca, NY: Cornell University Press.
Wilson, J. Q., & Herrnstein, R. J. (1985). Crime and human nature. New York: Simon & Schuster.
Zahn-Waxler, C., Cole, P. M., & Barrett, K. C. (1991). Guilt and empathy: Sex differences and implications for the development of depression. In J. Garber & K. A. Dodge (Eds.), The development of emotion regulation and dysregulation (pp. 243–272). New York: Cambridge University Press.
Zoccolillo, M. (1993). Gender and the development of conduct disorder. Development and Psychopathology, 5, 65–78.
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Kazdin, A.E., Crowley, M.J. Moderators of Treatment Outcome in Cognitively Based Treatment of Antisocial Children. Cognitive Therapy and Research 21, 185–207 (1997). https://doi.org/10.1023/A:1021832729480
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DOI: https://doi.org/10.1023/A:1021832729480