Abstract
BackgroundThe efficacy of parent-child training (PCT) regarding child symptoms may be reduced if the mother has attention-deficit/hyperactivity disorder (ADHD). The AIMAC study (ADHD in Mothers and Children) aimed to compensate for the deteriorating effect of parental psychopathology by treating the mother (Step 1) before the beginning of PCT (Step 2). This secondary analysis was particularly concerned with the additional effect of the Step 2 PCT on child symptoms after the Step 1 treatment.MethodsThe analysis included 143 mothers and children (aged 6–12 years) both diagnosed with ADHD. The study design was a two-stage, two-arm parallel group trial (Step 1 treatment group [TG]: intensive treatment of the mother including psychotherapy and pharmacotherapy; Step 1 control group [CG]: supportive counseling only for mother; Step 2 TG and CG: PCT). Single- and multi-group analyses with piecewise linear latent growth curve models were applied to test for the effects of group and phase. Child symptoms (e.g., ADHD symptoms, disruptive behavior) were rated by three informants (blinded clinician, mother, teacher).ResultsChildren in the TG showed a stronger improvement of their disruptive behavior as rated by mothers than those in the CG during Step 1 (Step 1: TG vs. CG). In the CG, according to reports of the blinded clinician and the mother, the reduction of children’s disruptive behavior was stronger during Step 2 than during Step 1 (CG: Step 1 vs. Step 2). In the TG, improvement of child outcome did not differ across treatment steps (TG: Step 1 vs. Step 2).ConclusionsIntensive treatment of the mother including pharmacotherapy and psychotherapy may have small positive effects on the child’s disruptive behavior. PCT may be a valid treatment option for children with ADHD regarding disruptive behavior, even if mothers are not intensively treated beforehand.Trial registrationISRCTN registry ISRCTN73911400. Registered 29 March 2007.
Highlights
The efficacy of parent-child training (PCT) regarding child symptoms may be reduced if the mother has attention-deficit/hyperactivity disorder (ADHD)
We conclude from our findings that parent-child training may be effective to reduce children’s disruptive behavior even if parental ADHD is not intensively treated beforehand
The discrepant results may be explained by different methodological approaches, we hypothesize that the positive effects in this analysis were mainly attributable to the fact that the parent-child training was individualized, which may have helped the parents to compensate for ADHD-related deficits and to enhance their treatment participation
Summary
The efficacy of parent-child training (PCT) regarding child symptoms may be reduced if the mother has attention-deficit/hyperactivity disorder (ADHD). The AIMAC study (ADHD in Mothers and Children) aimed to compensate for the deteriorating effect of parental psychopathology by treating the mother (Step 1) before the beginning of PCT (Step 2). This secondary analysis was concerned with the additional effect of the Step 2 PCT on child symptoms after the Step 1 treatment. As treatment success varies across families [4], several studies investigated the moderating role of parental ADHD in the efficacy of behavioral parent training This introduction builds in part on two comprehensive reviews summarizing the findings from this research area [5, 6]. There are studies reporting no deteriorating effect of parental ADHD on child benefit from treatment [13, 15, 16], which may at least partly be explained by less affected parents and more personalized treatment approaches in the respective studies [5]
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