A Comparative Evaluation of a Parent-Training Program -Republished Article.

This report is one of a series of outcome evaluation studies for parent-training procedures tailored specifically to families of preadolescent antisocial children. Referred families were screened to identify 19 problem children who were observed in their homes to be high-rate social aggressors. Cases were randomly assigned to the parent-training procedures or to a waiting-list comparison group. All but one of the latter accepted a referral for treatment elsewhere in the community. After an average of 17hours of therapy time, the cases in the experimental group were terminated. Posttreatment observation data were collected in the homes of both the experimental and the comparison groups. The results indicated that, relative to the changes in the comparison sample, the parent-training sample showed a significantly greater reduction in the observed rates of deviant child behavior.

Resurrecting the chimera: Progressions in parenting and peer processes.

This report uses 6-year outcomes of the Oregon Divorce Study to examine the processes by which parenting practices affect deviant peer association during two developmental stages: early to middle childhood and late childhood to early adolescence. The participants were 238 newly divorced mothers and their 5- to 8-year-old sons who were randomly assigned to Parent Management Training-Oregon Model (PMTO®) or to a no-treatment control group. Parenting practices, child delinquent behavior, and deviant peer association were repeatedly assessed from baseline to 6 years after baseline using multiple methods and informants. PMTO had a beneficial effect on parenting practices relative to the control group. Two stage models linking changes in parenting generated by PMTO to children's growth in deviant peer association were supported. During the early to middle childhood stage, the relationship of improved parenting practices on deviant peer association was moderated by family socioeconomic status (SES); effective parenting was particularly important in mitigating deviant peer association for lower SES families whose children experience higher densities of deviant peers in schools and neighborhoods. During late childhood and early adolescence, the relationship of improved parenting to youths' growth in deviant peer association was mediated by reductions in the growth of delinquency during childhood; higher levels of early delinquency are likely to promote deviant peer association through processes of selective affiliation and reciprocal deviancy training. The results are discussed in terms of multilevel developmental progressions of diminished parenting, child involvement in deviancy producing processes in peer groups, and increased variety and severity of antisocial behavior, all exacerbated by ecological risks associated with low family SES.

Coercive family process and early-onset conduct problems from age 2 to school entry.

The emergence and persistence of conduct problems (CPs) during early childhood is a robust predictor of behavior problems in school and of future maladaptation. In this study we examined the reciprocal influences between observed coercive interactions between children and caregivers, oppositional and aggressive behavior, and growth in parent report of early childhood (ages 2-5) and school-age CPs (ages 7.5 and 8.5). Participants were drawn from the Early Steps multisite randomized prevention trial that includes an ethnically diverse sample of male and female children and their families (N = 731). A parallel-process growth model combining latent trajectory and cross-lagged approaches revealed the amplifying effect of observed coercive caregiver-child interactions on children's noncompliance, whereas child oppositional and aggressive behaviors did not consistently predict increased coercion. The slope and initial levels of child oppositional and aggressive behaviors and the stability of caregiver-child coercion were predictive of teacher-reported oppositional behavior at school age. Families assigned to the Family Check-Up condition had significantly steeper declines in child oppositional and aggressive behavior and moderate reductions in oppositional behavior in school and in coercion at age 3. Results were not moderated by child gender, race/ethnicity, or assignment to the intervention condition. The implications of these findings are discussed with respect to understanding the early development of CPs and to designing optimal strategies for reducing problem behavior in early childhood with families most in need.

Duration and mutual entrainment of changes in parenting practices engendered by behavioral parent training targeting recently separated mothers.

Parent management training (PMT) has beneficial effects on child and parent adjustment that last for 5 to 10 years. Short-term changes in parenting practices have been shown to mediate these effects, but the manner in which changes in specific components of parenting are sequenced and become reciprocally reinforcing (or mutually entrained) to engender and sustain the cascade of long-term beneficial effects resulting from PMT has received modest empirical attention. Long-term changes in parenting resulting from the Oregon model of PMT (PMTO) over a 2-year period were examined using data from the Oregon Divorce Study-II in which 238 recently separated mothers and their 6- to 10-year-old sons were randomly assigned to PMTO or a no treatment control (NTC) group. Multiple indicators of observed parenting practices were used to define constructs for positive parenting, monitoring and discipline at baseline, and at 6-, 12-, 18- and 30-months postbaseline. PMTO relative to NTC resulted in increased positive parenting and prevented deterioration in discipline and monitoring over the 30-month period. There were reliable sequential, transactional relationships among parenting practices; positive parenting supported better subsequent monitoring, and positive parenting and better monitoring supported subsequent effective discipline. Small improvements in parenting resulting from PMTO and small deteriorations in parenting in the NTC group may be sustained and amplified by mutually entrained relationships among parenting practices. These data about the change processes engendered by PMTO may provide information needed to enhance the power, effectiveness, and efficiency of behavioral parent training interventions.

Looking Forward: The Promise of Widespread Implementation of Parent Training Programs.

Over the past quarter century, researchers have developed a body of parent training programs that have proven effective in reducing child behavior problems, but few of these have made their way into routine practice. This article describes the long and winding road of implementation as applied to children's mental health. Adopting Rogers' (1995) diffusion framework and Fixsen and colleagues' implementation framework (Fixsen, Naoom, Blase, Friedman, & Wallace, 2005), we review more than a decade of research on the implementation of Parent Management Training-Oregon Model (PMTO). Data from U.S. and international PMTO implementations are used to illustrate the payoffs and the challenges of making empirically supported interventions routine practice in the community. Technological advances that break down barriers to communication across distances, the availability of efficacious programs suitable for implementation, and the urgent need for high quality mental health care provide strong rationales for prioritizing implementation. Over the next quarter of a century, the challenge is to reduce the prevalence of children's psychopathology by creating science-based delivery systems to reach families in need, everywhere.

Covert antisocial behavior, peer deviancy training, parenting processes, and sex differences in the development of antisocial behavior during childhood.

Two longitudinal studies were used to examine the occurrence and consequences of peer deviancy training during childhood and the relative role of early covert antisocial behavior in risk for antisocial behavior in early adolescence. Peer deviancy training was apparent in a sample of at-risk first grade children, and it showed persistence and increased prevalence across the school year. Peer deviancy training, peer rejection, and unskilled parenting made additive contributions to the development of antisocial behavior during kindergarten and first grade and to antisocial behavior in fourth grade. Skilled parenting partially mitigated the association of peer deviancy training with antisocial behavior for boys. The appearance and growth of covert antisocial behavior was a predictor of fourth grade antisocial for boys and girls, more so than aggressive and overt antisocial behavior. Peer deviancy training and early covert antisocial behavior were key pathways to girls' antisocial behavior in fourth grade, and they complemented the roles of peer rejection and overt antisocial behavior for boys. The relationships of parenting and peer processes to trajectories of antisocial behavior were similar for boys and girls; but boys showed higher levels of antisocial behavior, were more involved in peer deviancy training, and were more likely to experience peer rejection.

Refining Intervention Targets in Family-Based Research: Lessons From Quantitative Behavioral Genetics.

The results from a large body of family-based research studies indicate that modifying the environment (specifically dimensions of the social environment) through intervention is an effective mechanism for achieving positive outcomes. Parallel to this work is a growing body of evidence from genetically informed studies indicating that social environmental factors are central to enhancing or offsetting genetic influences. Increased precision in the understanding of the role of the social environment in offsetting genetic risk might provide new information about environmental mechanisms that could be applied to prevention science. However, at present, the multifaceted conceptualization of the environment in prevention science is mismatched with the more limited measurement of the environment in many genetically informed studies. In this article, we present a framework for translating quantitative behavioral genetic research to inform the development of preventive interventions. The measurement of environmental indices amenable to modification is discussed within the context of quantitative behavioral genetic studies. In particular, emphasis is placed on the necessary elements that lead to benefits in prevention science, specifically the development of evidence-based interventions. We provide an example from an ongoing prospective adoption study to illustrate the potential of this translational process to inform the selection of preventive intervention targets.

Cascading effects following intervention.

Four different sources for cascade effects were examined using 9-year process and outcome data from a randomized controlled trial of a preventive intervention using the Parent Management Training-Oregon Model (PMTO™). The social interaction learning model of child antisocial behavior serves as one basis for predicting change. A second source addresses the issue of comorbid relationships among clinical diagnoses. The third source, collateral changes, describes events in which changes in one family member correlate with changes in another. The fourth component is based on the long-term effects of reducing coercion and increasing positive interpersonal processes within the family. New findings from the 9-year follow-up show that mothers experienced benefits as measured by standard of living (i.e., income, occupation, education, and financial stress) and frequency of police arrests. It is assumed that PMTO reduces the level of coercion, which sets the stage for a massive increase in positive social interaction. In effect, PMTO alters the family environment and thereby opens doors to healthy new social environments.

Testing the Oregon delinquency model with 9-year follow-up of the Oregon Divorce Study.

This paper presents experimental tests of the Oregon delinquency model applied within a randomized design of an at-risk sample of single mothers and their elementary school-aged sons. In the theoretical model, ineffective parenting practices and deviant peer association serve as the primary mechanisms for growth in adolescent delinquent behavior and early arrests. Multiple-method assessments of 238 mothers and sons include delinquency as measured by teacher reports and official arrest records, parenting skills measured by observations of parent-child interactions, and deviant peer association as reported by focal boys. Analyses of the 9-year follow-up data indicate that the Oregon model of parent management training significantly reduced teacher-reported delinquency and police arrests for focal boys. As hypothesized, the experiments demonstrated that improving parenting practices and reducing contacts with deviant peers served as mediating mechanisms for reducing rates of adolescent delinquency. As predicted, there was also a significant delay in the timing of police arrests for youth in the experimental as compared to the control group.

A Comparison of Models for Interstate Wars and for Individual Violence.

It is assumed that violence is functional at both individual and societal levels. A model developed for violent individuals is compared with a proposed model for interstate wars. In both domains, the data are consistent with the assumption that violence is functional. At the societal level, the contingencies of training are provided by official staff and require reasonably well-socialized soldiers. At the individual level, reinforcers are provided by victims, and aggressors are usually socially incompetent. In the societal model, decision makers receive rein-forcers for initiating and winning wars. The combat soldiers' behavior is somewhat paradoxical. Soldiers are thought to remain in harm's way out of love for their buddies. The actual reinforcers for their combat behavior are unknown.

Toward a comprehensive model of antisocial development: a dynamic systems approach.

The purpose of this article is to develop a preliminary comprehensive model of antisocial development based on dynamic systems principles. The model is built on the foundations of behavioral research on coercion theory. First, the authors focus on the principles of multistability, feedback, and nonlinear causality to reconceptualize real-time parent-child and peer processes. Second, they model the mechanisms by which these real-time processes give rise to negative developmental outcomes, which in turn feed back to determine real-time interactions. Third, they examine mechanisms of change and stability in early- and late-onset antisocial trajectories. Finally, novel clinical designs and predictions are introduced. The authors highlight new predictions and present studies that have tested aspects of the model

The contributions of ineffective discipline and parental hostile attributions of child misbehavior to the development of conduct problems at home and school.

Data were collected in a longitudinal study of 134 boys and 132 girls and their families during kindergarten and first grade. Four hours of parent-child interaction were coded to ascertain parent discipline practices. A structured interview assessed maternal attributions about child behavior. Maternal ratings of child conduct problems at kindergarten entry reliably predicted the mother's subsequent hostile attributions concerning child misbehavior and use of ineffective discipline tactics. Ineffective maternal discipline and the interaction of ineffective discipline and hostile attribution predicted growth in child conduct problems at home during kindergarten and first grade. Changes in teacher-reported and observed child conduct problems at school during kindergarten and first grade were predicted by growth in conduct problems at home and by the interaction of ineffective discipline and hostile attribution.

Deviancy training and association with deviant peers in young children: ocurrence and contribution to early-onset conduct problems.

The relationships of deviant talk and role taking during peer interaction, association with deviant peers, and growth in overt and covert conduct problems during kindergarten and first grade were examined in a community sample of 267 boys and girls. At entry to kindergarten, high levels of overt and covert conduct problems predicted association with deviant peers, and deviant peer association predicted deviant talk and role taking during peer interaction during kindergarten. Association with deviant peers, and deviant talk and role taking predicted growth in overt and covert conduct problems on the playground, in the classroom, and at home during kindergarten and first grade. Peer processes associated with growth in conduct problems that escalate rapidly during late childhood and adolescence appear to occur in earlier childhood. These peer processes may play a central role in the evolution of conduct problems to include covert as well as overt forms.

Evaluating fidelity: predictive validity for a measure of competent adherence to the Oregon model of parent management training.

When efficacious interventions are implemented in real-world conditions, it is important to evaluate whether or not the programs are practiced as intended. This article presents the Fidelity of Implementation Rating System (FIMP), an observation-based measure assessing competent adherence to the Oregon model of Parent Management Training (PMTO). FIMP evaluates 5 dimensions of competent adherence to PMTO (i.e., knowledge, structure, teaching skill, clinical skill, and overall effectiveness) specified in the intervention model. Predictive validity for FIMP was evaluated with a subsample of stepfamilies participating in a preventive PMTO intervention. As hypothesized, high FIMP ratings predicted change in observed parenting practices from baseline to 12 months. The rigor and scope of adherence measures are discussed.

How do outcomes in a specified parent training intervention maintain or wane over time?

In a randomized prevention trial, 238 recently separated mothers and their young sons were assigned to either Parent Management Training (PMT) or a comparison group. Families were intensively assessed at baseline and at each 6-month interval through 30 months. To understand the effects of PMT, we first evaluated effect sizes among family variables over time. Second, because observed parenting was the target of PMT, we hypothesized a sequential pattern of structured changes within and between individuals. Using constructs with mismatched sources of data, we conducted a set of latent growth mediational analyses to test hypothesized mechanisms explaining change. Effect sizes indicated that parenting changed first within 12 months, followed by changes in boy behaviors and finally changes in maternal depression within 30 months. Unique follow-up findings indicated that intervention effects on reductions in maternal depression were mediated by reductions in boy externalizing; intervention effects on externalizing were mediated by reductions in boy depression. As expected, increases in effective parenting predicted reductions in child behavior problems. PMT effects on internalizing were direct and indirect, partially mediated by parenting practices. Results are discussed from a system's perspective on PMT amplifiers.

Systematic changes in families following prevention trials.

A selective prevention design was applied to 238 recently separated families. Of these, 153 mothers randomly assigned to the experimental (E) group participated in 14 group sessions focused on Parent Management Treatment (PMT). Prior analyses showed that, over time, the group of families in the untreated group deteriorated in both parenting practices and in child outcomes. In keeping with the classic prevention pattern, families in the E group showed modest improvements in parenting and in child outcomes. Improvements in parenting were associated with significant reductions in problem behavior. The data showed that those mothers who improved their parenting skills during the first 12 months also showed significant reductions in maternal depression during that same interval. A cross-lagged panel analysis showed that a reduction in maternal depression during the first year of the study was a significant predictor of maintenance or improvements over the next 18 months. The findings are consistent with the concept of the family as a system.

Longitudinal analysis of flexibility and reorganization in early adolescence: a dynamic systems study of family interactions.

A dynamic systems (DS) approach was used to study changes in the structure of family interactions during the early adolescent transition period. Longitudinal observational data were collected in 5 waves prior to, during, and after the transition. Boys (n = 149 families) were videotaped problem solving with their parents at 9-10 years old and every 2 years thereafter until they were 18 years old State space grids (a new DS method) were constructed for all families across all waves. Two variables indexing the variability of the family interactions were derived from the grids. As hypothesized, the DS variables revealed a significant quadratic effect related to a peak in variability at 13-14 years of age.

Continuity of parenting practices across generations in an at-risk sample: a prospective comparison of direct and mediated associations.

A prospective model of parenting and externalizing behavior spanning 3 generations (G1, G2, and G3) was examined for young men from an at-risk sample of young adult men (G2) who were in approximately the youngest one third of their cohort to become fathers. It was first predicted that the young men in G2 who had children the earliest would show high levels of antisocial behavior. Second, it was predicted that G1 poor parenting practices would show both a direct association with the G2 son's subsequent parenting and a mediated effect via his development of antisocial and delinquent behavior by adolescence. The young fathers had more arrests and were less likely to have graduated from high school than the other young men in the sample. Findings were most consistent with the interpretation that there was some direct effect of parenting from G1 to G2 and some mediated effect via antisocial behavior in G2.