Child Behavior Problem
Conditions
Keywords
attachment, parent, training, sensitivity
Brief summary
Background:The quality of attachment is greatly influenced by parental sensitivity. Attachment based interventions are designed to promote parental sensitivity, to change parental mental representations and to improve understanding of the developmental needs of the child. Very few studies have investigated the effect of attachment-based interventions on psychiatric symptoms in children. Targeting parental sensitivity and the parent-child interaction might have an important impact on psychiatric symptoms in a clinical sample of children referred to child psychiatric services. Objectives: The primary objective is to investigate whether Circle of Security-Parenting (COS-P) has an effect on parental sensitivity in parents of children referred to child psychiatric services. The secondary objectives are to investigate the effect on children's behavioral and emotional symptoms and the parental stress and reflective functioning after 10 weeks of intervention and at the 24 week follow-up. The study is also exploring the effect of parental attachment style, parental stress and parental psychopathology on the effect of the intervention. Methods: The trial will include 128 families of children (age 3-8 years) who are referred to child psychiatric services in a randomized and controlled design. Included families will be randomized to COS-P+ Treatment as Usual (TAU) or TAU only. Perspectives: Considering the important impact of the quality of the parent-child relationship on the child's well-being, it is essential to target it in interventions and to investigate the relation with psychiatric symptoms. Generally there is a lack of interventions targeting parental sensitivity in psychiatric child populations. Working with the parents on the child-parent relation, might have an important impact on their children's current psychiatric symptoms and could additionally prevent future psychopathology.
Interventions
OTHERCircle of Security-Parenting
COS-P is a brief, behavioral and insight oriented therapeutic group approach for parents with the aim to promote parental sensitivity and attachment and autonomy in the parent-child relationship. The parents will participate in ten weekly 1,5-hour sessions at the clinic conducted by two COS-certified therapists. Groups will include 4-5 families at a time.
OTHERTreatment as Usual
TAU consists of clinical assessment and treatment.
Sponsors
Region Syddanmark
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
3 Years to 8 Years
Healthy volunteers
No
Inclusion criteria
* Children who score equal or above the 93d percentile on CBCL-total score * Score above 93d percentile on the CBCL- ODD or aggression scale * Informed consent from both custody.
Exclusion criteria
For children: * autism spectrum disorders * serious psychopathology requiring immediate clinical attention * head injury or verified neurological disease * intelligence quotient (IQ) \<80 * medical condition, requiring treatment * no informed consent from custody For parents: * a diagnosis of schizophrenia * bipolar disorder * known substance abuse * severe intellectual impairment * suicide attempt in the past
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Maternal sensitivity | after 10 weeks of intervention | Maternal sensitivity is measured by observing a mother-child interaction and is rated using Coding Interactive Behavior (CIB) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Dyadic reciprocity | after 10 weeks of intervention | Measured by observing a mother-child interaction and is rated using Coding Interactive Behavior (CIB) |
| Negative states | after 10 weeks of intervention | Measured by observing a mother-child interaction and is rated using Coding Interactive Behavior (CIB) |
| Child Behaviour Check List (CBCL)-Total score-parent rated | after 10 weeks of intervention | Parent questionnaire on child symptoms. Score range (0-236). Higher indicates more problems. |
| CBCL-ODD score-parent rated. Score range: 0-26. Higher indicates more problems. | after 10 weeks of intervention | Parent questionnaire on child symptoms |
| Berkeley Puppet interview | after 10 weeks of intervention | Child interview |
| Coping with childrens negative emotions scale | baseline | Parent questionnaire on their strategies coping with children's negative emotions. Score range 72-504. |
| Parental Reflective Functioning Questionnaire | baseline | Parent self-report measure that assesses parental reflective functioning or mentalizing. Score range 1-126. |
| Eyberg Child Behaviour Inventory (ECBI) | after 10 weeks of intervention | Parent questionnaire on child behavior. Score range 36-252. Higher indicating more problems. |
| Maternal Intrusiveness | after 10 weeks of intervention | Measured by observing a mother-child interaction and is rated using Coding Interactive Behavior (CIB) |
| Maternal Sensitivity | 24 week follow-up | Measured by observing a mother-child interaction and is rated using Coding Interactive Behavior (CIB) |
Other
| Measure | Time frame | Description |
|---|---|---|
| Standardized Assessment of Personality (SAPAS)-mother and partner | baseline | A short and simple interview-administered screen for personality disorders. Score range 1-8, higher score indicating more problems. |
| Strength and Difficulties Questionnaire (SDQ) | baseline | Parent questionnaire on the strength and difficulties of the child. Total difficulties score 0-40. Higher indicating more problems. |
| Brief Symptom Inventory | baseline | Parent questionnaire on their own symptoms. Score range 0-212. Higher indicating more problems. |
| Attention Deficit Hyperactivity Disorder- Rating Scale (ADHD-RS) | after 10 weeks of intervention | Parent questionnaire on child ADHD symptoms. Score range: 1-78. Higher indicates more problems. |
| Parental Stress Scale | after 10 weeks of intervention | Parent rating scale on their stress level. Score range: 18-90. Higher scores indicate more stress. |
| Major Depression Inventory- mother and partner | baseline | Parent questionnaire on their own depressive symptoms. Score range 0-50. Higher scores indicating more severe symptoms. |
| Revised Adult Attachment Scale (RAAS) | baseline | Questionnaire regarding the attachment style of the mother and partner. Scofre range 18-90. |
Countries
Denmark
Contacts
Primary ContactAida Bikic, PhD
Backup ContactSøren Dalsgaard, PhD
Outcome results
None listed