ABSTRACT

Objective

Few studies have evaluated attachment-based parent interventions for pre-teens and teens, and in particular, differential adolescent trajectories of response. This study examined distinct patterns, and multi-level predictors, of intervention response among youth with serious behavioral and mental health problems whose parents participated in Connect, an attachment- and trauma-informed parent program.

Method

Participants included 682 parents (M_age = 42.83, 86% mothers) and 487 youth (M_age = 13.95, 53% female, 28.1% ethnic minority) enrolled in a community-based evaluation of Connect. Parents and youth reported on youth externalizing and internalizing problems (EXT and INT) at six time points from baseline through 18-months post-intervention. Demographic and youth and family level predictors were assessed at baseline.

Results

Growth mixture modeling revealed three distinct trajectory classes in both the parent and youth models based on different patterns of co-occurring EXT and INT and degree of improvement over time. Youth with severe EXT showed the largest and fastest improvement, and, interestingly, were characterized by higher callous-unemotional traits and risk-taking at program entry. Youth with comorbid EXT/INT demonstrated a partial or moderate response to intervention in the parent and youth model, respectively, and were characterized by more attachment anxiety at baseline. Most youth showed relatively moderate/low levels of EXT/INT at baseline which gradually improved. Caregiver strain also predicted trajectory classes.

Conclusions

These results have significance for tailoring and personalizing interventions for high-risk youth and provide new understanding regarding the profiles of subgroups of youth who show different responses to an attachment-based parent intervention.

中文翻译：

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不同青少年对依恋父母干预的反应模式和预测因素

摘要

客观的

很少有研究评估针对青少年前和青少年的基于依恋的父母干预措施，特别是不同的青少年反应轨迹。这项研究检查了父母参加了Connect（依恋和创伤知情父母计划）的有严重行为和心理健康问题的青少年的干预反应的不同模式和多层次预测因素。

方法

参与者包括参加基于社区的Connect评估的682 名父母（M_年龄 = 42.83，86% 的母亲）和 487 名青年（M_年龄 = 13.95，53% 的女性，28.1% 的少数民族）。父母和青少年在从基线到干预后 18 个月的六个时间点报告了青少年外化和内化问题（EXT 和 INT）。在基线时评估了人口统计和青年及家庭水平的预测因素。

结果

生长混合模型揭示了父母模型和青少年模型中的三个不同的轨迹类别，这些轨迹类别基于同时发生的 EXT 和 INT 的不同模式以及随时间的改进程度。患有严重 EXT 的青少年表现出最大和最快的改善，有趣的是，其特点是在项目进入时具有更高的冷酷无情特征和冒险精神。患有 EXT/INT 共病的青少年分别对父母和青少年模型的干预表现出部分或中度反应，并且在基线时表现出更多的依恋焦虑。大多数年轻人在基线时表现出相对中等/低水平的 EXT/INT，并逐渐改善。照顾者压力也预测了轨迹类别。

结论

这些结果对于为高危青少年量身定制和个性化干预具有重要意义，并为对基于依恋的父母干预表现出不同反应的青少年亚群的概况提供新的理解。