Objective

Behavioral parent training is an evidence-based intervention for children with attention-deficit/hyperactivity disorder (ADHD), but it is unknown which of its components are most effective. This meta-regression analysis investigated which specific behavioral techniques that parents learn in parent training are associated with effects on parental outcomes.

Method

A search was performed for randomized controlled trials on parent training for children with ADHD, with positive parenting, negative parenting, parenting sense of competence, parent–child relationship quality, and parental mental health as outcome measures. After screening 23,026 publications, 29 studies contributing 138 effect sizes were included (N = 2,345). For each study, the dosage of 39 behavioral techniques was derived from intervention manuals, and meta-regression determined which techniques were related to outcomes.

Results

Parent training had robust small- to medium-sized positive effects on all parental outcomes relative to control conditions, both for unblinded and probably blinded measures. A higher dosage of techniques focusing on the manipulation of antecedents of behavior was associated with better outcomes on parenting sense of competence and parental mental health, and a higher dosage of techniques focusing on reinforcement of desired behaviors was related to larger decreases in negative parenting. Higher dosages of psychoeducation were negatively related to parental outcomes.

Conclusion

Although techniques were not investigated in isolation, the results suggested that manipulation of antecedents of behavior and reinforcement techniques are key components of parent training for children with ADHD in relation to parental outcomes. These exploratory findings may help to strengthen and tailor parent training interventions for children with ADHD.

中文翻译：

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荟萃分析：父母培训的哪些组成部分对注意力缺陷/多动障碍儿童有效？

客观的

行为父母培训是针对注意力缺陷/多动障碍 (ADHD) 儿童的循证干预措施，但尚不清楚其中哪些成分最有效。这项元回归分析调查了父母在父母培训中学习的哪些特定行为技巧与对父母结果的影响有关。

方法

对多动症儿童父母培训的随机对照试验进行了搜索，以积极养育、消极养育、养育能力感、亲子关系质量和父母心理健康作为结果衡量标准。在筛选了 23,026 篇出版物后，纳入了 29 项研究，贡献了 138 个效应量（N = 2,345）。对于每项研究，39 种行为技术的剂量来自干预手册，元回归确定了哪些技术与结果相关。

结果

对于非盲法和可能的盲法测量，家长培训对所有与控制条件相关的家长结果都有强大的中小型积极影响。侧重于操纵行为前因的技术的较高剂量与更好的育儿能力感和父母心理健康的结果相关，而侧重于强化期望行为的技术的更高剂量与消极育儿的更大减少有关。较高剂量的心理教育与父母的结局呈负相关。

结论

虽然技术没有被孤立地研究，但结果表明，对行为和强化技术的前因的操纵是与父母结果相关的多动症儿童父母培训的关键组成部分。这些探索性发现可能有助于加强和定制针对多动症儿童的家长培训干预措施。