Comparison of Two Psychosocial Therapies for Treating Children With Oppositional-Defiant Disorder

Mediators, Moderators, and Treatment Outcomes With ODD Youth

This study will evaluate the effectiveness of two different psychosocial therapies, parent management training and collaborative problem solving, in treating children with oppositional-defiant disorder.

Study Overview

• Status: Completed
• Conditions: Oppositional-Defiant Disorder
• Intervention / Treatment: Behavioral: Collaborative problem solving (CPS); Behavioral: Parent management training (PMT); Behavioral: Waitlist control

Detailed Description

Oppositional-defiant disorder (ODD) is characterized by a recurrent pattern of developmentally inappropriate levels of negative, defiant, disobedient, and hostile behavior toward authority figures. Behaviors associated with ODD include temper tantrums; persistent stubbornness; resistance to directions; unwillingness to compromise, give in, or negotiate; deliberate or persistent testing of limits; and verbal and minor physical aggression. The usual treatment approach for children with ODD is parent management training (PMT). PMT primarily involves teaching parents strategies to respond consistently and correctly to their child's behavior. However, PMT does not always lead to longstanding results and there is a need for alternative treatments. Collaborative problem-solving (CPS) is a treatment approach that involves both the parent and child by teaching parents to help their child control their emotions and to problem-solve as a family. This study will compare the effectiveness of CPS and PMT in treating children with ODD.

Participants in this open-label study will include children with ODD and their parents. Participants will be randomly assigned to one of three groups: CPS, PMT, or waitlist control. Parents assigned to the CPS group will be taught strategies to help their child identify and regulate emotions and to solve behavior problems together as a family. Parents assigned to the PMT group will be taught how to respond consistently and appropriately to their child's positive and negative behaviors. Participants assigned to the waitlist control condition group will wait 10 weeks before treatment begins. Participants will attend a 1-hour treatment session each week for 10 weeks. In order to determine whether treatment is effective, participants will be asked to complete a variety of questionnaires, talk with their child about solving problems, and complete a structure diagnostic interview prior to the beginning of treatment, following treatment, and at a 1-year follow-up session. Parents will be asked to submit their child's school grades and school attendance records. If granted permission by the parents, the child's teacher will complete a questionnaire regarding the child's behavior in school for the year prior to participating in the study and up to 1 year after treatment. The information collected will help to determine how treatment affects each child's progress.

• Study Type: Interventional
• Enrollment (Actual): 150
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Virginia
    • Blacksburg, Virginia, United States, 24060
      • Child Study Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 8 years to 14 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria for Children:

• Meets DSM-IV criteria for oppositional-defiant disorder
• Parent or guardian willing to provide informed consent

Exclusion Criteria for Children:

• History or current diagnosis of CD, autism, pervasive developmental disorders (PDD), or any psychotic disorder
• An estimated Full Scale IQ below 80
• Current suicidal or homicidal ideation

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: 1; Participants will receive collaborative problem solving.	Behavioral: Collaborative problem solving (CPS); CPS is a treatment approach that involves both the parent and child by teaching parents to help their child control their emotions and to problem solve as a family. Parents assigned to the CPS group will be taught strategies to help their child identify and regulate emotions and to solve behavior problems together as a family. Participants will attend a 1-hour treatment session each week for 10 weeks.; Other Names: CPS
Active Comparator: 2; Participants will receive parent management training.	Behavioral: Parent management training (PMT); PMT primarily involves teaching parents strategies to respond consistently and correctly to their child's behavior. Parents assigned to the PMT group will be taught how to respond consistently and appropriately to their child's positive and negative behaviors. Participants will attend a 1-hour treatment session each week for 10 weeks.; Other Names: PMT
Active Comparator: 3; Participants assigned to waitlist control will receive one of the two treatments after a 10-weeks waitlist period.	Behavioral: Waitlist control; Participants assigned to the waitlist control condition group will wait 10 weeks before beginning treatment one of the two treatment options.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
ODD, conduct disorder (CD), and attention deficit hyperactivity disorder (ADHD) using a Diagnostic Interview Schedule for Children	Measured at Year 1 follow-up visit
Disruptive Behavior Disorders Rating Scale	Measured at Year 1 follow-up visit

Secondary Outcome Measures

Outcome Measure	Time Frame
Behavior Assessment System for Children	Measured at Year 1 follow-up visit
Parent Satisfaction Questionnaire: Parental satisfaction with the treatment approach and the strategies they use to discipline their children in terms of both difficulty and usefulness	Measured at Weeks 4 and 7, immediately post-treatment, and Year 1 follow-up visit

Collaborators and Investigators

• Sponsor: Virginia Polytechnic Institute and State University
• Collaborators: National Institute of Mental Health (NIMH)
• Investigators: Principal Investigator: Thomas H. Ollendick, PhD, Department of Psychology, Virginia Tech

Study record dates

Study Major Dates

• Study Start: June 1, 2007
• Primary Completion (Actual): August 1, 2012
• Study Completion (Actual): August 1, 2012

Study Registration Dates

• First Submitted: July 30, 2007
• First Submitted That Met QC Criteria: July 30, 2007
• First Posted (Estimate): August 1, 2007

Study Record Updates

• Last Update Posted (Estimate): June 7, 2013
• Last Update Submitted That Met QC Criteria: June 6, 2013
• Last Verified: June 1, 2013

More Information

Terms related to this study

• Keywords: Children; Therapy; Conduct Disorder; Attention Deficit and Disruptive Behavior Disorders; Behavior Problems in Youth; Argumentativeness; Attention Deficit Disorder
• Additional Relevant MeSH Terms: Mental Disorders; Pathologic Processes; Neurodevelopmental Disorders; Disease; Attention Deficit and Disruptive Behavior Disorders
• Other Study ID Numbers: R01MH076141 (U.S. NIH Grant/Contract); DDTR B3-PDC