コーチング代替子育て戦略 (CAPS) 研究 (CAPS)
コーチング代替子育て戦略 (CAPS) 研究: 高リスク家族における自己調整の神経生物学的および行動的メカニズムを標的とする
調査の概要
詳細な説明
児童虐待(CM)は米国における深刻な公衆衛生問題であり、子どもの自己調整スキルの発達を損ない、薬物使用やその他の規制障害のリスクを増幅させることが知られています。 20セッションの集中的な子育て介入である親子相互作用療法(PCIT)は、CMの子育ての質を改善し、前向きな子育てと子どもの行動を改善し、CMの再犯率を減少させることが示されています(Chaffin et al.、2004)。ただし、その効果の根底にあるメカニズムはほとんど理解されていません。 このプロジェクトは、(a) 実験的介入デザインを使用して PCIT の効果の根底にある変化の理論モデルをテストする、(b) 一連の自己調節の神経行動学的尺度を含む、(c) を使用するという点で、CM 介入文献のギャップに対処します。親の自己規制を強化し、CMを軽減し、子供の規制と行動の改善を支援するための、証拠に基づく介入のRCTにおける子育ての観察的測定。 研究の目的は次のとおりです。
目的 1: 過酷で嫌悪的な子育てと CM 再犯の減少、子供の行動適応の促進など、CM 特有の結果に対する PCIT の主な効果をテストする。 介入家族は、サービスを受けている家族と比較して、事後テストで有意に大きな行動改善(つまり、否定的な子育ての減少、肯定的な子育ての増加、子供の内在化/外在化の問題の減少)を示し、6か月の追跡調査でCM再犯率が低いという仮説が立てられています。いつものように(SAU)。
具体的な目的 2: CM の親の自主規制の指標に対する PCIT の影響を判断する。 まず、研究者らは、PCIT が子育てにおける CM 親の自己調整能力の向上に直接効果を及ぼすという仮説を検証します。 第二に、研究者らは、親の自己規制の尺度が、CM の減少と子育ての改善に対する PCIT 介入の効果をどのように仲介するかを調査する予定である。 第三に、研究者らは、親の介入前の自己規制レベルが結果に対する介入効果を和らげるかどうかを調査する予定である。 CM サブタイプの調整役割 (つまり、身体的虐待対ネグレクト)、重症度、および関心のある結果に対するその他の重要な社会的文脈の要因も考慮されます。
具体的な目的 3: CM 児童の自己調整の神経行動指標に対する PCIT の影響を調査する。 CM は、注意、感情、生理機能、行動を調整する子供の能力の発達に悪影響を及ぼします。 これらの領域の欠陥は、精神病理学、早期に発症する行為上の問題、およびその後の薬物乱用のリスクを高めます。 研究者らは、PCITは主に子育てを対象としているが、対照群と比較して治療後のCM小児の自己調節の神経生物学的指標の改善に影響を与えるだろうと仮説を立てている。 次に、研究者らは、子育てへの介入効果によって子どもの成果がどの程度影響を受けるかをテストする予定である。 PCIT に基づく介入の結果として嫌悪的な子育てが減少することにより、子どもの規制上の欠陥や問題行動が軽減されるだろうとの仮説が立てられています。
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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Oregon
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Eugene、Oregon、アメリカ、97403
- University of Oregon
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
説明
包含基準:
- レーン郡在住
- 親は18歳以上です
- ベースライン時点で3歳から7歳までの子供の実母または監護者の母親
- 子供と同じ家庭環境に住んでいる
- 英語が流暢である必要があります
- 母親と子供は身体的に評価を完了できる必要があります
- 家族はレーン郡署に未解決の訴訟を起こしている。 保健サービス。
除外基準:
- 家庭内での児童への性的虐待
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:独身
武器と介入
参加者グループ / アーム |
介入・治療 |
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実験的:親子インタラクションセラピー (PCIT)
参加者は親子インタラクションセラピー(PCIT)を受けます。 PCIT は、過酷で強制的な相互作用のパターンを遮断し、親の温かく前向きな子育て、自主性のサポート、有能な児童管理スキルを高めることによって、児童の機能を改善するように設計されています。 。 |
PCIT は、16 ~ 20 セッションのライブコーチングによる子育て介入です。
児童福祉家庭向けの PCIT は、モチベーション向上トレーニングに続いて 2 つの連続した治療フェーズで提供されます。フェーズ 1、子ども主導型相互作用 (CDI) は、前向きな子育てを強化し、過酷な嫌悪感のある子育てを中断します。フェーズ 2、親主導型相互作用 (PDI) は、効果的な親のコマンドと、子供が従わないときの一貫したタイムアウト プロトコルを指導します。
他の名前:
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介入なし:通常通りのサービス (SAU)
参加者は、福祉省 (DHS) 児童サービスが提供する通常のサービスをすべて受けられます。
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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DPICS-IV で観察された子育てスキル (子ども主導の遊び中)
時間枠:介入前および介入後 (8 か月)
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二項親子インタラクション コーディング システム (DPICS) は、DPICS の子ども主導の遊びタスク中に、肯定的な「プライド」の子育てスキルと否定的な「やってはいけないスキル」の子育て行動をコード化しました。
スコアは 5 分間のタスク中の行動数を反映し、スコアが高いほどより多くの行動を反映します。
より高い肯定的な子育てスコアはより良い結果を反映し、より高い否定的な子育てスコアはより悪い結果を反映します。
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介入前および介入後 (8 か月)
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クリーンアップ状況タスク中の DPICS-IV 観察コーディング
時間枠:介入前および介入後 (8 か月)
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DPICS コード化されたポジティブな「PRIDE」子育てスキル、効果的な親のコマンド、および DPICS クリーンアップ状況タスク中の子供のコンプライアンス行動。
肯定的な子育てスコアは、タスク中のコード化された行動の合計のうち、肯定的な「プライド」スキルである割合を反映します。
有効な (直接の) 親コマンドは、直接の準拠可能なコマンドであったすべてのコマンドの割合を反映します。
子供の遵守スコアは、直後の行動ターンで子供が従った効果的な直接的な命令の割合を反映しました。
3 つのスケールすべてで高いスコアは、より良い結果を反映しています。
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介入前および介入後 (8 か月)
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停止信号タスク: 親の抑制制御の強化
時間枠:介入前と介入後 (8 か月)
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停止信号応答時間 (SSRT) を使用して、親の抑制制御プロセスの効率、または抑制応答を引き起こすのに必要な時間をミリ秒単位で評価しました。
SSRT スコアが低いほど、反応時間が速くなり、抑制制御が優れていることを反映します。
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介入前と介入後 (8 か月)
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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児童虐待 (CM) の再犯の減少
時間枠:治療後最長1年
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児童福祉事件記録の虐待分類コーディングごとに、CM の新しいエピソードが少なくなる
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治療後最長1年
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その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
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BRIEF-A: 感情制御スケール (親の感情規制の増加)
時間枠:介入前と介入後 (8 か月)
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親は BRIEF-A 感情コントロールの問題スケールで自己報告し、スコアが低いほど感情コントロールの問題が少ない (つまり、感情制御が優れている) ことを示します。
標準化された T スコア (M=50、SD = 10) が得られます。
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介入前と介入後 (8 か月)
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BRIEF (実行機能の行動評価目録) 子供の成果
時間枠:介入前と介入後
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抑制、シフト、および感情コントロールの問題に関する親の報告書ごとの子供のBRIEFスコアは、スコアが低いほど規制上の問題が少ないことを反映しています。
標準化された T スコア (M=50、SD = 10) が得られます。
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介入前と介入後
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親の生理的調節
時間枠:介入前と介入後
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生理学的調節 (呼吸性洞性不整脈または RSA スコアは、両親の副交感神経系に関連した心臓活動を反映する感情調節の末梢生理学的マーカーです。
RSA スコアは、安静時および子供との感情的に顕著な相互作用に応じた親から得られました。
RSA スコアが高いほど、副交感神経の心臓調節がより優れていることを反映します (より良い結果)。
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介入前と介入後
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子どもの感情規制
時間枠:介入後 (6 か月)
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感情的なゴー/ノーゴータスクのパフォーマンス: 怒りに対する誤報。
スコアが高いほど、怒りに対する誤報の割合が高いことを反映します(結果は悪化します)。
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介入後 (6 か月)
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子供の生理的調節
時間枠:介入前と介入後 (8 か月)
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生理学的調節 (呼吸性洞性不整脈または RSA スコアは、小児の副交感神経系に関連する心臓活動を反映する感情調節の末梢生理学的マーカーです。
RSA スコアは、安静時および親との感情的に顕著な相互作用に応じた子供から得られました。
RSA スコアが高いほど、副交感神経の心臓調節がより優れていることを反映します (より良い結果)。
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介入前と介入後 (8 か月)
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子供の症状の軽減
時間枠:介入前と介入後 (8 か月)
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外傷症状チェックリストのスコア (TSCL-YC); T スコアが報告されます。50 は標準偏差 10 の母集団平均を示します。スコアが高いほど、外傷症状が大きいことを示します。
TSCL-YC の臨床的に有意な上昇は、T=70 カットオフ以上のスコアに反映されます。
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介入前と介入後 (8 か月)
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Eyberg Child Behavior Inventory (ECBI) の児童行動問題スコア (破壊的行動の問題の減少)
時間枠:介入前と介入後 (8 か月)
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ECBI は、親が報告した問題児行動の強度 (ECBI-強度スコア) と問題児行動の数 (EBCI-問題スコア) で構成されます。
標準化された T スコア (M=50、SD=10) が報告され、スコアが低いほど結果がより成功したことを反映します。
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介入前と介入後 (8 か月)
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BRIEF-A: 保護者の自己評価
時間枠:介入前と介入後 (8 か月)
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親は BRIEF-A で自己報告し、規制管理の問題が少ないことを反映してスコアが低くなります。
標準化された T スコア (M=50、SD = 10) が得られます。
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介入前と介入後 (8 か月)
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協力者と研究者
スポンサー
捜査官
- 主任研究者:Elizabeth A Skowron, PhD、University of Oregon
出版物と役立つリンク
一般刊行物
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