Enhancing Long-Term Outcome in Child Behavior Disorders

Summary

Principal Investigator: David Kolko
Affiliation: University of Pittsburgh
Country: USA
Abstract: This application extends an outcome study of acute treatment (NIMH Grant #57727; "Effectiveness of Community Services for Conduct Problems") that compares Community-based (n=72) and Clinical-based (n=72) multimodal treatment protocols for young children (ages 6-11) with a diagnosis of Oppositional Defiant Disorder or Conduct Disorder. The two specialty treatments are being compared to treatment-as-usual in the same health system (TAU; n=40) through a recent supplement (MH 57727-02S1; 6/1/00) and to a fourth comparison group composed of matched healthy controls (CONT; n=60; NINR Grant #07615; 10/1/00). Outcome assessments were conducted at pre- and post-treatment, and at 6-, 12- and 24-month follow-ups. Preliminary outcome (pre-post) analyses indicate higher rates of treatment completion and some differential rates of recovery from ODD or CD favoring the Community (vs. Clinic) condition, and many overall improvements, but few group differences, on clinical outcomes. In addition, specialty treatment shows several improvements on these measures, relative to TAU. This renewal application extends this work by incorporating a novel, long-term assessment and follow-up care phase to address these aims: 1) document the long-term (36-month) follow-up effects of acute treatment, 2) evaluate a booster treatment protocol that is designed to enhance long-term outcome by promoting the maintenance of existing gains and preventing other adverse, high-risk outcomes, and 3) examine multivariate models (individual, contextual, treatment variables) to predict long-term outcomes in this large patient sample, now aged 9-16 years. The specialty treatment cases will be considered for randomization to the booster protocol or routine follow-up care conditions. All four samples will participate in assessments conducted at 36-mos. follow-up (pre-booster assessment), six months later (post-booster treatment; at 42-mos.), and then at three follow-ups (six-months [48-mos.], 1-year [54-mos.], and 2-years later [66-mos.]). The results bear implications for the conceptualization and administration of a chronic care model of behavior problems and will provide the first large-scale evaluation of booster treatment in ODD or CD children.
Funding Period: 1998-08-01 - 2008-11-30
more information: NIH RePORT

Top Publications

  1. ncbi Feasibility and preliminary efficacy of an after-school program for middle schoolers with ADHD: a randomized trial in a large public middle school
    Brooke S G Molina
    Youth and Family Research Program, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
    J Atten Disord 12:207-17. 2008
  2. ncbi Community vs. clinic-based modular treatment of children with early-onset ODD or CD: a clinical trial with 3-year follow-up
    David J Kolko
    Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
    J Abnorm Child Psychol 37:591-609. 2009
  3. ncbi The Child Behavior Checklist (CBCL) and the CBCL-bipolar phenotype are not useful in diagnosing pediatric bipolar disorder
    Rasim Somer Diler
    Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
    J Child Adolesc Psychopharmacol 19:23-30. 2009
  4. ncbi Salivary gonadal and adrenal hormone differences in boys and girls with and without disruptive behavior disorders: Contextual variants
    Lorah D Dorn
    Cincinnati Children s Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, OH, United States
    Biol Psychol 81:31-9. 2009

Detail Information

Publications4

  1. ncbi Feasibility and preliminary efficacy of an after-school program for middle schoolers with ADHD: a randomized trial in a large public middle school
    Brooke S G Molina
    Youth and Family Research Program, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
    J Atten Disord 12:207-17. 2008
    ..This pilot study tests the feasibility and preliminary efficacy of an after-school treatment program for middle schoolers with ADHD using a randomized clinical trial design...
  2. ncbi Community vs. clinic-based modular treatment of children with early-onset ODD or CD: a clinical trial with 3-year follow-up
    David J Kolko
    Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
    J Abnorm Child Psychol 37:591-609. 2009
    ..We discuss the nature and implications of these novel findings regarding the role of treatment context or setting for the treatment and long-term outcome of behavior disorders...
  3. ncbi The Child Behavior Checklist (CBCL) and the CBCL-bipolar phenotype are not useful in diagnosing pediatric bipolar disorder
    Rasim Somer Diler
    Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
    J Child Adolesc Psychopharmacol 19:23-30. 2009
    ..The purpose of this study was to evaluate the usefulness of the CBCL and CBCL-PBD to identify BP in children <12 years old...
  4. ncbi Salivary gonadal and adrenal hormone differences in boys and girls with and without disruptive behavior disorders: Contextual variants
    Lorah D Dorn
    Cincinnati Children s Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, OH, United States
    Biol Psychol 81:31-9. 2009
    ..g., family functioning, delinquent peers) were noted for cortisol and adrenal androgens. Findings argue for considering hormones as an influence on DBD beyond simple direct one-to-one associations...