Current Grants
Parent-child interaction therapy (PCIT) is an evidence-based treatment
for disruptive behavior in young children. Approximately 70% of children
with a disruptive behavior disorder in PCIT studies have a comorbid diagnosis
of ADHD. Yet PCIT has not been directly examined as a treatment for ADHD-related
behaviors per se. The objective of this project is to determine the
applicability of a prescriptive model of psychosocial treatment for ADHD
in preschoolers. Prescriptive treatments try to match patients with the
treatment likely to be most beneficial, based on premorbid
patient characteristics. The characteristic of interest in this application
is the presence or absence of comorbid disruptive behavior disorders [comprised
of Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD)]. The treatments
to be compared are Individual PCIT and Group PCIT. A prescriptive model
of treatment is proposed to test the hypothesis that preschoolers with ADHD
who have co-morbid ODD or CD will require the more intensive treatment (namely,
Individual PCIT) to change their behavior, whereas children with ADHD-only
will require the less intensive treatment (namely, Group PCIT) to change
their behavior.
Project SHAPE has three specific aims:(a) To determine whether children with ADHD-only and their parents will differ from children with ADHD + ODD/CD and their parents on treatment outcome measures at post-treatment and at all follow-up assessments; (b) To conduct an economic evaluation of Group and Individual PCIT for the treatment of ADHD-related behaviors. and (c) To identify determinants of immediate and longer-term treatment response to Individual PCIT and Group PCIT. Multiple informants and methods of measurement will be used to assess parenting skills and coping and children’s ADHD-related behavior problems at home and school.
Participants will be 128 families with a preschool-age child (4 to 6 years) with ADHD. Families will be randomly assigned to one of two groups: (a) Individual PCIT, or (b) Group PCIT, stratified by comorbid diagnostic status. Half (64) of the families (32 families with a child with ADHD-only, and 32 with a child with ADHD and ODD/CD) will receive Individual PCIT. The other 64 families (32 with a child with ADHD only, and 32 with a child with ADHD and ODD/CD) will receive Group PCIT. Comprehensive assessments will be conducted at four time points -- at pre- and post-treatment and at 12- and 24-months post-treatment. We expect all families to show statistically significant improvements on outcome measures immediately after treatment (Group or Individual) and at the follow-up assessments. We expect families of children with ADHD + ODD/CD to show better outcomes after Individual PCIT than Group PCIT on all outcome measures after treatment and at follow-up. We expect equivalence in primary outcome variables between Individual PCIT and Group PCIT for children with ADHD-only and their families, but we expect costs of Group PCIT to be substantially lower than costs of Individual PCIT, providing additional evidence of the utility of prescriptive treatments. Finally, we expect to identify predictors of outcome for young children with ADHD and test models of mechanisms for change by examining concomitant changes in intervention-targeted mediators, such as parenting skills.
Project SHAPE was developed by Drs. Sheila M. Eyberg and Stephen R. Boggs
in the Department of Clinical and Health Psychology at the University of
Florida and Dr. Regina Bussing in the Department of Psychiatry at the University
of Florida and is funded by a grant from the National Institute of Mental
Health.
