Effect Of Parent Training On Children With Attention-deficit/Hyperactivity Disorder

Objective:1.To investigate the effectiveness of parent training(PT)on ADHD symptom,parent-child relationship,parental rearing practice and parents'mental health.2.To explore the effect of parent training on drug treatment compliance of children with ADHD.Methods:83 subjects with attention-deficit/hyperactivity disorder(ADHD)aged 6-16meeting the diagnostic criteria of the International Classification of Diseases 10 (ICD-10),all referred to Shanghai mental health center,were assigned to 7 weeks of PT plus concurrent routine clinical care(RCC)(n=54)or to 7 weeks of RCC(n=29)alone.PT consisted of 7sessions in group format;RCC included supportive counseling,with or without pharmacotherapy.Children with and without medication could participate.Parent-reported Version IV Scale-parent form(SNAP-?),ODD symptom scale,caregiver strain questionnaire(CGSQ),Self-Rating Parent-child relationship scale,anxiety self-rating scale(SAS),depression self-rating(SDS)and self-made drug therapy questionnaire were assessed before and after seven weeks treatment.The childrenover 10 years of age completed Egna Minnen Betraffande uppfostran(EMBU)before and after intervention.Results:1.Repeated measures ANOVA of SNAP-?:the differences of two groups patients with different time in attention deficit(F=0.4,p=0.51),hyperactivity and impulsivity subscores(F=20.53,p=0.47)have no statistical significance.Compared with the baseline,after training,attention deficit(t=4.42,p=0.00),hyperactivity,and impulsivity(t=2.13,p=0.04)subscores of SNAP-? were all significantly decreased;compared with the baseline,in control group attention deficit subscores were significantly decreased after follow-up,(t=3.27,p=0.00);2.Repeated measures ANOVA of ODD symptom scale:the differences of two groups patients with different time in ODD symptom(F=1.45,p=0.23)have no statistical significance.Compared with the baseline,after parent training,ODD symptom scores were significantly decreased(t=2.78,p=0.01)3.Repeated measures ANOVA of CGSQ:the differences of two groups patients with different time in subjective strain(F=0.95,p=0.33),objective strain(F=0.11,p=0.74)subscore and CGSQ total score(F=0.15,p=0.70)have no statistical significance.Compared with the baseline,after training subscores of subjective strain were significantly decreased;4.Repeated measures ANOVA of Self-Rating Parent-child relationship scale:the differences of two groups patients with different time in total score have no statistical significance(F=0.15,p=0.70);Compared with the baseline,after training,the total score of Self-Rating Parent-child relationship scale in invention group was significantly decreased(t=-2.59,p=0.01);compared with the baseline,after follow-up,in control group,the total score of Self-Rating Parent-child relationship scaleincreased(t=-2.66,p=0.02);4.After training,in the intervention group,the scores of mother's refusal,denial(t=3.26,p=0.02)and over-interference(t=3.59,p=0.02)were all significantly decreased;after training,the scores of father's over-interference was significantly increased(t=-2.63,P=0.03).5.After intervention,the rate of children taking medication in the intervention group increased by 14.73%,while increased by 18.18%in the control group,the difference was not statistically significant(?~2=0.61,p=0.44);6.Compared with the control group,the acceptance rate of drug treatment in the intervention group was significantly higher and the differences were statistically significant(?~2=13.86,P=0.00).Conclutions:1.Adjunctive PT maybe limit the prescription of polypharmaceutical treatment.However,parents'drug treatment acceptance rate was significantly improved after parent training,which is conducive to children's long-term drug treatment compliance;2.Adjunctive PT did not show significant advantages on children's ADHD core symptoms,ODD symptoms,parenting stress and parent-child relationship compared with routine treatment,while the results of the study showed that PT has the potential to improve behaviorial problems,reduce the parenting pressure,promote a better development of parent-child relationship and improve mother's rearing style.While due to the small sample size and short follow-up time,the significant heterosis of the drug samples,the effect of parent training was not significant.Expand the sample size and extend follow-up time,the effect maybe significant.