Behavioral Parent Training as a Treatment for Externalizing Behaviors and Disruptive Behavior Disorders: A Meta-Analysis

AbstractAttention-Deficit/Hyperactivity Disorder (ADHD) is a childhood psychiatric disorder often comorbid with disruptive behavior disorders (DBDs). ADHD comorbid with DBDs (ADHD+DBDs) is a complex phenotype with a risk component that can be attributed to common genetic variants. Here we report a large GWAS meta-analysis of ADHD+DBDs based on seven cohorts in total including 3,802 cases and 31,305 controls. Three genome-wide significant loci were identified on chromosomes 1, 7, and 11. A GWAS meta-analysis including a Chinese cohort supported the locus on chromosome 11 to be a strong risk locus for ADHD+DBDs across European and Chinese ancestries (rs7118422, P=3.15×10-10, OR=1.17). This locus was not associated with ADHD without DBDs in a secondary GWAS of 13,583 ADHD cases and 22,314 controls, suggesting that the locus is a specific risk locus for the comorbid phenotype.We found a higher SNP heritability for ADHD+DBDs (h2SNP =0.34) when compared to ADHD without DBDs (h2SNP =0.20). Genetic correlations of ADHD+DBDs with aggressive (rg =0.81) and anti-social behaviors (rg=0.82) were high, and polygenic risk score analyses revealed a significant increased burden of variants associated with ADHD and aggression in individuals with ADHD+DBDs compared to ADHD without DBDs. Our results suggests that ADHD+DBDs represent a more severe phenotype with respect to the genetic risk load than ADHD without DBDs, in line with previous studies, and that the risk load to some extent can be explained by variants associated with aggressive behavior.

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Improving Availability, Utilization, and Cost Efficacy of Parent Training Programs for Children with Disruptive Behavior Disorders

Preventing Childhood Disorders, Substance Abuse, and Delinquency ◽

10.4135/9781483327679.n7 ◽

2014 ◽

pp. 144-160 ◽

Cited By ~ 9

Author(s):

Charles Cunningham

Keyword(s):

Parent Training ◽

Disruptive Behavior ◽

Behavior Disorders ◽

Training Programs ◽

Disruptive Behavior Disorders ◽

Parent Training Programs ◽

Cost Efficacy

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Meta-Analysis of fMRI Studies of Disruptive Behavior Disorders

American Journal of Psychiatry ◽

10.1176/appi.ajp.2016.15081089 ◽

2016 ◽

Vol 173 (11) ◽

pp. 1119-1130 ◽

Cited By ~ 63

Author(s):

Analucia A. Alegria ◽

Joaquim Radua ◽

Katya Rubia

Keyword(s):

Disruptive Behavior ◽

Behavior Disorders ◽

Meta Analysis ◽

Disruptive Behavior Disorders

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Risk variants and polygenic architecture of disruptive behavior disorders in the context of attention-deficit/hyperactivity disorder

Nature Communications ◽

10.1038/s41467-020-20443-2 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Ditte Demontis ◽

◽

Raymond K. Walters ◽

Veera M. Rajagopal ◽

Irwin D. Waldman ◽

...

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Disruptive Behavior ◽

Attention Deficit ◽

Behavior Disorders ◽

Meta Analysis ◽

Disruptive Behavior Disorders ◽

Genetic Correlations ◽

Chromosome 11 ◽

Hyperactivity Disorder ◽

Risk Variants

AbstractAttention-Deficit/Hyperactivity Disorder (ADHD) is a childhood psychiatric disorder often comorbid with disruptive behavior disorders (DBDs). Here, we report a GWAS meta-analysis of ADHD comorbid with DBDs (ADHD + DBDs) including 3802 cases and 31,305 controls. We identify three genome-wide significant loci on chromosomes 1, 7, and 11. A meta-analysis including a Chinese cohort supports that the locus on chromosome 11 is a strong risk locus for ADHD + DBDs across European and Chinese ancestries (rs7118422, P = 3.15×10−10, OR = 1.17). We find a higher SNP heritability for ADHD + DBDs (h2SNP = 0.34) when compared to ADHD without DBDs (h2SNP = 0.20), high genetic correlations between ADHD + DBDs and aggressive (rg = 0.81) and anti-social behaviors (rg = 0.82), and an increased burden (polygenic score) of variants associated with ADHD and aggression in ADHD + DBDs compared to ADHD without DBDs. Our results suggest an increased load of common risk variants in ADHD + DBDs compared to ADHD without DBDs, which in part can be explained by variants associated with aggressive behavior.

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Multiple Family Group Service Delivery Model for Children With Disruptive Behavior Disorders: Impact on Caregiver Stress and Depressive Symptoms

Journal of Emotional and Behavioral Disorders ◽

10.1177/1063426617717721 ◽

2017 ◽

Vol 26 (3) ◽

pp. 182-192 ◽

Cited By ~ 2

Author(s):

Geetha Gopalan ◽

Lindsay A. Bornheimer ◽

Mary Acri ◽

Andrew Winters ◽

Kyle H. O’Brien ◽

...

Keyword(s):

Depressive Symptoms ◽

Disruptive Behavior ◽

Behavior Disorders ◽

Disruptive Behavior Disorders ◽

Behavioral Parent Training ◽

Multiple Family Group ◽

Strengthening Families Program ◽

Clinically Significant ◽

Strengthening Families

Disproportionately high rates of caregiver stress and depression are found among poverty-impacted communities, with high levels of caregiver stress and depression putting youth at heightened risk for the onset and perpetuation of disruptive behavior disorders. The purpose of this study was to examine the effects of a behavioral parent training program called the 4Rs and 2Ss for Strengthening Families Program (4R2S) on caregiver stress and depressive symptoms among 320 youth aged 7 to 11 and their families assigned to either the 4R2S or services as usual (SAU) condition. Among caregivers with clinically significant (CS) scores at baseline, 4R2S participants manifested significantly reduced scores on the stress and depressive symptom scores to SAU participants at 6-month follow-up. Findings suggest that 4R2S may reduce caregiver stress and depressive symptoms among those caregivers initially manifesting CS levels of stress or depressive symptoms.

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The Efficacy of Parent Training Interventions for Disruptive Behavior Disorders in Treating Untargeted Comorbid Internalizing Symptoms in Children and Adolescents: A Systematic Review

Clinical Child and Family Psychology Review ◽

10.1007/s10567-021-00349-1 ◽

2021 ◽

Author(s):

Eleni Zarakoviti ◽

Roz Shafran ◽

Danai Papadimitriou ◽

Sophie D. Bennett

Keyword(s):

Parent Training ◽

Disruptive Behavior ◽

Internalizing Problems ◽

Behavior Disorders ◽

Internalizing Symptoms ◽

Disruptive Behavior Disorders ◽

Future Research ◽

Triple P ◽

Training Interventions ◽

The Impact

AbstractDisruptive behavior disorders (DBDs) are among the primary reasons for child and youth referrals to mental health services and are linked to poor adult outcomes including antisocial behavior disorder. Research indicates a high incidence of internalizing problems in those with DBDs and those who have DBDs with cooccurring internalizing problems may have more severe later outcomes. Interventions targeted at internalizing symptoms have been found to also reduce comorbid externalizing problems. The impact of treatments for DBDs on comorbid internalizing disorders is not known. Databases PsycINFO, EMBASE and MEDLINE were systematically searched based on the Cochrane guidelines for systematic reviews. Records were independently reviewed by two reviewers. 12 papers were deemed eligible. A quality assessment of the selected studies was conducted independently by both reviewers. The 12 studies included 1334 young people with a mean age of 5 years. The parent training interventions assessed were the Incredible Years (6/12 studies), Triple-P (5/12) and Tuning In To Kids (1/12). 11 of the 12 studies reported significant reductions in primary externalizing behavior problems and DBDs. 7 studies reported significant reductions in internalizing symptoms. Mechanisms of change, clinical implications and directions for future research are discussed.

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