Efficacy of guided and unguided web-assisted self-help for parents of children with attention-deficit/hyperactivity disorder and oppositional defiant disorder: A three-arm randomized controlled trial / Manfred DOPFNER in Journal of Child Psychology and Psychiatry, 66-9 (September 2025)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 66-9 (September 2025) . - p.1320-1332 Titre : Efficacy of guided and unguided web-assisted self-help for parents of children with attention-deficit/hyperactivity disorder and oppositional defiant disorder: A three-arm randomized controlled trial Type de document : texte imprimé Auteurs : Manfred DOPFNER, Auteur ; Julia PLUCK, Auteur ; Kerstin Daniela ROSENBERGER, Auteur ; Marie-Theres KLEMP, Auteur ; Judith MÃœHLENMEISTER, Auteur ; Laura WÄHNKE, Auteur ; Martin HELLMICH, Auteur ; Stephanie SCHÃœRMANN, Auteur ; Christina DOSE, Auteur Article en page(s) : p.1320-1332 Langues : Anglais (eng) Mots-clés : ADHD  oppositional defiant disorder  school children  parent training  e-health Index. décimale : PER Périodiques Résumé : Background Empirical evidence supports the efficacy of behavioral online parent training. However, further large trials in school-age children with externalizing behavior problems and analyses on the impact of additional therapist support are needed. This three-arm randomized controlled trial examined the efficacy of guided and unguided web-assisted self-help (WASH) for parents of children with externalizing behavior problems. Methods Parents of 431 children (6 12 years) with elevated externalizing symptoms were randomly assigned to either treatment as usual (TAU), a 6-month behavioral WASH intervention (WASH+TAU), or WASH plus telephone-based support (WASH+S+TAU). Assessments took place at baseline and at 3, 6, and 12 months. The primary outcome was child externalizing symptoms as rated by a clinician blinded to condition; secondary outcomes were parent-rated child externalizing symptoms, internalizing symptoms, functional impairment, quality of life, parenting practices, and parental internalizing symptoms. (German Clinical Trials Register (DRKS): DRKS00013456; URL: https://drks.de/search/de/trial/DRKS00013456; registered on January 3rd 2018). Results Linear mixed models for repeated measures revealed a significant overall intervention effect on blinded clinician-rated externalizing symptoms at 6 months in both the intention-to-treat sample and per-protocol samples, with at least 25% (PP25) or 40% treatment utilization (PP40), respectively (intention-to-treat: p .017). Subsequent pairwise comparisons revealed a greater symptom reduction in WASH+S+TAU than in the other conditions (intention-to-treat: WASH+S+TAU vs. WASH+TAU: p .029, d 0.28, 95% CI [ 0.54, 0.03]; WASH+S+TAU vs. TAU: p .009, d 0.34 [ 0.59, 0.09]). At 12 months, a significant overall effect on blinded clinician-rated externalizing symptoms only emerged in the PP40 sample (p .035). Secondary analyses revealed an overall effect on child functional impairment at 12 months (intention-to-treat and per-protocol analyses) and on negative parenting behaviors at 6 months in the PP40 sample. For both variables, pairwise comparisons demonstrated significant differences between WASH+S+TAU and TAU. Conclusions Parent-directed WASH is effective in reducing blinded clinician-rated externalizing symptoms, but only when combined with additional support. En ligne : https://doi.org/10.1111/jcpp.14153 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=566 [article] Efficacy of guided and unguided web-assisted self-help for parents of children with attention-deficit/hyperactivity disorder and oppositional defiant disorder: A three-arm randomized controlled trial [texte imprimé] / Manfred DOPFNER, Auteur ; Julia PLUCK, Auteur ; Kerstin Daniela ROSENBERGER, Auteur ; Marie-Theres KLEMP, Auteur ; Judith MÃœHLENMEISTER, Auteur ; Laura WÄHNKE, Auteur ; Martin HELLMICH, Auteur ; Stephanie SCHÃœRMANN, Auteur ; Christina DOSE, Auteur . - p.1320-1332. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 66-9 (September 2025) . - p.1320-1332 Mots-clés : ADHD  oppositional defiant disorder  school children  parent training  e-health Index. décimale : PER Périodiques Résumé : Background Empirical evidence supports the efficacy of behavioral online parent training. However, further large trials in school-age children with externalizing behavior problems and analyses on the impact of additional therapist support are needed. This three-arm randomized controlled trial examined the efficacy of guided and unguided web-assisted self-help (WASH) for parents of children with externalizing behavior problems. Methods Parents of 431 children (6 12 years) with elevated externalizing symptoms were randomly assigned to either treatment as usual (TAU), a 6-month behavioral WASH intervention (WASH+TAU), or WASH plus telephone-based support (WASH+S+TAU). Assessments took place at baseline and at 3, 6, and 12 months. The primary outcome was child externalizing symptoms as rated by a clinician blinded to condition; secondary outcomes were parent-rated child externalizing symptoms, internalizing symptoms, functional impairment, quality of life, parenting practices, and parental internalizing symptoms. (German Clinical Trials Register (DRKS): DRKS00013456; URL: https://drks.de/search/de/trial/DRKS00013456; registered on January 3rd 2018). Results Linear mixed models for repeated measures revealed a significant overall intervention effect on blinded clinician-rated externalizing symptoms at 6 months in both the intention-to-treat sample and per-protocol samples, with at least 25% (PP25) or 40% treatment utilization (PP40), respectively (intention-to-treat: p .017). Subsequent pairwise comparisons revealed a greater symptom reduction in WASH+S+TAU than in the other conditions (intention-to-treat: WASH+S+TAU vs. WASH+TAU: p .029, d 0.28, 95% CI [ 0.54, 0.03]; WASH+S+TAU vs. TAU: p .009, d 0.34 [ 0.59, 0.09]). At 12 months, a significant overall effect on blinded clinician-rated externalizing symptoms only emerged in the PP40 sample (p .035). Secondary analyses revealed an overall effect on child functional impairment at 12 months (intention-to-treat and per-protocol analyses) and on negative parenting behaviors at 6 months in the PP40 sample. For both variables, pairwise comparisons demonstrated significant differences between WASH+S+TAU and TAU. Conclusions Parent-directed WASH is effective in reducing blinded clinician-rated externalizing symptoms, but only when combined with additional support. En ligne : https://doi.org/10.1111/jcpp.14153 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=566

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