Assessing and treating three to twelve-year-olds displaying disruptive behaviour problems

Abstract

The aim of this thesis was (a) to examine a Swedish version of a measure for early identification and treatment evaluation of children with disruptive behaviour problems and (b) to explore the effectiveness, in terms of reduction of children’s disruptive behavioural problems, of interventions not specifically directed towards the children but to their caregivers and other adults in their immediate environment. The focus of this thesis has been on clinical applicability. However, their have been considerable advances in the knowledge of the origins, development and maintenance of disruptive behaviour in children. This has led to corresponding changes in treatment. In line with this, research on phenomenology, prevalence, etiology, treatment and assessment of children that display disruptive behaviour are presented as an introduction to the empirical studies. The aim of study I was to develop and examine a systemic school-based model for detection and early intervention among 4 to 12 year old children who displayed externalizing behaviour problems. The intervention was a combination of the Marte Meo model and Coordination meetings. Treatment effects in the group who had received the intervention (N= 33) were compared with a group (N=16) who had received treatment-as-usual in their ordinary school setting. Assessments were carried out before and two years after the intervention. There was a significant decrease in children’s symptoms for the intervention group, but not for the comparison group. The aim of study II was to evaluate the effectiveness of the structured parent training programme Incredible Years Series in diverse clinical settings in Sweden. Parents of 113 children aged 3 to 9 participated in the study. Pre-data were collected prior to commencement of the parent training groups and post-data immediately after the training group sessions had finished. Significant reduction was found on all symptom-related measures in parents’ ratings. A significant increase in the self-rated well-being of the parents was also found. The aim of study III was to examine the psychometric properties and obtain Swedish norms for the Eyberg Child Behaviour Inventory (ECBI). Parents of 841 children aged 3 to 10 participated. The ECBI showed sound psychometric properties and seems to be a very useful measure in a Swedish context. Normative data from the Swedish sample was also presented. The aim of Study IV was to examine a three factor solution of the ECBI in a confirmatory factor analysis based on 22 items in a Swedish sample. The same sample as in study III was used. The results were consistent with the results from an American sample indicating that the 22-item version of the ECBI is a robust and useful alternative that can be used for evaluating and measuring treatment outcome. Preliminary normative data was also presented. Key words: Disruptive Behaviour Problems, Assessment, Early intervention, Eyberg Child Behaviour Inventory (ECBI), School based model, Marte Meo, Parent training, Incredible Years Series