Practitioner Review: Current best practice in the use of parent training and other behavioural interventions in the treatment of children and adolescents with attention deficit hyperactivity disorder

被引：127

作者：

Daley, David ^{[1
,2
,3
]}

Van der Oord, Saskia ^{[4
,5
]}

Ferrin, Maite ^{[6
,7
]}

Cortese, Samuele ^{[6
,8
]}

Danckaerts, Marina ^{[9
]}

Doepfner, Manfred ^{[10
]}

Van den Hoofdakker, Barbara J. ^{[11
,12
]}

Coghill, David ^{[13
,14
]}

Thompson, Margaret ^{[6
]}

Asherson, Philip ^{[15
]}

Banaschewski, Tobias ^{[16
]}

Brandeis, Daniel ^{[16
,17
]}

Buitelaar, Jan ^{[18
]}

Dittmann, Ralf W. ^{[16
]}

Hollis, Chris ^{[1
,2
,3
]}

Holtmann, Martin ^{[19
]}

Konofal, Eric ^{[20
]}

Lecendreux, Michel ^{[20
]}

Rothenberger, Aribert ^{[21
]}

Santosh, Paramala ^{[15
]}

Simonoff, Emily ^{[15
]}

Soutullo, Cesar ^{[22
]}

Steinhausen, Hans Christoph ^{[23
,24
,25
]}

Stringaris, Argyris ^{[26
]}

Taylor, Eric ^{[15
]}

Wong, Ian C. K. ^{[27
]}

Zuddas, Alessandro ^{[28
,29
]}

Sonuga-Barke, Edmund J. ^{[15
,30
,31
]}

机构：

[1] Univ Nottingham, Sch Med, Div Psychiat & Appl Psychol, Nottingham, England

[2] Univ Nottingham, Inst Mental Hlth, NIHR MindTech Healthcare Technol Cooperat, Nottingham, England

[3] Univ Nottingham, Inst Mental Hlth, Ctr ADHD & Neurodev Disorders Lifespan CANDAL, Nottingham, England

[4] Katholieke Univ Leuven, Dept Psychol, Leuven, Belgium

[5] Univ Amsterdam, Amsterdam, Netherlands

[6] Univ Southampton, Dev Brain Behav Lab, Acad Unit Psychol, Southampton, Hants, England

[7] Huntercombe Hosp Maidenhead, Maidenhead, Berks, England

[8] NYU, Child Study Ctr, Langone Med Ctr, New York, NY USA

[9] Katholieke Univ Leuven, Dept Child & Adolescent Psychiat, Leuven, Belgium

[10] Univ Cologne, Dept Child & Adolescent Psychiat, Cologne, Germany

[11] Univ Groningen, Univ Med Ctr Groningen, Dept Child & Adolescent Psychiat, Groningen, Netherlands

[12] Univ Groningen, Dept Clin Psychol & Expt Psychopathol, Groningen, Netherlands

[13] Univ Melbourne, Royal Childrens Hosp, Melbourne, Vic, Australia

[14] Univ Dundee, Sch Med, Dundee, Scotland

[15] Kings Coll London, Inst Psychiat Psychol & Neurosci, London, England

[16] Heidelberg Univ, Med Fac Mannheim, Cent Inst Mental Hlth, Dept Child & Adolescent Psychiat & Psychotherapy, Mannheim, Germany

[17] Univ Hosp Psychiat, Dept Child & Adolescent Psychiat & Psychotherapy, Zurich, Switzerland

[18] Radboud Univ Nijmegen, Med Ctr, Dept Cognit Neurosci, Nijmegen, Netherlands

[19] Ruhr Univ Bochum, LWL Univ Hosp Hamm, Dept Child & Adolescent Psychiat & Psychotherapy, Bochum, Germany

[20] Hosp Robert Debre, Pediat Sleep Disorders Ctr, Paris, France

[21] Univ Goettingen, Gottingen, Germany

[22] Univ Navarra Clin, Dept Psychiat & Med Psychol, Child & Adolescent Psychiat Unit, Pamplona, Spain

[23] Univ Basel, Dept Psychol, Basel, Switzerland

[24] Univ Zurich, Dept Child & Adolescent Psychiat, Zurich, Switzerland

[25] Child & Adolescent Mental Hlth Ctr, Capital Reg Psychiat, Copenhagen, Denmark

[26] NIH, Bldg 10, Bethesda, MD 20892 USA

[27] UCL, Sch Pharm, Res Dept Practice & Policy, London, England

[28] Univ Cagliari, Dept Biomed Sci, Child & Adolescent Neuropsychiat Unit, Cagliari, Italy

[29] A Cao Paediat Hosp, Cagliari, Italy

[30] Univ Ghent, Ghent, Belgium

[31] Univ Aarhus, Aarhus, Denmark

来源：

JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY | 2018年 / 59卷 / 09期

基金：

英国惠康基金;

关键词：

ADHD; behaviour therapy; conduct disorder; parent training; treatment trials; RANDOMIZED CONTROLLED-TRIAL; SELF-CONTROL THERAPY; DEFICIT/HYPERACTIVITY-DISORDER; NONPHARMACOLOGICAL INTERVENTIONS; NEUROPSYCHOLOGICAL OUTCOMES; CLINICAL-TRIAL; MATERNAL ADHD; HIGH-RISK; PROGRAM; METAANALYSIS;

D O I：

10.1111/jcpp.12825

中图分类号：

B844 [发展心理学（人类心理学）];

学科分类号：

040202 ;

摘要：

Background: Behavioural interventions are recommended for use with children and young people with attention deficit hyperactivity disorder (ADHD); however, specific guidance for their implementation based on the best available evidence is currently lacking. Methods: This review used an explicit question and answer format to address issues of clinical concern, based on expert interpretation of the evidence with precedence given to meta-analyses of randomised controlled trials. Results: On the basis of current evidence that takes into account whether outcomes are blinded, behavioural intervention cannot be supported as a front-line treatment for core ADHD symptoms. There is, however, evidence from measures that are probably blinded that these interventions benefit parenting practices and improve conduct problems which commonly co-occur with ADHD, and are often the main reason for referral. Initial positive results have also been found in relation to parental knowledge, children's emotional, social and academic functioning - although most studies have not used blinded outcomes. Generic and specialised ADHD parent training approaches - delivered either individually or in groups - have reported beneficial effects. High-quality training, supervision of therapists and practice with the child, may improve outcomes but further evidence is required. Evidence for who benefits the most from behavioural interventions is scant. There is no evidence to limit behavioural treatments to parents with parenting difficulties or children with conduct problems. There are positive effects of additive school-based intervention for the inattentive subtype. Targeting parental depression may enhance the effects of behavioural interventions. Conclusions: Parent training is an important part of the multimodal treatment of children with ADHD, which improves parenting, reduces levels of oppositional and noncompliant behaviours and may improve other aspects of functioning. However, blinded evidence does not support it as a specific treatment for core ADHD symptoms. More research is required to understand how to optimise treatment effectiveness either in general or for individual patients and explore potential barriers to treatment uptake and engagement. In terms of selecting which intervention formats to use, it seems important to acknowledge and respond to parental treatment preferences.

引用

页码：932 / 947

页数：16

共 70 条

[11] Parent involvement in treatment for ADHD: A meta-analysis of the published studies [J].