Maternal Depression and Parenting Practices Predict Treatment Outcome in Italian Children with Disruptive Behavior Disorder

Childhood aggression has been conceptualized as a risk marker on the developmental trajectories leading to a variety of negative adolescent outcomes such as delinquency, substance use and poor school adjustment. The contextual social-cognitive model emphasizes parenting processes in the development and escalation of aggressive behavioral problems. Many multi-component treatment models have been found to be efficacious in reducing children's aggressive behaviors. However a major goal in clinical research is to discover predictors of negative treatment outcome. It has been hypothesized that the change in inconsistent or harsh maternal discipline, and the level of maternal depression, may affect the efficacy of a multi-component treatment on child aggressive behavior. The aim of the study is to test this hypothesis in 62 Italian children (mean age 9.6) with disruptive behavior disorders, treated with Coping Power Program. We used the residualized change in a two-wave model to measure the change in aggressive behavior, as an outcome variable; and the change in parenting practices and the level of maternal depression at the beginning of the treatment were the independent variables. Our results show that a decrease in inconsistent discipline, but not in harsh discipline, was associated with a better treatment outcome in children. Furthermore, a higher level of maternal depression predicted a worse treatment outcome in children. According to our findings, change in parenting skill is a key mechanism for promoting a positive treatment outcome. The implications of these findings for the implementation of strategies aimed at preventing aggressive behavior and promoting better treatment outcome after multi-component intervention are discussed.