Testing effectiveness of a community-based aggression management program for children 7 to 11 years old and their families.
OBJECTIVE
There are few well-evaluated uncomplicated community-based interventions for childhood aggression. The authors assess the impact of a community-based anger management group on child aggressive behaviors, using a randomized, controlled trial (RCT).


METHODS
Families with children 7 to 11 years old were recruited through advertisements and randomized (N = 123). Inclusion required parent concern about anger/aggressive behavior, RCT agreement, and a telephone behavior screen. Intervention participants were offered three parent education/skill-building group sessions, 10 weekly child group sessions, and three in-home family practice sessions. Nine groups ran from August 2002 to August 2004. Interviewers naïve to randomization collected data on all participants pre- and postgroup. Outcomes included child-rated anger and parent-rated child aggressive behavior, externalizing behavior and hostility, parent-child relationship, and parenting stress. Intent-to-treat analyses were done.


RESULTS
Pre/postoutcome comparisons indicated no significant differences between intervention versus control, with small effect sizes for most outcomes (0.27-0.29). Although not significant, the magnitude of improvement favored intervention families on all parent-rated measures.


CONCLUSIONS
Overall, there was no differential impact of participating in a community-based anger management group versus control on child aggressive behaviors and other associated measures. The impact of regression to the mean, effect, and sample size estimates; child comorbidity; and programmatic and methodological issues are discussed.
Lipman
Ellen L
EL
Drs. Lipman, Boyle, and Cunningham are with the Department of Psychiatry and Behavioural Neurosciences McMaster University and The Offord Centre for Child Studies, Hamilton, Ontario, Canada; Ms. Kenny, Ms. Sniderman, and Mr. Duku are with The Offord Centre for Child Studies; Mrs. Mills was formerly with and Mr. Evans and Ms. Waymouth are with McMaster Children's Hospital, Chedoke Site, Hamilton. Electronic address: lipmane@mcmaster.ca.
Boyle
Michael H
MH
Drs. Lipman, Boyle, and Cunningham are with the Department of Psychiatry and Behavioural Neurosciences McMaster University and The Offord Centre for Child Studies, Hamilton, Ontario, Canada; Ms. Kenny, Ms. Sniderman, and Mr. Duku are with The Offord Centre for Child Studies; Mrs. Mills was formerly with and Mr. Evans and Ms. Waymouth are with McMaster Children's Hospital, Chedoke Site, Hamilton.
Cunningham
Charles
C
Drs. Lipman, Boyle, and Cunningham are with the Department of Psychiatry and Behavioural Neurosciences McMaster University and The Offord Centre for Child Studies, Hamilton, Ontario, Canada; Ms. Kenny, Ms. Sniderman, and Mr. Duku are with The Offord Centre for Child Studies; Mrs. Mills was formerly with and Mr. Evans and Ms. Waymouth are with McMaster Children's Hospital, Chedoke Site, Hamilton.
Kenny
Meghan
M
Drs. Lipman, Boyle, and Cunningham are with the Department of Psychiatry and Behavioural Neurosciences McMaster University and The Offord Centre for Child Studies, Hamilton, Ontario, Canada; Ms. Kenny, Ms. Sniderman, and Mr. Duku are with The Offord Centre for Child Studies; Mrs. Mills was formerly with and Mr. Evans and Ms. Waymouth are with McMaster Children's Hospital, Chedoke Site, Hamilton.
Sniderman
Carrie
C
Drs. Lipman, Boyle, and Cunningham are with the Department of Psychiatry and Behavioural Neurosciences McMaster University and The Offord Centre for Child Studies, Hamilton, Ontario, Canada; Ms. Kenny, Ms. Sniderman, and Mr. Duku are with The Offord Centre for Child Studies; Mrs. Mills was formerly with and Mr. Evans and Ms. Waymouth are with McMaster Children's Hospital, Chedoke Site, Hamilton.
Duku
Eric
E
Drs. Lipman, Boyle, and Cunningham are with the Department of Psychiatry and Behavioural Neurosciences McMaster University and The Offord Centre for Child Studies, Hamilton, Ontario, Canada; Ms. Kenny, Ms. Sniderman, and Mr. Duku are with The Offord Centre for Child Studies; Mrs. Mills was formerly with and Mr. Evans and Ms. Waymouth are with McMaster Children's Hospital, Chedoke Site, Hamilton.
Mills
Brenda
B
Drs. Lipman, Boyle, and Cunningham are with the Department of Psychiatry and Behavioural Neurosciences McMaster University and The Offord Centre for Child Studies, Hamilton, Ontario, Canada; Ms. Kenny, Ms. Sniderman, and Mr. Duku are with The Offord Centre for Child Studies; Mrs. Mills was formerly with and Mr. Evans and Ms. Waymouth are with McMaster Children's Hospital, Chedoke Site, Hamilton.
Evans
Peter
P
Drs. Lipman, Boyle, and Cunningham are with the Department of Psychiatry and Behavioural Neurosciences McMaster University and The Offord Centre for Child Studies, Hamilton, Ontario, Canada; Ms. Kenny, Ms. Sniderman, and Mr. Duku are with The Offord Centre for Child Studies; Mrs. Mills was formerly with and Mr. Evans and Ms. Waymouth are with McMaster Children's Hospital, Chedoke Site, Hamilton.
Waymouth
Marjorie
M
Drs. Lipman, Boyle, and Cunningham are with the Department of Psychiatry and Behavioural Neurosciences McMaster University and The Offord Centre for Child Studies, Hamilton, Ontario, Canada; Ms. Kenny, Ms. Sniderman, and Mr. Duku are with The Offord Centre for Child Studies; Mrs. Mills was formerly with and Mr. Evans and Ms. Waymouth are with McMaster Children's Hospital, Chedoke Site, Hamilton.
D000374:Aggression / Q000523:psychology*; D000786:Anger; D002648:Child; D002653:Child Behavior Disorders / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003156:Community Mental Health Services / Q000592:standards*; D017579:Domestic Violence / Q000523:psychology* / Q000706:statistics & numerical data*; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D016896:Treatment Outcome