title: Randomized trial of parent management training in children with tic disorders and disruptive behavior.
abstract: Oppositional, defiant, and disruptive behaviors are common in clinical samples of children with tic disorders. In this study, we sought to evaluate the short-term efficacy of a structured parent training program in children with tic disorders accompanied by disruptive behavior. Children with tic disorders and at least a moderate level of disruptive behavior were randomly assigned to a 10-session structured parent management training program or to continue treatment as usual. Twenty-four children (18 boys and 6 girls) between the ages of 6 and 12 years (mean 8.9 +/- 2.0 years) were enrolled; 23 subjects completed the study. At baseline, subjects showed moderate to severe levels of oppositional and defiant behavior. Twenty subjects (83%) were on stable medication. The parent-rated Disruptive Behavior Rating Scale score decreased by 51% in the parent management training group compared with a decrease of 19% in the treatment as usual group (P < .05). On the Improvement scale of the Clinical Global Impression, a rater masked to treatment assignment classified 7 of 11 subjects who completed parent management training as much improved or very much improved compared with 2 of 12 subjects in the treatment as usual group (Fisher exact test, P < .05). These results suggest that parent management training is helpful for short-term improvement in disruptive behavior problems in children with tic disorders. Larger randomized clinical trials are needed.
authors.affiliation: Yale Child Study Center, New Haven, CT 06520-7900, USA. lawrence.scahill@yale.edu
authors.forename: Lawrence
authors.initials: L
authors.lastname: Scahill
authors.forename: Denis G
authors.initials: DG
authors.lastname: Sukhodolsky
authors.forename: Karen
authors.initials: K
authors.lastname: Bearss
authors.forename: Diane
authors.initials: D
authors.lastname: Findley
authors.forename: Vanya
authors.initials: V
authors.lastname: Hamrin
authors.forename: Deirdre H
authors.initials: DH
authors.lastname: Carroll
authors.forename: Adrienne L
authors.initials: AL
authors.lastname: Rains
mesh_terms: D000704:Analysis of Variance; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000150:complications / Q000523:psychology* / Q000628:therapy; D002648:Child; D002652:Child Behavior / Q000523:psychology; D003237:Connecticut; D005260:Female; D006801:Humans; D008297:Male; D016487:Parenting / Q000523:psychology*; D010290:Parents / Q000193:education* / Q000523:psychology; D010865:Pilot Projects; D015397:Program Evaluation; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D012737:Sex Factors; D013981:Tic Disorders / Q000150:complications / Q000523:psychology* / Q000628:therapy; D016896:Treatment Outcome