Heart rate and treatment effect in children with disruptive behavior disorders.
OBJECTIVE
To examine whether children with disruptive behavior disorders (DBDs; hyperkinetic conduct disorder, conduct disorder, hyperkinetic disorder) characterized by low heart rate profit less from an intensive cognitive behavioral intervention aimed at reducing impulsive, oppositional and aggressive behavior problems.


METHODS
Basal heart rate was studied in twenty-three children (aged 7-12 years) with DBD at the beginning of intervention comprising an intensive day-care treatment and parent training. The disruptive behavior of the child was assessed before treatment and after termination (12 weeks later). Therapy responders and non-responders were compared in regard to heart rate and other risk factors (cognitive functioning and socio-economic status).


RESULTS
Statistical analyses yielded evidence for a significant reduction of disruptive problem behaviors (aggression, delinquency) that is more prominent in DBD children with high heart rate scores compared to patients with low heart rate scores. Heart rate was significantly lower in children who did not profit from therapy. A logistic regression analysis revealed that heart rate is a significant predictor for therapy success whereas other risk factors had no impact on therapy success.


CONCLUSIONS
Further studies investigating biological and psychosocial predictors of treatment effectiveness are necessary. In addition, it might be helpful to consider different subtypes of aggressive behavior for selecting the best possible treatment options.
Department of Child and Adolescent Psychiatry and Psychotherapy, University of Frankfurt, Deutschordenstrasse 50, 60528, Frankfurt/Main, Germany. Christina.Stadler@em.uni-frankfurt.de
Christina
C
Stadler
Dörte
D
Grasmann
Jörg M
JM
Fegert
Martin
M
Holtmann
Fritz
F
Poustka
Klaus
K
Schmeck
D000374:Aggression / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D016896:Treatment Outcome