title: Behavioral parent training as an adjunct to routine care in children with attention-deficit/hyperactivity disorder: moderators of treatment response.
abstract: OBJECTIVE
  To investigate predictors and moderators of outcome of behavioral parent training (BPT) as adjunct to ongoing routine clinical care (RCC), versus RCC alone.
  
  
  METHODS
  We randomly assigned 94 referred children (4-12 years) with attention-deficit/hyperactivity disorder (ADHD) to BPT plus RCC or RCC alone. Outcome was based on parent-reported behavioral problems and ADHD symptoms. Predictor/moderator variables included children's IQ, age, and comorbidity profile, and maternal ADHD, depression, and parenting self-efficacy.
  
  
  RESULTS
  Superior BPT treatment effects on behavioral problems and ADHD symptoms were present in children with no or single-type comorbidity-anxiety/depression or oppositional defiant disorder (ODD)/conduct disorder (CD)-and when mothers had high parenting self-efficacy, but absent in children with broad comorbidity (anxiety/depression and ODD/CD) and when mothers had low parenting self-efficacy. In older children ADHD symptoms tended to decrease more through BPT than in younger children.
  
  
  CONCLUSIONS
  Adjunctive BPT is most useful when mothers have high parenting self-efficacy and in children with no or single-type comorbidity.
authors.affiliation: University Center of Child and Adolescent Psychiatry, P.O. Box 660, 9700 AR Groningen, The Netherlands. b.van.den.hoofdakker@accare.nl
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: van den Hoofdakker
authors.forename: Maaike H
authors.initials: MH
authors.lastname: Nauta
authors.forename: Lianne
authors.initials: L
authors.lastname: van der Veen-Mulders
authors.forename: Sjoerd
authors.initials: S
authors.lastname: Sytema
authors.forename: Paul M G
authors.initials: PM
authors.lastname: Emmelkamp
authors.forename: Ruud B
authors.initials: RB
authors.lastname: Minderaa
authors.forename: Pieter J
authors.initials: PJ
authors.lastname: Hoekstra
mesh_terms: D001008:Anxiety Disorders / Q000628:therapy; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000628:therapy; D001521:Behavior Therapy / Q000379:methods*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D019955:Conduct Disorder / Q000628:therapy; D003866:Depressive Disorder / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D016487:Parenting; D010290:Parents / Q000193:education*
chemical_list: D000697:Central Nervous System Stimulants