title: Efficacy of a multimodal treatment for disruptive behavior disorders in children and adolescents: focus on internalizing problems.
abstract: Disruptive Behavior Disorders (DBDs) are among the most common reasons for youth referrals to mental health clinics. Aim of this study is to compare short and medium term efficacy of a multimodal treatment program (MTP), compared to community care (treatment-as-usual, TAU). The sample included 135 youths with DBDs (113 males, age range 9-15 years, mean age 12±2.5 years) were assigned either to a MTP (n=64), or addressed to community care for a TAU (n=71). Outcome measures were the Child Behaviour Checklist (CBCL) and the Children's Global Assessment Scale (C-GAS). All subjects were assessed at the baseline (T0), after 1-year treatment (T1) and after a 2-year follow-up (T2). Compared with patients receiving TAU, youths in the MTP showed, both at T1 and T2, significantly lower scores on CBCL Externalizing Scale, Internalizing Scale, Anxious/Depressed, Social Problems, and Aggressive Behavior, and higher scores at the C-GAS. Improvement in Internalizing Scales was particularly evident, with a shift from the clinical to the non-clinical range. Rate of use of mental health services and scholastic failure were reduced in the MTP. It is suggested that the improvement of the Internalizing symptoms is a crucial component of the therapeutic process in this MTP.
authors: IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, Calambrone, Pisa, Italy.
authors: Gabriele
authors: G
authors: Masi
authors: IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, Calambrone, Pisa, Italy.
authors: Annarita
authors: A
authors: Milone
authors: Uninettuno Telematic International University, Rome, Italy.
authors: Marinella
authors: M
authors: Paciello
authors: IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, Calambrone, Pisa, Italy; Clinical-Experimental Department of Medicine and Pharmacology, University of Messina, Italy.
authors: Francesca
authors: F
authors: Lenzi
authors: IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, Calambrone, Pisa, Italy.
authors: Pietro
authors: P
authors: Muratori
authors: IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, Calambrone, Pisa, Italy.
authors: Azzurra
authors: A
authors: Manfredi
authors: IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, Calambrone, Pisa, Italy.
authors: Lisa
authors: L
authors: Polidori
authors: IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, Calambrone, Pisa, Italy. Electronic address: gabriele.masi@inpe.unipi.it.
authors: Laura
authors: L
authors: Ruglioni
authors: Department of Psychology, The University of Alabama, Tuscaloosa, AL, USA.
authors: John E
authors: JE
authors: Lochman
authors: IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, Calambrone, Pisa, Italy.
authors: Filippo
authors: F
authors: Muratori
mesh_terms: D000293:Adolescent; D000374:Aggression; D001007:Anxiety / Q000175:diagnosis / Q000628:therapy*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000523:psychology / Q000628:therapy*; D002648:Child; D003131:Combined Modality Therapy; D003156:Community Mental Health Services / Q000706:statistics & numerical data; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders; D011613:Psychotherapy / Q000379:methods*
keywords: Adolescents; Children; Conduct disorder; Disruptive behavior disorders; Internalizing symptoms; Oppositional Defiant Disorder; Treatment