title: Behavioral and Nondirective Guided Self-Help for Parents of Children with Externalizing Behavior: Mediating Mechanisms in a Head-To-Head Comparison.
abstract: Parent training (PT) delivered as a guided self-help intervention may be a cost- and time-effective intervention in the treatment of children with externalizing disorders. In face-to-face PT, parenting strategies have repeatedly been identified as mediating mechanisms for the decrease of children's problem behavior. Few studies have examined possible mediating effects in guided self-help interventions for parents. The present study aimed to investigate possible mediating variables of a behaviorally oriented guided self-help program for parents of children with externalizing problems compared to a nondirective intervention in a clinical sample. A sample of 110 parents of children with externalizing disorders (80 % boys) were randomized to either a behaviorally oriented or a nondirective guided self-help program. Four putative mediating variables were examined simultaneously in a multiple mediation model using structural equation modelling. The outcomes were child symptoms of ADHD and ODD as well as child externalizing problems, assessed at posttreatment. Analyses showed a significant indirect effect for dysfunctional parental attributions in favor of the group receiving the behavioral program, and significant effects of the behavioral program on positive and negative parenting and parental self-efficacy, compared to the nondirective intervention. Our results indicate that a decrease of dysfunctional parental attributions leads to a decrease of child externalizing problems when parents take part in a behaviorally oriented guided self-help program. However, none of the putative mediating variables could explain the decrease in child externalizing behavior problems in the nondirective group. A change in dysfunctional parental attributions should be considered as a possible mediator in the context of PT.
authors.affiliation: Department of Psychiatry, Psychosomatics and Psychotherapy in Childhood and Adolescence, Medical Faculty, University of Cologne, Cologne, Germany. josepha.katzmann@gmx.de.
authors.forename: Josepha
authors.identifier: http://orcid.org/0000-0002-8328-092X
authors.initials: J
authors.lastname: Katzmann
authors.affiliation: School of Child and Adolescent Psychotherapy, University Hospital of Cologne, Cologne, Germany.
authors.forename: Christopher
authors.initials: C
authors.lastname: Hautmann
authors.affiliation: Department of Psychiatry, Psychosomatics and Psychotherapy in Childhood and Adolescence, Medical Faculty, University of Cologne, Cologne, Germany.
authors.forename: Lisa
authors.initials: L
authors.lastname: Greimel
authors.affiliation: Department of Psychiatry, Psychosomatics and Psychotherapy in Childhood and Adolescence, Medical Faculty, University of Cologne, Cologne, Germany.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Imort
authors.affiliation: Department of Psychiatry, Psychosomatics and Psychotherapy in Childhood and Adolescence, Medical Faculty, University of Cologne, Cologne, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Pinior
authors.affiliation: Department of Psychiatry, Psychosomatics and Psychotherapy in Childhood and Adolescence, Medical Faculty, University of Cologne, Cologne, Germany.
authors.forename: Kristin
authors.initials: K
authors.lastname: Scholz
authors.affiliation: Department of Psychiatry, Psychosomatics and Psychotherapy in Childhood and Adolescence, Medical Faculty, University of Cologne, Cologne, Germany.|School of Child and Adolescent Psychotherapy, University Hospital of Cologne, Cologne, Germany.
authors.forename: Manfred
authors.initials: M
authors.lastname: Döpfner
mesh_terms: D000328:Adult; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000523:psychology*; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D016487:Parenting / Q000523:psychology*; D000066553:Problem Behavior / Q000523:psychology*; D020377:Self Efficacy
keywords: Externalizing behavior; Guided self-help; Mediation; Parental attributions