Effectiveness of Parent-Based Intervention on Anxiety Symptoms and Externalizing Problems of 6-9 Years Old Children

Document Type : Original Article

Authors

1 دانشجوی دکتری روانشناسی دانشگاه شهید چمران اهواز، اهواز، ایران

2 استادیار، گروه روانشناسی بالینی دانشگاه شهید چمران اهواز، اهواز، ایران

3 استاد، گروه روانشناسی بالینی دانشگاه شهید چمران اهواز،‌ اهواز، ایران

4 دانشیار، گروه روانشناسی بالینی دانشگاه شهید چمران اهواز، اهواز، ایران

Abstract

Introduction:Childhood is the most important life stages. Often incompatibility and psychiatric disorders in adolescence and adulthood arises from the neglect of emotional-behavioral problems during childhood. Present study has been aimed to evaluate effectiveness of parent-based intervention on anxiety symptoms and externalizing problems of 6-9 years old children of Ahvaz city.
Method: This research design is quasi-experimental design. In this study, 30 mothers of eligible volunteers were selected by using convenience sampling method and were  assigned to two experimental group and control group (n=15). The experimental group received 10 sessions of intervention (one session per week for 2 hours) and control group were waiting for intervention. The participants of both groups responded to Children's Behavior Checklist and Spence Children's Anxiety Scale before intervention, at the end of intervention (approximately two months), and 2 months after the end of intervention (follow-up).The data was analyzed by multivariate covariance and univariate analysis of variance (MANOVA and ANOVA).
Results: The findings of data analysis showed that parent-based intervention has significantly reduced symptoms of anxiety (p<0.001, F=60.67) and externalizing problems (p≤0.001, F=56.22) in children of experimental group compared to control group and these results has been maintained for two months after intervention.
Conclusion: Parent-based intervention can be used in reduction of anxiety symptoms and externalizing problems in children.

Keywords


 1- Cartwright‐Hatton S, McNally D, White C, Verduyn C. Parenting skills training: an effective intervention for internalizing symptoms in younger children? J Child Adolesc Psychiatr Nurs. 2005; 18(2): 45-52.
2- Achenbach T, Rescorla L. Manual for the ASEBA school-age forms and profiles: an integrated system of multi-informant assessment Burlington. Burlington: University of Vermont. 2001.
3- Martin A, Volkmar FR, Lewis M. Lewis's child and adolescent psychiatry: a comprehensive textbook: Lippincott Williams & Wilkins. 2007.
4- Mor N, Meijers J. Cognitive behavioral therapy in childhood anxiety. J Psychol Relat Sci. 2009; 46(4): 282.
5- Sadock BJ, Kaplan HI, Sadock VA. Kaplan & Sadock's Synopsis of Psychiatry: Behavioral Sciences/clinical Psychiatry: Lippincott Williams & Wilkins. 2007.
6- Seligman LD, Ollendick TH. Cognitive-behavioral therapy for anxiety disorders in youth. Child Adolesc Psychiatr Clin North Am. 2011; 20(2): 217-38.
7- Teubert D, Pinquart M. A meta-analytic review on the prevention of symptoms of anxiety in children and adolescents. J Anxiety Disord. 2011; 25(1046): 59.
8- Podell JL, Mychailyszyn M, Edmunds J, Puleo CM, Kendall PC. The Coping Cat Program for anxious youth: The FEAR plan comes to life. J Cogn Behav Pract. 2010; 17(2): 132-41.
9- Ginsburg GS, Kingery JN. Evidence-based practice for childhood anxiety disorders. J Contemp Psychother. 2007; 37(3): 123-32.
10- James AA, Soler A, Weatherall RR. Cognitive behavioural therapy for anxiety disorders in children and adolescents. The Cochrane Library.
11- Albano AM, Kendall PC. Cognitive behavioural therapy for children and adolescents with anxiety
disorders: Clinical research advances. Int Rev Psychiatr. 2002; 14(2): 129-34.
12- Edmunds J, ONeil K, Kendall P. A review of cognitive-behavioral therapy for anxiety disorders in children and adolescents: Current Status and future Directions. Tidsskr Nor Psychol Foren. 2011; 48: 26-33.
13- Barrett PM. Treatment of childhood anxiety: Developmental aspects. Clin Psychol Rev. 2000; 20(4): 479-94.
14- Kendall PC, Flannery-Schroeder EC. Methodological issues in treatment research for anxiety disorders in youth. J Abnorm Child Psychol. 1998; 26(1): 27-38.
15- Monga S, Rosenbloom BN, Tanha A, Owens M, Young A. Comparison of child–parent and parent-only cognitive-behavioral therapy programs for anxious children aged 5 to 7 years: Short-and long-term outcomes. J Am Acad Child Adolesc Psychiatr. 2015; 54(2): 138-46.
16- Silverman WK, Kurtines WM, Ginsburg GS, Weems CF, Lumpkin PW, Carmichael DH. Treating anxiety disorders in children with group cognitive-behavioral therapy: A randomized clinical trial. J Consult Clin Psychol. 1999; 67(6): 995.
17- Waters AM, Ford LA, Wharton TA, Cobham VE. Cognitive-behavioural therapy for young children with anxiety disorders: Comparison of a child+ parent condition versus a parent only condition. J Behav Res Ther. 2009; 47(8): 654-62.
18- Kennedy SJ, Rapee RM, Edwards SL. A selective intervention program for inhibited preschool-aged children of parents with an anxiety disorder: Effects on current anxiety disorders and temperament. J Am Acad Child Adolesc Psychiatr. 2009; 48(6): 602-9.
19- Stallard P. Cognitive behavioral therapy with children and young people East Sussex: Routledge. 2008.
20- Puliafico A, Comer J, Pincus D. Adapting parent-child interaction therapy to treat anxiety disorders in young children. J Child Adolesc Psychiatr Clin North Am. 2012; 21(3): 607-19.
21- Cartwright-Hatton S. From timid to tiger: A treatment manual for parenting the anxious child: John Wiley & Sons.  2010.
22- Goldstein LH, Harvey EA, Friedman-Weieneth JL. Examining subtypes of behavior problems among 3-year-old children, part III: Investigating differences in parenting practices and parenting stress. J Abnorm Child Psychol. 2007; 35(1): 125-36.
23- Pardini DA, Fite PJ, Burke JD. Bidirectional associations between parenting practices and conduct problems in boys from childhood to adolescence: The moderating effect of age and African-American ethnicity. J Abnorm Child Psychol. 2008; 36(5): 647-62.
24- Tellegen CL, Sanders MR. Using primary care parenting interventions to improve outcomes in children with developmental disabilities: A case
report. Hindou Publ Corp, Case reports in pediatrics. 2012.
25- Belsky J. Differential susceptibility to rearing influence. Origins of the social mind: Evolutionary psychology and child development. 2005; 139-63.
26- Gere MK, Villabø MA, Torgersen S, Kendall PC. Overprotective parenting and child anxiety: The role of co-occurring child behavior problems. . J Anxiety Disord. 2012; 26(6): 642-9.
27- Skendi V, Alikaj V, Spaho E, Suli A. 2139–Overprotective parenting and anxiety of children presented at albanian child and adolescent psychiatry clinic. J Eur Psychiatr. 2013; 28:1.
28- Ghanizadeh A, Mohammadi MR, Yazdanshenas A. Psychometric properties of the Farsi translation of the kiddie schedule for affective disorders and schizophrenia-present and lifetime version. BMC Psychiatr. 2006; 6(1): 10.
29- Shahrivar Z, Kousha M, Moallemi S, Tehrani‐Doost M, Alaghband‐Rad J. The Reliability and Validity of Kiddie‐Schedule for Affective Disorders and Schizophrenia‐Present and Life‐time Version‐Persian Version. J Child Adolesc Ment Health. 2010; 15(2): 97-102.
30- Farzadfar S, Hooman H. The role of child rearing training skills in reducing mother’s stress and children’s behavioral problems. Dev Psychol. 2008; 15(4): 277-92.  [Persian].
31- Minaei A. Adaptation and normalization of Achenbach child behavior checklist, youth self-report and teacher’s report form. Res Except Child. 2006; 19(1): 529-58.  [Persian].
32- Yazdkhasti F, Oreyzi H. Standardization of Child, Parent and Teacher’s Forms of Child Behavior Checklist in the City of Isfahan. Iran J Clin Psychol. 2011; 17(1): 60-70.
33- Tehrani-Doost M, Shahrivar Z, Pakbaz B, Rezaie A, Ahmadi F. Normative data and psychometric properties of the child behavior checklist and teacher rating form in an Iranian community sample. Iran J Pediatr. 2011;21(3):331.
34- Spence SH. Structure of anxiety symptoms among children: a confirmatory factor-analytic study. . J Abnorm Psychol. 1997; 106(2): 280.
35- Spence SH. A measure of anxiety symptoms among children. Behav Res Ther. 1998; 36(5): 545-66.
36- Mousavi R, Moradi A, Farzad V, Mahdavi S. Psychometric properties of the Spence children's anxiety scale with an Iranian sample. Int J Psychol. 2007; 1(1): 17-26.
37- Hooman H. Multivariate data analysis in scientific research. 3th ed ed. Tehran Paykefarhang. 2011.
38- Alilou M, Yadegari N, Haghnazari F, Poursharifi H, Hashemi T. The effects of family
cognitive-behavioral therapy in the reduction of anxiety in children with anxiety disorders. Biannu J Appl Couns. 2013; 3(1): 19-34. [Persian].
39- Bakhtiari M, Ghamkhar Fard Z, tahmasian K. The effectiveness of group cognitive-behavior therapy in children with generalized anxiety disorder. Thought Behav Clin Psychol. 2013; 27(7): [Persian].
40- Flannery-Schroeder EC, Kendall PC. Group and individual cognitive-behavioral treatments for youth with anxiety disorders: A randomized clinical trial. Cogn Ther Res. 2000; 24(3): 251-78.
41- Kendall PC, Flannery-Schroeder E, Panichelli-Mindel SM, Southam-Gerow M, Henin A, Warman M. Therapy for youths with anxiety disorders: A second randomized clincal trial. J Consult Clin Psychol. 1997; 65(3): 366.
42- Manassis K, Mendlowitz SL, Scapillato D, Avery D, Fiksenbaum L, Freire M, et al. Group and individual cognitive-behavioral therapy for childhood anxiety disorders: a randomized trial. J Am Acad Child Adolesc Psychiatr. 2002; 41(12): 1423-30.
43- Nauta MH, Scholing A, Emmelkamp PM, Minderaa RB. Cognitive-behavioral therapy for children with anxiety disorders in a clinical setting: No additional effect of a cognitive parent training. J Am Acad Child Adolesc Psychiatr. 2003; 42(11): 1270-8.
44- Walkup JT, Albano AM, Piacentini J, Birmaher B, Compton SN, Sherrill JT, et al. Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. N Eng J Med. 2008; 359(26): 2753-66.
45- Davoudi I, Basak S, Zarezadegan B. The effectiveness of positive parent training in reducing conduct problems of children and maternal stress of their mothers. Biannu J Appl Couns. 2012;2(2):45-59.  [Persian].
46- Forehand R, Lafko N, Parent J, Burt KB. Is parenting the mediator of change in behavioral parent training for externalizing problems of youth? J Clin Psychol Rev. 2014;34(8):608-19.
47- Haji S, Azkhosh M, Tahmasian K, Bayat M, Biglarian A. The efficacy of “parenting the strong-willed child” program for mothers’ parenting practices and children’s behavioral problems. J Fam Res. 2013;8(4):373-90.  [Persian].
48- McKee L, Colletti C, Rakow A, Jones DJ, Forehand R. Parenting and child externalizing behaviors: Are the associations specific or diffuse? J Aggress Violent Behav. 2008; 13(3): 201-15.
49- Slobodskay H. Behavioral problems, effects of parenting and family structure on. Int Encycl Soc Behav Sci. 2015; 2: 470-6.
50- Cartwright-Hatton S, McNally D, Field AP, Rust S, Laskey B, Dixon C, et al. A new parenting-based group intervention for young anxious children: Results of a randomized controlled trial. Am Acad Child Adolesc Psychiatr. 2011; 50(3): 242-51.
51- Shroeder C, Gordon B. Assessment and treatment of childhood problems. 3th ed ed. Tehran: Danjeh. 2014.
52- Chapman LK, Petrie J, Vines L, Durrett E. The co-occurrence of anxiety disorders in African American parents and their children. J Anxiety Disord. 2012; 26(1): 65-70.
53- Eisen AR, Schaefer CE. Separation anxiety in children and adolescents: An individualized approach to assessment and treatment: Guilford Press. 2007.
54- Waters AM, Zimmer-Gembeck MJ, Farrell LJ. The relationships of child and parent factors with children's anxiety symptoms: Parental anxious rearing as a mediator. J Anxiety Disord. 2012; 26(7): 737-45.