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Practitioner Review: Psychological treatments for children and adolescents with conduct disorder problems – a systematic review and meta‐analysis
Author(s) -
Bakker M.J.,
Greven C.U.,
Buitelaar J.K.,
Glen J.C.
Publication year - 2017
Publication title -
journal of child psychology and psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.652
H-Index - 211
eISSN - 1469-7610
pISSN - 0021-9630
DOI - 10.1111/jcpp.12590
Subject(s) - meta analysis , psychological intervention , randomized controlled trial , psychology , conduct disorder , clinical psychology , intervention (counseling) , comorbidity , medline , inclusion (mineral) , psychiatry , medicine , social psychology , political science , law
Background This meta‐analysis evaluates the efficacy of nonpharmacological treatments for conduct disorder ( CD ) problems in children and adolescents, based on child, parent and teacher report. Methods PubMed, Psyc INFO and EMBASE were searched for peer‐reviewed articles published between January 1970 and March 2015. Main inclusion criteria were nonpharmacological treatment, participants younger than 18 years, clinical CD problems/diagnosis, randomized controlled trials and inclusion of at least one CD problem‐related outcome. Treatment efficacy is expressed in effect sizes ( ES s) calculated for each rater (parent, teacher, self and blinded observer). Results Of 1,549 articles retrieved, 17 (published between June 2004 and January 2014) describing 19 interventions met the inclusion criteria. All studies used psychological treatments; only three studies included a blinded observer to rate CD problems. Most studies were of very poor to fair quality. ES s were significant but small for parent‐reported outcomes (0.36, 95% CI = 0.27–0.47), teacher‐reported outcomes (0.26, 95% CI = 0.12–0.49) and blinded observer outcomes (0.26, 95% CI = 0.06–0.47), and they were nonsignificant for self‐reported outcomes (−0.01, 95% CI = −0.25 to 0.23). Comorbidity, gender, age, number of sessions, duration, intervention type, setting, medication use or dropout percentage did not influence the effect of treatment. Conclusions Psychological treatments have a small effect in reducing parent‐, teacher‐ and observer‐rated CD problems in children and adolescents with clinical CD problems/diagnosis. There is not enough evidence to support one specific psychological treatment over another. Future studies should investigate the influence of participant characteristics (e.g. age of CD onset), use more homogeneous outcome measures and allow better evaluation of study quality. Many reports failed to provide detailed information to allow optimization of psychological treatment strategies.