Tuesday, March 25, 2014

Early Intervention May Help Prevent Development of Antisocial Personality, Study Suggests

An intervention involving group parental training appears to improve behavior and reading performance among children with severe antisocial behavior who have been identified as needing treatment. Study findings were published in AJP in Advance. The intervention was less successful for a group of “high risk” children identified in the community as being at risk for antisocial behavior but not necessarily requiring treatment.

Researchers in England and the United States conducted two follow-up studies of randomized trials of group parental training. One involved 120 clinic-referred 3- to 7-year-olds with severe antisocial behavior for whom treatment was indicated, 93 of whom were reassessed between ages 10 and 17. The other involved 109 high-risk 4- to 6-year-olds with elevated antisocial behavior who were selectively screened from the community, 90 of whom were reassessed between ages 9 and 13. The primary psychiatric outcome measures were antisocial behavior and antisocial character traits. Also assessed were reading achievement (an important domain of youth functioning at work) and parent-adolescent relationship quality.

In each study, the intervention group received "The Incredible Years" basic videotape program, which covers play; praise and rewards; limit setting; and handling misbehavior. In each session, videotaped scenes of parents and children together are shown, depicting “right” and “wrong” ways of handling children. Each study also had a control group that received usual care in the form of individual mental health treatment or (in the high-risk study) telephone counseling.

In the indicated sample, both elements of antisocial personality were improved in the early intervention group at long-term follow-up compared with the control group. Additionally, reading ability improved, parental expressed emotion was warmer, and parental supervision was closer. In contrast, in the selective high-risk sample, early intervention was not associated with improved long-term outcomes.

“The findings provide the first evidence that parent training for young children with clinical-level antisocial behavior may reduce the poor outcomes and high cost of later antisocial personality,” the researchers stated.

For more information on research studies of antisocial behavior, see the Psychiatric News article, "Early Disregard for Others' Pain May Foretell Antisocial Behavior." Also see the article, "Behavioral Management for Children and Adolescents: Assessing the Evidence" in Psychiatric Services in Advance.

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