Preditores neuropsicológicos de eficácia do treinamento de pais em grupo para crianças com transtornos externalizantes

Abstract

Introduction: The Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder and Oppositional Defiant Disorder (ODD) are Externalizing Disorders that cause impairments in social, academic and family functioning. Among the most effective treatments for these children are the Parent Training programs. These are designed to enable parents to modify their disciplinary and education practices and enable them to act effectively on the undesired behaviors. Objective: Verify the effectiveness of the Group Parent Training in the treatment of children with Externalizing Disorders in a sample of children from the Clinic of Child and Adolescent Psychiatry, HC-UFMG and identify possibles neuropsychological, clinical and demographic predictors of Parent Training effectiveness. Method: Twenty-five parents of children aged 6 to 10 years with Externalizing Disorders participated in the Parent Training and filled the scales before (T1) and after (T2) treatment. Twenty parents from the same clinic, who were on the waiting list for treatment, filled the behavioral scales in two times (T1, T2), with an interval of three months, corresponding to the duration of treatment. Wilcoxon test was used to analyze the effectiveness of treatment. Children and parents in the clinical group passed through neuropsychological assessment before starting treatment. Spearman correlation was used to investigate the relationship between rate of change and neuropsychological variables, clinical and demographic. Linear regression was used in order to identify predictors of efficacy. Results: The treatment group showed a significant difference between scores at T1 (before treatment) and T2 (after treatment), that is, a significant improvement in the intensity of symptoms of inattention, hyperactivity/impulsivity, ODD symptoms, behaviors of disobedience and its severity as well as the rule-breaking and aggressive behaviors. The waiting list group showed no significant difference between scores at T1 and T2. A higher rate of improvement in symptoms of inattention in children was predicted by the intensity of these symptoms before the intervention and attention difficulties of children in neuropsychological task. A higher rate of improvement in symptoms of hyperactivity in children was predicted by attentional difficulties of children in neuropsychological task. A higher rate of improvement in symptoms of ODD in children was predicted by the intensity of symptoms and difficulty of parents in cognitive flexibility task. Conclusion: The efficacy of treatment was confirmed in this sample. The worst performance of parents and children in neuropsychological tasks and a greater intensity of symptoms before Parents Training is associated with a higher rate of reduction in symptoms of inattention, hyperactivity and ODD in children.