Does behavioural parent training reduce internalising symptoms (or not) among children with externalising problems?

Christy Bloss1, Sophie Brown1, Vilas Sawrikar2,3

  • 1Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK.

Insights

Behaviour parent training (BPT) effectively reduces child externalizing problems. While evidence for reducing internalizing symptoms is unclear, a meta-analysis found BPT shows a small benefit for these issues in children.

Area of Science:

  • Child Psychology
  • Clinical Psychology
  • Developmental Psychology

Background:

  • Behaviour parent training (BPT) is established for reducing child externalizing problems.
  • The efficacy of BPT for secondary benefits, specifically reducing internalizing symptoms, requires further investigation.

Purpose of the Study:

  • To systematically review and meta-analyze the effects of BPT on internalizing symptoms in children aged 2-12 years with externalizing problems.
  • To assess the reliability and robustness of BPT's impact on internalizing outcomes.

Main Methods:

  • Systematic search of multiple electronic databases (PsycINFO, MEDLINE, EMBASE, CINAHL, SCOPUS).
  • Inclusion of 24 studies examining internalizing outcomes following BPT in children with elevated externalizing problems.
  • Meta-analysis of internalizing problem outcomes, including heterogeneity and moderation analyses.

Main Results:

  • A significant small treatment effect size (g = -0.41) was found for reducing internalizing symptoms immediately post-BPT.
  • Moderate heterogeneity (I² = 44%) was observed across studies.
  • Moderation analyses suggested the overall treatment effect was robust to variations in study characteristics, despite methodological limitations.

Conclusions:

  • BPT programs targeting externalizing problems demonstrate a potential to improve associated internalizing symptoms.
  • Current evidence suggests a small but significant effect, though limitations in study methodology and heterogeneity necessitate cautious interpretation.
  • Further research is required to confirm the reliability and clinical significance of these findings.

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