Personalised interventions for subgroups of children with conduct problems

Area of Science:

• Child Psychology
• Behavioral Science
• Clinical Psychology

Background:

• Conduct problems in childhood are linked to adverse long-term outcomes like antisocial behavior and substance misuse.
• Children with conduct problems exhibit variability in onset, comorbidities, and environmental factors, suggesting potential for differential treatment responses.
• Personalized interventions tailored to specific subgroups of children with conduct problems warrant investigation for improved outcomes.

Purpose of the Study:

• To systematically review and appraise the effectiveness of personalized interventions for children with conduct problems, specifically those adapted or developed for prespecified subgroups.
• To assess the impact of these personalized interventions on child conduct problems, treatment outcomes, and parenting skills.

Main Methods:

• A systematic review using Cochrane search methods identified randomized controlled trials (RCTs) comparing personalized interventions to non-personalized interventions or controls.
• Included were children aged 2-12 years with conduct problems within defined subgroups.
• Primary outcomes included child conduct problems/disruptive behavior; secondary outcomes covered personalized treatment results, parenting, family functioning, and educational outcomes. Certainty of evidence was assessed using GRADE.

Main Results:

• Thirteen RCTs (858 participants) were included, with interventions personalized for subgroups based on co-occurring conditions, parent characteristics, or environmental factors.
• Personalized interventions showed a potential slight short-term improvement in child conduct problems (ECBI Problem subscale) but had little to no effect on other measures.
• Evidence certainty for all outcomes was very low, with inconclusive results for personalized treatment outcomes and parenting skills due to data heterogeneity.

Conclusions:

• There is limited evidence supporting the effectiveness of personalized interventions for subgroups of children with conduct problems.
• The very low certainty of evidence necessitates large-scale RCTs with standardized measures to confirm efficacy and guide clinical decisions.
• Future research should focus on medium- and long-term effects, include diverse populations (low- and middle-income countries), and target under-represented age groups (9-12 years).