Psychosocial Interventions for Disruptive Behavior in Children and Adolescents: A Meta-Analysis

In childhood and adolescence, disruptive behavior is a common reason for childhood referral to mental health services.

To determine the most effective psychosocial interventions for disruptive behavior in children and adolescents.

Ovid MEDLINE, the Cochrane Library, PsycINFO, and Embase were searched from 2014 to July 22, 2024.

Randomized controlled trials comparing psychosocial interventions with treatment as usual or waitlist.

Data abstraction, risk of bias, and strength of evidence were completed by 1 reviewer and checked by a second reviewer; disagreements were resolved by consensus.

Sixty-four RCTs in preschool and school-aged children were included in meta-analyses. An additional 20 trials in adolescents were included but could not be pooled. Based on meta-analyses, both parent-only interventions and multicomponent interventions that included a parent, caregiver, or teacher plus a child were associated with reductions in disruptive behavior in preschool (SMD, -0.61 [95% CI, -0.99 to -0.31] and SMD, -0.96 [95% CI, -1.39 to -0.60]) and school-aged (SMD, -0.39 [95% CI, -0.58 to -0.22] and SMD, -0.61 [95% CI, -1.05 to -0.20]) children when assessed immediately posttreatment. Results were less consistent with longer follow-up across interventions.

There was substantial heterogeneity across age groups regarding interventions and outcomes, which made drawing definitive conclusions challenging.

Multicomponent psychosocial interventions and parent-only psychosocial interventions were better than treatment as usual or waitlist at reducing parent-reported disruptive behaviors for preschool and school-aged children immediately posttreatment. Evidence for long-term outcomes and studies conducted in adolescents was limited.