Parent-Child Interaction Therapy (PCIT) with Puerto Rican families  Maribel Matos-Román, Ph.D. University of Puerto Rico P...
Specific Aims <ul><li>To revise and culturally adapt PCIT for Puerto Rican preschool aged children with a diagnosis of ADH...
Inclusion criteria <ul><li>4  to  6 years – 11 months of age  </li></ul><ul><li>Parent complaints of significant hyperacti...
Inclusion criteria <ul><li>IQ  >  80 (PPVT) </li></ul><ul><li>ADHD diagnosis, Combined or Hyperactive-Impulsive Type -  NI...
Aim 1 <ul><li>Translation of the PCIT manual and handouts  </li></ul><ul><li>Linguistic adaptations </li></ul><ul><li>Psyc...
Aim 1 <ul><li>Nine families  </li></ul><ul><ul><li>9 children </li></ul></ul><ul><ul><ul><li>7 M and 2 F; Mean age: 4.9 ye...
Aim 1 <ul><li>Nine families   </li></ul><ul><ul><li>7 fathers (1 stepfather) </li></ul></ul><ul><ul><ul><li>Mean age: 32.8...
Aim 1 <ul><li>Procedures </li></ul><ul><ul><li>Screening and outcome measures (Pre-treatment assessment) </li></ul></ul><u...
Screening Measures <ul><li>Disruptive Behavior Scale for Children (DBRS) </li></ul><ul><ul><li>9 hyperactivity symptoms, 8...
Outcome Measures <ul><li>Eyberg Child Behavior Inventory (ECBI) </li></ul><ul><li>Child Behavior Checklist (CBCL) </li></u...
Results <ul><li>PCIT feasible to implement and acceptable </li></ul><ul><li>High level of satisfaction  </li></ul><ul><ul>...
Results <ul><li>Treatment gains  maintained through 3-month follow-up </li></ul><ul><li>Reliable change index (RCI) </li><...
Modifications <ul><li>8 sessions for CDI and 9 for PDI </li></ul><ul><li>Handout about pharmacological treatment for ADHD ...
Aim 2 – Pilot Study <ul><li>32 families </li></ul><ul><ul><li>Treatment group (TG); n=20 </li></ul></ul><ul><ul><li>Wait-l...
Sample Demographic and Clinical Characteristics -1.63 56.83 (4.97) 53.30 (6.44) C-GAS -.93 6.33 (1.23) 5.85 (1.53) DBRS – ...
Results – Pilot Study <ul><li>Treatment Group (n=19) </li></ul><ul><ul><li>Lower levels of hyperactivity </li></ul></ul><u...
Results – Pilot Study <ul><ul><li>Reduction in the parenting stress (FEI)  </li></ul></ul><ul><ul><li>Use of adequate pare...
Intensity Problems
Hyperactivity Aggression
Hyperactivity ODD
Externalizing Aggressive
Total Severity
 
 
BDI SCL  - 36
Conclusions <ul><li>PCIT seems to be: </li></ul><ul><ul><li>A  responsive family intervention for Puerto Rican families wh...
Research Team   <ul><li>Co-investigators </li></ul><ul><ul><li>José J. Bauermeister, Ph.D. </li></ul></ul><ul><ul><li>Guil...
Acknowledgments <ul><li>Funded by NIMH 5R24MH-49368-11 </li></ul><ul><li>Dr. Maribel Matos </li></ul><ul><li>E-mail: m-mat...
¡Gracias!
Upcoming SlideShare
Loading in …5
×

Parent-Child Interaction Therapy (PCIT) with Puerto Rican ...

781
-1

Published on

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
781
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
7
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide
  • This has been the end of my presentation, thanks for your attention… Any other questions?
  • Parent-Child Interaction Therapy (PCIT) with Puerto Rican ...

    1. 1. Parent-Child Interaction Therapy (PCIT) with Puerto Rican families Maribel Matos-Román, Ph.D. University of Puerto Rico PCIT Conference January 26-28, 2006 Gainesville, FL
    2. 2. Specific Aims <ul><li>To revise and culturally adapt PCIT for Puerto Rican preschool aged children with a diagnosis of ADHD who also present high rates of behavior problems. </li></ul><ul><li>To conduct a randomized controlled pilot study to evaluate the initial efficacy, feasibility, and acceptability of the refined PCIT for children with a diagnosis of ADHD and problem behaviors and their families. </li></ul>
    3. 3. Inclusion criteria <ul><li>4 to 6 years – 11 months of age </li></ul><ul><li>Parent complaints of significant hyperactivity and behavior problems </li></ul><ul><li>No evidence of neurological, pervasive developmental disorders or significant handicaps </li></ul><ul><li>Be a child of a Puerto Rican mother </li></ul><ul><li>No treatment with stimulant or psychotropic medication </li></ul><ul><li>No involvement in other forms of child psychotherapy and/or pharmacotherapy </li></ul>
    4. 4. Inclusion criteria <ul><li>IQ > 80 (PPVT) </li></ul><ul><li>ADHD diagnosis, Combined or Hyperactive-Impulsive Type - NIMH DISC-IV. </li></ul><ul><li>A score above the 93rd percentile on hyperactivity and ODD or aggression scales (DBRS or BASC) </li></ul><ul><li>Absence of domestic violence and chaotic family environment </li></ul><ul><li>No indicators of severe psychopathology on parents </li></ul>
    5. 5. Aim 1 <ul><li>Translation of the PCIT manual and handouts </li></ul><ul><li>Linguistic adaptations </li></ul><ul><li>Psychoeducational module about ADHD and behavior problems </li></ul><ul><ul><li>Description of hyperactivity and its relationship to behavior problems </li></ul></ul><ul><ul><li>Associated difficulties </li></ul></ul><ul><ul><li>Risks and protective factors </li></ul></ul><ul><ul><li>Possible etiologies </li></ul></ul><ul><ul><li>Treatment options </li></ul></ul>
    6. 6. Aim 1 <ul><li>Nine families </li></ul><ul><ul><li>9 children </li></ul></ul><ul><ul><ul><li>7 M and 2 F; Mean age: 4.9 years; Mean IQ: 104.4, SD = 10.08 </li></ul></ul></ul><ul><ul><li>9 mothers </li></ul></ul><ul><ul><ul><li>2 single parents, Mean age: 31.89, SD = 6.31 Range: 25 to 43 </li></ul></ul></ul><ul><ul><ul><li>Education: 15.6 years (nearly a BA, SD = 1.59; Range: 14 to 19) </li></ul></ul></ul><ul><ul><ul><li>7 worked full-time, 1 part-time, 1 college student </li></ul></ul></ul>
    7. 7. Aim 1 <ul><li>Nine families </li></ul><ul><ul><li>7 fathers (1 stepfather) </li></ul></ul><ul><ul><ul><li>Mean age: 32.86, SD = 5.34 Range: 27 to 43 </li></ul></ul></ul><ul><ul><ul><li>Education: 16.0 years (BA, SD = 3.79; Range: 12 to 23 </li></ul></ul></ul><ul><ul><ul><li>Full-time jobs </li></ul></ul></ul>
    8. 8. Aim 1 <ul><li>Procedures </li></ul><ul><ul><li>Screening and outcome measures (Pre-treatment assessment) </li></ul></ul><ul><ul><li>Psychoeducational sessions (2 sessions) </li></ul></ul><ul><ul><li>CDI and PDI </li></ul></ul><ul><ul><ul><li>Mean CDI sessions = 7.47 (6 - 9) </li></ul></ul></ul><ul><ul><ul><li>Mean PDI sessions= 7.79 (6 - 10) </li></ul></ul></ul><ul><ul><li>Post treatment assessment </li></ul></ul><ul><ul><li>3-month follow-up assessment </li></ul></ul>
    9. 9. Screening Measures <ul><li>Disruptive Behavior Scale for Children (DBRS) </li></ul><ul><ul><li>9 hyperactivity symptoms, 8 ODD symptoms </li></ul></ul><ul><li>Behavioral Assessment System for Children-Parent Rating Scales (BASC-PRS) </li></ul><ul><ul><li>Subscales of Hyperactivity and Aggression </li></ul></ul><ul><li>Peabody Picture Vocabulary Test (PPVT-HAA) </li></ul><ul><li>NIMH DISC IV - Parent Version </li></ul><ul><ul><li>ADHD, ODD, generalized anxiety disorder, separation anxiety disorder, major depression, and disthymia modules </li></ul></ul>
    10. 10. Outcome Measures <ul><li>Eyberg Child Behavior Inventory (ECBI) </li></ul><ul><li>Child Behavior Checklist (CBCL) </li></ul><ul><li>BASC, DBRS </li></ul><ul><li>Home Situations Questionnaire (HSQ) </li></ul><ul><li>Family Experiences Inventory (FEI) </li></ul><ul><li>Parent Practices Inventory (PPI) </li></ul><ul><li>Beck Depression Inventory (BDI) </li></ul><ul><li>Symptom Checklist – 36 (SCL-36) </li></ul><ul><li>Treatment and Evaluation Survey (TES) </li></ul><ul><li>Therapy Attitude Inventory (TAI) </li></ul>
    11. 11. Results <ul><li>PCIT feasible to implement and acceptable </li></ul><ul><li>High level of satisfaction </li></ul><ul><ul><li>Mean TAI score: 48.67, SD=1.32 </li></ul></ul><ul><ul><li>Mothers’ reports of being felt understood, confident, comfortable, and supported by their therapists. </li></ul></ul><ul><li>Positive changes in children’s behavior </li></ul><ul><li>Reduction in family stress </li></ul><ul><li>Improvement in parent-child relationships </li></ul>
    12. 12. Results <ul><li>Treatment gains maintained through 3-month follow-up </li></ul><ul><li>Reliable change index (RCI) </li></ul><ul><ul><li>89% in ECBI-Intensity and the ECBI-Problem </li></ul></ul><ul><ul><li>62% in ADHD-Hyperactivity </li></ul></ul><ul><ul><li>88% in ODD </li></ul></ul><ul><ul><li>56% in the PPI </li></ul></ul><ul><ul><li>78% in the FEI </li></ul></ul>
    13. 13. Modifications <ul><li>8 sessions for CDI and 9 for PDI </li></ul><ul><li>Handout about pharmacological treatment for ADHD </li></ul><ul><li>Modification of time-out procedures </li></ul><ul><ul><li>Loss of privileges </li></ul></ul><ul><ul><li>Definition of silence </li></ul></ul><ul><ul><li>Duration of time-out </li></ul></ul><ul><li>Scripts for CDI and PDI </li></ul>
    14. 14. Aim 2 – Pilot Study <ul><li>32 families </li></ul><ul><ul><li>Treatment group (TG); n=20 </li></ul></ul><ul><ul><li>Wait-list group (WL); n= 12 </li></ul></ul><ul><li>No difference between groups </li></ul><ul><ul><li>gender distribution </li></ul></ul><ul><ul><li>age </li></ul></ul><ul><ul><li>IQ </li></ul></ul><ul><ul><li>parents’ education </li></ul></ul><ul><ul><li>children’s impairment in adaptive functioning </li></ul></ul><ul><ul><li>screening ratings of hyperactivity and aggressive or ODD behaviors </li></ul></ul>
    15. 15. Sample Demographic and Clinical Characteristics -1.63 56.83 (4.97) 53.30 (6.44) C-GAS -.93 6.33 (1.23) 5.85 (1.53) DBRS – No. ODD symptoms -1.32 17.92 (3.87) 16.05 (3.89) DBRS-ODD -.91 8.08 (1.16) 7.60 (1.60) DBRS-No. Hyp. Symptoms -1.11 22.67 (2.84) 21.25 (3.82) DBRS-Hyperactivity -1.53 21.25 (5.50) 18.10 (5.74) BASC-Aggression -.02 36.00 (6.49) 35.95 (6.94) BASC-Hyperactivity .38 32.08 (6.29) 33.05 (7.48) Mother’s age 1.36 14.58 (1.31) 15.40 (1.82) Mother’s education -1.23 106.67 (7.81) 101.95 (13.96) Peabody (IQ) -.61 60.00 (7.47) 58.50 (6.37) Age (months) .04 67 70 Gender (% male) ---- 12 20 Participants χ 2 /t W-list group Treatment Group Measure
    16. 16. Results – Pilot Study <ul><li>Treatment Group (n=19) </li></ul><ul><ul><li>Lower levels of hyperactivity </li></ul></ul><ul><ul><li>Less aggressive and ODD behaviors </li></ul></ul><ul><ul><li>Less externalizing behaviors </li></ul></ul><ul><ul><li>Significant reduction in general behavioral problems (ECBI) </li></ul></ul><ul><ul><li>Significant reduction in the behaviors they assessed as problematic (ECBI-Problems) </li></ul></ul>
    17. 17. Results – Pilot Study <ul><ul><li>Reduction in the parenting stress (FEI) </li></ul></ul><ul><ul><li>Use of adequate parenting practices </li></ul></ul><ul><ul><li>Mean CDI sessions: 7 (6 to 9) </li></ul></ul><ul><ul><li>Mean PDI sessions: 8 (6 to 10) </li></ul></ul><ul><ul><li>High level of consumer satisfaction </li></ul></ul><ul><ul><ul><li>Mean TAI scores: 47.77 (SD: 2.93) </li></ul></ul></ul><ul><li>Wait-list Group (n= 12) </li></ul><ul><ul><li>No significant changes in any measure </li></ul></ul><ul><li>ANCOVAs with pretreatment scores as covariates. </li></ul>
    18. 18. Intensity Problems
    19. 19. Hyperactivity Aggression
    20. 20. Hyperactivity ODD
    21. 21. Externalizing Aggressive
    22. 22. Total Severity
    23. 25. BDI SCL - 36
    24. 26. Conclusions <ul><li>PCIT seems to be: </li></ul><ul><ul><li>A responsive family intervention for Puerto Rican families who have preschool- age children with significant behavior problems. </li></ul></ul><ul><ul><li>An acceptable and effective treatment for Puerto Rican parents. </li></ul></ul><ul><ul><li>Efficacious to reduce significantly the behavior problems associated with ADHD and ODD. </li></ul></ul><ul><li>. </li></ul>
    25. 27. Research Team <ul><li>Co-investigators </li></ul><ul><ul><li>José J. Bauermeister, Ph.D. </li></ul></ul><ul><ul><li>Guillermo Bernal, Ph.D. </li></ul></ul><ul><li>Data Analysis </li></ul><ul><ul><li>José V. Martínez, Ph.D. </li></ul></ul><ul><ul><li>Eduardo Cumba, Ph.D. </li></ul></ul><ul><li>Research Assistants </li></ul><ul><li>Graduate students </li></ul><ul><li>Rosalie Torres </li></ul><ul><li>Rocheli Santiago </li></ul><ul><li>Ixa Rodriguez </li></ul><ul><li>Liliana Torres </li></ul><ul><li>Michelle Jurado </li></ul><ul><li>Elisabet Avilés </li></ul><ul><li>Kenneth Junco </li></ul><ul><li>Undergraduate students </li></ul><ul><li>Marisol De Jesús </li></ul><ul><li>Damaris Cordero </li></ul><ul><li>Wilmarie Ríos </li></ul><ul><li>Arlene Román </li></ul>
    26. 28. Acknowledgments <ul><li>Funded by NIMH 5R24MH-49368-11 </li></ul><ul><li>Dr. Maribel Matos </li></ul><ul><li>E-mail: m-matos@uprrp.edu </li></ul>
    27. 29. ¡Gracias!

    ×