Gunnar Bjørnebekk

Treatment Outcomes and Mediators of Parent Management Training: A One-Year Follow-Up of Children with Conduct Problems

This effectiveness study presents the results of a 1-year follow-up of a randomized controlled trial of Parent Management Training. Families of 112 Norwegian girls and boys with clinic-level conduct problems participated, and 75 (67%) families were retained at follow-up. Children ranged in age from 4 to 12 at intake (M = 8.44). Families randomized to the control group received an active treatment alternative as would be normally offered by participating agencies. Multi-informant, multisetting outcome measures were collected and results from both intention-to-treat and treatment-on-the-treated analyses are presented. In two separate indirect effects models, assignment to Parent Management Training—the Oregon model predicted greater effective discipline and family cohesion at postassessment, which in turn predicted improvements in several child domains at follow-up.

Measurement of implementation components ten years after a nationwide introduction of empirically supported programs – a pilot study

BackgroundTen years after the nationwide dissemination of two evidence-based treatment programs, the status of the implementation components was evaluated in a cross-sectional study. The aim of the study was to pilot a standardized measure of implementation components by examining the factor structure, the reliabilities of the scores, and their association with implementation outcome variables. The aim was also to compare implementation profiles of the two evidence-based programs based on multi informant assessments.MethodsThe 218 participants in the study were therapists, supervisors, and agency leaders working with Parent Management Training, the Oregon model (PMTO), and Multisystemic Therapy (MST) in Norway. Interviewers filled in an electronic version of the Implementation Components Questionnaire during a telephone interview.ResultsThe factor analysis of the eight one-dimensional subscales resulted in an individual clinical-level factor and an organizational system-level factor. Age, experience, and number of colleagues in the workplace were negatively correlated with positive ratings of the implementation process, but the number of colleagues working with the same program predicted positive ratings. MST and PMTO had different implementation profiles and therapists, supervisors, and managers evaluated some of the implementation drivers significantly differently.ConclusionsThe psychometric quality of the questionnaire was supported by measures of internal consistency, factor analyses of the implementation components, and the comparisons of implementation profiles between programs and respondent groups. A moderate, but consistent association in the expected direction was found with the implementation outcome variables.

Psychometric Properties of the Scores on the Behavioral Inhibition and Activation Scales in a Sample of Norwegian Children

The primary aim of this study was to examine the psychometric properties of the scores on a version for children of the Carver and White Behavioral Inhibition and Activation scales (the BIS—BAS scales). This involved administering the BIS—BAS scales, the Positive and Negative Affect Schedule, the Junior Eysenck Personality Questionnaire Revised—Abbreviated, and the Achievement Motives Scale to a population of 661 Norwegian sixth graders. The findings reveal that the scores on the BIS—BAS scales for children have a theoretically meaningful factor structure as well as satisfactory convergent validity and reliability. However, the results indicate that the version for children of the BAS scale actually may consist of two subscales: one related to the experience of pleasurable affect and one to persistence in goal pursuit. To a large extent, the relationship with the other scales was as expected.

A Randomized Effectiveness Trial of Brief Parent Training Six-Month Follow-Up

Objective: To examine the follow-up effectiveness of brief parent training (BPT) for children with emerging or existing conduct problems. Method: With the use of a randomized controlled trial and parent and teacher reports, this study examined the effectiveness of BPT compared to regular services 6 months after the end of the intervention. Participants included 216 children (3–12 years) and parents randomly assigned to BPT or a comparison group. Results: BPT had beneficial effects on caregiver assessments of parenting practices (i.e., positive parenting and harsh discipline) and child conduct problems in the families 6 months after the intervention. The effects of BPT in schools and day care centers were limited. Compared to posttest the effects sizes were smaller and number of significant effects lower. Conclusion: Although effects decreased over time, this study demonstrate that a short-term manual-based intervention (3–5 sessions) could be effective in reducing conduct problems 6 month after the intervention.

Future Time Orientation and Temperament: Exploration of Their Relationship to Primary and Secondary Psychopathy

The present study combines Lykkens theory about the role of reward sensitivity and punishment insensitivity in the development of antisocial behavior with Gjesmes theory of future time orientation. 158 adolescents comprised a target group of 79 adolescents who had defined behavioral problems and a matched referential group of 79 adolescents who did not have notable behavioral problems. The results suggest that attributes related to primary psychopathy are associated with a relatively weak or hyporeactive behavioral inhibition system, behavioral approach reactivity, and low future time orientation. Moreover, attributes related to secondary psychopathy are related to an overly sensitive (hyper-reactive) behavioral approach system and low future time orientation. Robust positive associations for behavioral approach reactivity and low future time orientation with primary and secondary psychopathy suggest that high behavioral approach/low future time orientation may represent a core feature common to the two factors of psychopathy.

Motivation and Temporal Distance: Effect on Cognitive and Affective Manifestations

The implications of temporal distance on motivation-related concepts were examined. The results of an experiment, based on 585 Grade 6 students, indicated that both positive (approach) and negative (avoidance) motivation increased as the future goal or event approached in time. This increase in approach and avoidance motivation influenced the performance of the pupils differently. For pupils with success orientation, the performance increased. For pupils with failure orientation, the performance remained about the same.

Children With Conduct Problems and Co-occurring ADHD: Behavioral Improvements Following Parent Management Training

To scale up evidence-based treatment of conduct problems, parent management training, Oregon model (PMTO) has been disseminated throughout Norway. This study examined whether Attention Deficit Hyperactivity Disorder (ADHD) predicted the outcomes of PMTO. Of 253 children and families, 97 were reported to have an ADHD diagnosis. Although different at intake, the groups with and without ADHD had close to an equal change in behavioral status following treatment. Maternal depression and family income predicted the combined groups behavior following PMTO. The study indicates that reductions in conduct problems following PMTO are of the same magnitude in children with or without ADHD. However, some characteristics may differentially predict outcomes for children with combined problems.

Observed callousness as a predictor of treatment outcomes in parent management training.

Background: The goal of this study was to examine how observed Callous–Unemotional (CU) behavior influenced change in externalized and internalized problems, hyperactivity, social competence, and treatment satisfaction following parent management training. Methods: Three hundred twenty-three children and their families received Parent Management Training—the Oregon model (PMTO). They were compared at intake and after treatment in order to examine differences in 14 treatment outcomes using hierarchical regression analyses. Results: Children with low levels of observed CU showed the greatest gains after PMTO treatment. This was evident in parent, therapist, self, and teacher reports. Conclusions: The results indicate that it is possible to observe CU behavior among children with conduct problems, and that children with elevated levels of observed CU behavior may be in need of additional treatment or components of treatment or more intense versions of parent management treatment.

Three Randomized Effectiveness Trials — One Question: Can Callous-Unemotional Traits in Children Be Altered?

Children with conduct problems and callous-unemotional (CU) traits are at risk for multiple problems. Outcome research and mediation analyses testing for mechanisms of change in CU traits have been limited. We examined whether parent training—in a short-term (Brief Parent Training; BPT) or a comprehensive format (Parent Management Training, Oregon Model; PMTO)—or child-directed social skills training (Individual Social Skills Training [ISST]) produced positive effects on CU traits. In mediation models we tested parenting practices as mechanisms of change for CU traits. We pooled data from three randomized effectiveness trials, and 551 families were included in this study. Families had children between 3 and 12 years of age and displayed emerging or present conduct problems at home, day care, or school (BPT M age = 7.28, 31.9% girls; PMTO M age = 8.56, 36.5% girls; ISST M age = 7.64, 19.7% girls). Assessments were completed preintervention, postintervention, and at follow-up (6 months following intervention). Both BPT (d = .32) and PMTO (d = .39) had positive effects on CU traits at posttest, whereas ISST did not (d = –.06). At follow-up, only PMTO produced a significant effect (d = .48) on CU traits. A significant indirect effect on CU traits emerged by positive parenting. Both parent training conditions outperformed ISST. Only PMTO maintained its effects at follow-up. The findings suggest that PMTO can reduce CU traits and that improved positive parenting is associated with positive outcomes for children’s CU traits.