RESUMEN
This study evaluated the effectiveness of a multisystemic early intervention that included a comparison of an emotion- and behavior-focused parenting program for children with emerging conduct problems. The processes that moderated positive child outcomes were also explored. A repeated measures cluster randomized group design methodology was employed with three conditions (Tuning in to Kids, Positive Parenting Program, and waitlist control) and two periods (preintervention and 6-month follow-up). The sample consisted of 320 predominantly Caucasian 4- to 9-year-old children who were screened for disruptive behavior problems. Three outcome measures of child conduct problems were evaluated using a parent (Eyberg Child Behavior Inventory) and teacher (Strengths and Difficulties Questionnaire) rating scale and a structured child interview (Home Interview With Child). Six moderators were assessed using family demographic information and a parent-rated measure of psychological well-being (Depression Anxiety and Stress Scales short form). The results indicated that the multisystemic intervention was effective compared to a control group and that, despite different theoretical orientations, the emotion- and behavior-focused parenting programs were equally effective in reducing child conduct problems. Child age and parent psychological well-being moderated intervention response. This effectiveness trial supports the use of either emotion- or behavior-focused parenting programs in a multisystemic early intervention and provides greater choice for practitioners in the selection of specific programs.
Asunto(s)
Terapia Conductista , Trastornos de la Conducta Infantil/prevención & control , Educación/métodos , Emociones , Responsabilidad Parental/psicología , Padres/educación , Problema de Conducta/psicología , Adulto , Niño , Conducta Infantil/psicología , Trastornos de la Conducta Infantil/psicología , Trastornos de la Conducta Infantil/terapia , Preescolar , Intervención Educativa Precoz , Femenino , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Relaciones Padres-Hijo , Padres/psicología , Evaluación de Programas y Proyectos de Salud , Encuestas y CuestionariosRESUMEN
This paper evaluates the real-world effectiveness of an emotion-focused, multi-systemic early intervention combining an emotion socialization parenting program with a child and school socio-emotional intervention for children with emerging conduct problems. Schools in lower socioeconomic areas of Victoria, Australia were randomized into intervention or wait-list control. Children in the first 4 years of elementary school were screened for behavior problems and those in the top 8 % of severity were invited to participate in the intervention. The study sample consisted of 204 primary caregivers and their children (Mage = 7.05, SD = 1.06; 74 % boys). Data were collected at baseline and 10 months later using parent and teacher reports and direct child assessment. Measures of parent emotion socialization, family emotion expressiveness, and children's emotion competence, social competence and behavior were administered. Results showed intervention parents but not controls became less emotionally dismissive and increased in empathy, and children showed better emotion understanding and behavior compared to control children. These outcomes lend support for an emotion-focused approach to early intervention in a real-world context for children with conduct problems.
Asunto(s)
Trastorno de la Conducta/terapia , Intervención Médica Temprana/métodos , Emociones/fisiología , Terapia Familiar/métodos , Responsabilidad Parental/psicología , Socialización , Niño , Femenino , Humanos , Masculino , Instituciones Académicas , Habilidades Sociales , Resultado del TratamientoRESUMEN
The goal of this study was to examine the impact of different parenting characteristics on child disruptive behavior and emotional regulation among a sample of at-risk children. The sample consisted of 373 Australian 5- to 9-year-old children who were screened for serious behavior problems. Seven parenting variables based on self-report were evaluated, involving parenting practices, emotion beliefs and behaviors, emotion expressiveness, and mental health. Outcome variables based on parent/teacher report were child disruptive behavior problems and emotion regulatory ability. When entered simultaneously in a multiple regression analysis, inconsistent discipline, negative parental emotional expressiveness, and parent mental health demonstrated the strongest relationship to disruptive behavior problems and problems with emotion regulation. The data presented here elucidate multiple risk pathways to disruptive behavior disorders and can inform the design of prevention and early intervention programs.
Asunto(s)
Déficit de la Atención y Trastornos de Conducta Disruptiva , Conducta Materna/psicología , Relaciones Padres-Hijo , Conducta Paterna/psicología , Déficit de la Atención y Trastornos de Conducta Disruptiva/etiología , Déficit de la Atención y Trastornos de Conducta Disruptiva/prevención & control , Déficit de la Atención y Trastornos de Conducta Disruptiva/psicología , Australia , Niño , Conducta Infantil , Preescolar , Inteligencia Emocional , Emoción Expresada , Salud de la Familia , Femenino , Humanos , Masculino , Salud Mental , Responsabilidad Parental/psicología , Factores de Riesgo , Índice de Severidad de la EnfermedadRESUMEN
The lack of data in the open literature on human exposure to the nerve agent O-ethyl-S-(2-diisopropylaminoethyl) methylphosphonothioate (VX) gives a special relevance to the data presented in this study in which we report the quantification of VX-butyrylcholinesterase adduct from a relatively low-level accidental human exposure. The samples were analyzed by gas chromatography-high resolution mass spectrometry using the fluoride ion regeneration method for the quantification of multiple nerve agents including VX. Six human plasma samples from the same individual were collected after the patient had been treated once with oxime immediately after exhibiting signs of exposure. Detection limits of approximately 5.5 pg/mL plasma were achieved for the G-analogue of VX (G-VX). Levels of the G-VX ranged from 81.4 pg/mL on the first day after the exposure to 6.9 pg/mL in the sample taken 27 days after the exposure. Based on the reported concentration of human butyrylcholinesterase in plasma of approximately 80 nM, it can be calculated that inhibition levels of >or= 0.05% of BuChE can be accurately quantified. These data further indicate that the fluoride ion regeneration method is a potentially powerful tool that can be used to assess low-level exposure to VX.
Asunto(s)
Butirilcolinesterasa/metabolismo , Monitoreo del Ambiente/métodos , Compuestos Organotiofosforados/sangre , Biomarcadores/análisis , Biomarcadores/sangre , Butirilcolinesterasa/química , Calibración , Sustancias para la Guerra Química/análisis , Sustancias para la Guerra Química/metabolismo , Inhibidores de la Colinesterasa/sangre , Inhibidores de la Colinesterasa/metabolismo , Exposición a Riesgos Ambientales/análisis , Fluoruros/química , Cromatografía de Gases y Espectrometría de Masas/métodos , Humanos , Compuestos Organotiofosforados/química , Compuestos Organotiofosforados/metabolismo , Compuestos de Potasio/químicaRESUMEN
Organophosphorus nerve agents (OPNAs) continue to pose a threat to military personnel and the general public because of their toxicity and their potential use as weapons of mass destruction. An effective method for the detection of human exposure to OPNAs involves the refluoridation of nerve agents adducted to the serum protein butyrylcholinesterase. The regenerated agents are then enriched by solid-phase extraction and quantified by isotope-dilution gas chromatography-mass spectrometry. We have previously reported improvements that resulted in a 10-fold increase in sensitivity. We have now made further changes to the method that include the addition of confirmation ions, the addition of soman (GD) to the assay, the expansion of the linear range, and the elimination of high-volume injection to decrease background noise and run time while improving sensitivity. This report includes the standard operating procedures for this method for tabun, sarin, soman, cyclohexylsarin, and VX and validation studies. The method's limits of detection ranged from 5.5 to 16.5 pg/mL for the G analogue of VX and GD, respectively. Characterization of quality control (QC) materials resulted in an average coefficient of variation of 15.1% for the five analytes in low QC pools and 11.7% in high QC pools.