Aggressive Behavior Clinical Trial
Official title:
Individual and Group Intervention Formats With Aggressive Children
The planned study will randomly assign aggressive children to one of two versions of the Coping Power child component. The two versions of Coping Power will either deliver the child component of the program in the usual small group format (Group Coping Power: GCP) or in a newly-developed individual format (Individual Coping Power: ICP). By providing a direct comparison of two different formats of the same intervention, the planned study's design will fill a critical gap in our current understanding of the relative effectiveness of group vs. individual programs. Further, this study will allow for examination of the specific factors that influence relative effectiveness of these two formats, important information with broad implications for program development, training of clinicians, and intervention implementation.
Specific Aim 1: The study will test the hypothesis that the Coping Power intervention will
produce larger effect sizes when delivered in an individual format in comparison to a group
format. Although there are advantages of both formats, pilot data suggests that the group
format may be diminishing the strength of outcome effects of intervention in comparison to
the same intervention delivered in individual format. This pilot data is consistent with
some prior findings, but a direct randomized comparison of children assigned to group versus
individual formats has not been conducted, despite the critically important conceptual,
clinical, and policy implications.
Hypothesis 1-1: It is hypothesized that ICP will produce greater reductions in behavior
outcomes including substance use, externalizing behavior problems, and delinquency at a
1-year follow-up, in comparison to GCP.
Hypothesis 1-2: it is hypothesized that the ICP condition will produce greater improvements
in children's social competence, which is directly targeted by the intervention, in
comparison to GCP.
Specific Aim 2: Individual and group variation in effect sizes will be an outcome of youth
behavior in the group (i.e., deviancy training) and group leader behavior management skill.
We see youth behavior to be highly influenced by group leader management practices. We
understand that some groups and/or individual children present challenges to even the most
competent group leaders, and therefore, variation will be observable and meaningful. The
design of the study allows for the testing of both group level and individual effects, and
linkage of these effects to specific behaviors. Such information will provide an empirical
basis for clinical training for group interventions with youth in general and Coping Power
in particular.
Hypothesis 2-1: It is hypothesized that peer escalation in the GCP condition will predict
worse outcomes, and that the level of group deviance in the GCP condition will moderate the
effectiveness of the GCP condition, with better outcome effects for the groups with the
highest initial screening scores.
Hypothesis 2-2: It is hypothesized that group interventions will be compromised by
individual children's reactions to the interpersonal dynamics of the groups, such as
inadvertent attention to deviant behavior and talk provided by group members and/or the
group leader.
Hypothesis 2-3: It is hypothesized that level of positive group leader behaviors (directing
attention to rules, correcting behavior, providing praise for compliance, introduction and
review of activities, clear directions) will moderate the effectiveness of the GCP
condition.
Specific Aim 3: Variability in outcome scores will differ between conditions. Hypothesis
3-1: It is hypothesized that there will be greater variability in the outcome scores of
children in the GCP condition than in those of children in the ICP condition.
Specific Aim 4: Child characteristics will be examined as potential moderators of
intervention effects.
Hypothesis 4-1: It is hypothesized that youth with low effortful control will be most
vulnerable to deviancy effects in group interventions and therefore will show lower effect
sizes than youth higher in effortful control at baseline. Thus we expect effortful control
to function as a moderator of group intervention effectiveness, but not individual
intervention effectiveness.
Research Question 1: In addition, we will investigate the possibility that characteristics
of the youth's decision-making (impulsive decision-making; outcome expectations), affective
arousal (callous-unemotional traits; low physiological arousal in response to negative
consequences), temperament and behavior characteristics (baseline severity of aggressive
behavior); perceived and actual peer reactions (perceived peer competence; peer rejection;
peer victimization; deviant peers) and demographic characteristics (sex; age; race) will
moderate the effectiveness of both interventions.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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