Psychosocial interventions for child disruptive behaviors: A meta-analysis

BACKGROUND: Disruptive behavior disorders are among the most common child and adolescent psychiatric disorders and associated with significant impairment. OBJECTIVE: Systematically review studies of psychosocial interventions for children with disruptive behavior disorders. METHODS: We searched Medline (via PubMed), Embase, and PsycINFO. Two reviewers assessed studies against predetermined inclusion criteria. Data were extracted by 1 team member and reviewed by a second. We categorized interventions as having only a child component, only a parent component, or as multicomponent interventions. RESULTS: Sixty-six studies were included. Twenty-eight met criteria for inclusion in our metaanalysis. The effect size for the multicomponent interventions and interventions with only a parent component had the same estimated value, with a median of 21.2 SD reduction in outcome score (95% credible interval, 21.6 to 20.9). The estimate for interventions with only a child component was 21.0 SD (95% credible interval, 21.6 to 20.4). LIMITATIONS: Methodologic limitations of the available evidence (eg, inconsistent or incomplete outcome reporting, inadequate blinding or allocation concealment) may compromise the strength of the evidence. Population and intervention inclusion criteria and selected outcome measures eligible for inclusion in the meta-analysis may limit applicability of the results. CONCLUSIONS: The 3 intervention categories were more effective than the control conditions. Interventions with a parent component, either alone or in combination with other components, were likely to have the largest effect. Although additional research is needed in the community setting, our findings suggest that the parent component is critical to successful intervention.