The prevention program for externalizing problem behavior (PEP) improves child behavior by reducing negative parenting: analysis of mediating processes in a randomized controlled trial

Abstract

Background Our indicated Prevention program for preschool children with Externalizing Problem behavior (PEP) demonstrated improved parenting and child problem behavior in a randomized controlled efficacy trial and in a study with an effectiveness design. The aim of the present analysis of data from the randomized controlled trial was to identify the mediating processes that account for these positive treatment effects. We hypothesized that a decrease in negative parenting and increases in positive parenting and parental warmth would mediate the relationship between treatment and child improvement. Method Parents of 155 children were randomly assigned to the PEP intervention group (n = 91) or a nontreated control group (n = 64). Parents rated their child's problem behavior and their own parenting practices before and after PEP training. Parental warmth was assessed during standardized play situations. Four mediation models were tested using structural equation modeling. Trial registration number ISRCTN12686222; http://www.controlled-trials.com/isrctn/pf/12686222. Results Changes in child externalizing problem behavior were most strongly mediated by reductions of negative parenting in difficult parenting situations. Increases in positive parenting also served as a mediator. Changes in parental warmth, parents' feeling of self‐efficacy, and parental mental health did not play a mediating role in the association between PEP treatment and child behavior. Conclusions In our program, the most important component was to teach parents how to reduce dysfunctional parenting strategies in conflict situations.

Exploration of Mechanisms behind Changes after Participation in a Parenting Intervention: A Qualitative Study in a Low‐Resource Setting

“…Mechanisms behind change after participation in parenting interventions have mainly been explored through quantitative designs (i.e., moderators and mediator analyses). Some studies have found that changes in externalizing problems are mediated by reductions in negative parenting behaviors (e.g., hitting and yelling) and increases in positive parenting practices (e.g., praise) (Gardner, Burton & Klimes, 2006;Hanisch, Hautmann, Pluck, Eichelberger & Dopfner, 2013). Self-efficacy and parental stress did not mediate this association .…”

Perceived mother and father acceptance‐rejection predict four unique aspects of child adjustment across nine countries

“…Results of parenting interventions (usually with mothers) in the United States and Europe have demonstrated that improving parenting behaviors can have positive effects on later child adjustment (Guttentag et al, 2014; Hanisch, Hautmann, Plück, Eichelberger, & Döpfner, 2014; Landry, Smith, Swank, & Guttentag, 2008; Watson et al, 2014). The results of this study suggest that parenting interventions with mothers and fathers may have similar effects on child adjustment in Western and non-Western countries.…”

Indirect Effects of the Fast Track Intervention on Conduct Disorder Symptoms and Callous-Unemotional Traits: Distinct Pathways Involving Discipline and Warmth

“…A cross-sectional study involving first graders from the same sample used in the current study, showed that harsh discipline correlated with both aggression and oppositional behavior, whereas warmth was only correlated with oppositional behavior (Stormshak, Bierman, McMahon, Lengua, & Conduct Problems Prevention Research Group [CPPRG], 2000). Moreover, in a study examining mediators of a preventive parenting intervention for high-risk preschoolers, harsh parenting, but not warmth, partially accounted for program effects on decreased conduct problems (Hanisch, Hautmann, Plück, Eichelberger, & Döpfner, 2014). Taken together, prior research provides more consistent support for the proximal effects of harsh discipline than warmth on conduct problems.…”