Psychosocial interventions for disruptive behaviour problems in children in low- and middle-income countries: a systematic review and meta-analysis

Autor:	Brandon A. Kohrt, Mark Kurzrok, Marianna Purgato, Megan Hosein, Ahmad Adi, Wietse A. Tol, Isabella Morton, Matthew D. Burkey
Rok vydání:	2018
Předmět:	Gerontology psychosocial interventions Adolescent Psychological intervention Developing country Child Behavior Disorders child behaviour law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial low-income countries law Developmental and Educational Psychology Humans 0501 psychology and cognitive sciences 030212 general & internal medicine Child Developing Countries Problem Behavior 05 social sciences Mental health Confidence interval Psychotherapy meta-analysis Psychiatry and Mental health Attention Deficit and Disruptive Behavior Disorders Strictly standardized mean difference Child Preschool Meta-analysis Pediatrics Perinatology and Child Health disruptive behaviour disorders Psychology Psychosocial 050104 developmental & child psychology
Zdroj:	Journal of Child Psychology and Psychiatry. 59:982-993
ISSN:	0021-9630
DOI:	10.1111/jcpp.12894
Popis:	Background Most of the evidence for psychosocial interventions for disruptive behaviour problems comes from Western, high-income countries. The transferability of this evidence to culturally diverse, low-resource settings with few mental health specialists is unknown. Methods We conducted a systematic review with random-effects meta-analysis of randomized controlled trials examining the effects of psychosocial interventions on reducing behaviour problems among children (under 18) living in low- and middle-income countries (LMIC). Results Twenty-six randomized controlled trials (representing 28 psychosocial interventions), evaluating 4,441 subjects, met selection criteria. Fifteen (54%) prevention interventions targeted general or at-risk populations, whereas 13 (46%) treatment interventions targeted children selected for elevated behaviour problems. Most interventions were delivered in group settings (96%) and half (50%) were administered by non-specialist providers. The overall effect (standardized mean difference, SMD) of prevention studies was -0.25 (95% confidence interval (CI): -0.41 to -0.09; I2 : 78%) and of treatment studies was -0.56 (95% CI: -0.51 to -0.24; I2 : 74%). Subgroup analyses demonstrated effectiveness for child-focused (SMD: -0.35; 95% CI: -0.57 to -0.14) and behavioural parenting interventions (SMD: -0.43; 95% CI: -0.66 to -0.20), and that interventions were effective across age ranges. Conclusions Our meta-analysis supports the use of psychosocial interventions as a feasible and effective way to reduce disruptive behaviour problems among children in LMIC. Our study provides strong evidence for child-focused and behavioural parenting interventions, interventions across age ranges and interventions delivered in groups. Additional research is needed on training and supervision of non-specialists and on implementation of effective interventions in LMIC settings.
Databáze:	OpenAIRE
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