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Is emotion regulation a mediator between parenting skills and treatment outcome in Parent-Child Interaction Therapy?
Title
Is emotion regulation a mediator between parenting skills and treatment outcome in Parent-Child Interaction Therapy?
Creator
Butler, Kristina
Date
2020
Description
Disruptive behavior disorders are prevalent in preschool children and are associated with a range of negative developmental sequelae. There is...
Show moreDisruptive behavior disorders are prevalent in preschool children and are associated with a range of negative developmental sequelae. There is extensive evidence that Parent-Child Interaction Therapy (PCIT) is an effective behavioral parent training program for decreasing disruptive behaviors in young children. However, the mechanism that accounts for the reduction in externalizing behaviors in PCIT is not well understood. Children’s emotion regulation (ER) is one possible mechanism that accounts for treatment effectiveness. Parenting skills focused on in PCIT serve to increase warmth in caregiver-child interactions, which, in turn, lead to increases in children’s ER skills. ER also has been shown to moderate externalizing behaviors in PCIT. However, to date, there are no longitudinal studies that have examined ER as a mediator in PCIT. The aim of this study was to determine if child ER serves as a mediator between changes in parenting skills and decreases in externalizing behavior problems after PCIT treatment. A diverse sample of 67 children and their mothers participated in PCIT treatment in a community mental health center. All variables were assessed twice, at baseline and after treatment. Positive parenting skills (“Do Skills”) and negative ones (“Don’t Skills”) were assessed during a video recorded 5-minute task using the Dyadic Parent-Child Interaction Coding System. Child ER was assessed during a video recorded 5-minute clean-up task with a behavioral coding scheme adapted from previous research. Child behavior problems were measured using the Child Behavior Checklist Externalizing Scale. Difference scores used in the final analyses were calculated by subtracting the baseline score from the final assessment score for each measure.Results of linear regression analyses revealed a significant, negative relation between changes in ER and externalizing behavior problems. Findings did not support ER as a partial mediator between parenting skills and child externalizing problems. However, moderation analyses indicated that change in ER moderated the relation between change in positive parenting skills (Do Skills) and change in behavior problems, such that the interaction was significant for greater changes in ER. Specifically, increases in Do Skills led to less improvement in disruptive behaviors in children whose ER skills decreased. Also, increases in Do Skills led to greater reductions in behavior problems in children whose ER skills showed greater improvement. This study provides evidence that change in ER moderates changes in Do Skills and change in externalizing problems in PCIT. Findings also suggest that adding strategies to PCIT that focus on increasing child ER may enhance effectiveness of this treatment.
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