Citation

Miller NV, Haas SM, Waschbusch DA, Willoughby MT, Helseth SA, Crum KI, Coles EK, Pelham WE. Behav. Ther. 2014; 45(5): 606-618.

Affiliation

Center for Children and Families, Florida International University.

Copyright

(Copyright © 2014, Association for Behavioral and Cognitive Therapies, Publisher Elsevier Publishing)

DOI

10.1016/j.beth.2013.10.006

PMID

25022772

Abstract

The conduct problems of children with callous-unemotional (CU) traits (i.e., lack of empathy, lack of guilt/lack of caring behaviors) are particularly resistant to current behavioral interventions, and it is possible that differential sensitivities to punishment and reward may underlie this resistance. Children with conduct problems and CU (CPCU) are less responsive to behavioral punishment techniques (e.g., time-out), whereas reward techniques (e.g., earning points for prizes or activities) are effective for reducing conduct problems. This study examined the efficacy of modified behavioral interventions, which de-emphasized punishment (Condition B) and emphasized reward techniques (Condition C), compared with a standard behavioral intervention (Condition A). Interventions were delivered through a summer treatment program over 7weeks with an A-B-A-C-A-BC-A design to a group of 11 children (7-11years; 91% male). All children were diagnosed with either oppositional defiant disorder or conduct disorder, in addition to attention-deficit hyperactivity disorder.

RESULTS revealed the best treatment response occurred during the low-punishment condition, with rates of negative behavior (e.g., aggression, teasing, stealing) increasing over the 7weeks. However, there was substantial individual variability in treatment response, and several children demonstrated improvement during the modified intervention conditions. Future research is necessary to disentangle treatment effects from order effects, and implications of group treatment of CPCU children (i.e., deviancy training) are discussed.

Language: en