Mental health promotion in young children : parents as a key to the identification and reduction of risk for development of disruptive behavior problems.

Abstract

The main aim of this dissertation was threefold. First, to establish norms for a psychometric inventory used to assess behavior problems. The project presents the first Norwegian standardization of an assessment tool specifically designed to measure childhood conduct problems. Norwegian norms for the Eyberg Child Behavior Inventory (ECBI; Robinson, Eyberg, & Ross, 1980) based on data obtained from a random population sample (N = 4063) of children in the age range of four to twelve years are presented. The sample was drawn from rural and urban areas within three Norwegian town districts. Clinical and research advantages of having a properly standardized assessment tool for this specific subclass of childhood psychiatric problems in Norway are discussed. The second aim of this dissertation was to evaluate the effects of a short PT intervention to test whether a lower “dosage” of PT can be used to reduce risk factors related to development of childhood behavior problems. Data were obtained from parents in a RCT on PT for children aged 2 to 8 years (N = 186) at pre, post and one year follow up. The results showed significant differences in changes in the two groups, regarding reductions in harsh parenting and child behavior problems, strengthening positive parenting and parent’s sense of competence. The effects regarding parenting and parents’ perception of their satisfaction and efficacy all lasted through one-year follow up. These findings suggests that a shortened version of a well-structured parenting intervention, the Incredible Years program, implemented in primary care at community level, seems to be a sound way to reduce harsh parenting, and to strengthen positive parenting and parents’ sense of competence, in an effort to reduce important risk factors related to the development of early childhood behavior problems. The third aim of this dissertation was to explore characteristics of parents who signed up for parenting classes as well as their own reasons for participation. A substantial amount of research has revealed clear socio-economic differences in parental help-seeking behavior in a way where parents with higher socio-economic status more often seek help. However, researchers have also suggested that giving parent training to all parents in a nonstigmatizing fashion would enhance the effectiveness of such programs. Data were obtained from parents in a study on parent training for children aged 2 to 8 years (N = 189), and a follow up survey on these parents (N = 118). Results showed that parents in our study had high education, were married, and employed in full time jobs. The mean age of the children was under 4 years, and their Intensity and Problem scores on ECBI were higher than the Norwegian mean scores for their age group. Aspects of parent stress, parental concern, and parenting practices predicted the ECBI Intensity scores to a rather large extent. It seems to be the case, that parents with high SES risk factors may not come forward to participate in face-to-face self-recruitment mental health promotion interventions, even if the parenting intervention is offered at a time suitable for parents, is free of charge, and is offered in a nonstigmatizing way.