Individual and Group Intervention Formats With Aggressive Children
Condition: Aggressive Behavior
MeSH terms: Aggression
Study type: Interventional

Summary: 
      The planned study will randomly assign aggressive children to one of two versions of the
      Coping Power child component. The two versions of Coping Power will either deliver the child
      component of the program in the usual small group format (Group Coping Power: GCP) or in a
      newly-developed individual format (Individual Coping Power: ICP). By providing a direct
      comparison of two different formats of the same intervention, the planned study's design will
      fill a critical gap in our current understanding of the relative effectiveness of group vs.
      individual programs. Further, this study will allow for examination of the specific factors
      that influence relative effectiveness of these two formats, important information with broad
      implications for program development, training of clinicians, and intervention
      implementation.
    

Detailed description: 
      Specific Aim 1: The study will test the hypothesis that the Coping Power intervention will
      produce larger effect sizes when delivered in an individual format in comparison to a group
      format. Although there are advantages of both formats, pilot data suggests that the group
      format may be diminishing the strength of outcome effects of intervention in comparison to
      the same intervention delivered in individual format. This pilot data is consistent with some
      prior findings, but a direct randomized comparison of children assigned to group versus
      individual formats has not been conducted, despite the critically important conceptual,
      clinical, and policy implications.

      Hypothesis 1-1: It is hypothesized that ICP will produce greater reductions in behavior
      outcomes including substance use, externalizing behavior problems, and delinquency at a
      1-year follow-up, in comparison to GCP.

      Hypothesis 1-2: it is hypothesized that the ICP condition will produce greater improvements
      in children's social competence, which is directly targeted by the intervention, in
      comparison to GCP.

      Specific Aim 2: Individual and group variation in effect sizes will be an outcome of youth
      behavior in the group (i.e., deviancy training) and group leader behavior management skill.
      We see youth behavior to be highly influenced by group leader management practices. We
      understand that some groups and/or individual children present challenges to even the most
      competent group leaders, and therefore, variation will be observable and meaningful. The
      design of the study allows for the testing of both group level and individual effects, and
      linkage of these effects to specific behaviors. Such information will provide an empirical
      basis for clinical training for group interventions with youth in general and Coping Power in
      particular.

      Hypothesis 2-1: It is hypothesized that peer escalation in the GCP condition will predict
      worse outcomes, and that the level of group deviance in the GCP condition will moderate the
      effectiveness of the GCP condition, with better outcome effects for the groups with the
      highest initial screening scores.

      Hypothesis 2-2: It is hypothesized that group interventions will be compromised by individual
      children's reactions to the interpersonal dynamics of the groups, such as inadvertent
      attention to deviant behavior and talk provided by group members and/or the group leader.

      Hypothesis 2-3: It is hypothesized that level of positive group leader behaviors (directing
      attention to rules, correcting behavior, providing praise for compliance, introduction and
      review of activities, clear directions) will moderate the effectiveness of the GCP condition.

      Specific Aim 3: Variability in outcome scores will differ between conditions. Hypothesis 3-1:
      It is hypothesized that there will be greater variability in the outcome scores of children
      in the GCP condition than in those of children in the ICP condition.

      Specific Aim 4: Child characteristics will be examined as potential moderators of
      intervention effects.

      Hypothesis 4-1: It is hypothesized that youth with low effortful control will be most
      vulnerable to deviancy effects in group interventions and therefore will show lower effect
      sizes than youth higher in effortful control at baseline. Thus we expect effortful control to
      function as a moderator of group intervention effectiveness, but not individual intervention
      effectiveness.

      Research Question 1: In addition, we will investigate the possibility that characteristics of
      the youth's decision-making (impulsive decision-making; outcome expectations), affective
      arousal (callous-unemotional traits; low physiological arousal in response to negative
      consequences), temperament and behavior characteristics (baseline severity of aggressive
      behavior); perceived and actual peer reactions (perceived peer competence; peer rejection;
      peer victimization; deviant peers) and demographic characteristics (sex; age; race) will
      moderate the effectiveness of both interventions.
    

Intervention name(s): Individual intervention; Group Intervention
Intervention type(s): Behavioral; Behavioral
Intervention description(s): 34 weekly sessions of cognitive-behavioral Coping Power intervention, delivered in an individual one-to-one format; 34 weekly sessions of Coping Power intervention, delivered in a small group format (6 children per gorup)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention