Psychosocial Interventions for Disruptive Behavior in Children and Adolescents: A Meta-Analysis.

CONTEXT: In childhood and adolescence, disruptive behavior is a common reason for childhood referral to mental health services.

OBJECTIVE

To determine the most effective psychosocial interventions for disruptive behavior in children and adolescents.

DATA SOURCES: Ovid MEDLINE, the Cochrane Library, PsycINFO, and Embase were searched from 2014 to July 22, 2024.

STUDY SELECTION: Randomized controlled trials comparing psychosocial interventions with treatment as usual or waitlist.

DATA EXTRACTION: Data abstraction, risk of bias, and strength of evidence were completed by 1 reviewer and checked by a second reviewer; disagreements were resolved by consensus.

RESULTS

Sixty-four RCTs in preschool and school-aged children were included in meta-analyses. An additional 20 trials in adolescents were included but could not be pooled. Based on meta-analyses, both parent-only interventions and multicomponent interventions that included a parent, caregiver, or teacher plus a child were associated with reductions in disruptive behavior in preschool (SMD, -0.61 [95% CI, -0.99 to -0.31] and SMD, -0.96 [95% CI, -1.39 to -0.60]) and school-aged (SMD, -0.39 [95% CI, -0.58 to -0.22] and SMD, -0.61 [95% CI, -1.05 to -0.20]) children when assessed immediately posttreatment. Results were less consistent with longer follow-up across interventions.

LIMITATIONS: There was substantial heterogeneity across age groups regarding interventions and outcomes, which made drawing definitive conclusions challenging.

CONCLUSIONS

Multicomponent psychosocial interventions and parent-only psychosocial interventions were better than treatment as usual or waitlist at reducing parent-reported disruptive behaviors for preschool and school-aged children immediately posttreatment. Evidence for long-term outcomes and studies conducted in adolescents was limited.