Randomized controlled trial of individualized arousal-biofeedback for children and adolescents with disruptive behavior disorders (DBD).
Publication year
2024Source
European Child & Adolescent Psychiatry, 33, 9, (2024), pp. 3055-3066ISSN
Annotation
01 september 2024
Publication type
Article / Letter to editor
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Organization
Cognitive Neuroscience
Human Genetics
Psychiatry
Journal title
European Child & Adolescent Psychiatry
Volume
vol. 33
Issue
iss. 9
Page start
p. 3055
Page end
p. 3066
Subject
Cognitive Neuroscience - Radboud University Medical Center - DCMN; Human Genetics - Radboud University Medical Center - DCMN; Psychiatry - Radboud University Medical Center - DCMNAbstract
Disruptive behavior disorders [including conduct disorder (CD) and oppositional defiant disorder (ODD)] are common childhood and adolescent psychiatric conditions often linked to altered arousal. The recommended first-line treatment is multi-modal therapy and includes psychosocial and behavioral interventions. Their modest effect sizes along with clinically and biologically heterogeneous phenotypes emphasize the need for innovative personalized treatment targeting impaired functions such as arousal dysregulation. A total of 37 children aged 8-14 years diagnosed with ODD/CD were randomized to 20 sessions of individualized arousal biofeedback using skin conductance levels (SCL-BF) or active treatment as usual (TAU) including psychoeducation and cognitive-behavioral elements. The primary outcome was the change in parents´ ratings of aggressive behavior measured by the Modified Overt Aggression Scale. Secondary outcome measures were subscales from the Child Behavior Checklist, the Inventory of Callous-Unemotional traits, and the Reactive-Proactive Aggression Questionnaire. The SCL-BF treatment was neither superior nor inferior to the active TAU. Both groups showed reduced aggression after treatment with small effects for the primary outcome and large effects for some secondary outcomes. Importantly, successful learning of SCL self-regulation was related to reduced aggression at post-assessment. Individualized SCL-BF was not inferior to active TAU for any treatment outcome with improvements in aggression. Further, participants were on average able to self-regulate their SCL, and those who best learned self-regulation showed the highest clinical improvement, pointing to specificity of SCL-BF regulation for improving aggression. Further studies with larger samples and improved methods, for example by developing BF for mobile use in ecologically more valid settings are warranted.
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- Academic publications [244127]
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- Faculty of Medical Sciences [92874]
- Open Access publications [105172]
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