Parent Emotion Socialization and Treatment Outcomes for Children with Oppositional Defiant Disorder: The Mediating Role of Emotion Regulation
Oppositional Defiant Disorder (ODD), characterized by irritability and defiant behavior, is associated with several negative outcomes in childhood and adulthood (APA, 2000; Webster- Stratton, 1996). There are a variety of approaches to treating ODD that differ in their focus on parents, children, or both parent and child (Greene & Ablon, 2005; Kazdin, 2005). These treatments also target different underlying processes of oppositional behaviors, such as parenting behaviors and children's emotion regulation. Research suggests that parent emotion socialization practices may indirectly influence externalizing behaviors, such as those present in ODD, through children's emotion regulation abilities (Eisenberg, Cumberland, & Spinrad, 1998). The present study examines this mediation model in children diagnosed with ODD (n = 100; 58 boys) who received either Parent Management Training or Creative & Proactive Solutions. Findings indicate that families receiving CPS exhibited higher decreases in ODD symptoms than those receiving PMT. There was no evidence for an indirect effect of emotion socialization on symptoms of ODD through emotion regulation. Regarding direct effects, increases in emotion encouraging, emotion discouraging, and emotion regulation were associated with decreases in ODD symptoms, whereas increases in problem solving were associated with increases in ODD symptoms. There were also pre-treatment indicators of children's treatment response, such as parent's problem solving, children's emotional lability, and ADHD symptoms. These results indicate the importance of both emotion socialization and emotion regulation in treatment improvement, as well as factors that may contribute to treatment response. Treatment implications and future research directions are discussed.