Role of Caregiver Psychopathology, Parenting, and Parenting Competence on Outcomes Following Multisystemic Therapy




Fernandes, Bethany

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Background: Multisystemic Therapy (MST) is a comprehensive family-based treatment that is well-established for the treatment of youth with significant externalizing behaviors, with several studies examining its mechanisms of change, including parenting behaviors like inconsistent discipline . Research has yet to examine parenting as a mechanism of change while considering factors that may affect parenting, namely parent psychopathology and perceptions of parenting competence. Additionally, research has largely focused on post-treatment outcomes when examining mechanisms of change. This study examined the association between parent psychopathology at the start of treatment and child aggressive behaviors at long-term follow-up, and whether perceptions of parenting competence and consistent discipline mediate this association. Methods: Data for this study came from a NIMH-funded effectiveness study that examined a range of bio-psycho-social variables that can be used to examine mechanisms of change in MST. Parent report of psychopathology was measured at the start of treatment. Parent report of parenting incompetence and level of consistent discipline were measured at end-of-treatment. Finally, adolescent aggressive behavior was measured six months after treatment. Of the 185 youth recruited for the original study, 114 youth with participating female caregivers were included in this study. At study entry, youth age ranged from 12 to 17 (M=15.20, SD=1.35) while caregiver age ranged from 30 to 72 (M=43.22, SD=8.95). Results: Using the Preacher and Hayes PROCESS model to run our results, the direct effect of parent psychopathology on long-term outcomes was not significant (z(107)=1.12, p = .2633). While parent psychopathology and parent incompetence were significantly related (t(108)=2.97, p = .0037) and the relationship between parent incompetence and consistent discipline was significant (t(108)=5.48, p < .001), the indirect effects of parent sense-of-competence and consistent discipline between parent psychopathology and youth outcomes were insignificant after controlling for youth age, initial aggression report, socioeconomic status, and time between assessments. Conclusion: Results showed sense-of-competence and consistency of discipline were not sequential or non-sequential mediators of relations between parent psychopathology and aggressive outcomes at 6 months. More research is needed to better understand the complex relationship between sense-of-competence and consistent discipline as mediators of behavior.