Childhood disruptive behavior disorders (DBDs) are serious emotional, attentional and behavioral syndromes including attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder. DBDs are highly prevalent, significant public health problems with enormous health care costs and persistent effects on children's social, academic and emotional development. DBDs are associated with higher risks for substance abuse, delinquency, and peer rejection. Childhood DBDs occur and are managed within the context of the family and are associated with maternal depression, divorce, harsher discipline, and intra familial conflict. Parents are gatekeepers to a child's entry into care;treatment is dependent on how parents perceive and define a child's symptomatic behaviors. The Family Management Style Framework (FMSF) was developed to describe the unique management styles of families with chronically ill children. Use of the FMSF can address the knowledge gap about management of childhood DBDs. The purpose of this preliminary mixed methods study is to use the FMSF to describe the complexity of parents'day-to-day management of DBDs across three dimensions: parent definition and management of the behavior, and perceived consequences. This innovative study supports a core NINR strategic goal: to identify foundational knowledge necessary for development of predictive models and interventions that promote and sustain the mental and emotional health of families. Two semi-structured parent interviews will be conducted with a purposeful sample of 50 partnered and single parents of children aged 3-16 years diagnosed with DBDs at the University of Iowa. Oversampling strategies will be used to recruit a diverse sample of parents reflective of the clinic clientele. Interview 1 will be scheduled within 7 days of diagnosis, and Interview 2 after 30 days of treatment to explore how dimensions of management changed or remained stable. In addition data from a 53-item Likert questionnaire will be used to triangulate and expand on interview data. This study will use constant comparison methods for systematic iterative data collection, coding, and analysis. Data will be analyzed within each family unit and across cases to develop a typology of family management of DBDs.
Specific aims are:
Aim 1 : To explore the components of the FMSF in families of children with DBDs within 7 days of diagnosis.
Aim 2 : To explore the changes over time in the components of the FMSF in families of children with DBDs at = 30 days after diagnosis. The long-term goal of this research is to develop theory-driven, family-focused and individualized interventions for families of children with DBDs to improve child, parent and family function.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Predoctoral Individual National Research Service Award (F31)
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National Institute of Nursing Research Initial Review Group (NRRC)
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Banks, David
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University of Iowa
Schools of Nursing
Iowa City
United States
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