The Impact of Co-morbid Internalizing Problems and Stress on Multi-Systemic Therapy Treatment Outcomes in a Delinquent Population 公开

Fries, Allison Elizabeth (2011)

Permanent URL: https://etd.library.emory.edu/concern/etds/8c97kq86s?locale=zh
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Abstract

Abstract
The Impact of Co-morbid Internalizing Problems and Stress on Multi-Systemic Therapy Treatment Outcomes in a Delinquent Population
By Allison E. Fries

With increased rates of delinquency in the adolescent population, there is a heightened demand for effective therapies directed at externalizing behaviors. However, relatively few research studies have explored the role of co-morbid internalizing problems, which are common in the delinquent population, in terms of their potential impact on therapy outcomes for these youth. The present study investigates the influences of co-morbid internalizing behavior problems on Multi-Systemic Therapy (MST) treatment outcomes. It further explores the impact of co-morbid internalizing problems on stress, and stress on therapy outcomes. A sample of 185 youth participants (121 male, 64 female) were enrolled in MST treatment with their primary caregivers. Regression analyses were conducted to examine the relationship between co-morbid internalizing problems, stress, and treatment outcome. Treatment outcome was defined as changes in delinquent and externalizing behaviors. Stress was evaluated during treatment using youth reports of daily hassles and recent negative life events, and caregiver reports of total and youth-related stress. Co-morbid internalizing was significantly positively associated with delinquency but not externalizing problems at the conclusion of MST treatment. Though stress was found to be significantly associated with both treatment outcome measures, no support was found for stress as a mediator between co-morbid internalizing problems and treatment outcome. The study recommends incorporation of stress management techniques for the youth and caregiver participants in MST treatment protocols, along with an increased focus on stress and co-morbid internalizing behavior problems, both of which are detrimental to treatment success.

Table of Contents

Table of Contents
Introduction...3

Multi-Systemic Therapy (MST)...3
Co-morbid Internalizing Problems...7
Stress as a Mediator of Treatment Outcome...8
Purpose...10

Method...10

Participants...10
Procedure...11
Measures...12

Externalizing and Internalizing Behavior Problems...12
Stress...13

Results...14

Preliminary Analyses...14
Potential Confounds...14
Hypothesis Testing...15

Discussion...17

Stress...18
Stress Generation...19
Limitations...20
Strengths...21
Future Directions...22

References...24
Illustrations...29

Figures...30
Tables...31

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