A failure to confirm the effectiveness of a brief group psychoeducational program for mothers of children with high-functioning pervasive developmental disorders: a randomized controlled pilot trial

Figures & data

Figure 1 Participant flow diagram.

Abbreviations: GP, group psychoeducational program; TAU, treatment as usual.

Table 1 Baseline sociodemographic and clinical characteristics of participants

Characteristics	Group psychoeducational intervention + TAU (n=36)	TAU alone (n=36)	All participants (n=72)
Mothers
Age, mean (SD), years	35.14 (4.55)	34.94 (4.90)	35.04 (4.55)
Education, n (%)
<High school	0	1 (2.8)	1 (1.4)
High school diploma	16 (44.4)	10 (27.8)	26 (36.1)
Some college	13 (36.1)	16 (44.4)	29 (40.3)
University	7 (19.4)	9 (25.0)	16 (22.2)
Occupation, n (%)
Employed, full-time	4 (11.1)	6 (16.7)	10 (4.5)
Employed, part-time	10 (27.8)	9 (25.0)	19 (8.6)
Homemaker	22 (61.1)	21 (58.3)	43 (59.7)
Marital status, n (%)
Married	36 (100)	33 (91.7)	69 (95.8)
Divorced or widowed	0 (0)	2 (5.6)	2 (2.8)
Single	0 (0)	1 (2.8)	1 (1.4)
Number of siblings of children, n (%)
No siblings	9 (25.0)	12 (33.3)	21 (29.2)
One	23 (63.9)	21 (58.3)	44 (19.9)
Two or more	4 (11.1)	3 (8.4)	6 (2.7)
Number of mothers having more than two children with PDDs, n (%)	5 (13.9)	2 (5.6)	7 (9.7)
Maternal mental disorder, n (%)
Mood disorder	3 (8.3)	4 (11.1)	7 (9.7)
Anxiety disorder	0	2 (5.6)	2 (2.8)
PDDs	1 (2.8)	0	1 (1.4)
Other	2 (5.6)	0	2 (2.8)
Psychotropic medication and usage, n (%), mean (SD)
Anxiolytic agents	4 (11.1)	4 (11.1)	8 (11.1)
Antidepressant agents	1 (2.8)	2 (5.6)	3 (4.2)
Other	1 (2.8)	4 (11.1)	5 (6.9)
Children
Age, mean (SD), years	4.4 (0.83)	4.6 (1.01)	4.5 (0.92)
Grade of children at kindergarten or nursery school, n (%)
Before entering kindergarten or nursery school	5 (13.9)	6 (16.7)	11 (15.3)
Kindergarten or nursery school pupil	31 (86.1)	30 (83.3)	61 (84.7)
Diagnosis, n (%)
Autistic disorder	8 (22.2)	14 (38.9)	22 (30.6)
Asperger’s disorder	12 (33.3)	3 (8.3)	15 (6.8)
Pervasive developmental disorder – not otherwise specified	16 (44.4)	19 (52.8)	35 (48.6)
Psychotropic medication, n (%)	1 (2.8)	0	1 (1.4)
Cocurricular training and therapy, n (%)	23 (63.9)	31 (86.1)	54 (75.0)
Speech therapy	20 (55.6)	24 (66.7)	44 (61.1)
Special educational programs	9 (25.0)	15 (41.7)	24 (33.3)
Parent trainings	1 (2.8)	1 (2.8)	2 (2.8)
Other	7 (19.4)	7 (19.4)	14 (19.4)

Abbreviations: SD, standard deviation; TAU, treatment as usual; PDD, pervasive developmental disorder.

Figure 2 Total scores of the 28-item General Health Questionnaire at baseline, week 7, and week 21.

Note: *P<0.05.
Abbreviations: GP, group psychoeducational program; TAU, treatment as usual.

Table 2 Results of primary outcome

	GP + TAU	TAU alone	df	t	P-value	Interaction (allocation × time)
GHQ-28 total score, mean (standard division), unpaired t-test
Baseline	8.56 (6.08)	9.08 (7.11)	70	−0.34	0.74	0.01
Week 7	6.92 (5.34)	9.19 (6.95)	70	−1.56	0.12
Week 21	9.50 (7.98)	6.94 (6.10)	70	1.526	0.13
Measure	GP + TAU	TAU alone	df	F	P-value
GHQ-28 total score, mean (standard error), ANCOVA
Week 7	6.999 (0.982)	9.112 (0.982)	1	2.315	0.133
Week 21	9.655 (0.999)	6.789 (0.999)	1	4.111	0.046*

Note:

* P<0.05.

Abbreviations: ANCOVA, analysis of covariance; GHQ-28, 28-item General Health Questionnaire; GP, group psychoeducational program; TAU, treatment as usual.

Figure 3 Total scores of the Aberrant Behavior Checklist at baseline, week 7, and week 21.

Table 3 Results for each secondary outcome measure with unpaired t-test

Measure, mean (standard division)	GP + TAU	TAU alone	P-value
ABC total score
Baseline	44.50 (24.37)	37.25 (22.48)	0.19
Week 7	38.25 (26.06)	35.72 (23.39)	0.67
Week 21	39.75 (30.85)	30.83 (22.60)	0.17
ZBI total score
Baseline	32.17 (14.01)	33.58 (16.40)	0.70
Week 7	30.47 (15.55)	33.55 (16.98)	0.42
Week 21	31.67 (18.41)	30.83 (17.50)	0.85
SF-36, PF total score
Baseline	53.67 (6.50)	53.08 (8.48)	0.74
Week 7	53.96 (6.49)	52.00 (8.87)	0.29
Week 21	53.97 (5.97)	53.58 (6.66)	0.79
SF-36, RP total score
Baseline	47.41 (10.47)	43.63 (14.78)	0.22
Week 7	45.99 (11.07)	43.82 (14.79)	0.48
Week 21	44.39 (13.24)	46.65 (13.03)	0.47
SF-36, BP total score
Baseline	47.83 (12.81)	48.17 (12.21)	0.91
Week 7	47.27 (12.39)	47.89 (12.59)	0.83
Week 21	44.82 (11.76)	49.50 (14.99)	0.15
SF-36, GH total score
Baseline	44.44 (11.45)	47.48 (10.47)	0.24
Week 7	46.60 (10.71)	46.45 (11.66)	0.95
Week 21	44.24 (11.38)	46.90 (13.29)	0.37
SF-36, VT total score
Baseline	42.13 (10.14)	44.01 (10.69)	0.45
Week 7	45.11 (10.71)	43.32 (10.69)	0.47
Week 21	42.72 (11.44)	45.46 (11.37)	0.31
SF-36, SF total score
Baseline	45.77 (13.21)	41.93 (14.81)	0.25
Week 7	47.23 (10.60)	41.56 (15.50)	0.07
Week 21	44.11 (12.23)	44.12 (13.84)	1
SF-36, RE total score
Baseline	46.67 (11.22)	41.83 (15.26)	0.13
Week 7	46.79 (10.16)	43.01 (13.78)	0.19
Week 21	44.30 (12.40)	48.44 (11.30)	0.14
SF-36, MH total score
Baseline	42.18 (10.45)	42.24 (12.53)	0.98
Week 7	43.81 (10.82)	43.05 (11.62)	0.78
Week 21	41.66 (10.79)	46.37 (9.89)	0.06

Abbreviations: ABC, Aberrant Behavior Checklist; BP, bodily pain; GH, general health perceptions; GP, group psychoeducational program; MH, mental health; PF, physical functioning; RE, role limitations due to emotional problems; RP, role limitations due to physical problems; SF, social functioning; SF-36, 36-item Short Form Health Survey; TAU, treatment as usual; VT, vitality; ZBI, Zarit Burden Interview.

Table 4 Adjusted results for each secondary outcome measure

Measure	7 weeks				21 weeks
	GP + TAU	TAU alone	F	P-value	GP + TAU	TAU alone	F	P-value
ABC-J total score, mean (SE), ANCOVA	35.636 (3.056)	38.336 (3.056)	0.385	0.537	37.052 (3.490)	33.531 (3.490)	0.503	0.481
J-ZBI total score, mean (SE), ANCOVA	31.116 (1.433)	32.912 (1.433)	0.784	0.379	32.319 (1.879)	30.181 (1.879)	0.647	0.424
SF-36 score, mean (SE), ANCOVA
Physical functioning	53.737 (0.858)	52.230 (0.858)	1.541	0.219	53.780 (0.689)	53.764 (0.689)	0	0.987
Role physical	45.351 (2.077)	44.463 (2.077)	0.09	0.765	43.378 (1.891)	47.658 (1.891)	2.534	0.116
Bodily pain	47.365 (1.779)	47.804 (1.779)	0.03	0.862	44.911 (1.946)	49.403 (1.946)	2.666	0.107
General health	47.797 (1.206)	45.251 (1.206)	2.208	0.142	45.530 (1.381)	45.609 (1.381)	0.002	0.968
Vitality	45.430 (1.656)	43.001 (1.656)	1.071	0.304	43.225 (1.670)	44.947 (1.670)	0.53	0.469
Social functioning	46.436 (2.014)	42.361 (2.014)	2.029	0.159	43.380 (2.012)	44.847 (2.012)	0.263	0.610
Role emotional	46.135 (1.958)	43.654 (1.958)	0.79	0.377	43.277 (1.763)	49.465 (1.763)	6.056	0.016*
Mental health	43.823 (1.601)	43.033 (1.601)	0.122	0.728	41.671 (1.472)	46.356 (1.472)	5.066	0.028*

Notes: Each analysis was adjusted according to the its baseline score.

* P<0.05.

Abbreviations: ABC, Aberrant Behavior Checklist; ANCOVA, analysis of covariance; GP, group psychoeducational program; J, Japanese version; SE, standard error; SF-36, 36-item Short Form Health Survey; TAU, treatment as usual; ZBI, Zarit Burden Interview.

Table 5 Completer analysis

Measure	7 weeks				21 weeks
	GP + TAU	TAU alone	F	P-value	GP + TAU	TAU alone	F	P-value
GHQ-28 total score, mean (SE), ANCOVA	7.749 (1.183)	9.098 (1.005)	0.754	0.389	10.661 (1.180)	6.772 (1.003)	6.295	0.015*
ABC-J total score, mean (SE), ANCOVA	39.937 (3.703)	39.046 (3.129)	0.033	0.857	41.261 (4.240)	34.173 (3.583)	1.575	0.214
J-ZBI total score, mean (SE), ANCOVA	32.597 (1.537)	33.097 (1.306)	0.061	0.805	35.093 (2.067)	30.350 (1.757)	3.054	0.086
SF-36 score, mean (SE), ANCOVA
Physical functioning	52.965 (1.001)	52.595 (0.849)	0.079	0.78	53.406 (0.813)	54.051 (0.690)	0.364	0.549
Role physical	45.456 (2.453)	44.776 (2.074)	0.043	0.836	42.861 (2.287)	48.156 (1.933)	3.028	0.087
Bodily pain	47.227 (2.200)	47.853 (1.869)	0.047	0.829	44.460 (2.264)	49.448 (1.924)	2.819	0.098
General health	48.148 (1.393)	45.382 (1.182)	2.27	0.137	44.382 (1.648)	45.713 (1.398)	0.146	0.703
Vitality	44.795 (1.991)	43.065 (1.691)	0.437	0.511	42.177 (2.018)	45.042 (1.714)	1.167	0.284
Social functioning	46.304 (2.490)	42.783 (2.106)	1.132	0.292	41.105 (2.276)	45.422 (1.925)	2.038	0.159
Role emotional	45.351 (2.312)	43.913 (1.952)	0.217	0.643	43.277 (1.763)	49.465 (1.763)	6.056	0.016*
Mental health	42.942 (2.148)	49.670 (1.813)	5.51	0.022*	40.089 (1.744)	46.539 (1.482)	7.935	0.007*

Notes: Each analysis was adjusted according to the baseline score.

* P<0.05.

Abbreviations: ABC, Aberrant Behavior Checklist; ANCOVA, analysis of covariance; GHQ-28, 28-item General Health Questionnaire; GP, group psychoeducational program; J, Japanese version; SE, standard error; SF-36, 36-item Short Form Health Survey; TAU, treatment as usual; ZBI, Zarit Burden Interview.