Effects of cognitive behavioural therapy, dialectical behavioural therapy, and paternal anxiety on youth emotional and behavioural dysregulation: a systematic review, meta-analysis, and longitudinal study

Abstract

Background
Emotional dysregulation (ED) is a prominent feature across a range of psychiatric and neurodevelopmental disorders in childhood and adolescence. ED is also implicated in systemic risk factors, such as paternal anxiety. The body of knowledge around ED is growing, but despite this, little is known around interventions to treat ED and intergenerational influences on ED including emotional and behavioural problems.

Aims
This thesis aimed to (1) synthesis existing evidence, through systematic review and meta-analysis, on the effectiveness of cognitive behavioural therapy (CBT) and dialectical behavioural therapy (DBT) for reducing ED in children and young people, and (2) examine the bidirectional associations between paternal anxiety and child emotional and behavioural problems using a pre-existing longitudinal dataset.

Methods
Chapter 1: By conducting a systematic review and meta-analysis, existing evidence was synthesised evaluating randomised control trials for CBT/DBT- based interventions on ED in children and young people. Chapter 2: By employing logistic regression models to the Avon Longitudinal Study of Parents and Children (ALSPAC) dataset, a population-based longitudinal analysis was conducted, examining the impact of paternal anxiety on child outcomes.

Results
The meta-analysis (k = 3) showed a small-to-moderate reduction in ED for CBT compared to control (Hedge’s g = -0.43, 95% CI = [-0.63, -0.23]). The longitudinal analysis found that paternal anxiety at 18 weeks gestation and 8 weeks postnatally was significantly associated with increased risk of emotional and behavioural difficulties in children at 7-8 years.

Conclusion
Chapter 1’s findings suggest that both CBT and DBT are interventions which reduces ED outcomes for children and young people, compared to a control. Chapter 2’s findings suggest that paternal anxiety plays an important role in developmental child mental health outcomes. To conclude, clinicians should consider early intervention for ED with therapeutic intervention and the role of paternal mental health and it’s impact on child mental health.

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Identifiers

ORCID for James Swanton: orcid.org/0009-0007-4633-1517

ORCID for Alessio Bellato: orcid.org/0000-0001-5330-6773

ORCID for Pete Lawrence: orcid.org/0000-0001-6181-433X

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