Maternal PTSD and Behavioral Parent Training Treatment for a Girl With Conduct Disorder and Callous–Unemotional Traits

Very little is known about the impact of parental psychopathology on treatment outcome for youth with conduct problems (CPs) and callous–unemotional (CU) traits. This case study describes behavioral parent training (BPT) for “Amy,” an 11-year-old girl presenting with CP/CU traits who had a mother diagnosed with posttraumatic stress disorder (PTSD). Maternal and paternal reports of child behavior problems and impairments were collected to assess treatment outcome. Weekly ratings of maternal PTSD were also collected to examine changes in maternal psychopathology over the course of BPT. Parent ratings showed that treatment was associated with reductions in oppositional defiant disorder (ODD) symptoms, conduct disorder (CD) symptoms, and impairment, and with improvements in treatment goal progress. However, the frequency of negative behaviors remained high throughout treatment. Maternal PTSD symptoms remained in the clinical range throughout BPT, but there was some evidence of synchrony between maternal PTSD symptoms and child negative behaviors. These findings highlight the importance of examining parental psychopathology in understanding BPT outcomes for children with CP/CU traits and call for greater attention to addressing child and parent difficulties that may impede improvement in treatment for youth with CP/CU traits.