Evidence map›Paper›PMID 40062662›Full record

Trial reportJournal of child psychology and psychiatry, and allied disciplines2025

Efficacy of guided and unguided web-assisted self-help for parents of children with attention-deficit/hyperactivity disorder and oppositional defiant disorder: A three-arm randomized controlled trial.

Manfred Döpfner, Julia Plück, Kerstin Daniela Rosenberger, Marie-Theres Klemp, Judith Mühlenmeister, Laura Wähnke, Martin Hellmich, Stephanie Schürmann, Christina Dose

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of child psychology and psychiatry, and allied disciplines, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Manfred Döpfner *Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Julia Plück *Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Kerstin Daniela RosenbergerFaculty of Medicine and University Hospital Cologne, Institute of Medical Statistics and Computational Biology (IMSB), University of Cologne, Cologne, Germany.
Marie-Theres KlempFaculty of Medicine and University Hospital Cologne, School for Child and Adolescent Cognitive Behavior Therapy (AKiP), University of Cologne, Cologne, Germany.
Judith MühlenmeisterFaculty of Medicine and University Hospital Cologne, School for Child and Adolescent Cognitive Behavior Therapy (AKiP), University of Cologne, Cologne, Germany.
Laura WähnkeFaculty of Medicine and University Hospital Cologne, School for Child and Adolescent Cognitive Behavior Therapy (AKiP), University of Cologne, Cologne, Germany.
Martin HellmichFaculty of Medicine and University Hospital Cologne, Institute of Medical Statistics and Computational Biology (IMSB), University of Cologne, Cologne, Germany.
Stephanie SchürmannDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Christina DoseFaculty of Medicine and University Hospital Cologne, School for Child and Adolescent Cognitive Behavior Therapy (AKiP), University of Cologne, Cologne, Germany.

Funding

Innovation Fund of the German Statutory Health Insurance Companies VF1_2016-058
6 · The paper itself

Abstract

backgroundEmpirical evidence supports the efficacy of behavioral online parent training. However, further large trials in school-age children with externalizing behavior problems and analyses on the impact of additional therapist support are needed. This three-arm randomized controlled trial examined the efficacy of guided and unguided web-assisted self-help (WASH) for parents of children with externalizing behavior problems.

methodsParents of 431 children (6-12 years) with elevated externalizing symptoms were randomly assigned to either treatment as usual (TAU), a 6-month behavioral WASH intervention (WASH+TAU), or WASH plus telephone-based support (WASH+S+TAU). Assessments took place at baseline and at 3, 6, and 12 months. The primary outcome was child externalizing symptoms as rated by a clinician blinded to condition; secondary outcomes were parent-rated child externalizing symptoms, internalizing symptoms, functional impairment, quality of life, parenting practices, and parental internalizing symptoms. (German Clinical Trials Register (DRKS): DRKS00013456; URL: https://drks.de/search/de/trial/DRKS00013456; registered on January 3rd 2018).

resultsLinear mixed models for repeated measures revealed a significant overall intervention effect on blinded clinician-rated externalizing symptoms at 6 months in both the intention-to-treat sample and per-protocol samples, with at least 25% (PP25) or 40% treatment utilization (PP40), respectively (intention-to-treat: p = .017). Subsequent pairwise comparisons revealed a greater symptom reduction in WASH+S+TAU than in the other conditions (intention-to-treat: WASH+S+TAU vs. WASH+TAU: p = .029, d = -0.28, 95% CI [-0.54, -0.03]; WASH+S+TAU vs. TAU: p = .009, d = 0.34 [-0.59, -0.09]). At 12 months, a significant overall effect on blinded clinician-rated externalizing symptoms only emerged in the PP40 sample (p = .035). Secondary analyses revealed an overall effect on child functional impairment at 12 months (intention-to-treat and per-protocol analyses) and on negative parenting behaviors at 6 months in the PP40 sample. For both variables, pairwise comparisons demonstrated significant differences between WASH+S+TAU and TAU.

conclusionsParent-directed WASH is effective in reducing blinded clinician-rated externalizing symptoms, but only when combined with additional support.

Indexed as

Attention Deficit and Disruptive Behavior DisordersAttention Deficit Disorder with HyperactivityBehavior TherapyInternet-Based InterventionOutcome Assessment, Health CareParentingParentsAdultChildFemaleHumansMaleOppositional Defiant DisorderADHDe‐healthoppositional defiant disorderparent trainingschool children

Identifiers

PMID40062662
PMCPMC12350813

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.