REDUCING AGGRESSION IN CHILDREN THROUGH A SCHOOL-BASED COPING POWER PROGRAM

Abstract

Aggression is a characteristic feature of many psychiatric disorders (e.g., conduct disorder, impulse control disorders and some personality disorders). Despite the tremendous work in evidence based practices for childhood behavior problems, and efficacy of the cognitive behavioral interventions for aggressive, disruptive and conduct problems in Western countries, there was an extreme scarcity in Pakistan for empirical support for such interventions. The present research aims to culturally adapt, implement and evaluate a cognitive behavioral intervention program (Coping Power Program) for Pakistani school children with aggressive problems. This represents the very first intervention study conducted in Pakistan for the reduction of child aggression. The Coping Power program is an indicated prevention program for at-risk aggressive children, and had demonstrated short and long-term effects on antisocial outcomes. The present research consists of three studies. Study-I designed for cultural adaptation and translation of Coping Power Program (CPP) -child component and outcome measures, according to a heuristic model proposed by Barrera and Castro (2006). Cultural mismatches were identified in the content and structure of the CPP with main focus to maintain the core contents of the program. Islamic concepts and teachings with cultural elements were added in the adapted version of CPP. A pilot test was conducted for CPP adapted Urdu version and outcome measures. A sample of 37 fourth and fifth grade boys, with their parents and teachers participated in the study. Five at risk aggressive boys participated in Coping Power intervention group condition. The results indicated moderate to good reliability in all outcome measures, and CPP adapted version was considered as an ix effective intervention program to implement on Pakistani children with some modifications. Pilot testing of CPP demonstrated improvements in targeted aggressive boys. Study-II is designed to evaluate the contextual social cognitive model of aggression, which serves as a conceptual framework for the Coping Power Program. Initially 859 fourth grade boys were screened out to identify the aggression severity group (nonaggressive, moderately aggressive and severely aggressive children). 401 children (Mean age =9.44, SD=0.50) were identified as potential participants (180 nonaggressive, 100 moderately aggressive, and 121 severely aggressive). Four domains (self-regulation, social and cognitive competencies, school bonding, and parenting practices) were assessed with Urdu translated outcome measures. Results indicated significant differences among all groups; severely aggressive children exhibited elevated levels of reactive and proactive aggression, poor social cognitive processes, and experienced more corporal punishment from parents as compared to the other groups. Peer rejection was also linked with severe behavior problems and social cognitive processes of the moderately aggressive and severely aggressive children. Study-III was designed to evaluate the effectiveness of abbreviated version of Coping Power Program (25 Child group sessions in adapted version). The purpose of the study was to determine the extent to which CPP is capable of reducing behavior problems and improving prosocial and competent behavior in children, when delivered in a different culture i.e., Pakistan. With randomized control trial (RCT) of pre- and post-testing, 112 fourth grade boys were allocated to Coping Power intervention condition (n=51) and control condition (n=61). Intervention took place during the fifth grade year, at the time of transition to middle school. Pre- and post-treatment were collected from child, parent and teacher x to assess the intervention effects. Analyses of Covariance (ANCOVAs) were used in order to adjust the intervention effects for scores on the baseline measures. Within group analyses of variance (ANOVAs) were further used to explain the interaction effects which were significant in ANCOVAs. Effect sizes are calculated for both groups independently, i.e., between groups and within subjects. Results showed significant differences in measures of all domains. A significant reduction was found in aggression, and impulsivity for the intervention group as compared to the control group. Boys who received Coping Power Program intervention also showed improvements in behavior, social skills and social cognitive processes, with better anger control and problem solving strategies in comparison to control children. The study provides preliminary evidence supporting the effectiveness of Coping Power Program for Pakistani children. Despite its limitations, the results of this study are promising, and suggest that CPP is an effective intervention to reduce behavior problems and promote healthy and positive behavior in children, even when implemented in different contexts with greater potential for violence exposure. The implications are discussed for the implementation of strategies aimed at preventing aggressive behavior in school.