Mechanisms of Behavioral and Affective Treatment Outcomes in a Cognitive Behavioral Intervention for Boys
Open accessAbstract
Evidence for effective treatment for behavioral problems continues to grow, yet evidence about the effective mechanisms underlying those interventions has lagged behind. The Stop Now and Plan (SNAP) program is a multicomponent intervention for boys between 6 and 11. This study tested putative treatment mechanisms using data from 252 boys in a randomized controlled trial of SNAP versus treatment as usual. SNAP includes a 3 month group treatment period followed by individualized intervention, which persisted through the 15 month study period. Measures were administered in four waves: at baseline and at 3, 9 and 15 months after baseline. A hierarchical linear modeling strategy was used. SNAP was associated with improved problem-solving skills, prosocial behavior, emotion regulation skills, and reduced parental stress. Prosocial behavior, emotion regulation skills and reduced parental stress partially mediated improvements in child aggression. Improved emotion regulation skills partially mediated treatment-related child anxious-depressed outcomes. Improvements in parenting behaviors did not differ between treatment conditions. The results suggest that independent processes may drive affective and behavioral outcomes, with some specificity regarding the mechanisms related to differing treatment outcomes.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Studies have already suggested the empirical superiority of deploying evidence-based treatment modules or kernels to target person-specific maladaptive processes of change, over global protocols targeting global syndromes.
“Studies have already suggested the empirical superiority of deploying evidencebased treatment modules or kernels to target person-specific maladaptive processes of change, over global protocols targeting global syndromes 118,119 .”
From “Third-wave” cognitive and behavioral therapies and the emergence of a process-based approach to intervention in psychiatry (2021) · cites this paper as [118]
The passage on treatment mechanisms (page unavailable) reports that CBT components aimed at problem solving and anger regulation were associated with improved outcomes in a meta-analysis. The Abstract also reports that SNAP included individualized intervention. Neither passage establishes that person-specific modules or kernels outperform global protocols targeting syndromes. (LLM, conf=0.78)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Preacher, K. J., & Hayes, A. F. (2008) · Behavior Research Methods · doi:10.3758/brm.40.3.879 · Cited by 34,117 · see citing works
Introduction to Statistical Mediation Analysis
MacKinnon, D. P. (2012) · doi:10.4324/9780203809556 · Cited by 5,618 · see citing works
Manual for ASEBA School-Age Forms & Profiles
Achenbach, T. M. (2001) · Medical Entomology and Zoology · Cited by 4,676 · see citing works
Psychological Assessment Resources
Abidin, R. R. (1995) · Medical Entomology and Zoology · Cited by 3,140 · see citing works
Angold, A., Costello, E. J., & Erkanli, A. (1999) · Journal of Child Psychology and Psychiatry · doi:10.1111/1469-7610.00424 · Cited by 1,872 · see citing works
Multilevel Modeling of Individual and Group Level Mediated Effects
Krull, J. L., & MacKinnon, D. P. (2001) · Multivariate Behavioral Research · doi:10.1207/s15327906mbr3602_06 · Cited by 1,325 · see citing works
Oppositional Defiant and Conduct Disorder: A Review of the Past 10 Years, Part I
LOEBER, R., BURKE, J. D., LAHEY, B. B., WINTERS, A., & ZERA, M. (2000) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200012000-00007 · Cited by 1,192 · see citing works
Self-citationEvidence-Based Psychosocial Treatments for Children and Adolescents With Disruptive Behavior
Eyberg, S. M., Nelson, M. M., & Boggs, S. R. (2008) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374410701820117 · Cited by 935 · see citing works
Webster-Stratton, C. H., Reid, M. J., & Hammond, M. A. (2001) · Journal of Clinical Child & Adolescent Psychology · doi:10.1207/s15374424jccp3003_2 · Cited by 852 · see citing works
Landenberger, N. A., & Lipsey, M. W. (2005) · Journal of Experimental Criminology · doi:10.1007/s11292-005-3541-7 · Cited by 850 · see citing works
Angold, A. C., Costello, E. J., & Erkanli, A. (1999) · PubMed · Cited by 723 · see citing works
Chorpita, B. F., & Daleiden, E. L. (2009) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0014565 · Cited by 687 · see citing works
Oppositional defiant disorder and conduct disorder: a review of the past 10 years, part II.
Burke, J. D., Loeber, R., & Birmaher, B. (2002) · Journal of the American Academy of Child and Adolescent Psychiatry · doi:10.1097/00004583-200211000-00009 · Cited by 610 · see citing works
Self-citationCallous/Unemotional Traits and Social-Cognitive Processes in Adjudicated Youths
Pardini, D. A., Lochman, J. E., & Frick, P. J. (2003) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200303000-00018 · Cited by 497 · see citing works
Social Skills Training with Children and Young People: Theory, Evidence and Practice
Spence, S. H. (2003) · Child and Adolescent Mental Health · doi:10.1111/1475-3588.00051 · Cited by 490 · see citing works
Preventing Antisocial Behavior: Interventions from Birth through Adolescence.
Kruttschnitt, C., McCord, J., & Tremblay, R. E. (1993) · Contemporary Sociology A Journal of Reviews · doi:10.2307/2074436 · Cited by 445 · see citing works
Cognitive Social Learning Mediators of Aggression
Perry, D. G., Perry, L. C., & Rasmussen, P. (1986) · Child Development · doi:10.2307/1130347 · Cited by 441 · see citing works
Handling Missing Data by Maximum Likelihood
Allison, P. D. (2012) · Cited by 423 · see citing works
Chorpita, B. F., Daleiden, E. L., Ebesutani, C., Young, J., Becker, K. D., Nakamura, B. J., Phillips, L., Ward, A., Lynch, R., Trent, L., et al. (2011) · Clinical Psychology: Science and Practice · doi:10.1111/j.1468-2850.2011.01247.x · Cited by 393 · see citing works
Lochman, J. E., & Wells, K. C. (2002) · Development and Psychopathology · doi:10.1017/s0954579402004157 · Cited by 322 · see citing works
Preventing antisocial behavior: Interventions from birth through adolescence.
McCord, J., & Tremblay, R. E. (1992) · Guilford Press eBooks · Cited by 310 · see citing works
Duckworth, A. L., Tsukayama, E., & May, H. (2010) · Social Psychological and Personality Science · doi:10.1177/1948550609359707 · Cited by 234 · see citing works
Moving beyond efficacy and effectiveness in child and adolescent intervention research.
Greca, A. M. L., Silverman, W. K., & Lochman, J. E. (2009) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0015954 · Cited by 185 · see citing works
Mediators of change for multisystemic therapy with juvenile sexual offenders.
Henggeler, S. W., Letourneau, E. J., Chapman, J. E., Borduin, C. M., Schewe, P. A., & McCart, M. R. (2009) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0013971 · Cited by 174 · see citing works
An experimental test of the coercion model: Linking theory, measurement, and intervention.
Dishion, T. J., Patterson, G. R., & Kavanagh, K. (1992) · Cited by 174 · see citing works
Predicting future clinical adjustment from treatment outcome and process variables.
Patterson, G. R., & Forgatch, M. S. (1995) · Psychological Assessment · doi:10.1037/1040-3590.7.3.275 · Cited by 171 · see citing works
Evaluating Group-Based Interventions When Control Participants Are Ungrouped
Bauer, D. J., Sterba, S. K., & Hallfors, D. D. (2008) · Multivariate Behavioral Research · doi:10.1080/00273170802034810 · Cited by 165 · see citing works
Evidence-based treatment research: advances, limitations, and next steps
Kazdin, A. E. (2011) · American Psychologist · doi:10.1037/a0024975 · Cited by 155 · see citing works
Burke, J. D., Boylan, K., Rowe, R., Duku, E., Stepp, S. D., Hipwell, A. E., & Waldman, I. D. (2014) · Journal of Abnormal Psychology · doi:10.1037/a0037898 · Cited by 138 · see citing works
Self-citationHINSHAW, S. P. (2002) · Development and Psychopathology · doi:10.1017/s0954579402004078 · Cited by 121 · see citing works
Augimeri, L. K., Farrington, D. P., Koegl, C. J., & Day, D. M. (2007) · Journal of Child and Family Studies · doi:10.1007/s10826-006-9126-x · Cited by 116 · see citing works
Burke, J. D., & Loeber, R. (2014) · Prevention Science · doi:10.1007/s11121-014-0490-2 · Cited by 77 · see citing works
Self-citationKoegl, C. J., Farrington, D. P., Augimeri, L. K., & Day, D. M. (2008) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104508090606 · Cited by 49 · see citing works
Flagged first, then by citations
2 of the 35 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Hayes, S. C., & Hofmann, S. G. (2021) · World Psychiatry · doi:10.1002/wps.20884 · Cited by 260 · see citing works
Evidence-Base Update for Parenting Stress Measures in Clinical Samples
Holly, L. E., Fenley, A. R., Kritikos, T. K., Merson, R. A., Abidin, R. R., & Langer, D. A. (2019) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2019.1639515 · Cited by 199 · see citing works
Baglivio, M. T., Wolff, K. T., Piquero, A. R., Greenwald, M. A., & Epps, N. (2017) · Journal of Youth and Adolescence · doi:10.1007/s10964-016-0573-4 · Cited by 147 · see citing works
The differential impact of social services on young people’s resilience
Ungar, M. T. (2017) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2017.09.024 · Cited by 65 · see citing works
Augimeri, L. K., Walsh, M., Donato, A., Blackman, A., & Piquero, A. R. (2017) · Journal of Criminal Justice · doi:10.1016/j.jcrimjus.2017.08.010 · Cited by 57 · see citing works
CBT-Enhanced Emotion Regulation as a Mechanism of Improvement for Childhood Irritability
Derella, O. J., Johnston, O. G., Loeber, R., & Burke, J. D. (2019) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2016.1270832 · Cited by 55 · see citing works
Self-citationWeeland, J., Helmerhorst, K. O. W., & Lucassen, N. (2021) · Journal of Family Theory & Review · doi:10.1111/jftr.12408 · Cited by 53 · see citing works
Byrd, A. L., Hawes, S. W., Burke, J. D., Loeber, R., & Pardini, D. A. (2017) · Developmental Cognitive Neuroscience · doi:10.1016/j.dcn.2017.12.004 · Cited by 44 · see citing works
Self-citationHow can adolescent aggression be reduced? A multi-level meta-analysis
Castillo-Eito, L., Armitage, C. J., Norman, P. E., Day, M. R., Doğru, O. C., & Rowe, R. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101853 · Cited by 44 · see citing works
Mouton, B., Loop, L., Stiévenart, M., & Roskam, I. (2018) · Child & Family Behavior Therapy · doi:10.1080/07317107.2018.1477348 · Cited by 28 · see citing works
Dryburgh, N. S. J., Khullar, T. H., Sandre, A., Persram, R. J., Bukowski, W. M., & Dirks, M. A. (2020) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2020.1790381 · Cited by 26 · see citing works
Alsem, S. C., Keulen, J., Verhulp, E., van Dijk, A., & de Castro, B. D. (2022) · Aggressive Behavior · doi:10.1002/ab.22019 · Cited by 18 · see citing works
Hall, K., Youssef, G., Simpson, A., Sloan, E., Graeme, L., Perry, N., Moulding, R., Baker, A. L., Beck, A. K., & Staiger, P. K. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.554100 · Cited by 17 · see citing works
“, 2017); aggression, anxiety, and depressive outcomes in children (Burke and Loeber, 2016); BPD symptoms and deliberate self-harm in adult women (Gratz et al.”
BackgroundBrigden, A., Parslow, R. M., Linney, C., Higson‐Sweeney, N., Read, R. K., Loades, M. E., Davies, A. K., Stoll, S., Beasant, L., Morris, R. W., et al. (2019) · BMJ Paediatrics Open · doi:10.1136/bmjpo-2019-000543 · Cited by 19 · see citing works
McQuade, J. D., Murray-Close, D. K., Breslend, N. L., Balda, K. E., Kim, M. M., & Marsh, N. P. (2019) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-019-00544-3 · Cited by 16 · see citing works
Baglivio, M. T., Wolff, K. T., Piquero, A. R., DeLisi, M., & Vaughn, M. G. (2017) · Criminal Justice and Behavior · doi:10.1177/0093854817714810 · Cited by 16 · see citing works
Evidence-Based Psychosocial Treatments for Disruptive Behaviors in Children: Update
Kaminski, J. W., Claussen, A. H., Sims, R. S. C., & Bhupalam, S. (2024) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2024.2405988 · Cited by 14 · see citing works
Derella, O. J., Burke, J. D., Romano-Verthelyi, A. M., Butler, E. J., & Johnston, O. G. (2020) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104520918331 · Cited by 14 · see citing works
Self-citationNothing Fake Here: The Public Criminology Case for Being Smart on Crime by Being Smarter on People
Piquero, A. R. (2019) · Justice Evaluation Journal · doi:10.1080/24751979.2019.1597636 · Cited by 13 · see citing works
Jennings, W. G., Loeber, R., Ahonen, L., Piquero, A. R., & Farrington, D. P. (2018) · Journal of Criminal Justice · doi:10.1016/j.jcrimjus.2017.12.002 · Cited by 12 · see citing works
Self-citationSex Differences in the Classification of Conduct Problems: Implications for Treatment
Smaragdi, A., Blackman, A., Donato, A., Walsh, M., & Augimeri, L. K. (2020) · Journal of Developmental and Life-Course Criminology · doi:10.1007/s40865-020-00149-1 · Cited by 11 · see citing works
Koegl, C. J., Farrington, D. P., & Augimeri, L. K. (2019) · Journal of Developmental and Life-Course Criminology · doi:10.1007/s40865-019-00129-0 · Cited by 10 · see citing works
van de Sande, M. C., Kocken, P., Diekstra, R. F. W., Reis, R., Gravesteijn, C., & Fekkes, M. (2023) · Frontiers in Education · doi:10.3389/feduc.2023.1225103 · Cited by 12 · see citing works
Jiang, D., Zhang, H., Liu, K., Mignone, J., & Pepler, D. J. (2022) · Journal of Child and Family Studies · doi:10.1007/s10826-022-02463-2 · Cited by 9 · see citing works
Cognitive behavioral skill-based training program for enhancing anger control among youth
Sharma, M., Hamza, A., Marimuthu, P., & Murli, S. (2019) · Industrial Psychiatry Journal · doi:10.4103/ipj.ipj_28_17 · Cited by 7 · see citing works
Statistical power in partially nested designs probing multilevel mediation
Kelcey, B., Bai, F., & Xie, Y. (2020) · Psychotherapy Research · doi:10.1080/10503307.2020.1717012 · Cited by 7 · see citing works
Sullivan, A. D. W., Parent, J. M., Forehand, R., & Compas, B. E. (2018) · Behaviour Research and Therapy · doi:10.1016/j.brat.2018.05.006 · Cited by 5 · see citing works
Kingsman, J. (2023) · International Journal of Educational Research · doi:10.1016/j.ijer.2023.102257 · Cited by 7 · see citing works
Craig, S. G., Frankiewicz, K., Stearns, N. R., Lapointe, J. G., Cortese, A., Vogel, N., & Pepler, D. J. (2025) · Prevention Science · doi:10.1007/s11121-025-01788-w · Cited by 4 · see citing works
Youth Experiences in Evaluating the Canadian SNAP® Boys Youth Leadership Program
Sewell, K. M., Fredericks, K., Mohamud, A., Kallis, J., & Augimeri, L. K. (2020) · Child and Adolescent Social Work Journal · doi:10.1007/s10560-020-00658-4 · Cited by 4 · see citing works
What changes when? A reply to Beauchaine and Slep
Weeland, J., Chhangur, R. R., Jaffee, S. R., der Giessen, D. V., Matthys, W., de Castro, B. O., & Overbeek, G. J. (2018) · Development and Psychopathology · doi:10.1017/s0954579418000755 · Cited by 3 · see citing works
Do we really need a process-based approach to psychotherapy?
Emmelkamp, P. M. G. (2021) · World Psychiatry · doi:10.1002/wps.20889 · Cited by 2 · see citing works
Sewell, K. M., Woods, S., Bélisle, E., Walsh, M., & Augimeri, L. K. (2019) · Journal of Evidence-Based Social Work · doi:10.1080/26408066.2019.1629139 · Cited by 2 · see citing works
Augimeri, L. K., Walsh, M., Kivlenieks, M., & Pepler, D. J. (2017) · Wiley eBooks · doi:10.1002/9781119057574.whbva028 · Cited by 2 · see citing works
Schouwenaars, I. M. G., & Gravesteijn, C. (2025) · Sustainable development · doi:10.5772/intechopen.1009520 · Cited by 1 · see citing works
Sex differences in temperament and career Juvenile offending among justice-involved youth
Wolff, K. T., Lang, J. A., Lerner, L. J., & Baglivio, M. T. (2025) · Journal of Criminal Justice · doi:10.1016/j.jcrimjus.2025.102434 · Cited by 1 · see citing works
Psychosocial Treatments That “Work” for Ethnic Minority Youth
Holly, L. E., Stoll, R. D., Rapp, A. M., Piña, A., & Chavira, D. A. (2018) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780190634841.013.10 · Cited by 1 · see citing works
Smaragdi, A., Schwarz, L., Austevik, T. J., Walsh, M., Webster, C., & Augimeri, L. K. (2024) · Children and Youth Services Review · doi:10.1016/j.childyouth.2024.107824 · Cited by 1 · see citing works
The Development of Aggression and Violence Over the Life Span
Burke, J. D. (2017) · The Wiley Handbook of Violence and Aggression · doi:10.1002/9781119057574.whbva027
Self-citationImprove your skills with virtual reality
Alsem, S. C. (2023) · doi:10.33540/1649
Chiodi, S. L., Lúcio, P. S., Ilari, B. S., Germano, N. D. G., Cogo‐Moreira, H., & Bortz, G. (2024) · Child Psychiatry & Human Development · doi:10.1007/s10578-024-01738-7
Alsem, S. C., Verhulp, E. E., van Dijk, A., & de Castro, B. O. (2025) · Cognitive Therapy and Research · doi:10.1007/s10608-025-10685-z
Hofmann, L., Dose, C., Döpfner, M., & Goertz‐Dorten, A. (2026) · Child Psychiatry & Human Development · doi:10.1007/s10578-026-01999-4
- Authors
- Burke, J. D., & Loeber, R.
- Affiliations
- University of Connecticut (US)
- University of Pittsburgh (US)
- Corresponding author
- Burke, Jeffrey D.
- ORCID
- Burke, Jeffrey D.
- Venue
- Journal of Abnormal Child Psychology
- Published
- 2015-01-27
- Volume
- 44
- Issue
- 1
- Pages
- 179-189
- ISSN
- 0091-0627 (ISSN-L)
- 1573-2835
- PMC
- PMC4516715
- OpenAlex
- W2084621828
- Cited by
- 45
- References
- 35
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 3 · 2023: 3 · 2022: 2 · 2021: 4 · 2020: 6 · 2019: 7 · 2018: 5 · 2017: 7 · 2016: 1
- FWCI
- 5.34
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Research on Child and Adolescent Psychopathology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K01MH074148, MH074148)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Social Sciences › Psychology › Clinical Psychology › Child Therapy and Development
- Keywords
- therapeutic mechanisms, cognitive-behavioral intervention, boys, child aggression, emotion regulation, prosocial behavior, problem-solving skills, parental stress, anxious/depressed symptoms, parental behavior, mediation analysis, child behavior problems
- MeSH terms
- Formative Feedback, Adaptation, Psychological, Child, Child Behavior Disorders, Emotions, Humans, Male, Problem Solving, Psychiatric Status Rating Scales, Psychotherapy, Group, Role Playing, Stress, Psychological, Cognitive Behavioral Therapy, Parenting, Social Skills
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
