Effects of Topper Training on psychosocial problems, self-esteem, and peer victimisation in Dutch children: A randomised trial

Autoři: Lilian Vliek aff001;  Geertjan Overbeek aff002;  Bram Orobio de Castro aff003
Působiště autorů: Knowledge Centre of Topper Training Foundation, Almere, The Netherlands aff001;  Research Priority Area Yield, Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands aff002;  Department of Developmental Psychology, Utrecht University, Utrecht, The Netherlands aff003
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225504


Most interventions aimed at improving social interactions either target internalising or externalising problem behaviour in children. However, a recent review shows that a transdiagnostic approach might fit better to the diversity of problems within a group and within an individual (comorbidity). We examined the effectiveness of a transdiagnostic intervention, called Topper Training: a cognitive behavioural intervention in the peer group with parents included, that targets both internalising and externalising behaviour problems. A randomised trial with a waiting list control group was conducted, using 132 children with mild to severe psychosocial problems. Children were randomised into 77 intervention and 55 waiting list children (50% boys; age = 8–11 years). GLM repeated measures analyses yielded significant intervention effects directly after the training on parent-reported (but not teacher-reported) emotional symptoms (Cohen’s d = .70), peer relationship problems (d = .41), and impact of these problems (d = .59). Significant effects were also found for child-perceived peer victimisation (d = .62), self-esteem (d = .45) and teacher-reported conduct problems (d = .42). Parent-reported effects on emotional, conduct problems and impact of the problems and child-reported effects on self-esteem were clinically relevant. No significant effects of Topper Training were found for prosocial behaviour and bullying. Within-participant t-tests in the intervention group between post-intervention and follow-up indicated that effects extended over a six-month follow-up period. Depression decreased significantly from post-test to follow-up. In conclusion, children with mild to severe internalising and/or externalising problems can benefit from the transdiagnostic Topper Training intervention.

Klíčová slova:

Behavior – Emotions – Children – Parenting behavior – Prosocial behavior – Psychological and psychosocial issues – Schools – Teachers


1. Crick NR, Dodge KA. A review and reformulation of social information-processing mechanisms in children’s social adjustment. Psychological Bulletin. 1994;115(1): 74–101.

2. Engel GL. The clinical application of the biopsychosocial model. The American Journal of Psychiatry. 1980;137: 535–544. doi: 10.1176/ajp.137.5.535 7369396

3. Theunissen, MHC. The early detection of psychosocial problems in children aged 0 to 6 years by Dutch preventive child healthcare: professionals and their tools [dissertation]. TNO Leiden, The Netherlands; 2013.

4. Bot M, de Leeuw den Bouter BJ, Adriaanse MC. Prevalence of psychosocial problems in Dutch children aged 8–12 years and its association with risk factors and quality of life. Epidemiol Psychiatr Sci. 2011;20: 357–65. doi: 10.1017/s2045796011000540 22201213

5. Reijneveld SA, Vogels AGC, Hoekstra F, Crone MR. Use of the Pediatric Symptom Checklist for the detection of psychosocial problems in preventive child healthcare. BMC Public Health. 2006;6: 1471–2458.

6. Romeo R, Knapp M, Scott S. Economic cost of severe antisocial behaviour in children–And who pays it. British Journal of Psychiatry. 2006;188: 547–553. doi: 10.1192/bjp.bp.104.007625 16738345

7. Van Lier PAC. Preventing disruptive behavior in early elementary school children. Rotterdam: Optima Grafische Communicatie; 2002.

8. Scott S, Knapp M, Henderson J, Maughan B. Financial cost of social exclusion: follow up study of antisocial children into adulthood. British Medical Journal (Clinical Research Ed.), 2001;323(7306): 191–194.

9. Marchette LK, Weisz JR. Practitioner review: Emperical evolution of youth psychotherapy toward transdiagnostic approaches. J Child Psychol Psychiatry. 2017 Sep:58(9): 970–984. doi: 10.1111/jcpp.12747 28548291

10. Caspi A, Houts RM, Belsky DW, Goldman-Mellor SJ, Harrington H, Israel S, et al. The p factor: One general psychopathology factor in the structure of psychiatric disorders? Clinical Psychological Science. 2014 Mar; 2(2): 119–137. doi: 10.1177/2167702613497473 25360393

11. Sauer-Zavala S, Gutner CA, Farchione TJ, Boettcher HT, Bullis JR, Barlow DH. Current definitions of “Transdiagnostic” in treatment development: A search for consensus. Behavior Therapy. 2017;48(1): 128–138. doi: 10.1016/j.beth.2016.09.004 28077216

12. Allen LB, White KS, Barlow DH, Shear KM, Gorman JM, Woods SW. Cognitive-behavior therapy(CBT) for panic disorder: Relationship of anxiety and depression comorbidity with treatment outcome. Journal of Psychopathology and Behavioral Assessment. 2010;32(2): 185–192. doi: 10.1007/s10862-009-9151-3 20421906

13. DeRubeis RJ, Hollon SD, Amsterdam JD, Shelton RC, Young PR, Salomon RM, et al. Cognitive therapy vs medications in the treatment of moderate to severe depression. Archives of General Psychiatry. 2005;62(4): 409–416. doi: 10.1001/archpsyc.62.4.409 15809408

14. McHugh RK, Murray HW, Barlow DH. Balancing fidelity and adaptation in the dissemination of empirically-supported treatments: The promise of transdiagnostic interventions. Behaviour Research and Therapy. 2009;47(11): 946–953. doi: 10.1016/j.brat.2009.07.005 19643395

15. Brosnan R, Carr A. Adolescent conduct problems. In: Carr A, editor. What works with children and adolescents: A critical review of psychological interventions with children, adolescents and their families. London: Routledge; 2000. pp. 131–154.

16. Sukhodolsky DG, Kassinove H, Gorman BS. Cognitive-behavioral therapy for anger in children and adolescents: A meta-analysis. Aggression and Violent Behavior. 2003;9: 247–269.

17. Greenberg MT, Domitrovich C, Bumbarger B. The prevention of mental disorders in school-aged children: Current state of the field. Prevention & Treatment. 2001;4(1): 1–62.

18. Salmivalli C. Participant role approach to school bullying: Implications for interventions. Journal of Adolescence. 1999;22(4): 453–459. doi: 10.1006/jado.1999.0239 10469509

19. Vliek L, Orobio de Castro B. Stimulating positive social interaction: What can we learn from TIGER (Kanjertraining)? In: Doll B, Baker J, Pfohl B, Yoon J, editors. Handbook of Youth Prevention Science. New York: Routledge; 2010. pp. 288–308.

20. Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist. 2000;55: 68–78. doi: 10.1037//0003-066x.55.1.68 11392867

21. Deci EL, Ryan RM. Self-determination theory. In: Van Lange PAM, Kruglanski AW, Higgins ET, editors. Handbook of theories of social psychology: Vol. 1. Sage, Thousand Oaks; 2012. pp. 416–437. doi: 10.4135/9781446201022

22. Topper Training Foundation. Handleiding Kanjertraining Basisonderwijs. Almere: Topper Training Foundation; 2007–2019. Dutch.

23. Vliek L, Overbeek G, Orobio de Castro B. Improving Classroom Climate: Effectiveness of Toppertraining (Kanjertraining) in Disruptive Primary School Classes. In: Vliek L. Effects of Kanjertraining (Topper Training) on Emotional Problems, Behavioural Problems and Classroom Climate [dissertation]. Utrecht University; 2015. Available from https://www.kanjertraining.nl/wp-content/uploads/2015/08/effects_of_eanjertraining/dissertation-1.pdf

24. Vliek L, Overbeek G, Orobio de Castro B. “I want to behave prosocially and I can choose to do so”: Effectiveness of TIGER (Kanjertraining) in 8- to 11-year-olds. European Journal of Developmental Psychology. 2014;11(1): 77–89.

25. Goodman R. Psychometric properties of the Strengths and Difficulties Questionnaire (SDQ). Journal of the American Academy of Child and Adolescent Psychiatry, 2001;40: 1337–1345. doi: 10.1097/00004583-200111000-00015 11699809

26. Van Widenfelt BM, Goedhart AW, Treffers PDA, Goodman R. Dutch version of the Strengths and Difficulties Questionnaire (SDQ). European Child & Adolescent Psychiatry. 2003;12(6): 281–289.

27. Goodman R. The extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden. Journal of Child Psychology and Psychiatry. 1999;40: 791–801. 10433412

28. Van Leuven M, Van Beek Y. Children’s Depression Inventory, Nederlandse Bewerking. Internal Report. Utrecht, The Netherlands: Utrecht University; 2000. Dutch.

29. Kovacs M. Children’s Depression Inventory, Manual. New York/Toronto: Multi-Health Systems; 1992.

30. Kovacs MD. Children’s Depression Inventory (CDI): Technical manual. North Tonawanda, NY: Multi Health Systems Inc; 2001.

31. Mattison RE, Handford HA, Kales HC, Goodman AL, McLaughlin RE. Four-year predictive value of the Children’s Depression Inventory. Psychological Assessment, 1990;2: 169–174.

32. Van Beek Y. Hessen DJ, Hutteman R, Verhulp EE, van Leuven M. Age and gender differences in depression across adolescence: Real or 'bias'? Journal of Child Psychology and Psychiatry and Allied Disciplines. 2012;53(9): 973–985.

33. Veerman JW, Straathof MAE, Treffers PhDA, Van den Bergh BRH, Ten Brink LT. Competentiebelevingsschaal voor Kinderen: handleiding. Lisse: Harcourt Assessment BV; 2004. Dutch.

34. Harter S. Manual for the self-perception profile for children. Denver, CO: University of Denver; 1988.

35. Muris P, Meesters C, Fijen P. The Self-Perception Profile for Children: further evidence for its factor structure, reliability, and validity. Personality and individual differences. 2002; 35: 1791–1802.

36. Vliek L, Riet B, Weide G, Overbeek G, Orobio de Castro B. Psychometric quality of the Topper questionnaire: reliability, validity and normative data. In: L Vliek. Effects of Kanjertraining (Topper Training) on Emotional Problems, Behavioural Problems and Classroom Climate [dissertation]. Utrecht University; 2015. Available from https://www.kanjertraining.nl/wp-content/uploads/2015/08/effects_of_eanjertraining/dissertation-1.pdf

37. Olweus D. The Revised Olweus Bully/Victim Questionnaire. Mimeo. Bergen, Norway: Research Center for Health Promotion, University of Bergen; 1996.

38. Farrington DP, Ttofi MM. School-based programs to reduce bullying and victimization. Campbell Systematic Reviews, 6; 2010. (First published: 15 December 2009; Last updated: 8 March 2010).

39. Morawska A, Mitchell AE, Burgess S, Fraser J. Effects of Triple P parenting intervention on child health outcomes for childhood asthma and eczema: Randomised controlled trial. Behavior Research and Therapy. 2016;83: 35–44.

40. Altman N, Krzywinski M. Points of significance: Interpreting P values. Nature Methods. 2017;14: 213–214. doi: 10.1038/nmeth.4210

41. Wasserstein R, Lazar NA. The ASA’s statement on p-values: Context, process, and purpose. The American Statistician. 2016;70: 129–133.

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2019 Číslo 11