This prospective study examined baseline differences and treatment-related change in four discrete parent-child behavioral synchrony dimensions (Coordinated Routines, Mutual Cooperation, Harmonious Communication, Emotional Ambience) across three conduct problem subgroups — CP-only, primary CU (CU without internalizing problems), and secondary CU (CU with internalizing problems) — in N=234 clinic-referred children aged 2–7 years. A subsample (n=142) received PCIT or PCIT-CU parent training and was reassessed post-treatment and at 3-month follow-up.
At baseline, mother-child Harmonious Communication and Emotional Ambience were significantly lower in secondary CU than in primary CU and CP-only groups (e.g., Emotional Ambience: Mdiff = −0.72, d = 2.52). Parent training improved synchrony broadly across dyads; however, at 3-month follow-up, mother-child affective synchrony remained lower for secondary CU than primary CU (Harmonious Communication: Mdiff = −1.03, d = 2.28), and father-child Harmonious Communication deteriorated in secondary CU while improving in primary CU.
- Father participation was lower than mother participation, reducing power to detect subgroup differences in father-child synchrony. - Observations used brief, standardized tasks (3 × 5-minute plays) that may not reflect home interactions. - No typically-developing comparison group was included, limiting interpretation of how clinical subgroups diverge from normative patterns.
Children with secondary CU traits (high CU + internalizing problems) show the greatest deficits in affective parent-child synchrony and the least durable gains after parent training — clinicians should assess synchrony across child-led and parent-led contexts and consider augmenting PCIT with strategies that directly target parental cognitions and emotions toward the child. Standard PCIT gains in synchrony may not hold at 3 months for secondary CU dyads, signaling a need for booster sessions or tailored follow-up support.
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