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Based on the same sample (\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u200999), the present study examined cross-sectional indirect associations between treatment condition and outcomes via intermediate variables, which conceptually correspond to mediation. We hypothesized that ScouT would lead to stronger reductions in the peer-related aggression-maintaining factor (PAM factor; including dysfunctional social information processing, emotional dysregulation, impulse control problems, deficits in social skills, and dysfunctional social interactions), whereas STARK would lead to greater improvements in self-concept, which in turn would be associated with lower concurrently assessed clinician-, parent- and teacher-rated DBD symptoms and overall externalizing behaviors. Our analysis yielded support for the hypothesized indirect association through the PAM factor, with consistency across all outcome measures. Unexpectedly, compared with STARK, ScouT also led to a more favorable self-concept, which was indirectly associated with less severe clinician-rated DBD symptoms, but not with the other outcomes. This latter indirect association was small and should additionally be interpreted with caution given the low reliability of the clinician-rated scale. These findings may indicate that the treatment of children with DBD may benefit from directly targeting aggression-maintaining factors. Limitations include the concurrent assessment of the intermediate variables (PAM factor, self-concept) and the outcomes, which does not permit causal conclusions. Future research should refine methodologies and explore additional treatment mechanisms.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:\u00a0<\/jats:bold>\n                    The study was registered at clinicaltrials.gov on 2014-05-18 (Identifier: NCT02143427).\n                  <\/jats:p>","DOI":"10.1007\/s10578-026-01999-4","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T08:42:17Z","timestamp":1773391337000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mediation of Treatment Effects in Problem-Focused Social Skills Training versus Resource Activation for Children with Disruptive Behavior Problems: A Cross-Sectional Analysis"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5455-7563","authenticated-orcid":false,"given":"Leonie","family":"Hofmann","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5405-4934","authenticated-orcid":false,"given":"Christina","family":"Dose","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7929-0463","authenticated-orcid":false,"given":"Manfred","family":"D\u00f6pfner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5874-2520","authenticated-orcid":false,"given":"Anja","family":"G\u00f6rtz-Dorten","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"1999_CR1","unstructured":"National Institute for Health and Care Excellence (2013) Antisocial Behaviour and Conduct Disorders in Children and Young People: Recognition, Intervention and Management. https:\/\/www.nice.org.uk\/guidance\/cg158"},{"issue":"2","key":"1999_CR2","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1007\/s00787-018-1144-x","volume":"28","author":"A Goertz-Dorten","year":"2019","unstructured":"Goertz-Dorten A, Benesch C, Berk-Pawlitzek E, Faber M, Hautmann C, Hellmich M, Lindenschmidt T, Schuh L, Stadermann R, Doepfner M (2019) Efficacy of individualized social competence training for children with oppositional defiant disorders\/conduct disorders: a randomized controlled trial with an active control group. 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Prof. Dr. Goertz-Dorten has received income as head, supervisor, and lecturer of the Department of Evaluation of the Center for Child and Adolescent Cognitive Behavior Therapy at the University Hospital Cologne and as a consultant for child behavior therapy at the National Association of Statutory Health Insurance Physicians (Kassen\u00e4rztliche Bundesvereinigung). She has received royalties from publishing companies (Hogrefe, Huber) as an author of treatment manuals, books, and rating scales to assess mental disorders, and of psychological tests, computer programs, and smartphone applications. She has served as an Advisor for Digital Health applications, for which she has received royalties from a company (eyelevel GmbH), and research support from the German Ministry of Education and Research. Prof. Dr. Doepfner has received consulting income and research support from Medice, eyelevel GmbH, and medigital, and research support from the German Research Foundation, the German Ministry of Education and Research, the German Ministry of Health, and the Innovation Fund. He has received income as former head, supervisor, and lecturer of the Center for Child and Adolescent Cognitive Behaviouur Therapy at the University Hospital Cologne and as a consultant for child behavior therapy at the National Association of Statutory Health Insurance Physicians (Kassen\u00e4rztliche Bundesvereinigung). He has received royalties from treatment manuals, books, and psychological tests published by Beltz, Elsevier, Enke, Guilford, Hogrefe, Huber, Kohlhammer, Schattauer, Springer, and Wiley. Dr. Dose has received royalties from a publishing company (Hogrefe) as an author of self-help books for parents and teachers of children with ADHD. Ms. Hofmann reports no biomedical financial interests or potential conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The study was registered at clinicaltrials.gov (Identifier: NCT02143427) and approved by the ethics committee of the University Hospital of Cologne, Germany. All procedures were in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"All participants, parents, and teachers provided written informed consent.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}