Evaluating a program to prevent anxiety in children of anxious parents: a randomized controlled trial.

IF 6.5 1区医学 Q1 PSYCHIATRY

Journal of Child Psychology and Psychiatry Pub Date : 2025-03-12 DOI:10.1111/jcpp.14151

Sigrid Elfström, Anna Rosengren, Rebecca Andersson, Johanna Engelbrektsson, Albin Isaksson, Micaela Meregalli, Livia van Leuven, Maria Lalouni, Lars-Göran Öst, Ata Ghaderi, Johan Åhlén

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引用次数: 0

Abstract

Background: Pediatric anxiety disorders are prevalent, particularly among children with anxious parents. This trial evaluated a program for anxious parents aimed at preventing offspring anxiety disorders and symptoms over 12 months.

Methods: This parallel, randomized, controlled, open-label trial was conducted at Karolinska Institutet, Stockholm, Sweden. Inclusion criteria comprised heightened parental anxiety and the child (5-9 years old) not currently meeting criteria for an anxiety disorder. The program, Confident Parents-Brave Children (CPBC) involves six video conferencing group sessions. An external researcher randomly allocated (1:1) participants to CPBC or a self-help control. The primary outcome was change in clinical severity ratings (CSR) between pre- and 12-month assessments, assessed by the Anxiety Disorders Interview Schedule. Secondary outcomes included parent-rated child anxiety symptoms and parental self-efficacy. The study was preregistered at ClinicalTrials.gov (NCT04722731).

Results: The trial included 215 parents (91% female) and 277 children (48% girls, mean age 7.0). At the 12-month assessment, no statistically significant difference was found between conditions on the primary outcome (change in CSR), OR = 0.67 (95% CI: 0.30, 1.48). No statistically significantly lower prevalence of anxiety disorder at the 12-month assessment was found in the CPBC group compared with the control group, OR = 0.57 (95% CI: 0.24, 1.31). When stratifying by age, children 5-6 years in CPBC showed lower risk of increased CSR, OR = 0.24 (95% CI: 0.08, 0.77), and anxiety diagnosis, OR = 0.23 (95% CI: 0.05, 0.84), compared to controls. Regarding secondary outcomes, CPBC children exhibited larger decreases in anxiety symptoms than control children from pre- to the 12-month assessment, Cohen's d = .35 (95% CI: 0.15, 0.55). Parents in both conditions showed increased parental self-efficacy over time, with no significant between-group effect. The 12-month assessment was completed by 204 parents (95%).

Conclusions: The CPBC may have potential for preventing anxiety in young children; however, further research is warranted.

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评估一个预防焦虑父母的孩子焦虑的项目：一项随机对照试验。

背景：儿童焦虑症很普遍，特别是在父母焦虑的儿童中。这项试验评估了一项针对焦虑父母的计划，旨在预防子女在12个月内出现焦虑障碍和症状。方法：这项平行、随机、对照、开放标签的试验在瑞典斯德哥尔摩的卡罗林斯卡研究所进行。纳入标准包括父母高度焦虑和儿童（5-9岁）目前不符合焦虑障碍的标准。这个名为“自信的父母-勇敢的孩子”（CPBC）的项目包括六个视频会议小组会议。外部研究人员随机分配（1:1）参与者到CPBC或自助控制组。主要结果是临床严重程度评分（CSR）在前和12个月评估之间的变化，由焦虑障碍访谈时间表评估。次要结局包括父母评定的儿童焦虑症状和父母自我效能。该研究已在ClinicalTrials.gov （NCT04722731）进行预注册。结果：该试验包括215名家长（91%为女性）和277名儿童（48%为女孩，平均年龄7.0岁）。在12个月的评估中，两种情况在主要结局（CSR变化）上没有统计学上的显著差异，OR = 0.67 （95% CI: 0.30, 1.48）。在12个月的评估中，CPBC组的焦虑障碍患病率与对照组相比没有统计学意义上的显著降低，OR = 0.57 （95% CI: 0.24, 1.31）。当按年龄分层时，与对照组相比，CPBC中5-6岁儿童的CSR增加风险较低，OR = 0.24 (95% CI: 0.08, 0.77)，焦虑诊断风险较低，OR = 0.23 （95% CI: 0.05, 0.84）。关于次要结果，CPBC儿童在12个月前的评估中表现出比对照组儿童更大的焦虑症状下降，Cohen’s d = .35（95% ci: 0.15, 0.55）。随着时间的推移，两种情况下的父母都表现出了更高的自我效能感，没有显著的组间效应。204名家长（95%）完成了12个月的评估。结论：CPBC可能具有预防幼儿焦虑的潜力；然而，进一步的研究是必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Child Psychology and Psychiatry 医学-精神病学

CiteScore

13.80

自引率

5.30%

发文量

169

审稿时长

1 months

期刊介绍： The Journal of Child Psychology and Psychiatry (JCPP) is a highly regarded international publication that focuses on the fields of child and adolescent psychology and psychiatry. It is recognized for publishing top-tier, clinically relevant research across various disciplines related to these areas. JCPP has a broad global readership and covers a diverse range of topics, including: Epidemiology: Studies on the prevalence and distribution of mental health issues in children and adolescents. Diagnosis: Research on the identification and classification of childhood disorders. Treatments: Psychotherapeutic and psychopharmacological interventions for child and adolescent mental health. Behavior and Cognition: Studies on the behavioral and cognitive aspects of childhood disorders. Neuroscience and Neurobiology: Research on the neural and biological underpinnings of child mental health. Genetics: Genetic factors contributing to the development of childhood disorders. JCPP serves as a platform for integrating empirical research, clinical studies, and high-quality reviews from diverse perspectives, theoretical viewpoints, and disciplines. This interdisciplinary approach is a key feature of the journal, as it fosters a comprehensive understanding of child and adolescent mental health. The Journal of Child Psychology and Psychiatry is published 12 times a year and is affiliated with the Association for Child and Adolescent Mental Health (ACAMH), which supports the journal's mission to advance knowledge and practice in the field of child and adolescent mental health.