Family Based Prevention of Child Anxiety

以家庭为基础预防儿童焦虑

• 批准号: 8074518
• 负责人: Golda Susan Ginsburg
• 金额: $ 51.2万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-01 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8074518
• 关键词: Adolescent; Adult; Age; Anxiety; Anxiety Disorders; Child; Cognition; Cognitive Therapy; Data; Disease; Experimental Designs; Family; Gender; Genetic; Goals; High Prevalence; Impairment; Incidence; Institute of Medicine (U.S.); Intervention; Life; Light; Measures; Mediating; Mediator of activation protein; Mental Health; Mental disorders; Mentored Patient-Oriented Research Career Development Award; Methods; Monitor; National Institute of Mental Health; Outcome; Parenting behavior; Parents; Pharmaceutical Preparations; Pilot Projects; Population; Prevalence; Prevention; Prevention Research; Preventive; Preventive Intervention; Psychosocial Influences; Public Health; Randomized; Recommendation; Relative (related person); Risk; Schools; Severities; Social Functioning; Symptoms; Target Populations; Training; Treatment Efficacy; Youth; base; cost; design; effective therapy; follow-up; improved; informant; intervention effect; mental disorder prevention; offspring; post intervention; prevent; psychologic; psychosocial; response; social; working group

DESCRIPTION (provided by applicant): Anxiety disorders are among the most common psychiatric illnesses in children and adolescents with prevalence rates averaging 5-10%. These disorders are associated with significant short- and long-term impairment in academic, familial, social, and psychological functioning. Although medication and cognitive-behavioral therapies have been found to be effective treatments, efforts to prevent anxiety disorders in youth have been limited. In light of the high prevalence, the associated impairment, and the cost of treating these disorders (estimated at 42 billion dollars a year for adults), preventive measures could have a significant public health impact. Family aggregate studies indicate that children of anxious parents are at an elevated risk for developing anxiety disorders and thus an important target population for prevention. Results from the PI's K23 pilot study found that a brief family-based intervention reduced the incidence of anxiety disorders in this population by 30-50%. The purpose of this R01 application is to evaluate the efficacy of this intervention for reducing anxiety symptoms and preventing the onset of anxiety disorders in the offspring of anxious parents. In addition, this study will examine theoretically-based mediators of intervention effects. The intervention will be evaluated using a 2 (intervention condition: prevention versus an information- monitoring control) x 4 (assessment period: pre-, post-intervention, 6-, and 12-month follow-up) experimental design. This study uses rigorous scientific methods including a randomized controlled design, multiple informants and measures to assess key constructs, independent evaluators (IEs) to assess outcome and mediator variables, and intensive training for therapists and IEs to assure a high quality of study implementation. This study will be the first aimed at preventing anxiety disorders in the offspring of anxious parents. This application responds to recommendations made by the National Advisory Mental Health Work Group on Mental Disorders Prevention Research (2001) and earlier recommendations from both the Institute of Medicine's Committee on Prevention of Mental Disorders and the NIMH's Prevention Steering Committee (Mrazek & Haggerty, 1994) to develop and evaluate preventive interventions for youth. Anxiety disorders in children and adolescents are common and debilitating illnesses. While cognitive-behavioral treatment is effective, prevention efforts would have a significant public health impact by reducing the need for treatment and altering the life trajectories of at risk children. Offspring of anxious adults are at a significant risk for developing these disorders and an important target for prevention efforts. The purpose of this R01 application is to evaluate whether a short-term psychosocial intervention, developed by the PI in a pilot study, can prevent the onset of anxiety disorders in the offspring of anxious parents.

描述（由申请人提供）：焦虑症是患病率为5-10％的儿童和青少年最常见的精神病。这些疾病与学术，家族，社会和心理功能的重大短期和长期障碍有关。尽管已经发现药物和认知行为疗法是有效的治疗方法，但预防青年焦虑症的努力受到限制。鉴于患病率很高，相关的损害以及治疗这些疾病的成本（估计每年为420亿美元），预防措施可能会对公共卫生产生重大影响。家庭骨料研究表明，焦虑父母的孩子患焦虑症的风险较高，因此是预防焦虑症的重要目标。 PI的K23试点研究的结果发现，简短的基于家庭的干预措施使该人群中焦虑症的发生率降低了30-50％。 R01应用的目的是评估这种干预措施减轻焦虑症状的功效，并防止焦虑父母后代的焦虑症发作。此外，这项研究将研究基于理论上的干预效应中的介体。干预措施将使用2（干预条件：预防与信息监测控制）进行评估）x 4（评估期：干预前，干预后，6个月和12个月的随访）实验设计。这项研究使用了严格的科学方法，包括随机控制设计，多个线人和措施，以评估关键构造，独立评估者（IES）评估结果和调解人变量，以及对治疗师和IES的深入培训，以确保高质量的研究实施。这项研究将是第一个旨在预防焦虑父母后代的焦虑症。该申请回应了国家咨询精神卫生工作组预防研究（2001年）的建议，以及医学研究所预防精神疾病委员会和NIMH的预防指导委员会（Mrazek＆Haggerty，1994年）的早期建议，以制定和评估针对青年的预防干预措施。儿童和青少年的焦虑症是常见的，使人衰弱。尽管认知行为治疗有效，但预防努力将通过减少治疗的需求和改变风险儿童的生命轨迹而产生重大的公共卫生影响。焦虑成年人的后代面临着这种疾病的重大风险，也是预防努力的重要目标。 R01应用的目的是评估PI在试点研究中开发的短期心理社会干预是否可以防止焦虑父母后代的焦虑症发作。