Family Based Prevention of Child Anxiety

以家庭为基础预防儿童焦虑

• 批准号: 7683848
• 负责人: Golda Susan Ginsburg
• 金额: $ 51.81万
• 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/7683848
• 关键词: Adolescent; Adult; Age; Anxiety; Anxiety Disorders; Behavior Therapy; Child; Cognition; Cognitive; 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; cognitive behavior therapy; cost; design; effective therapy; follow up assessment; 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）：焦虑症是儿童和青少年中最常见的精神疾病之一，患病率平均为 5-10%。这些疾病与学术、家庭、社会和心理功能的严重短期和长期损害有关。尽管药物和认知行为疗法已被发现是有效的治疗方法，但预防青少年焦虑症的努力仍然有限。鉴于这些疾病的高患病率、相关的损害以及治疗这些疾病的费用（估计成人每年 420 亿美元），预防措施可能会对公共健康产生重大影响。家庭总体研究表明，焦虑父母的孩子患焦虑症的风险较高，因此是预防的重要目标人群。 PI 的 K23 试点研究结果发现，短暂的家庭干预可以将该人群的焦虑症发病率降低 30-50%。该 R01 应用程序的目的是评估这种干预措施对于减少焦虑父母的后代的焦虑症状和预防焦虑症发作的功效。此外，本研究还将研究基于理论的干预效果中介因素。将使用 2（干预条件：预防与信息监测控制）x 4（评估期：干预前、干预后、6 个月和 12 个月的随访）实验设计来评估干预措施。本研究采用严格的科学方法，包括随机对照设计、多个信息提供者和评估关键结构的措施、评估结果和中介变量的独立评估者 (IE) 以及对治疗师和 IE 的强化培训，以确保研究实施的高质量。这项研究将是第一个旨在预防焦虑父母的后代焦虑症的研究。此应用程序响应了国家精神疾病预防研究咨询心理健康工作组 (2001) 提出的建议以及医学研究所精神疾病预防委员会和 NIMH 预防指导委员会的早期建议 (Mrazek & Haggerty, 1994)制定和评估针对青少年的预防性干预措施。儿童和青少年的焦虑症是常见且使人衰弱的疾病。虽然认知行为治疗是有效的，但预防工作将通过减少治疗需求和改变高危儿童的生活轨迹，对公共健康产生重大影响。焦虑的成年人的后代面临着患这些疾病的巨大风险，也是预防工作的重要目标。此 R01 应用程序的目的是评估 PI 在试点研究中开发的短期心理社会干预是否可以预防焦虑父母的后代出现焦虑症。