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About 10% of U.S. children and adolescents suffer from anxiety disorders. Because familial transmission is common, via both nature and nurture, effective family-based interventions are desirable.
To explore one such intervention, researchers randomized families with an anxiety-disordered parent and a non–anxiety-disordered child aged 6 to 13 years to receive a family-based intervention or information only (a 36-page pamphlet). The intervention involved eight weekly 60-minute sessions with therapists and three optional monthly booster sessions; sessions targeted modifiable child and parent factors, including symptoms, behaviors, cognitions, and coping skills (e.g., anxiety-provoking parental modeling of anxiety, overcontrol/overprotection). Families were taught to recognize signs of anxiety and given strategies for anxiety reduction, desensitization, problem solving, and increasing child autonomy.
A total of 136 child/parent pairs participated. Overall, 79% of the parents were women, 69% had generalized anxiety disorder, and 65% were receiving treatment; mean child age was 9 years. Parental anxiety ratings were similar between groups. Assessments conducted postintervention and at 6- and 12-month follow-ups showed that, cumulatively, 19 controls but only 3 intervention-group children developed anxiety disorders (hazard ratio, 6.60; number needed to treat, 3.94). The intervention was more effective for children with higher baseline anxiety levels.
Ginsburg GS et al. Preventing onset of anxiety disorders in offspring of anxious parents: A randomized controlled trial of a family-based intervention. Am J Psychiatry 2015 Sep 25; [e-pub]. (http://dx.doi.org/10.1176/appi.ajp.2015.14091178)
Comment
Longer follow-up is needed to understand whether this intervention actually averts anxiety disorders or simply delays onset. Similarly, healthy, nonintervention controls are required to determine whether information-only control conditions might unintendedly generate anxiety. Nevertheless, the findings strongly suggest that this brief intervention can prevent — or at least delay onset of — anxiety disorders among children at high risk for them. The treatment manual is available on request from the authors.