Indicated Prevention of Anxiety and Depression in School Children: Preliminary Results from a Randomized Controlled Trial of a New Transdiagnostic Intervention

INTRODUCTION: Anxiety and depression are common disorders in childhood. The disorders have high comorbidity and influences children in several important domains. Having elevated levels of internalizing symptoms may also reduce functioning and increase the risk of later development of a disorder. Identifying children with internalizing problems can be difficult, and schools may be an ideal arena to reach these children for prevention initiatives. This study evaluates a new transdiagnostic program targeting symptoms of anxiety and depression in school aged children.

METHOD: A cluster randomized controlled study with Norwegian school children (N = 823) aged 8 – 12 years was conducted in multiple schools (N = 36) in both urban and rural municipalities. A step-wise recruitment procedure was employed to recruit at-risk children. Children with elevated symptoms of anxiety and/or depression were invited to participate. Informed consent was obtained from N = 1725 children and they were screened using the Multidimensional Anxiety Scale for Children (MASC-C) and the Mood and Feelings Questionnaire, short version (SMFQ). Children scoring 1 SD or more above an expected population mean on the measures of anxiety and depression were included in the study.

RESULTS: The study design and results of the recruitment based on CONSORT guidelines will be presented. Girls were 57.4 % of the sample, with a mean age of 9.6 years. The largest at-risk group (N = 408, 49.6 %), was children reporting symptoms of both anxiety and depression (Combined group), while 29.8% (N = 245) reported symptoms of Depression only and 20.7 % (N = 170) reported symptoms of Anxiety only. One-way ANOVA analysis of a subset of the sample screened at pretest (N = 477) showed significant mean differences between the symptom groups on self-reported quality of life and self-esteem. Regression analysis showed that in the Depression only group and the Combined group, symptom levels were significantly associated with lower self-reported scores on both functional domains. Preliminary results of the program effects in relation to symptoms of anxiety and depression, user satisfaction and stigma will be presented.

DISCUSSION: We will discuss the importance of early identification and intervention for at-risk children. Preliminary results on primary measures together with the usefulness and challenges of targeting anxiety and depression simultaneously in one intervention in a school setting will also be discussed.

CONCLUSION: Children in primary care express interest in participating in preventive efforts in a school setting, and many report internalizing symptoms within at-risk levels. The school setting appears to be an important arena for reaching children with internalizing symptoms and for offering preventive interventions. Targeting high levels of symptoms through indicated prevention with a transdiagnostic program is an advance to the field.