Preventing Stress Related Ill-Health in Adolescence: A Transdiagnostic Approach

Introduction: Stress and stress-related problems such as symptoms of anxiety, depression, stress and worry is a widespread and growing problem amongst Swedish adolescents, especially girls. Similar trends have been observed in many countries. Thus, in the last decades there have been an increased focus on preventive interventions as a means for addressing these problems early in their development. From a clinical perspective, there has also been an increased focus on identifying transdiagnostic mechanisms that are important in the development and maintenance of several types of emotional problems. By targeting transdiagnostic mechanisms it might be possible to prevent the development of several problems early on. The aim of this study is to evaluate an internet-based indicated preventive program aimed at preventing emotional problems in adolescents, by targeting transdiagnostic processes such as rumination and worry.

Methods: This study is part of a four-year longitudinal-experimental study following a cohort of adolescents that in the spring of 2014 were enrolled in the 7^th and 8^th grade in public schools in three Swedish municipalities (N= 2768). In the second year of the study a subset of the sample reporting elevated levels of stress and worry (N=58) received an internet based rumination-focused preventive intervention aimed at reducing transdiagnostic mechanisms such as worry and rumination, consisting of six weekly modules. Levels of perceived stress, worry, depression and anxiety was assessed pre-, mid- and post-intervention for the intervention group as well as once a year within the longitudinal study for the total sample. Analysis include both within-group and between-group analyses, using a matched no contact control group already enrolled within the longitudinal study.

Results: Preliminary within-group results showed that participants reported decreases in worry (F(1, 30) 20.71, p < .001), perceived stress (F(2, 52) 14.12, p < .001), depressive symptoms (F(2, 58) 13.82, p < .001) and anxiety (F(1.56, 45.11) 3.51, p < .05) from pre- to post-intervention. Changes tended to occur the second half of the intervention. The next step is to compare our intervention group to a matched control group from our cohort to be able to draw conclusion of the preventive effects of the intervention. The first wave of these results will be collected during the spring of 2017 and included in the poster.

Conclusions: The preliminary results are promising. However it remains to see if there is a true preventive effect over time compared to the control group.