Evaluating a program to prevent anxiety in children of anxious parents: a randomized controlled trial / Sigrid ELFSTRÖM in Journal of Child Psychology and Psychiatry, 66-9 (September 2025)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 66-9 (September 2025) . - p.1345-1356 Titre : Evaluating a program to prevent anxiety in children of anxious parents: a randomized controlled trial Type de document : Texte imprimé et/ou numérique Auteurs : Sigrid ELFSTRÖM, Auteur ; Anna ROSENGREN, Auteur ; Rebecca ANDERSSON, Auteur ; Johanna ENGELBREKTSSON, Auteur ; Albin ISAKSSON, Auteur ; Micaela MEREGALLI, Auteur ; Livia VAN LEUVEN, Auteur ; Maria LALOUNI, Auteur ; Lars-Göran ÖST, Auteur ; Ata GHADERI, Auteur ; Johan AHLEN, Auteur Article en page(s) : p.1345-1356 Langues : Anglais (eng) Mots-clés : Anxiety disorders  prevention  parenting  internet-based intervention  randomized controlled trial  public health Index. décimale : PER Périodiques Résumé : Background Pediatric anxiety disorders are prevalent, particularly among children with anxious parents. This trial evaluated a program for anxious parents aimed at preventing offspring anxiety disorders and symptoms over 12?months. Methods This parallel, randomized, controlled, open-label trial was conducted at Karolinska Institutet, Stockholm, Sweden. Inclusion criteria comprised heightened parental anxiety and the child (5?9?years old) not currently meeting criteria for an anxiety disorder. The program, Confident Parents?Brave Children (CPBC) involves six video conferencing group sessions. An external researcher randomly allocated (1:1) participants to CPBC or a self-help control. The primary outcome was change in clinical severity ratings (CSR) between pre- and 12-month assessments, assessed by the Anxiety Disorders Interview Schedule. Secondary outcomes included parent-rated child anxiety symptoms and parental self-efficacy. The study was preregistered at ClinicalTrials.gov (NCT04722731). Results The trial included 215 parents (91% female) and 277 children (48% girls, mean age 7.0). At the 12-month assessment, no statistically significant difference was found between conditions on the primary outcome (change in CSR), OR?=?0.67 (95% CI: 0.30, 1.48). No statistically significantly lower prevalence of anxiety disorder at the 12-month assessment was found in the CPBC group compared with the control group, OR?=?0.57 (95% CI: 0.24, 1.31). When stratifying by age, children 5?6?years in CPBC showed lower risk of increased CSR, OR?=?0.24 (95% CI: 0.08, 0.77), and anxiety diagnosis, OR?=?0.23 (95% CI: 0.05, 0.84), compared to controls. Regarding secondary outcomes, CPBC children exhibited larger decreases in anxiety symptoms than control children from pre- to the 12-month assessment, Cohen's d?=?.35 (95% CI: 0.15, 0.55). Parents in both conditions showed increased parental self-efficacy over time, with no significant between-group effect. The 12-month assessment was completed by 204 parents (95%). Conclusions The CPBC may have potential for preventing anxiety in young children; however, further research is warranted. En ligne : https://doi.org/10.1111/jcpp.14151 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=566 [article] Evaluating a program to prevent anxiety in children of anxious parents: a randomized controlled trial [Texte imprimé et/ou numérique] / Sigrid ELFSTRÖM, Auteur ; Anna ROSENGREN, Auteur ; Rebecca ANDERSSON, Auteur ; Johanna ENGELBREKTSSON, Auteur ; Albin ISAKSSON, Auteur ; Micaela MEREGALLI, Auteur ; Livia VAN LEUVEN, Auteur ; Maria LALOUNI, Auteur ; Lars-Göran ÖST, Auteur ; Ata GHADERI, Auteur ; Johan AHLEN, Auteur . - p.1345-1356. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 66-9 (September 2025) . - p.1345-1356 Mots-clés : Anxiety disorders  prevention  parenting  internet-based intervention  randomized controlled trial  public health Index. décimale : PER Périodiques Résumé : Background Pediatric anxiety disorders are prevalent, particularly among children with anxious parents. This trial evaluated a program for anxious parents aimed at preventing offspring anxiety disorders and symptoms over 12?months. Methods This parallel, randomized, controlled, open-label trial was conducted at Karolinska Institutet, Stockholm, Sweden. Inclusion criteria comprised heightened parental anxiety and the child (5?9?years old) not currently meeting criteria for an anxiety disorder. The program, Confident Parents?Brave Children (CPBC) involves six video conferencing group sessions. An external researcher randomly allocated (1:1) participants to CPBC or a self-help control. The primary outcome was change in clinical severity ratings (CSR) between pre- and 12-month assessments, assessed by the Anxiety Disorders Interview Schedule. Secondary outcomes included parent-rated child anxiety symptoms and parental self-efficacy. The study was preregistered at ClinicalTrials.gov (NCT04722731). Results The trial included 215 parents (91% female) and 277 children (48% girls, mean age 7.0). At the 12-month assessment, no statistically significant difference was found between conditions on the primary outcome (change in CSR), OR?=?0.67 (95% CI: 0.30, 1.48). No statistically significantly lower prevalence of anxiety disorder at the 12-month assessment was found in the CPBC group compared with the control group, OR?=?0.57 (95% CI: 0.24, 1.31). When stratifying by age, children 5?6?years in CPBC showed lower risk of increased CSR, OR?=?0.24 (95% CI: 0.08, 0.77), and anxiety diagnosis, OR?=?0.23 (95% CI: 0.05, 0.84), compared to controls. Regarding secondary outcomes, CPBC children exhibited larger decreases in anxiety symptoms than control children from pre- to the 12-month assessment, Cohen's d?=?.35 (95% CI: 0.15, 0.55). Parents in both conditions showed increased parental self-efficacy over time, with no significant between-group effect. The 12-month assessment was completed by 204 parents (95%). Conclusions The CPBC may have potential for preventing anxiety in young children; however, further research is warranted. En ligne : https://doi.org/10.1111/jcpp.14151 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=566

Therapist-youth agreement on alliance change predicts long-term outcome in CBT for anxiety disorders / Krister W. FJERMESTAD in Journal of Child Psychology and Psychiatry, 57-5 (May 2016)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 57-5 (May 2016) . - p.625-632 Titre : Therapist-youth agreement on alliance change predicts long-term outcome in CBT for anxiety disorders Type de document : Texte imprimé et/ou numérique Auteurs : Krister W. FJERMESTAD, Auteur ; Matthew D. LERNER, Auteur ; Bryce D. MCLEOD, Auteur ; Gro Janne WERGELAND, Auteur ; Einar R. HEIERVANG, Auteur ; Wendy K. SILVERMAN, Auteur ; Lars-Göran ÖST, Auteur ; Andres DE LOS REYES, Auteur ; Odd E. HAVIK, Auteur ; Bente S. M. HAUGLAND, Auteur Article en page(s) : p.625-632 Langues : Anglais (eng) Mots-clés : Alliance  alliance agreement  CBT  anxiety  youth Index. décimale : PER Périodiques Résumé : Background In individual cognitive behavioral therapy (ICBT) for youth anxiety disorders, it is unclear whether, and from whose perspective, the alliance predicts outcome. We examined whether youth- and therapist-rated alliance, including level of youth-therapist alliance agreement, predicted outcome in a randomized controlled trial. Methods Youth (N = 91, M age = 11.4 years (SD = 2.1), 49.5% boys, 86.8% Caucasian) diagnosed with separation anxiety disorder, social phobia, or generalized anxiety disorder drawn from the ICBT condition of an effectiveness trial were treated with an ICBT program. Youth- and therapist-rated alliance ratings, assessed with the Therapeutic Alliance Scale for Children (TASC-C/T), were collected following session 3 (early) and 7 (late). Early alliance, change in alliance from early to late, and level of youth-therapist agreement on early alliance and alliance change were examined, in relation to outcomes collected at posttreatment and 1-year follow-up. Outcome was defined as primary diagnosis loss and reduction in clinicians' severity ratings (CSR; Anxiety Disorders Interview Schedule; ADIS-C/P) based on youth- and parent-report at posttreatment and follow-up, and youth treatment satisfaction collected at posttreatment (Client Satisfaction Scale; CSS). Results Early TASC-C scores positively predicted treatment satisfaction at posttreatment. Higher levels of agreement on change in TASC-C and TASC-T scores early to late in treatment predicted diagnosis loss and CSR reduction at follow-up. Conclusions Only the level of agreement in alliance change predicted follow-up outcomes in ICBT for youth anxiety disorders. The findings support further examination of the role that youth-therapist alliance discrepancies may play in promoting positive outcomes in ICBT for youth anxiety disorders. Clinical trial number NCT00586586, clinicaltrials.gov. En ligne : http://dx.doi.org/10.1111/jcpp.12485 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=288 [article] Therapist-youth agreement on alliance change predicts long-term outcome in CBT for anxiety disorders [Texte imprimé et/ou numérique] / Krister W. FJERMESTAD, Auteur ; Matthew D. LERNER, Auteur ; Bryce D. MCLEOD, Auteur ; Gro Janne WERGELAND, Auteur ; Einar R. HEIERVANG, Auteur ; Wendy K. SILVERMAN, Auteur ; Lars-Göran ÖST, Auteur ; Andres DE LOS REYES, Auteur ; Odd E. HAVIK, Auteur ; Bente S. M. HAUGLAND, Auteur . - p.625-632. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 57-5 (May 2016) . - p.625-632 Mots-clés : Alliance  alliance agreement  CBT  anxiety  youth Index. décimale : PER Périodiques Résumé : Background In individual cognitive behavioral therapy (ICBT) for youth anxiety disorders, it is unclear whether, and from whose perspective, the alliance predicts outcome. We examined whether youth- and therapist-rated alliance, including level of youth-therapist alliance agreement, predicted outcome in a randomized controlled trial. Methods Youth (N = 91, M age = 11.4 years (SD = 2.1), 49.5% boys, 86.8% Caucasian) diagnosed with separation anxiety disorder, social phobia, or generalized anxiety disorder drawn from the ICBT condition of an effectiveness trial were treated with an ICBT program. Youth- and therapist-rated alliance ratings, assessed with the Therapeutic Alliance Scale for Children (TASC-C/T), were collected following session 3 (early) and 7 (late). Early alliance, change in alliance from early to late, and level of youth-therapist agreement on early alliance and alliance change were examined, in relation to outcomes collected at posttreatment and 1-year follow-up. Outcome was defined as primary diagnosis loss and reduction in clinicians' severity ratings (CSR; Anxiety Disorders Interview Schedule; ADIS-C/P) based on youth- and parent-report at posttreatment and follow-up, and youth treatment satisfaction collected at posttreatment (Client Satisfaction Scale; CSS). Results Early TASC-C scores positively predicted treatment satisfaction at posttreatment. Higher levels of agreement on change in TASC-C and TASC-T scores early to late in treatment predicted diagnosis loss and CSR reduction at follow-up. Conclusions Only the level of agreement in alliance change predicted follow-up outcomes in ICBT for youth anxiety disorders. The findings support further examination of the role that youth-therapist alliance discrepancies may play in promoting positive outcomes in ICBT for youth anxiety disorders. Clinical trial number NCT00586586, clinicaltrials.gov. En ligne : http://dx.doi.org/10.1111/jcpp.12485 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=288

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