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 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] / 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 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] / 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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