Family Based Prevention of Child Anxiety

描述（由申请人提供）：焦虑症是儿童和青少年最常见的精神疾病之一，患病率平均为5- 10%。这些疾病与学术、家庭、社会和心理功能的显著短期和长期损害有关。虽然药物和认知行为疗法已被发现是有效的治疗方法，但预防青少年焦虑症的努力有限。鉴于这些疾病的高患病率、相关损害以及治疗费用（估计成人每年420亿美元），预防措施可能会对公共卫生产生重大影响。家庭总体研究表明，父母焦虑的儿童患焦虑症的风险较高，因此是预防的重要目标人群。来自PI的K23试点研究的结果发现，一个简短的以家庭为基础的干预措施使这一人群的焦虑症发病率降低了30- 50%。本R 01申请的目的是评估这种干预措施在减少焦虑父母的后代的焦虑症状和预防焦虑症发作方面的疗效。此外，本研究还将研究基于理论的干预效果的介质。将使用2（干预条件：预防与信息监测对照）× 4（评估期：干预前、干预后、6个月和12个月随访）实验设计评价干预。本研究采用严格的科学方法，包括随机对照设计，多个信息提供者和评估关键结构的措施，独立评估者（IE）评估结果和中介变量，以及对治疗师和IE的强化培训，以确保高质量的研究实施。这项研究将是第一项旨在预防焦虑父母后代焦虑症的研究。该应用程序响应了国家咨询心理健康工作组关于心理障碍预防研究的建议（2001年）以及医学研究所心理障碍预防委员会和NIMH预防指导委员会（Mrazek & Haggerty，1994年）的早期建议，以制定和评估青年预防干预措施。儿童和青少年的焦虑症是常见的和使人衰弱的疾病。虽然认知行为治疗是有效的，但预防工作将通过减少对治疗的需求和改变高危儿童的生活轨迹来产生重大的公共卫生影响。焦虑的成年人的后代有很大的风险发展这些疾病和预防工作的重要目标。本R 01申请的目的是评价PI在一项试点研究中开发的短期心理社会干预是否可以预防焦虑父母的后代发生焦虑症。

DESCRIPTION (provided by applicant): Anxiety disorders are among the most common psychiatric illnesses in children and adolescents with prevalence rates averaging 5-10%. These disorders are associated with significant short- and long-term impairment in academic, familial, social, and psychological functioning. Although medication and cognitive-behavioral therapies have been found to be effective treatments, efforts to prevent anxiety disorders in youth have been limited. In light of the high prevalence, the associated impairment, and the cost of treating these disorders (estimated at 42 billion dollars a year for adults), preventive measures could have a significant public health impact. Family aggregate studies indicate that children of anxious parents are at an elevated risk for developing anxiety disorders and thus an important target population for prevention. Results from the PI's K23 pilot study found that a brief family-based intervention reduced the incidence of anxiety disorders in this population by 30-50%. The purpose of this R01 application is to evaluate the efficacy of this intervention for reducing anxiety symptoms and preventing the onset of anxiety disorders in the offspring of anxious parents. In addition, this study will examine theoretically-based mediators of intervention effects. The intervention will be evaluated using a 2 (intervention condition: prevention versus an information- monitoring control) x 4 (assessment period: pre-, post-intervention, 6-, and 12-month follow-up) experimental design. This study uses rigorous scientific methods including a randomized controlled design, multiple informants and measures to assess key constructs, independent evaluators (IEs) to assess outcome and mediator variables, and intensive training for therapists and IEs to assure a high quality of study implementation. This study will be the first aimed at preventing anxiety disorders in the offspring of anxious parents. This application responds to recommendations made by the National Advisory Mental Health Work Group on Mental Disorders Prevention Research (2001) and earlier recommendations from both the Institute of Medicine's Committee on Prevention of Mental Disorders and the NIMH's Prevention Steering Committee (Mrazek & Haggerty, 1994) to develop and evaluate preventive interventions for youth. Anxiety disorders in children and adolescents are common and debilitating illnesses. While cognitive-behavioral treatment is effective, prevention efforts would have a significant public health impact by reducing the need for treatment and altering the life trajectories of at risk children. Offspring of anxious adults are at a significant risk for developing these disorders and an important target for prevention efforts. The purpose of this R01 application is to evaluate whether a short-term psychosocial intervention, developed by the PI in a pilot study, can prevent the onset of anxiety disorders in the offspring of anxious parents.