The prevention of anxiety in children through school-based interventions: study protocol for a 24-month follow-up of the PACES project

Trials

Elena Skryabina²  Rhiannon Phillips⁵  Neil Simpson³  Harry Daniels⁴  Rob Anderson¹  Gordon Taylor²  Paul Stallard² 

[1] University of Exeter Medical School, The Veysey Building, Salmon Pool Lane, Exeter EX2 4SG, UK;Department for Health, University of Bath, 22-23 Eastwood, Bath BA2 7AY, UK;Sirona Care and Health, Headquarters building, Bath BA2 5RP, UK;Department of Education, University of Oxford, 15 Norham Gardens, Oxford OX2 6PY, UK;Wales School for Primary Care Research, Cardiff University School of Medicine, Heath Park, Cardiff CF14 4XN, UK

关键词: Children;    Schools;    Anxiety;    Prevention;   

Others  :  807307
DOI  :  10.1186/1745-6215-15-77

 received in 2013-11-06, accepted in 2014-02-11,  发布年份 2014

【 摘 要 】

Background

Anxiety in children is common and incapacitating and increases the risk of mental health disorders in adulthood. Although effective interventions are available, few children are identified and referred for specialist treatment. Alternative approaches in which prevention programmes are delivered in school appear promising. However, comparatively little is known about the best intervention leader (health care–led vs. school-led), long-term effects or the primary preventive value of such programmes.

Methods/Design

Preventing Anxiety in Children through Education in Schools, or PACES, is a pragmatic cluster randomised controlled trial evaluating the effectiveness of a cognitive-behavioural therapy prevention programme (FRIENDS) on symptoms of anxiety and low mood in 9- to 10-year-old children. Forty-one schools were randomly assigned to one of three conditions: school-led FRIENDS, health care–led FRIENDS or treatment as usual. Assessments were undertaken at baseline, 6 months and 12 months, with the primary outcome measure being the Revised Child Anxiety and Depression Scale score at 12 months. Secondary outcome measures are changes in self-esteem, worries, bullying and life satisfaction.

Discussion

This protocol summarises the procedure for the 24-month follow-up of this cohort. The study will determine the medium-term effectiveness of an anxiety prevention programme delivered in schools.

Trial registration

ISRCTN23563048

【 授权许可】

   
2014 Stallard et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Costello EJ, Mustillo S, ErkanIi A, Keeler G, Angold A: Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 2003, 60:837-844.
• [2]Ford T, Goodman R, Meltzer H: The British Child and Adolescent Mental Health Survey 1999: the prevalence of DSM-IV disorders. J Am Acad Child Adolesc Psychiatry 2003, 42:1203-1211.
• [3]Garber J, Weersing VR: Comorbidity of anxiety and depression in youth: implications for treatment and prevention. Clin Psychol (New York) 2010, 17:293-306.
• [4]Essau CA, Conradt J, Petermann F: Frequency, comorbidity, and psychological impairment of anxiety disorders in German adolescents. J Anxiety Disord 2000, 14:263-279.
• [5]Kim-Cohen J, Caspi A, Moffitt TE, Harrington H, Milne BJ, Poulton R: Prior juvenile diagnoses in adults with mental disorder: developmental follow-back of a prospective-longitudinal cohort. Arch Gen Psychiatry 2003, 60:709-717.
• [6]Woodward LJ, Fergusson DM: Life course outcomes of young people with anxiety disorders in adolescence. J Am Acad Child Adolesc Psychiatry 2001, 40:1086-1093.
• [7]Kieling C, Baker-Henningham H, Belfer M, Conti G, Ertem I, Omigbodun O, Rohde LA, Srinath S, Ulkuer N, Rahman A: Child and adolescent mental health worldwide: evidence for action. Lancet 2011, 378:1515-1525.
• [8]Collins PY, Patel V, Joestl SS, March D, Insel TR, Daar AS, Bordin IA, Costello EJ, Durkin M, Fairburn C, Glass RI, Hall W, Huang Y, Hyman SE, Jamison K, Kaava S, Kapur S, Kleinman A, Ogunniyi A, Otero-Ojeda A, Poo MM, Ravindranath V, Sahakian BJ, Saxena S, Singer PA, Stein DJ, Anderson W, Dhansay MA, Ewart W, Phillips A, et al.: for the Scientific Advisory Board and the Executive Committee of the Grand Challenges on Global Mental Health: Grand challenges in global mental health. Nature 2011, 475:27-30.
• [9]Snell T, Knapp M, Healey A, Guglani S, Evans-Lacko S, Fernandez JL, Meltzer H, Ford T: Economic impact of childhood psychiatric disorder on public sector services in Britain: estimates from national survey data. J Child Psychol Psychiatry 2013, 54:977-985.
• [10]Ford T, Hamilton H, Meltzer H, Goodman R: Predictors of service use for mental health problems among British schoolchildren. Child Adolesc Ment Health 2008, 13:32-40.
• [11]Merikangas KR, He JP, Brody D, Fisher PW, Bourdon K, Koretz DS: Prevalence and treatment of mental disorders among US children in the, NHANES. Pediatrics 2001–2004, 2010(125):75-81.
• [12]Neil AL, Christensen H: Efficacy and effectiveness of school-based prevention and early intervention programs for anxiety. Clin Psychol Rev 2009, 29:208-215.
• [13]Fisak BJ Jr, Richard D, Mann A: The prevention of child and adolescent anxiety: a meta-analytic review. Prev Sci 2011, 12:255-268.
• [14]Merry SN, Hetrick SE, Cox GR, Brudevold-Iversen T, Bir JJ, McDowell H: Psychological and educational interventions for preventing depression in children and adolescents. Cochrane Database Syst Rev 2011., 12CD003380
• [15]Calear AL, Christensen H: Systematic review of school-based prevention and early intervention programs for depression. J Adolesc 2010, 33:429-438.
• [16]Sawyer MG, Pfeiffer S, Spence SH, Bond L, Graetz B, Kay D, Patton G, Sheffield J: School-based prevention of depression: a randomised controlled study of the beyondblue schools research initiative. J Child Psychol Psychiatry 2010, 51:199-209.
• [17]Araya R, Fritsch R, Spears M, Rojas G, Martinez V, Barroilhet S, Vöhringer P, Gunnell D, Stallard P, Guajardo V, Gaete J, Noble S, Montgomery AA: School intervention to improve mental health of students in Santiago, Chile: a randomized clinical trial. JAMA Pediatr 2013, 167:1004-1010.
• [18]Stallard P, Sayal K, Phillips R, Taylor JA, Spears M, Anderson R, Araya R, Lewis G, Millings A, Montgomery AA: Classroom based cognitive behavioural therapy in reducing symptoms of depression in high risk adolescents: pragmatic cluster randomised controlled trial. BMJ 2012, 345:e6058.
• [19]Miller LD, Laye-Gindhu A, Liu Y, March JS, Thordarson DS, Garland EJ: Evaluation of a preventive intervention for child anxiety in two randomized attention-control school trials. Behav Res Ther 2011, 49:315-323.
• [20]Miller LD, Laye-Gindhu A, Bennett JL, Liu Y, Gold S, March JS, Olson BF, Waechtler VE: An effectiveness study of a culturally enriched school-based CBT anxiety prevention program. J Clin Child Adolesc Psychol 2011, 40:618-629.
• [21]Mrazek PJ: Haggerty RJ (Eds.): Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research. Washington DC: National Academies Press; 1994.
• [22]Horowitz JL, Garber J: The prevention of depressive symptoms in children and adolescents: a meta-analytic review. J Consult Clin Psychol 2006, 74:401-415.
• [23]Giesen F, Searle A, Sawyer M: Identifying and implementing prevention programmes for childhood mental health problems. J Paediatr Child Health 2007, 43:785-789.
• [24]Stallard P: School-based interventions for depression and anxiety in children and adolescents. Evid Based Ment Health 2013, 16:60-61.
• [25]World Health Organization (WHO): Prevention of Mental Disorders. Geneva: WHO: Effective Interventions and Policy Options; 2004. Available at http://www.who.int/mental_health/evidence/en/prevention_of_mental_disorders_sr.pdf webcite (accessed 21 February 2014)
• [26]Stallard P, Taylor G, Anderson R, Daniels H, Simpson N, Phillips R, Skryabina E: School-based intervention to reduce anxiety in children: study protocol for a randomized controlled trial (PACES). Trials 2012, 13:227. BioMed Central Full Text
• [27]Department for Education and Skills: Excellence and Enjoyment: Social and Emotional Aspects of Learning (Publication DfES 1378–2005 G). London: DFES Publications; 2005. May 2005. Available at http://webarchive.nationalarchives.gov.uk/20130401151715/https://www.education.gov.uk/publications/eOrderingDownload/SEAL%20Guidance%202005.pdf webcite (accessed 21 February 2014)
• [28]Edwards P, Roberts I, Clarke M, DiGuiseppi C, Pratap S, Wentz R, Kwan I: Increasing response rates to postal questionnaires: systematic review. BMJ 2002, 324:1183.
• [29]Chorpita BF, Moffitt CE, Gray J: Psychometric properties of the Revised Child Anxiety and Depression Scale in a clinical sample. Behav Res Ther 2005, 43:309-322.
• [30]Sandin B, Chorot P, Valiente RM, Chorpita BF: Development of a 30-item version of the Revised Child Anxiety and Depression Scale. J Psychopathol Clin Psychol 2010, 15:165-178. Available at http://e-spacio.uned.es/fez/eserv.php?pid=bibliuned:Psicopat-2010-15-3-2020&dsID=Documento.pdf webcite (21 February 2014)
• [31]Muris P, Meesters C, Schouten E: A brief questionnaire of DSM-IV-defined anxiety and depression symptoms among children. Clin Psychol Psychother 2002, 9:430-442.
• [32]Rosenberg M: Society and the Adolescent Self-image. Princeton, NJ: Princeton University Press; 1965.
• [33]Chorpita BF, Tracey SA, Brown TA, Collica TJ, Barlow DH: Assessment of worry in children and adolescents: an adaptation of the Penn State Worry Questionnaire. Behav Res Ther 1997, 35:569-581.
• [34]Muris P, Meesters C, Gobel M: Reliability, validity, and normative data of the Penn State Worry Questionnaire in 8–12-yr-old children. J Behav Ther Exp Psychiatry 2001, 32:63-72.
• [35]Rees G, Goswami H, Bradshaw J: Developing an Index of Children’s Subjective Well-being in England. London: The Children’s Society; 2010. Available at https://www.childrenssociety.org.uk/sites/default/files/tcs/research_docs/Developing%20an%20Index%20of%20Children's%20Subjective%20Well-being%20in%20England_0.pdf webcite (21 February 2014)
• [36]Rice F, Frederickson N, Seymour J: Assessing pupil concerns about transition to secondary school. Br J Educ Psychol 2010, 81:244-263.
• [37]Goodman R: The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry 1997, 38:581-586.
• [38]Goodman R, Scott S: Comparing the Strengths and Difficulties Questionnaire and the Child Behavior Checklist: Is small beautiful? J Abnorm Child Psychol 1999, 27:17-24.
• [39]Ebesutani C, Chorpita BF, Higa-McMillan CK, Nakamura BJ, Regan J, Lynch RE: A psychometric analysis of the Revised Child Anxiety and Depression Scales–Parent Version in a school sample. J Abnorm Child Psychol 2011, 39:173-185.
• [40]Stevens K: Assessing the performance of a new generic measure of health-related quality of life for children and refining it for use in health state valuation. Appl Health Econ Health Policy 2011, 9:157-169.
• [41]Beecham J, Knapp M: Costing psychiatric interventions. In In Measuring Mental Health Needs. 2nd edition. London: Gaskell: Thornicroft G; 2001:200-224.
• [42]Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ, Elbourne D, Egger M, Altman DG: Consolidated Standards of Reporting Trials Group: CONSORT 2010 Explanation and Elaboration: updated guidelines for reporting parallel group randomised trials. J Clin Epidemiol 2010, 63:e1–e37. A published erratum appears in, J Clin Epidemiol 2012, 65:351.