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Cited by 66Child and Adolescent Psychosocial and Emotional DevelopmentAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild Therapy and Development

Indicated prevention interventions for anxiety in children and adolescents: a review and meta-analysis of school-based programs

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Hugh-Jones, Siobhan, Beckett, Sophie, Tumelty, Ella, Mallikarjun, Pavan·2021·European Child & Adolescent Psychiatry
DOI 10.1007/s00787-020-01564-xPMC PMC8140963
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Abstract

Anxiety disorders are among the most common youth mental health disorders. Early intervention can reduce elevated anxiety symptoms. School-based interventions exist but it is unclear how effective targeted approaches are for reducing symptoms of anxiety. This review and meta-analysis aimed to determine the effectiveness of school-based indicated interventions for symptomatic children and adolescents. The study was registered with PROSPERO [CRD42018087628]. We searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Library for randomised-controlled trials comparing indicated programs for child and adolescent (5–18 years) anxiety to active or inactive control groups. Data were extracted from papers up to December 2019. The primary outcome was efficacy (mean change in anxiety symptom scores). Sub-group and sensitivity analyses explored intervention intensity and control type. We identified 20 studies with 2076 participants. Eighteen studies were suitable for meta-analysis. A small positive effect was found for indicated programs compared to controls on self-reported anxiety symptoms at post-test ( g = − 0.28, CI = − 0.50, − 0.05, k = 18). This benefit was maintained at 6 ( g = − 0.35, CI = − 0.58, − 0.13, k = 9) and 12 months ( g = − 0.24, CI = − 0.48, 0.00, k = 4). Based on two studies, > 12 month effects were very small ( g = − 0.01, CI = − 0.38, 0.36). No differences were found based on intervention intensity or control type. Risk of bias and variability between studies was high ( I 2 = 78%). Findings show that school-based indicated programs for child and adolescent anxiety can produce small beneficial effects, enduring for up to 12 months. Future studies should include long-term diagnostic assessments.

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  • Meta-analytic and review data show that indicated prevention programs for emotional problems are more promising than universal prevention.

    “Meta-analytic and review data of indicated prevention programs for emotional problems have shown them to be more promising than universal prevention, i.e., interventions targeting the general population (Bennett et al., 2015;Hugh-Jones et al., 2021;Lawrence et al., 2017;Teubert & Pinquart, 2011).”

    From Effectiveness of a transdiagnostic indicated preventive intervention for adolescents at high risk for anxiety and depressive disorders (2024) · cites this paper as Hugh-Jones et al., 2021

    The Discussion says indicated programs may be more effective than universal programs over time, and the Conclusions report favourable effects for school-based anxiety prevention in children and adolescents. The claim extends that finding to emotional problems generally and omits the paper’s caution that its post-test effect was slightly smaller than those reported for universal programs. (LLM, conf=0.88)

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  • Our data reveal that indicated, brief transdiagnostic programs may produce significant effects, which persist at follow-up and after a booster session.

    “Although meta-analytic reviews have found that differences in indicated interventions are more evident at post-test and smaller at follow-ups (e.g., Hugh-Jones et al., 2021;Teubert & Pinquart, 2011), our data reveal that indicated, brief transdiagnostic programs may produce significant effects, which persist at follow-up and after a booster session.”

    From Effectiveness of a transdiagnostic indicated preventive intervention for adolescents at high risk for anxiety and depressive disorders (2024) · cites this paper as Hugh-Jones et al., 2021

    The citation supports the citing sentence’s background comparison, not the authors’ subsequent claim about their own brief transdiagnostic program or booster session. The Introduction reports that a review found a larger targeted-versus-universal difference at post-test than at follow-up, but those targeted programs combined indicated and selective interventions. The paper’s own Results also show a larger anxiety-symptom effect at 0–6 months than at post-test, so effects were not uniformly smaller at follow-up. (LLM, conf=0.83)

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Authors
Hugh-Jones, S., Beckett, S., Tumelty, E., & Mallikarjun, P.
Affiliations
University of Birmingham (GB)
ORCID
Venue
European Child & Adolescent Psychiatry
Publisher
Springer Science and Business Media LLC
Published
2020-06-13
Volume
30
Issue
6
Pages
849-860
ISSN
  • 1018-8827 (ISSN-L)
  • 1435-165X
DOI
10.1007/s00787-020-01564-x
PMC
PMC8140963
OpenAlex
W3035280077
Cited by
66
References
64
Citations by year
2026: 15 · 2025: 16 · 2024: 11 · 2023: 17 · 2022: 5 · 2021: 1 · 2020: 1
FWCI
0.47
Type
journal article
Language
en
Open access
Licence
Locations
  • European Child & Adolescent Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by-nc)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion, other-oa)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Child Therapy and Development
Keywords
anxiety disorders, children, adolescents, school-based intervention, indicated prevention, early intervention, anxiety symptoms, intervention effectiveness, long-term outcomes, youth mental health
MeSH terms
Adolescent, Anxiety Disorders, Child, Female, Humans, Male, Psychotherapy

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