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Cited by 62Child and Adolescent Psychosocial and Emotional DevelopmentAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and Access

Review: Prevention of anxiety among at‐risk children and adolescents – a systematic review and meta‐analysis

Open access
Lawrence, Peter J., Rooke, Sally M., Creswell, Cathy·2017·Child and Adolescent Mental Health
DOI 10.1111/camh.12226
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Abstract

Background: Anxiety disorders are common, often start in childhood and run a chronic course. As such there is a need for effective prevention. Methods: We conducted a systematic review and meta‐analyses of randomized, controlled trials to prevent the onset of anxiety disorders in ‘at risk’ young people. Diagnostic and symptom outcomes were examined. Putative moderators were tested as was publication bias. Results: We included 16 trials (2545 young people). Two trials reported diagnostic outcomes, and significant effects were found for these at end‐of‐programme ( RR = .09, 95% CI = .02 to .16), 6‐ ( RR = .17, 95% CI = .06 to .27) and 12‐month ( RR = .31, 95% CI .17 to .45) follow‐ups. Based on 16 trials, improved anxiety symptoms were significant compared to nonattention controls only, with small effect sizes reported by young people at the end‐of‐programmes, 6‐ and 12‐month follow‐ups; and by parents at the end of the programmes and 12‐, but not 6‐, month follow‐ups. There was no evidence of significant moderation or publication bias. Conclusions: Fourteen studies included children and young people who presented with elevated anxiety symptoms, but anxiety disorder was not ruled out in the participants in these studies. Hence, these studies might be reporting results of mixed prevention/early intervention programmes. Prevention programmes that target developmental risk factors, not only disorder maintaining factors, appear most promising. The clinically meaningful impact of anxiety disorder prevention programmes remains unknown.

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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 Lawrence et al., 2017

    The Introduction (page unavailable) describes limited longer-term benefit from universal anxiety prevention and reports one indicated-prevention study with a significant effect on anxiety-disorder onset at 12 months. But it also says indicated programs showed no significant reduction in anxiety symptoms across 17 studies. The review concerns anxiety in at-risk young people and does not establish that indicated programs are generally more promising than universal programs for emotional problems. (LLM, conf=0.85)

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Research works printed but not linked: 2

  1. Lawrence, P.J., & Creswell, C. (2016). Psychological risk in off- spring of parents with anxiety disorders: A meta-analysis. In P.J. Lawrence (Chair), Transmission of risk from parent anxi- ety disorders: Refining our understanding to inform preven- tion. Symposium conducted at the meeting of the European Association for Behavioural and Cognitive Therapies, Stock- holm, Sweden.
  2. Rubin, K.H., Coplan, R.J., & Bowker, J.C. (2009). Social with- drawal in childhood. Annual Review of Psychology, 60, 141.

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Authors
Lawrence, P. J., Rooke, S. M., & Creswell, C.
Affiliations
  • University of Reading (GB)
  • University of Southampton (GB)
Corresponding author
Lawrence, Peter J.
ORCID
Venue
Child and Adolescent Mental Health
Publisher
Wiley
Published
2017-07-10
Volume
22
Issue
3
Pages
118-130
ISSN
  • 1475-357X (ISSN-L)
  • 1475-3588
DOI
10.1111/camh.12226
OpenAlex
W2735505931
Cited by
62
References
70
Citations by year
2026: 3 · 2025: 8 · 2024: 6 · 2023: 9 · 2022: 10 · 2021: 7 · 2020: 8 · 2019: 6 · 2018: 5
FWCI
0.79
Type
journal article
Language
en
Open access
Licence
Locations
  • Child and Adolescent Mental Health (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • ePrints Soton (University of Southampton) (acceptedVersion)
  • CentAUR (University of Reading) (submittedVersion)
Funders
National Institute for Health Research
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 › Social Psychology › Mental Health Treatment and Access
Keywords
childhood anxiety, early intervention, developmental risk factors, anxiety symptoms, prevention programmes, parent-reported outcomes, publication bias

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