Randomized controlled trial for selective preventive transdiagnostic intervention for adolescents at risk for emotional disorders
Open accessAbstract
Significant evidence does exist on the effectiveness of transdiagnostic interventions to improve emotional problems in clinical populations, and their application as universal and indicated prevention programs. However, no randomized controlled trials (RCT) studying selective transdiagnostic prevention intervention have been published. This is the first known RCT to evaluate the efficacy/effectiveness of an evidence-based selective prevention transdiagnostic program for emotional problems in adolescents. The impact of three different interventions was evaluated: (1) PROCARE (Preventive transdiagnostic intervention for Adolescents at Risk for Emotional disorders), which is a group-based, abbreviated version of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A), along with adding a booster session to reduce risk of onset of anxiety and depression, (2) PROCARE + , which includes the PROCARE protocol along with personalized add-on modules tailored to match adolescents’ risk factors, and (3) an active control condition (ACC) based on emotional psychoeducation. In total, 208 adolescents (48.5% girls) evidencing high risk and low protective factors were randomized and allocated to PROCARE, PROCARE + or ACC. Data from 153 adolescents who completed all assessments in the different phases of the study were analyzed. Self- and parent-reported measures were taken at baseline, as well as after the intervention, a 6 month follow-up was carried out, together with a 1 month follow-up after the booster session. Differences between conditions were significant on most of the outcome measures, with superior effect sizes for PROCARE + in the short and long term. Interventions were acceptable in terms of acceptability, with good satisfaction rates. Tailored targeted selective transdiagnostic interventions focused on mitigating risk factors and promoting protective factors in vulnerable adolescents are promising.
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UP-A has been tested for universal prevention in an open trial compared to wait-list, for selective prevention in an RCT compared to active control at 6-month and 12-month follow-up, and for indicated preventive purposes in an initial cluster randomized wait-list-controlled trial.
“It has been tested for universal prevention in an open trial and compared to a wait-list control group (García-Escalera et al., 2019, 2020), for selective prevention in a RCT compared to an active control group at 6-month (Vivas-Fernandez et al., 2023) and 12-month follow-up (Vivas-Fernandez et al., in press), as well as for indicated preventive purposes in an initial cluster randomized wait-list-”
From Effectiveness of a transdiagnostic indicated preventive intervention for adolescents at high risk for anxiety and depressive disorders (2024) · cites this paper as Vivas-Fernandez et al., 2023
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Garcia-Lopez, L.-J., Jimenez-Vazquez, D., Muela-Martinez, J.-A., Piqueras, J. A., Espinosa-Fernandez, L., Canals-Sans, J., Vivas-Fernandez, M., Morales-Hidalgo, P., Diaz-Castela, M.-M., Rivera, M., et al. (2024) · Current Psychology · doi:10.1007/s12144-023-05421-3 · Cited by 34 · see citing works
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Jimenez-Vazquez, D., López, L. J. G., Piqueras, J. A., Muela-Martínez, J. A., Fernández, L. E., Vivas-Fernández, M., & Díaz-Castela, M. D. M. (2024) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2024.2384088 · Cited by 5 · see citing works
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- Authors
- Vivas-Fernandez, M., Garcia-Lopez, L.-J., Piqueras, J. A., Muela-Martinez, J.-A., Canals-Sans, J., Espinosa-Fernandez, L., Jimenez-Vazquez, D., Diaz-Castela, M. D. M., Morales-Hidalgo, P., Rivera, M., & Ehrenreich-May, J.
- Affiliations
- Universitat de Miguel Hernández d'Elx (ES)
- Venue
- Child and Adolescent Psychiatry and Mental Health
- Published
- 2023-06-23
- Volume
- 17
- Issue
- 1
- Pages
- 77-77
- ISSN
- 1753-2000 (ISSN-L)
- PMC
- PMC10290361
- OpenAlex
- W4381839154
- Cited by
- 20
- References
- 103
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 8 · 2023: 3
- FWCI
- 5.83
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Child and Adolescent Psychiatry and Mental Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RUJA (Universidad de Jaén) (publishedVersion, public-domain)
- RUJA. Institutional Repository of Scientific Production of the University of Jaén (University of Jaén) (acceptedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Agencia Estatal de Investigación (Project PID2019-111138RB-I00/AEI/10.13039/501100011033)
- Research Network on Chronicity, Primary Care and Prevention and Health Promotion
- 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 › Personality Disorders and Psychopathology
- Keywords
- transdiagnostic treatment, selective prevention, booster sessions, anxiety, depression, risk factors, protective factors, treatment acceptability, group intervention
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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