A 12-Month Follow-Up of PROCARE+, a Transdiagnostic, Selective, Preventive Intervention for Adolescents At-Risk for Emotional Disorders.

Few studies have reported long-term follow-up data on selective preventive interventions for adolescents. No follow-up selective preventive transdiagnostic studies for adolescents at-risk for emotional disorders, such as anxiety and depression, have been reported. To fill this gap, this study aims to provide the first follow-up assessment of a randomized controlled trial (RCT) studying selective transdiagnostic prevention in at-risk adolescents. A 12-month follow-up assessment was conducted with subjects who originally received either PROCARE (Preventive transdiagnostic intervention for Adolescents at Risk for Emotional disorders), PROCARE+, which includes the PROCARE protocol along with personalized add-on modules or an active control condition (ACC) based on emotional psychoeducation, and their respective booster session for each experimental condition. 80 subjects (47.5% girls) aged between 12 and 18 years (M = 14.62; SD 1.43) who completed these treatment conditions were available for the 12-month follow-up. The results demonstrate the superior long-term efficacy of the PROCARE+ intervention in mitigating emotional symptoms and obsessive-compulsive symptomatology compared to the PROCARE and ACC conditions, with effect sizes notably exceeding those commonly observed in preventive programs. While the three treatments demonstrated beneficial impacts, the pronounced results associated with PROCARE+ at the 12-month follow-up emphasized the importance of personalized treatment modules and the sustained benefits of booster sessions in the realm of preventive psychological interventions. The findings also highlight the potential role of add-on modules in enhancing the effects of the PROCARE+ condition.

Randomized controlled trial for selective preventive transdiagnostic intervention for adolescents at risk for emotional disorders.

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, online-delivered, 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, 286 adolescents (53.3% girls) evidencing high risk and low protective factors were randomized and allocated to PROCARE, PROCARE + or ACC. 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 +. Interventions were excellent in terms of acceptability, with good satisfaction rates. Tailored selective transdiagnostic interventions focused on mitigating risk factors and promoting protective factors in vulnerable adolescents are promising.

Randomized controlled trial for selective preventive transdiagnostic intervention for adolescents at risk for emotional disorders.

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.

Can parent training for parents with high levels of expressed emotion have a positive effect on their child's social anxiety improvement?

The role that parents' involvement may play in improving their child's social anxiety is still under debate. This paper aimed to investigate whether training parents with high expressed emotion (EE) could improve outcomes for adolescent social anxiety intervention. Fifty-two socially anxious adolescents (aged 13-18 years), whose parents exhibited high levels of expressed emotion, were assigned to either (a) a school-based intervention with an added parent training component, or (b) a school-based program focused solely on intervening with the adolescent (no parental involvement). Post-treatment and 12-month follow-up findings showed that school-based intervention with parent training was superior to the adolescent-specific program, yielding significant reductions in diagnosis remission, social and depressive symptomatology, particularly when the EE status of parents changed. Overall, the findings suggest that high-EE parents of children with social anxiety need to be involved in their child's therapy.

Ansiedad social y abuso psicológico / Social anxiety and psychological abuse

El abuso psicológico es una de las problemáticas que se encuentran desafortunadamente en vigencia y cuyas consecuencias negativas son nefastas para el individuo en particular y la sociedad en general. Aunque existe una considerable cantidad de información e investigación sobre este tema, aún se desconocen factores de riesgo a nivel de psicopatología. Como se ha observado en los artículos que preceden a éste, existen algunos indicios acerca del papel que puede estar jugando algunos trastornos de ansiedad y, más concretamente, el trastorno de ansiedad social, en el origen, desarrollo y mantenimiento del abuso. Como resultado, en este trabajo revisaremos aquellos estudios que han mostrado la relación entre presencia de ansiedad social y abuso sexual, abuso en la pareja, abuso escolar (bullying) y acoso laboral (mobbing), siguiendo, asimismo, el orden de los trabajos presentados en este monográfico. En general, los datos señalan que existe un cuerpo de evidencia que señala una fuerte correlación positiva entre ansiedad social y vulnerabilidad frente al abuso psicológico, en concreto con el abuso escolar y el acoso laboral (AU)

Psychological abuse is receiving increased attention focusing on its severe effects for the individual and for society as a whole. Despite the considerable amount of research, there is a lack of information on the role that psychopathology may play in the etiology, development and maintenance of the abuse. As can be seen in other papers in this special issue, there is scattered information regarding the potential role of anxiety disorders, and particularly the social anxiety disorder. To fill this gap, this paper reviews the state-of-art including studies examining or including the relationship between social anxiety and topics such as sexual abuse, couple abuse, bullying and mobbing, also covered in this special issue. Overall, findings indicate a strong correlation between social anxiety and vulnerability to psychological abuse, particularly to bullying and mobbing

Trastorno de ansiedad social en la infancia y adolescencia: estado actual, avances recientes y líneas futuras / Social anxiety disorder in childhood and adolescents: current trends, advances, and future directions

La revisión de la literatura actual revela un crecimiento significativo del número de estudios de investigación en el campo del trastorno de ansiedad social (TAS) en población infanto-juvenil. Sin embargo, aún hay diversas lagunas y debates sobre distintos aspectos de este trastorno. Este artículo tiene como objetivo describir la situación actual y las líneas futuras de investigación, con el fin de ampliar el conocimiento y la comprensión del TAS en niños y adolescentes. Para ello, se revisará la psicopatología y las explicaciones sobre la génesis del trastorno, a la vez que se discutirán los instrumentos de evaluación y los protocolos de tratamiento cognitivo-conductual basados en la evidencia empírica. A modo de conclusión, se presentan los retos/desafíos en este campo (AU)

The reviews of recent literature in the field reveal a significant growth in the number of research studies on social anxiety disorder (SAD) in children and adolescents. However, there is a lack of information and on-going debates on different issues related to this disorder. This paper presents a look ahead toward critical steps to extend our knowledge and improve the understanding of this disorder. In particular, this paper reviews the nature of social anxiety symptoms as well as etiological explanations for the disorder. Additionally, the issue of evidence-based assessment and treatment of SAD is discussed, with a particular focus on cognitive-behavioral interventions. We conclude with a discussion of future directions for the field