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Can anxiety disorders be prevented in children?

When parents have an anxiety disorder, it places their children at a greatly increased risk of developing an anxiety disorder. Probably because anxious parents model anxious behaviors to their kids. That’s the bad news for all you worried parents out there – ironically giving you one more worry to add to your list.

But is passing your own anxiety on to your children inevitable?

Fortunately not, suggest the findings of a well-designed study of anxiety prevention published online last week in The American Journal of Psychiatry.

Researchers at the Johns Hopkins University School of Medicine recruited 136 families where at least one parent already had a diagnosed anxiety disorder, such as Generalized Anxiety (chronic worry), Social Phobia, Panic Disorder, or Obsessive Compulsive Disorder. Each family also had a child, between the ages of 6-13, who did not have an anxiety disorder. Not yet, anyway: The average age of onset for an anxiety disorder is 11, so the researchers were smart to choose that high-risk age range.

Half of the families were randomly assigned to receive the “active” treatment of the study: 8-11 sessions of family-based cognitive-behavioral therapy (CBT) during which parents and children met together with a therapist and learned strategies of successful anxiety management.

The other half were randomized to the control group, and assigned a 36-page educational pamphlet about anxiety disorders. Don’t laugh at how ludicrous this sounds. The researchers note that reading a pamphlet is essentially “treatment as usual” for kids with an anxious parent, as the vast majority of children who could benefit from treatment for anxiety never receive it.

Levels of anxiety in the kids were assessed before the study, after 8 weeks (when the active family CBT had finished), and then 6 and 12 months later.

Results were impressive – or dispiriting, depending on how you want to look at them. By the end of the year, 5 percent of children in the family-based CBT group had developed an anxiety disorder. But a whopping 31 percent of the children in the control (pamphlet) group had suffered that fate.

Results of this study deserve notice for the following reasons.

First, this was a replication study and there aren’t enough of those. You may have heard the news recently that many published psychology studies don’t yield the same results when other researchers attempt to redo them (suggesting that the initial results were probably a fluke).

However, the findings of this current anxiety prevention study almost exactly matched those of a nearly identical, smaller one from 2009 (in that case, 30 percent of the control group and 0 percent of the family-based CBT kids went on to develop anxiety disorders over the course of one year). Hence, these are results in which we can have a bit of faith.

Second, any research that highlights the role of prevention in psychology is noteworthy. Historically, the field of mental health has concerned itself only with treating mental illness. This has not been the case in traditional medicine, where much of what doctors do is all about prevention: Vaccinations prevent measles, medications prevent asthma attacks and allergy flare-ups, those yearly check-ups can prevent a host of developmental problems. Why can’t the same model of preventative care apply to mental health? Why should we wait until a child is already suffering a mental illness before we intervene?

Finally, the findings of the study should offer some hope to all you anxious parents. Anxiety disorders are not only treatable (yours), but they are preventable (your children’s). I recommend you apply the lessons of this scientific article to your own life. Get some CBT for your own anxiety. Read a good book on parenting an anxious child. Reach out to a child therapist for some family sessions to help you stop modeling anxious behaviors to your child. You don’t have to be part of the problem anymore. You can be the solution.


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