Preventing problematic anxiety for youth

Background: Anxiety disorders are the most experienced child and youth mental health concern. At any given time, about 5.2% of children aged four to 18 likely meeting criteria for an anxiety disorder. Considering these disorders create substantial burdens for young people, including increased risk for poorer educational and employment outcomes, preventing anxiety disorders needs to be a priority. Methods: We used systematic review methods to identify randomized controlled trials (RCTs) evaluating programs aimed at preventing anxiety disorders in youth 12 years or older. After applying our rigorous inclusion criteria, we accepted four RCTs evaluating one universal program (assessed in two RCTs) and three programs for youth at greater risk for developing anxiety disorders. Results: One program produced benefits. Youth who received Cognitive-Behavioural Therapy (CBT) reported significantly less anxiety symptoms at six-month and one-year follow-up compared to youth in the control group. Neither of the RCTs assessing the universally delivered Partners in Parenting intervention showed any significant benefits compared to the control groups. As well, the Mindset and Cognitive Bias Modification programs also failed to show any significant benefits relative to the comparison groups. Conclusions: While efforts to prevent anxiety disorders should start in childhood, they are also needed for adolescents. Across both periods of development, CBT should be the starting point for anxiety prevention efforts.