Depression and anxiety disorders are prevalent among teenage girls. How can this be addressed? An evaluation of an Australian early intervention programme has shown that educating parents when girls are of preschool age can have lasting effects on their likelihood of developing depression and anxiety in adolescence.
Teaching parents how to reduce the anxiety of their preschool children can help protect those children against anxiety and depression as teenagers, according to new research from Macquarie University, Australia.
Girls whose parents received the early intervention continued to demonstrate marked benefits during their middle adolescent years. Effects were less clear for boys, however, who displayed low levels of distress regardless of intervention.
The original early intervention was a short, six-session programme for parents of 146 preschoolers who demonstrated withdrawn or shy behaviours. The programme educated parents on techniques and strategies to use with their children to reduce anxiety, particularly at times of stress, such as starting school.
Previous follow-ups were promising: on average, children whose parents received the intervention were less likely to have anxiety disorders by age seven. But rates of anxiety and depression rise dramatically in early adolescence. Could the programme still show benefits in those fragile years?
Eleven years after the preschool programme, 15-year-old girls whose parents had received the intervention showed significantly fewer diagnoses of anxiety disorders and depression than girls whose parents had not received the intervention.
In the intervention group, 39% of the girls had an anxiety disorder, compared to 61% of the control group. None of the girls in the intervention group had a depressive disorder, compared to 16% of the control group. The difference between the groups was not significant for boys.
The findings are important, as there are few evaluations of early interventions for the prevention of anxiety and depression, and even fewer with more than a year of follow-up data. Given that depressed or anxious children are more likely to become depressed or anxious adults, understanding the long-term picture is crucial.
The evaluation suggests that the programme was able to prevent depression among girls in their teenage years, and, critically, that the effects are more profound than many programmes delivered later in a child’s development. Given the low cost of the brief programme, it shows that even quite small effects can have significant public health benefits.
Future research is necessary to unpick the reasons why the intervention did not show clear preventative effects for boys. It may be that different programmes are needed or that a larger sample is necessary because the effects on boys are smaller than the effects on girls.
Long-term follow-ups are rare partly because keeping contact with participants and encouraging them to participate in new rounds of a study can be a challenge. Of the original 146 families, 103 returned data for the current study (a 71% response).
The small sample size is a limitation of this study, particularly when the group is divided by gender. Another issue is the lack of data between age seven and 15. If disorders had been assessed for these years, and if children whose parents received the programme had less anxiety and depression during those years, the programme effects might have appeared to be stronger. Finally, participating parents were likely to be more motivated than a cross-section of the population, so the effects demonstrated in this study may only apply to highly motivated parents.
Rapee, R. M. (2013) The preventative effects of a brief, early intervention for preschool-aged children at risk for internalizing: follow-up into middle adolescence. Journal of Child Psychology and Psychiatry, doi: 10. 1111/jcpp. 12048Return to Features