title: Preventing mood and anxiety disorders in youth: a multi-centre RCT in the high risk offspring of depressed and anxious patients.
abstract: BACKGROUND
  Anxiety and mood disorders are highly prevalent and pose a huge burden on patients. Their offspring is at increased risk of developing these disorders as well, indicating a clear need for prevention of psychopathology in this group. Given high comorbidity and non-specificity of intergenerational transmission of disorders, prevention programs should target both anxiety and depression. Further, while the indication for preventive interventions is often elevated symptoms, offspring with other high risk profiles may also benefit from resilience-based prevention programs.
  
  
  METHODS
  The current STERK-study (Screening and Training: Enhancing Resilience in Kids) is a randomized controlled clinical trial combining selected and indicated prevention: it is targeted at both high risk individuals without symptoms and at those with subsyndromal symptoms. Individuals without symptoms meet two of three criteria of the High Risk Index (HRI; female gender, both parents affected, history of a parental suicide (attempt). This index was developed in an earlier study and corresponds with elevated risk in offspring of depressed patients. Children aged 8-17 years (n = 204) with subthreshold symptoms or meeting the criteria on the HRI are randomised to one of two treatment conditions, namely (a) 10 weekly individual child CBT sessions and 2 parent sessions or (b) minimal information. Assessments are held at pre-test, post-test and at 12 and 24 months follow-up. Primary outcome is the time to onset of a mood or anxiety disorder in the offspring. Secondary outcome measures include number of days with depression or anxiety, child and parent symptom levels, quality of life, and cost-effectiveness. Based on models of aetiology of mood and anxiety disorders as well as mechanisms of change during interventions, we selected potential mediators and moderators of treatment outcome, namely coping, parent-child interaction, self-associations, optimism/pessimism, temperament, and emotion processing.
  
  
  CONCLUSIONS
  The current intervention trial aims to significantly reduce the risk of intergenerational transmission of mood and anxiety disorders with a short and well targeted intervention that is directed at strengthening the resilience in potentially vulnerable children. We plan to evaluate the effectiveness and cost-effectiveness of such an intervention and to identify mechanisms of change.
  
  
  BACKGROUND
  NTR2888.
authors.affiliation: Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands. m.h.nauta@rug.nl
authors.forename: Maaike H
authors.initials: MH
authors.lastname: Nauta
authors.forename: Helma
authors.initials: H
authors.lastname: Festen
authors.forename: Catrien G
authors.initials: CG
authors.lastname: Reichart
authors.forename: Willem A
authors.initials: WA
authors.lastname: Nolen
authors.forename: A Dennis
authors.initials: AD
authors.lastname: Stant
authors.forename: Claudi Lh
authors.initials: CL
authors.lastname: Bockting
authors.forename: Nic Ja
authors.initials: NJ
authors.lastname: van der Wee
authors.forename: Aartjan
authors.initials: A
authors.lastname: Beekman
authors.forename: Theo Ah
authors.initials: TA
authors.lastname: Doreleijers
authors.forename: Catharina A
authors.initials: CA
authors.lastname: Hartman
authors.forename: Peter J
authors.initials: PJ
authors.lastname: de Jong
authors.forename: Sybolt O
authors.initials: SO
authors.lastname: de Vries
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001007:Anxiety / Q000517:prevention & control / Q000523:psychology; D001008:Anxiety Disorders / Q000517:prevention & control* / Q000523:psychology; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology*; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000517:prevention & control / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000517:prevention & control* / Q000523:psychology; D010287:Parent-Child Relations; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome