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The Prevention of Child and Adolescent Anxiety: A Meta-analytic Review

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Abstract

The purpose of this study was to provide a comprehensive review of the effectiveness of child and adolescent anxiety prevention programs. Mean weighted effect sizes were calculated, and studies were encoded for potential moderator variables. A statistically significant effect size of .18 was obtained at post-intervention, which is consistent with effect sizes reported in reviews of depression, eating disorder, and substance abuse prevention programs. However, the effect sizes obtained at follow-up yielded mixed results. Significant moderators of program effectiveness were found including provider type (professional versus lay provider) and the use of the FRIENDS program. In contrast, program duration, participant age, gender, and program type (universal versus targeted) were not found to moderate program effectiveness. Clinical implications and directions for future research are discussed, including the need for more long-term follow-up, early prevention programs, and studies that systematically examine the impact of parent involvement on program effectiveness.

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Notes

  1. Studies using a single-group pretest-post design were excluded from overall effect size estimates. However, five pretest-post test effect sizes were available. Sufficient information to compute an estimate of the sampling variance was available for only two of these effect size estimates; therefore, a weighted mean effect size using the inverse of the sample variance was not computed. The five effects were weighted by sample size and produced a weighted mean effect size of .41. One study (Cooley et al. 2004) reported an unusually large effect size (d = 2.92). When this effect size was removed from the analysis, the effect size weighted by sample size produced a d of .33.

  2. One study (Siu 2007) demonstrated substantial departure (well over two standard deviations) from the other effects in terms of its overall magnitude (d = 1.65). The analyses were recomputed with this outlier removed. Removal of this unusually large effect and recalculation did not substantively affect the primary interpretation of the overall effect size, d = .18 (95% CI of 0.22 to .13), Z = 7.06, p < .001. The distribution of effect sizes continued to demonstrate heterogeneity, Q (25) = 89.86, p < .001. To prevent the effect size estimate from the Sui (2007) article from having undue influence on the moderator analyses, the value was removed from subsequent analyses.

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  1. University of North Florida, Jacksonville, FL, USA

    Brian J. Fisak Jr. & Dan Richard

  2. University of South Florida, Tampa, FL, USA

    Angela Mann

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Fisak, B.J., Richard, D. & Mann, A. The Prevention of Child and Adolescent Anxiety: A Meta-analytic Review. Prev Sci 12, 255–268 (2011). https://doi.org/10.1007/s11121-011-0210-0

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