The present thesis aimed to bridge an identified gap in the literature by evaluating the effectiveness of a universal prevention program for children aged 4 to 7 years, the objective of which was to enhance our understanding of risk and protective factors associated with early onset anxiety and predictors of outcome. A more comprehensive understanding of the contribution of such factors to the continuity, versus the discontinuity of anxiety over time is critical, with effective early intervention and prevention reliant on a comprehensive etiological model.
The objective of Study One (chapter eight) was to evaluate the effectiveness of the Fun FRIENDS program, a developmentally appropriate cognitive-behavioural intervention designed to target risk factors for anxiety and promote social competence. This study represents the first ever train-the-trainer universal trial to examine the effectiveness of Fun FRIENDS facilitated by classroom teachers in the school context. Participants (N= 488) included children from prep and grade one attending any one of fourteen Catholic Education schools in Brisbane, Australia. Schools were randomly allocated to one of three groups: the Intervention Group (IG), Active Comparison Group (CG) or Wait-list Control Group (WLG). Parents and teachers of the participating children completed questionnaires at pre- and post-intervention and 12-month follow up. Promising results were achieved in terms of significant reductions in anxiety, behavioural inhibition (BI) and parenting stress for the IG. In addition, significant improvements in parent-child interactions and social and emotional competence were achieved, with improvements maintained at 12-month follow-up. Teacher reports revealed significant improvement in terms of social and emotional competence, initiative and self-control.
Study Two (chapter nine) sought to further analyse the same data set, investigating the prevalence of child anxiety, BI, social and emotional competence, parental anxiety and stress at three time points, with the objective of identifying predictors of outcome. The main findings of the study indicated that baseline anxiety and BI were predictive of intervention response and that lower levels of both factors were associated with better treatment outcome. Similarly parental stress and psychopathology were found to predict poorer outcomes for children, with social and emotional competence identified as a protective factor. Higher levels of baseline social and emotional competence were found to be predictive of lower levels of anxiety at follow up. Age and gender were not found to differentially affect outcome for the IG suggesting that the Fun FRIENDS program may be effective for even the youngest children in the sample, which is encouraging for universal prevention models.
The obtained results are promising and provide a unique contribution to this under-researched area of the literature, however further research is required to replicate the findings and enhance understanding of developmental models of anxiety. The objective of which is to further contribute to early intervention and prevention protocols by targeting risk and protective factors.