Internalisierende Störungen bei Kindern und Jugendlichen: Studien zur Wirksamkeit von kognitiv-verhaltenstherapeutischer Gruppenprävention, Strategien zur Rekrutierung und Diagnostik

Anxious and depressive symptoms are highly common forms of child and adolescent psychopathology. Left untreated they often worsen over time and develop into full blown psychiatric disorders (Wittchen, Stein & Kessler, 1999). Anxiety and depression, known as internalizing disorders, often lead to considerable psychosocial impairment. Thus, international health organisations call for rigorous research on planning, conducting and implementing preventive interventions tapping anxiety and depression in children and adolescents (WHO, 2004). This cumulus consists of three studies on internalizung disorders. The first study reports the conduction and evaluation of a preventive group program for children aged 8-12 with moderate internalizing symptoms. Applying an indicated prevention approach, a cognitive-behavioral group program was carried out using a waitlist design (n=81). Parent- (CBCL) and self-report measures (SCAS) displayed medium intervention effect sizes emphasizing the efficacy of the approach. The second paper describes two different strategies for recruiting children into the program. The first approach contained intensive local media advertisement, the second used an epidemiological school survey to recruit children into the program. The two strategies yielded different results. While using local media proved to be an effective way to engage families into the program, participant recruitment via the schools was rather poor. The discrepancy and possible influencing factors are discussed and the urgent need for systematic research on recruitment strategies is stressed. The third study addresses the usefulness of a parent rating scale as a screening instrument for anxiety disorders in two large child and adolescent psychiatric populations. The Child Behavior Checklist (CBCL) is often used to screen at first contact in standard child and adolescent psychiatric settings adding valuable information to the diagnostic process. However, its correspondence to clinical, in particular anxiety, diagnoses has not always been clear. Using parent reports from 2,763 outpatients and 888 inpatients referred for psychiatric services, CBCL anxiety scales were examined regarding their predictive validity and potential use as screening devices for anxiety disorders. Adding valuable information to the diagnostic process, the CBCL’s associations with clinical anxiety diagnoses seem only moderate suggesting the additional use of other anxiety-specific instruments in clinical routine.