Preventing childhood anxiety and depression : testing the effectiveness of a school-based program in México
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A growing number of school-aged children experience or are at risk for myriad psychological and behavioral problems such as anxiety and depression that interfere with their interpersonal relationships, school performance, and potential to become productive citizens--hence, the critical nature of early prevention and intervention in schools. The purpose of this study was to assess the effectiveness of AMISTAD, a social and emotional program focusing on the prevention of anxiety and depression of four groups of students. Eight schools from a northern city in México were randomly selected and assigned to either an intervention or monitoring condition. Sixteen teachers implemented the intervention, and 16 served as control. Participants were 1,030 fourth- and fifth-grade students (ages 9-11), including 131 children with learning disabilities (LD). Children in the intervention group received the program and learned about relaxation techniques, coping with difficulties, positive thinking, and interpersonal skills, among others. For analysis, the sample was divided into four nonoverlapping groups: children diagnosis-free for anxiety and non-LD, children at risk for anxiety and non-LD, children at risk for anxiety with LD, and children diagnosis-free for anxiety with LD. The impact of the program was evaluated immediately after the intervention and after 6 months. Results showed statistically significant improvements of small impact for the overall sample and for children diagnosis-free for anxiety and non-LD, in that those receiving the program decreased the severity of their depressive symptoms, the number of children at risk for depression decreased, and these children increased their proactive coping skills. For children already showing risk for anxiety and/or LD, the program in the current format did not produce meaningful changes. Therefore, adaptations regarding culture, mode of delivery, and content should be incorporated in order to better meet these children’s needs. Finally, this study confirms the importance of prevention, as in the current study, almost 1 out of 5 children reported clinical depression, and it appears that without intervention, these symptoms will escalate over time.