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Figure 1

Flow of participants through study
Flow of participants through study

Figure 2

Theoretical model of the intergenerational transmission of anxiety
Theoretical model of the intergenerational transmission of anxiety

Parent and child characteristics

Group-SAPP (n=13) Internet-SAPP (n=14) Wait-list (n=13) p-valuec
Parent characteristics
               Female (n) 100% (13) 93% (13) 85% (11) .52
               Mean age (SD) 41.4 (4.7) 41.1 (4.5) 41.4 (3.9) .98
               > 2-year post-secondary education
                69% (9) 93% (13) 92% (12) .28
               Contact psychiatry
            No current or previous (n) 38% (5) 50% (7) 31% (4) .68
            Current (n) 8% (1) 0% (0) 15% (2)
            Previous (n) 54% (7) 50% (7) 54% (7)
               Psychiatric status
            Anxious (STAI-S>42)a 46% (6) 43% (6) 77% (10) .18
            Worried (PSWQ>48)b 92% (12) 71% (7) 92% (12) .46
Child characteristics
               Girl (n) 62% (8) 71% (10) 31% (4) .09
               Mean age (SD) 9.0 (2.0) 9.4 (2.4) 9.6 (2.2) .73
               Living situation
            Both guardians (n) 100% (13) 57% (8) 85% (11) .04
            Lone guardian (n) 0% (0) 14% (2) 0% (0)
            Alternating (n) 0% (0) 29% (4) 15% (2)
               Any mental health contact
            No current or previous (n) 92% (12) 93% (13) 85% (11) .68
            Current (n) 8% (1) 0% (0) 0% (0)
            Previous (n) 0% (0) 7% (1) 15% (2)

Continuous outcomes of children’s and parents’ health and behaviors (means, standard deviations, and within group effect sizes)

Group-SAPP Internet-SAPP Waitlist
Pre Post 12- month Effect size Pre-FU Pre Post 12- month Effect size Pre-FU Pre Post 12- month Effect size Pre-FU
Measure M (SD) M (SD) M (SD) d M (SD) M (SD) M (SD) d M (SD) M (SD) M (SD) d
OP 38.5 (10.2) 35.3 (10.1) 29.4 (11.6) 0.98 32.0 (8.1) 25.9 (7.1) 24.6 (8.4) 0.79 32.4 (9.7) 27.8 (9.6) 26.8 (9.6) 0.60
STAI-S 45.3 (10.4) 37.6 (9.5) 39.6 (9.3) 0.54 41.1 (10.4) 35.7 (7.6) 36.9 (11.8) 0.39 49.5 (11.1) 43.8 (10.2) 41.2 (9.3) 0.78
PSWQ 61.3 (8.9) 56.3 (9.7) 57.2 (10.4) 0.46 53.4 (11.6) 49.5 (10.5) 45.1 (10.5) 0.85 58.7 (8.9) 57.3 (10.0) 57.2 (9.0) 0.15
BBQ 40.7 (21.8) 45.5 (26.2) 52.8 (18.7) 0.65 45.7 (13.9) 48.2 (13.3) 55.9 (13.9) 0.55 45.8 (20.1) 50.1 (17.0) 45.0 (18.7) -0.04

Brief summary of session content of the SAPP

Session/module Content
1. Introduction In groups, participants were presented to each other and the course leader introduced the guidelines of the parent training intervention. In the Internet version, the platform was introduced, including describing how the participant receive feedback on home assignments and how they may communicate with the psychologist using text massages within the platform. The first session/module was then dedicated to parenting and psychoeducation of anxiety, including the physical, emotional and cognitive aspects of anxiety, and the cognitive behavioral formulation on how avoidance may increase anxiety and create problems in the long perspective.
2. Behavior analysis Focus on behavior analysis. Parents learned how to understand and evaluate behavior within a CBT-perspective by analyzing a situation, the activated behavior, and its consequences. Much time was spent on the parents working with their own examples.
3. Training stairs The so called “training stairs” are introduced. Parents learned how to divide challenging situations or problems into small steps to increase the probability of overcoming the problem through structured training. Parents were also encouraged to create training stairs relevant to their own situation.
4. Anxious parenting Devoted to parental behavior specifically relevant to anxious parents. Especially, overprotective behavior (such as limiting child autonomy, and exaggeratedly protecting the child of criticism and negative feelings) and behavior which assist the child’s avoidance were examined. Parents were encouraged to work with behavior analyses to identify and understand overprotective behavior in their own life.
5. Training stairs The training stairs were revisited. This time, parents were encouraged to think about how to use this strategy to help their child in challenging situations, or as a mean for the child to learn something new.
6. Problem solving A structured problem-solving method were introduced. Parents were then encouraged to think of one area where they could implement the strategy in their family, and together with their child explore structured problem solving.
7. Positive parenting Two parenting strategies were presented. The first involved the parent spending time alone with their child with the instruction to let the child choose activity and to only follow the child with interest without giving any instruction. The second strategy encouraged the parent to train the ability to prepare, instruct and reward the child in situations of shifting/stopping activities.
8. Plan ahead The parents planned how to use the strategies learned in the next three months.
eISSN:
2245-8875
Sprache:
Englisch
Zeitrahmen der Veröffentlichung:
Volume Open
Fachgebiete der Zeitschrift:
Medizin, Vorklinische Medizin, Grundlagenmedizin, andere