Randomized controlled trial for selective preventive transdiagnostic intervention for adolescents at risk for emotional disorders

Abstract

Signifcant evidence does exist on the efectiveness of transdiagnostic interventions to improve emotional problems in clinical populations, and their application as universal and indicated prevention programs. However, no rand‑ omized controlled trials (RCT) studying selective transdiagnostic prevention intervention have been published. This is the frst known RCT to evaluate the efcacy/efectiveness of an evidence-based selective prevention transdiagnostic program for emotional problems in adolescents. The impact of three diferent interventions was evaluated: (1) PRO‑ CARE (Preventive transdiagnostic intervention for Adolescents at Risk for Emotional disorders), which is a group-based, abbreviated version of the Unifed Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A), along with adding a booster session to reduce risk of onset of anxiety and depression, (2) PROCARE+, which includes the PROCARE protocol along with personalized add-on modules tailored to match adolescents’ risk factors, and (3) an active control condition (ACC) based on emotional psychoeducation. In total, 208 adolescents (48.5% girls) evidencing high risk and low protective factors were randomized and allocated to PROCARE, PROCARE+or ACC. Data from 153 adolescents who completed all assessments in the diferent phases of the study were analyzed. Self- and parent-reported measures were taken at baseline, as well as after the intervention, a 6 month follow-up was carried out, together with a 1 month follow-up after the booster session. Diferences between conditions were signifcant on most of the outcome measures, with superior efect sizes for PROCARE+in the short and long term. Interventions were acceptable in terms of acceptability, with good satisfaction rates. Tailored targeted selective transdiagnostic interventions focused on mitigating risk factors and promoting protective factors in vulnerable adolescents are promising.