In what is believed to be the first U.S. study designed to prevent anxiety disorders in the
children of anxious parents, researchers at the Johns Hopkins Children's Center have found that a
family-based program reduced symptoms and the risk of developing an anxiety disorder among these
Despite its small size, the study suggests that as few as eight weekly family sessions of
cognitive behavioral therapy go a long way to prevent or minimize the psychological damage of
childhood anxiety. Results of the study appear in the June issue of the Journal of Consulting and
"If psychiatrists or family doctors diagnose anxiety in adult patients, it's now clearly a good
idea that they ask about the patients' children and, if appropriate, refer them for evaluation," said
senior investigator Golda Ginsburg, a child psychologist at Johns Hopkins Children's Center and an
associate professor of psychiatry at the Johns Hopkins School of Medicine. "Right now, most doctors
don't think about this, let alone broach the subject."
Ginsburg said data show that the children of parents diagnosed with an anxiety disorder are up
to seven times more likely to develop an anxiety disorder themselves, and up to 65 percent of children
living with an anxious parent meet criteria for an anxiety disorder.
Prevention, rather than treatment, of childhood anxiety is critical because anxiety disorders
affect one in five U.S. children but often go unrecognized, according to a recent editorial in The New
England Journal of Medicine. Delay in diagnosis and treatment can lead to depression, substance abuse
and poor academic performance throughout childhood and well into adulthood.
The Johns Hopkins team studied 40 children between the ages of 7 and 12 not diagnosed with
anxiety themselves but who had one or both parents diagnosed with an anxiety disorder. Half the
children and their families were enrolled in an eight-week cognitive behavioral therapy, while the
other half were put on a waiting list and received no therapy at the time of the study, but were
offered therapy a year later.
The program, consisting of hourlong weekly sessions, was designed to help parents identify and
change behaviors believed to contribute to anxiety in the children while at the same time teaching
children coping and problem-solving skills.
Within a year, 30 percent of the children in the no-intervention group had developed an anxiety
disorder, compared to none of the children who participated in the family-based therapy. Both
parents and researchers who evaluated the children and their parents independently reported a 40
percent drop in anxiety symptoms in the year following the prevention program. There was no
reduction of anxiety symptoms among children on the waiting list.
The parental behaviors modified with treatment included overprotection, excessive criticism
and excessive expression of fear and anxiety in front of the children. The program targeted such
childhood risk factors as avoiding anxiety-provoking situations and anxious thoughts.
The Johns Hopkins team is now conducting a larger study involving 100 families. Interested
parents can obtain more information by e-mailing CAPS@jhmi.edu.
The research was funded by the National Institute of Mental Health.