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Anxiety disorders are among the most prevalent psychopathologies in children and adolescents around the world. They affect their personal, family, school and social functioning. Although symptoms of generalized anxiety disorder (GAD) are among the most commonly observed symptoms in adolescence, relatively little is known about the most important risk factors. Objectives The purpose of the present study was therefore 1) to document the prevalence of the central feature of GAD, excessive worrying, in high school students aged 12 to 17 years, by identifying the percentage of students reporting low, medium, and high levels of symptoms, 2) to identify key sociodemographic characteristics associated with high symptom level, and 3) to identify individual and family risk factors associated with high symptom level and estimate their relative contribution. Method A total of 8689 Quebec high school students (55.9% girls) participated in the study. The average age of these students was 14.34 years (SD=1.52). A k-means cluster analysis was first performed to create three categories based on the symptoms of generalized anxiety presented by the participants (low, medium, high). Multinomial logistic regression analyzes were then performed to identify the variables that best predict membership in these different categories. Results The results showed that 35.1% of the students reported a low level of symptoms, 40.2% reported an average level of symptoms, while 24.7% reported a high level of symptoms. Girls and adolescents in higher grades were more likely to report high levels of symptoms. Several factors were also identified as increasing the risk of being in the high generalized anxiety symptoms category compared to the average generalized anxiety symptoms and low generalized anxiety symptoms categories. These include fear of negative evaluation by others, perfectionism, depressed feelings, negative problem orientation and cognitive avoidance. Conclusion This study supports previous research showing that girls are at greater risk of developing generalized anxiety disorder. It also highlights the multidimensional aspect of the problem, by identifying the most important risk factors. Ultimately, this better understanding of the factors involved will allow us to better identify the targets to prioritize in the prevention of generalized anxiety disorders in adolescence.

Benzodiazepine medication is often prescribed for the short-term treatment of generalized anxiety disorder. The chronic nature of generalized anxiety disorder entails a prolonged use of these psychotropic medication on several months and several years, entailing also a psychological and physical addiction. The current study aims at determining if the combination of a behavioral and cognitive therapy and gradual withdrawal facilitate interrupting the use of benzodiazepine in patients with generalized anxiety disorder. In total, five participants have received the combined intervention according to an experimental protocol of unique case with multiple levels. Four among them have completed the withdrawal plan and have demonstrated important clinical improvements. Data collected during the 3rd and 6th month indicate the preservation of therapeutic gain. These results suggest that behavioral and cognitive therapy facilitates stopping the use of benzodiazepine medication in patients with generalized anxiety disorder by significantly reducing anxious symptoms.

Les benzodiazépines sont souvent prescrites pour le traitement à court terme du Trouble d’anxiété généralisée (TAG). La nature chronique du TAG entraîne une prise prolongée de ces psychotropes sur plusieurs mois et plusieurs années, entraînant ainsi une dépendance psychologique et physique. La présente étude vise à déterminer si la combinaison d’une thérapie comportementale et cognitive et d’un sevrage médicamenteux graduel facilite l’arrêt des benzodiazépines chez les patients souffrant d’un TAG. Au total, cinq participants ont reçu l’intervention combinée selon un protocole expérimental à cas uniques avec niveaux de base multiples. Quatre d’entre eux ont complété le plan de sevrage et ont démontré des améliorations cliniques importantes. Les données recueillies lors des suivis 3 et 6 mois indiquent un maintien des gains thérapeutiques. Ces résultats suggèrent que la thérapie comportementale et cognitive facilite l’arrêt des benzodiazépines chez les patients présentant un TAG tout en diminuant significativement les symptômes anxieux., Benzodiazepine medication is often prescribed for the short-term treatment of generalized anxiety disorder. The chronic nature of generalized anxiety disorder entails a prolonged use of these psychotropic medication on several months and several years, entailing also a psychological and physical addiction. The current study aims at determining if the combination of a behavioral and cognitive therapy and gradual withdrawal facilitate interrupting the use of benzodiazepine in patients with generalized anxiety disorder. In total, five participants have received the combined intervention according to an experimental protocol of unique case with multiple levels. Four among them have completed the withdrawal plan and have demonstrated important clinical improvements. Data collected during the 3rd and 6th month indicate the preservation of therapeutic gain. These results suggest that behavioral and cognitive therapy facilitates stopping the use of benzodiazepine medication in patients with generalized anxiety disorder by significantly reducing anxious symptoms., Las benzodiacepinas son con frecuencia prescritas para el tratamiento a corto plazo del Trastorno de ansiedad generalizada (TAG). La naturaleza crónica del TAG provoca la toma prolangada de estos psicotrópicos durante varios meses y varios años, ocasionando de esta manera una dependencia psicológica y física. El presente estudio busca determinar si la combinación de una terapia comportamental y cognitiva y una abstinencia gradual de medicamentos facilita la suspensión de las benzodiazepinas en los pacientes que sufren de un TAG. En total, cinco participantes recibieron la intervención combinada según un protocolo experimental de casos únicos con líneas de base múltiples. Cuatro de ellos completaron el plan de reducción y demostraron mejoras clínicas importantes. Los datos recopilados durante el seguimiento de 3 y 6 meses indican un mantenimiento de los beneficios terapéuticos. Estos resultados sugieren que la terapia comportamental y cognitiva facilita la suspensión de las benzodiacepinas en los pacientes que presentan un TAG al mismo tiempo que disminuyen significativamente los síntomas de ansiedad., As benzodiazepinas são freqüentemente prescritas para o tratamento a curto prazo do Transtorno de ansiedade generalizada (TAG). A natureza crônica do TAG leva a uma utilização prolongada dos psicotrópicos durante vários meses e anos, levando assim a uma dependência psicológica e física. O presente estudo visa determinar se a combinação de uma terapia comportamental e cognitiva e uma desabituação médica gradual facilita a interrupção no uso das benzodiazepinas nos pacientes que sofrem de um TAG. No total, cinco participantes receberam a intervenção combinada segundo um protocolo experimental em casos únicos com níveis de base múltiplas. Quatro dentre eles completaram o plano de desabituação e demonstraram melhorias clínicas importantes. Os dados recolhidos após três e seis meses, indicam uma manutenção dos ganhos terapêuticos. Estes resultados sugerem que a terapia cognitivo-comportamental facilita a interrupção no uso de benzodiazepinas em pacientes que apresentam um TAG e ao mesmo tempo diminuem em muito os sintomas de ansiedade.

Les troubles anxieux sont parmi les psychopathologies les plus prévalentes chez les enfants et les adolescents, et ce, d’un bout à l’autre du globe. Ils affectent leur fonctionnement sur les plans personnel, familial, scolaire et social. Bien que les symptômes du trouble d’anxiété généralisée (TAG) comptent parmi les symptômes les plus souvent observés à l’adolescence, on connaît relativement peu de choses à propos des principaux facteurs de risque associés.Objectifs La présente étude vise donc : 1) à documenter la prévalence de la caractéristique centrale du TAG, soit la tendance excessive à s’inquiéter, chez les élèves du secondaire âgés entre 12 et 17 ans, en identifiant le pourcentage d’élèves qui rapportent des symptômes de niveaux faible, moyen et élevé ; 2) à identifier les principales caractéristiques sociodémographiques associées à un niveau de symptômes élevé ; 3) à identifier les principaux facteurs de risque individuels et familiaux associés à un niveau de symptômes élevé et estimer leur contribution relative.Méthode Un total de 8 689 élèves (55,9 % de filles) québécois du secondaire ont participé à l’étude. Ces élèves étaient âgés en moyenne de 14,34 ans (é.-t. = 1,52). Une analyse de cluster de nuées dynamiques a été menée de manière à créer 3 catégories sur la base des symptômes d’anxiété généralisée présentés par les participants (faibles, moyens, élevés). Des analyses de régressions logistiques multinomiales ont été ensuite réalisées afin d’identifier les variables permettant le mieux de prédire l’appartenance à ces différentes catégories.Résultats Les résultats ont permis de montrer que 35,1 % des élèves rapportent un faible niveau de symptômes, 40,2 % rapportent un niveau moyen de symptômes alors que 24,7 % rapportent un niveau élevé de symptômes. Les filles et les adolescents et adolescentes des niveaux scolaires supérieurs sont plus nombreux à présenter des symptômes de niveau élevé. Plusieurs facteurs ont aussi été identifiés comme des facteurs augmentant le risque d’appartenir à la catégorie « symptômes d’anxiété généralisée élevés » en comparaison avec les catégories « symptômes d’anxiété généralisée moyens » et « symptômes d’anxiété généralisée faibles ». C’est notamment le cas de la peur du jugement des autres, du perfectionnisme, des sentiments dépressifs, de l’attitude négative face aux problèmes et de l’évitement cognitif.Conclusion Cette étude appuie donc le constat des études antérieures selon lequel les filles sont plus à risque de développer un trouble d’anxiété généralisée. Elle permet également de mettre en lumière l’aspect multidimensionnel de la problématique, en identifiant les facteurs de risque les plus importants. Ultimement, cette meilleure compréhension des facteurs impliqués permet de mieux identifier les cibles à prioriser en matière de prévention des troubles d’anxiété généralisée à l’adolescence., Anxiety disorders are among the most prevalent psychopathologies in children and adolescents around the world. They affect their personal, family, school and social functioning. Although symptoms of generalized anxiety disorder (GAD) are among the most commonly observed symptoms in adolescence, relatively little is known about the most important risk factors.Objectives The purpose of the present study was therefore 1) to document the prevalence of the central feature of GAD, excessive worrying, in high school students aged 12 to 17 years, by identifying the percentage of students reporting low, medium, and high levels of symptoms, 2) to identify key sociodemographic characteristics associated with high symptom level, and 3) to identify individual and family risk factors associated with high symptom level and estimate their relative contribution.Method A total of 8689 Quebec high school students (55.9% girls) participated in the study. The average age of these students was 14.34 years (SD=1.52). A k-means cluster analysis was first performed to create three categories based on the symptoms of generalized anxiety presented by the participants (low, medium, high). Multinomial logistic regression analyzes were then performed to identify the variables that best predict membership in these different categories.Results The results showed that 35.1% of the students reported a low level of symptoms, 40.2% reported an average level of symptoms, while 24.7% reported a high level of symptoms. Girls and adolescents in higher grades were more likely to report high levels of symptoms. Several factors were also identified as increasing the risk of being in the high generalized anxiety symptoms category compared to the average generalized anxiety symptoms and low generalized anxiety symptoms categories. These include fear of negative evaluation by others, perfectionism, depressed feelings, negative problem orientation and cognitive avoidance.Conclusion This study supports previous research showing that girls are at greater risk of developing generalized anxiety disorder. It also highlights the multidimensional aspect of the problem, by identifying the most important risk factors. Ultimately, this better understanding of the factors involved will allow us to better identify the targets to prioritize in the prevention of generalized anxiety disorders in adolescence.