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Classification models for subthreshold generalized anxiety disorder in a college population: Implications for prevention.
- Source :
-
Journal of anxiety disorders [J Anxiety Disord] 2015 Aug; Vol. 34, pp. 43-52. Date of Electronic Publication: 2015 Jun 17. - Publication Year :
- 2015
-
Abstract
- Generalized anxiety disorder (GAD) is one of the most common psychiatric disorders on college campuses and often goes unidentified and untreated. We propose a combined prevention and treatment model composed of evidence-based self-help (SH) and guided self-help (GSH) interventions to address this issue. To inform the development of this stepped-care model of intervention delivery, we evaluated results from a population-based anxiety screening of college students. A primary model was developed to illustrate how increasing levels of symptomatology could be linked to prevention/treatment interventions. We used screening data to propose four models of classification for populations at risk for GAD. We then explored the cost considerations of implementing this prevention/treatment stepped-care model. Among 2489 college students (mean age 19.1 years; 67% female), 8.0% (198/2489) met DSM-5 clinical criteria for GAD, in line with expected clinical rates for this population. At-risk Model 1 (subthreshold, but considerable symptoms of anxiety) identified 13.7% of students as potentially at risk for developing GAD. Model 2 (subthreshold, but high GAD symptom severity) identified 13.7%. Model 3 (subthreshold, but symptoms were distressing) identified 12.3%. Model 4 (subthreshold, but considerable worry) identified 17.4%. There was little overlap among these models, with a combined at-risk population of 39.4%. The efficiency of these models in identifying those truly at risk and the cost and efficacy of preventive interventions will determine if prevention is viable. Using Model 1 data and conservative cost estimates, we found that a preventive intervention effect size of even 0.2 could make a prevention/treatment model more cost-effective than existing models of "wait-and-treat."<br /> (Copyright © 2015 Elsevier Ltd. All rights reserved.)
- Subjects :
- Anxiety psychology
Anxiety Disorders economics
Anxiety Disorders prevention & control
Cognitive Behavioral Therapy economics
Cognitive Behavioral Therapy methods
Cost-Benefit Analysis
Female
Humans
Male
Psychiatric Status Rating Scales
Risk Factors
Students psychology
Watchful Waiting economics
Young Adult
Anxiety Disorders classification
Subjects
Details
- Language :
- English
- ISSN :
- 1873-7897
- Volume :
- 34
- Database :
- MEDLINE
- Journal :
- Journal of anxiety disorders
- Publication Type :
- Academic Journal
- Accession number :
- 26119139
- Full Text :
- https://doi.org/10.1016/j.janxdis.2015.05.011