Transdiagnostic interventions in prediagnostic youth with elevated distress: A meta-analysis of outcomes

The current systematic review and meta-analysis identified nonpharmacological outpatient interventions with transdiagnostic effects in youth with elevated psychological distress who do not meet the diagnostic criteria. We examined common elements that may be associated with treatment effects.

Of the 10,208 studies identified, k = 68 were included involving 10,805 individuals with a Mage of 16.96 years (SD = 1.80; 66.67% female). We examined changes in depression, anxiety, suicidality, disordered eating, and quality of life using random-effects models in the R meta package.

Cohen's d effect sizes (95% CIs) were 0.21 [0.11, 0.32] for depression (k = 64), 0.20 [0.11, 0.29] for anxiety (k = 57), and 0.11 [0.01, 0.21] for quality of life (k = 19). Heterogeneity was present (I2 ranging from 6.73 to 16.95%). Due to limited studies for eating (k = 5) and suicidality (k = 4), meta-analyses were not feasible for these outcomes. Moderator analyses indicated that adolescents (vs. children and emerging adults) derived significant benefits. Cognitive behavioral therapy was indicated as an effective transdiagnostic approach for depression and anxiety. The most frequent common elements across cognitive behavioral therapy approaches included cognitive literacy, emotional literacy, psychoeducation, goal setting, and problem solving.

These results provide the first quantitative test of transdiagnostic intervention approaches that can improve mental health in vulnerable, symptomatic youth. Further attention is required to outcomes related to disordered eating and suicidality given their prevalence and serious consequences in youth. Dismantling studies of cognitive behavioral therapy are required to identify effective common elements that can drive better mental health outcomes in youth. (PsycInfo Database Record (c) 2025 APA, all rights reserved).