13 1 GENERAL INTRODUCTION CURRENT PREVENTION PROGRAMS Prevention programs can be classified into three types, namely universal, selective, and indicated prevention (Garber & Weersing, 2010; Munoz et al., 2010). All three levels of prevention aim to decrease symptoms and/or the likelihood that disorders develop by reducing risk factors and increasing resilience (McGorry et al., 2011). Universal prevention programs target the entire population regardless of individuals’ risk status or symptoms, but some broader target groups may be distinguished. For anxiety and depression specifically, these broader target groups may be: women, young people, the elderly, ethnic minorities, people with low socio-economic status or little social support (Meijer et al., 2006). Selective prevention programs target specific subgroups of individuals who are known to have an increased risk of developing a disorder. Risk factors for anxiety and depression include having a parent with psychopathology, having a chronic disease, problems in social contacts (Meijer et al., 2006) or an avoidant coping style, or showing behavioural inhibition (Rapee, 2002). Indicated prevention programs are delivered to individuals who already show symptoms of anxiety or depression, which do not (yet) meet the diagnostic criteria of the disorder. This type of prevention is about early detection and intervention to prevent symptoms from getting worse (Meijer et al., 2006). Research indicates that selective and indicated (i.e., targeted) prevention programs generally have larger effect sizes and sustained effects over longer time periods compared to universal approaches in preventing and reducing symptoms of anxiety and depression in youth (Horowitz & Garber, 2006; Merry, 2007; Stice et al., 2009; Stockings et al., 2016; Teubert & Pinquart, 2011). Prevention programs for anxiety and depression often target transdiagnostic mechanisms related to both disorders (Butler et al., 2006; Schaeuffele et al., 2021). Anxiety and depression tend to have a high rate of comorbidity; not only the disorders often coexist, but also symptoms of anxiety and depression are highly correlated (Axelson & Birmaher, 2001; Balázs et al., 2013; J. R. Cohen et al., 2014; Cummings et al., 2014). Furthermore, overlapping risk factors and similar underlying mechanisms play a role in the onset, exacerbation and maintenance of the disorders. For example, it is known that parental psychopathology, negative parenting behaviour and parenting stress increase the risk for youth to develop mental health problems (Bijl et al., 2002; Connell & Goodman, 2002; Fox et al., 2010; Kane & Garber, 2004; Knappe et al., 2009; Lieb et al., 2002; Merikangas et al., 1998; Needham, 2008). Additionally, females, youth with (chronic) stress or those who have been through traumatic events have a higher risk as well (Chaplin et al., 2009;
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