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Long-Term Outcomes of an Australian Universal Prevention Trialof Anxiety and Depression Symptoms in Children and Youth:

An Evaluation of the Friends Program

Paula M. BarrettUniversity of Queensland, Pathways Health and Research Centre, Brisbane, Australia

Lara J. FarrellUniversity of Queensland, Pathways Health and Research Centre, Brisbane, Australia

Thomas H. OllendickVirginia Polytechnic Institute and State University, Blacksburg

Mark DaddsUniversity of New South Wales, Sydney, Australia

This study evaluated the long-term effectiveness of the FRIENDS Program in reduc-ing anxiety and depression in a sample of children from Grade 6 and Grade 9 in com-

parison to a control condition. Longitudinal data for Lock and Barretts (2003) uni-versal prevention trial is presented, along with data from 12-month follow-up to 24-and 36-month follow-up. Results of this study indicate that intervention reductions inanxiety reported in Lock and Barrett were maintained for students in Grade 6, withthe intervention group reporting significantly lower ratings of anxiety at long-term

follow-up. A significant Time Intervention Group Gender Effect on Anxiety was found, with girls in the intervention group reporting significantly lower anxiety at 12-month and 24-month follow-up but not at 36-month follow-up in comparison tothe control condition. Results demonstrated a prevention effect with significantly

fewer high-risk students at 36-month follow-up in the intervention condition than inthe control condition. Results are discussed within the context of prevention research.

Emotional disturbances in children and youth occurat alarmingly high rates, are associated with a numberof negative life consequences, and come at a tremen-dous cost to society. A Year Book of Australia reportindicated that 20% of children between the ages of 12 and 16 had a significant mental health problem(Stanley, 2002). Anxiety disorders are the most fre-quently experienced mental health disorder in child-hood and adolescence, with studies estimating a pointprevalence of 5% to 10% and a lifetime prevalence of approximately 20% (Essau, Condradt, & Petermann,

2000; Shaffer, Fischer, Dulcan, & Davies, 1996). Re-search has demonstrated that anxiety and depressivesymptoms are highly related in child and youth popula-tions (e.g., Dobson, 1985; Tannenbaum, Forehand, &Thomas, 1992). Estimates indicate approximately 2%to 5% of children and adolescents will suffer a majordepressive disorder of clinical severity (Kashani et al.,1987; Lewinsohn, Clarke, & Rohde, 1994). Beyondthe high prevalence rates, these emotional disorders are

associated with a wide range of psychosocial impair-ments, tend to be chronic and unremitting in course,and are associated with significant risk for other psy-chological disorders if left untreated (e.g., Cole,Peeke, Martin, Truglio, & Seroczynski, 1998; Kashani& Orvaschel, 1990; Last, Hansen, & Franco, 1997;Orvaschel, Lewinsohn, & Seeley, 1995).

There has been a recent surge in the field of preven-tion research for children and youth. Given the poten-tial of such approaches to impact on the incidence andprevalence of childhood emotional disorders, the need

for evidence-based prevention is strong. Primary pre-ventive interventions can be defined as either univer-sal, selected, or indicated and targeted (Mrazek &Haggerty, 1994). Universal interventions target wholepopulation groups, selective interventions involvechildren and youth identified as at risk of psychologi-cal problems, and indicated interventions target indi-viduals identified with mild to moderate symptoms of a disorder (Mrazek & Haggerty, 1994). Universal pre-vention interventions conducted in the school contexthave many advantages, including reducing recruit-ment, screening, and attrition difficulties; reaching abroad range of children and adolescents with varying

Journal of Clinical Child and Adolescent Psychology2006, Vol. 35, No. 3, 403411

Copyright 2006 byLawrence Erlbaum Associates, Inc.

403

Correspondence should be addressed to Lara Farrell, Schoolof Applied Psychology, Mt. Gravatt Campus, Griffith University,Queensland, Australia 4111. E-mail: [email protected]


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levels of risk for psychopathology; reducing stigmati-zation; enhancing peer support; and reducing psycho-social difficulties within the classroomthus promot-ing learning and healthy development (Evans, 1999;Kubiszyn, 1999). Support for preventative outcomesbased on the delivery of cognitive behavioral interven-tions in schools is growing.

The Queensland Early Intervention and Preventionof Anxiety Project (Dadds, Spence, Holland, Barrett &Laurens, 1997) represented the first cognitive behav-ioral trial for prevention of childhood anxiety. Thisstudy targeted children (ages 7 to 14 years) who weredisorder-free but exhibited anxious symptomatology(indicated prevention; Mrazek & Haggerty, 1994) aswell as children who met criteria for an anxiety disor-der but were in the less severe range (early interven-tion; Mrazek & Haggerty, 1994). Screening identified128 eligible participants who were randomly allocatedto either an intervention or a control condition. Diag-

nostic status was used as an outcome measure, and re-sults were favorable. Both groups demonstrated im-provement immediately postintervention; however, by6-month follow-up, the improvement was maintainedin the intervention group only. No differences betweengroups were evident at 12-month follow-up; however,at the 2-year follow-up, intervention effectiveness wasdemonstrated through the reduction of existing rates of anxiety disorder and prevention of the onset of newanxiety disorders (Dadds, Spence, Laurens, Mullins, &Barrett, 1999). Consistent with prior research (Last,Perrin, Hersen, & Kazdin, 1996), regardless of inter-vention status, participants in this study showed a gen-eral improvement across time; results further revealedgender (female), parental anxiety and pretreatment se-verity predicted poor response to intervention (Barrett,Dadds, & Rapee, 1996; Cobham, Dadds, & Spence,1998). This study demonstrated that anxiety disordersand the number of children at risk of anxiety can besuccessfully reduced through selected school-basedcognitivebehavioral intervention. An interesting out -come was putative delay in intervention effects, whichis consistent with the results of a similar preventiontrial for adolescent depression (Jaycox, Reivich, Gill-ham, & Seligman, 1994).

Barrett and Turner (2001) evaluated the effects of auniversal cognitive behavioral intervention for the pre-vention of internalizing symptoms in children in Grade6 (ages 9 to 10 years). Ten schools in the Brisbane re-gion participated in the project, which involved allchildren participating in the FRIENDS program duringclass time (Barrett, 2004, 2005; Barrett, Lowry-Web-ster, & Turner, 1999a, 1999b). This study evaluateda train-the-trainer model of intervention, wherebychildren were assigned to one of three conditions: (a)psychologist-led intervention, (b) teacher-led interven-tion (following a standardized teacher training work-

shop), or (c) standard curriculum (control condition).Barrett and Turner (2001) trained classroom teach-ers and psychologists to implement the 12-sessionFRIENDS program as part of the standard classroomcurriculum. Parents were invited to attend four parentevenings, which involved psychoeducation and par-enting strategies. Evaluation of childrens self-report

measures at postintervention indicated preventive ef-fects, with participants reporting significant reductionsin anxiety symptoms across psychologist and teacherintervention conditions. This study provided prelimi-nary evidence for the effectiveness of the FRIENDSprogram delivered by teachers at a school-based pop-ulation level, integrated within the standard schoolcurriculum.

Lowry-Webster, Barrett, and Dadds (2001) furtherexamined the effectiveness of the FRIENDS programas a universal strategy for prevention of childhood anx-iety. In total, 594 students, ages 10 to 13 years, were al-

located to either an intervention or a control conditionon the basis of class. At postassessment, all children re-ported significant reductions in anxiety, although thesedecreases were significantly greater in the interventiongroup compared to the control condition. A significantreduction in depression was found for the interventiongroup only. Further analysis of changes in risk statusshowed positive findings. Of the children in the inter-vention group at risk at preintervention, 75.3% were nolonger at risk at postintervention, compared to 54.8%of high-risk children in the control group. Lowry-Web-ster, Barrett, and Lock (2003) reported on outcomes at12-month follow-up for this sample. Results indicatedthat prevention effects were maintained up to the 12-month follow-up for children who received the pro-gram. The intervention group evidenced lower scoreson anxiety self-report measures, and the high-anxietychildren from the intervention condition reported re-ductions in both anxiety and depression scores. Diag-nostic interview data demonstrated that 85% of chil-dren in the intervention group who were scoring abovethe clinical cutoff for anxiety and depression werediagnosis-free at 12-month follow-up, compared toonly 31.2% of children in the control group. This fol-low-up study demonstrated clinically and statistically

significant reductions in anxiety symptoms and disor-ders from pretest to 12-month follow-up following theFRIENDS universal program.

Most recently, Lock and Barrett (2003) presentedthe results of a longitudinal school-based study of uni-versal prevention using the FRIENDS program acrosstwo distinct age groups. This study involved a group of 733 children enrolled in Grade 6 ( n = 336; ages 9 and10 years) and Grade 9 ( n = 401; ages 14 to 16 years)from seven socioeconomically diverse schools in themetropolitan area of Brisbane, Australia. Schools wererandomly assigned to either an intervention condition

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(FRIENDS) or a control condition (standard curricu-lum), and all students completed self-report measuresof anxiety, depression, and coping. Students identifiedas high risk based on elevated scores on an anxietymeasure were interviewed using a structured diagnos-tic interview. As with previous research (e.g., Daddset al., 1997, 1999; Lowry-Webster et al., 2001, 2003),

this study found general reductions in anxiety acrosstime regardless of intervention condition; however,these reductions were significantly greater for studentsin the intervention condition at both posttest and12-month follow-up. In terms of age differences, chil-dren in Grade 6 reported significantly higher levels of anxiety prior to the intervention and at postinterventionyet greater reductions in anxiety at 12-month follow-up, as well as lower levels of depression across timecompared to Grade 9 children. This finding suggestedthat the optimal time for preventing anxiety may be inlate childhood (9 to 10 years of age) versus early ado-

lescence. This study also examined gender differencesand found that girls were more likely to be at risk of ananxiety disorder and tend to report higher levels of anx-iety than boys over time. Moreover, Grade 6 girlswere most responsive to the intervention, as they re-ported greater reductions in anxiety compared to girlsin Grade 9 and boys across grades.

Lock and Barrett (2003) also examined the effectsof the intervention on depressive symptoms. Resultsindicated that there significant reductions in depres-sion; however, this effect was only apparent at 12-month follow-up, suggesting a delayed preventioneffect for depression. This finding of a delayed effect isconsistent with the finding from the Queensland EarlyIntervention project (Dadds et al., 1997) and is alsoconsistent with Jaycox and colleagues (1994) preven-tion trial for depression.

These preliminary studies have indicated signifi-cant promise for the effectiveness of the FRIENDSprogram as a selective, indicated, and universal preven-tion program for schools. However, as the true preven-tive impact of an intervention can better be determinedover a longer term, it is important to examine outcomesbeyond the 12-month follow-up. This study aims toevaluate the long-term prevention outcomes at 24-

month and 36-month follow-up, compared to existingdata at 12-month follow-up reported in Lock andBarretts (2003) longitudinal study. Students involvedin Lock and Barretts study were followed up again at24 months and 36 months. This study evaluates out-comes on measures of self-reported anxiety and de-pression across intervention and control schools from12-month follow-up to 24-month follow-up and 36-month follow-up. It was hypothesized that interventiongains from Lock and Barretts study would be main-tained; that is, there would be significantly lowerscores on anxiety and depression self-report across the

follow-up for children and youth in the interventioncondition in comparison to students in the control con-dition. It was further hypothesized that there would besignificantly fewer students at high risk for anxietyand depression in the intervention condition comparedwith the control condition at each follow-up point.Based on Lock and Barretts findings, it was antici-

pated that prevention effects (maintenance of gains vs.increases in symptoms over time) would be strongestfor children in the Grade 6 group compared with stu-dents in the Grade 9 group and for girls compared toboys.

Method

Participants

Participants included in this follow-up study were

669 children and youth from Lock and Barretts (2003)original sample of 737 Grade 6 (age 10 to 11 years) andGrade 9 (age 13 to 14 years) students. One school fromthe original sample (control school, n = 68) withdrewfrom the longitudinal study following the 12-monthfollow-up. The sample at 12-month follow-up con-sisted of 334 students in Grade 7 and 335 students inGrade 10. These students were followed up again at 24months (Grade 8 and Grade 11) and 36 months (Grade9 and Grade 12). All participants were students fromone of six coeducational schools extending from pre-school to Year 12 in the metropolitan area of Brisbane,Australia. Schools, rather than participants, were se-lected as the unit of random assignment; with schoolsrandomly assigned to either an intervention conditionor a control condition. The schools remaining in thisstudy were three intervention schools and three controlschools. At 12-month follow-up, there were a total of 379 participating students (54% female) within the in-tervention condition and a total of 290 participatingstudents within the control condition (48% female).

Socioeconomic status (SES) was based on paternaloccupation and was coded using the 9-point AustralianStandard Classification of Occupations Dictionary(Australian Bureau of Statistics and Department of Ed-

ucation, Training and Youth Affairs, 1997). The aver-age SES rating across schools was 5.67 ( SD = 1.21),typical of the SES distribution of Australia in general.This value is indicative of middle SES on average (e.g.,skilled, clerical, and trade occupations are coded as 5and semiprofessional occupations as 6) and is broadlyconsistent with the average SES reported in other Aus -tralian studies (e.g., Spence, Barrett, & Turner, 2003).The intervention and control schools did not differfrom each other on SES ratings. The majority of inter-vention (89%) and control students (84%) were born inAustralia, with the remainder coming froma wide vari-

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ety of ethnic backgrounds, as is typical of the Austra-lian population.

Procedure

Informed consent and assignment to experimen-tal conditions. All schools participating in the pro-

ject were from the independent education sector, andinitial consent was obtained from the principal of eachschool to invite students, their parents, and their teach-ers to participate in a longitudinal research project.Schools were matched in pairs based on geographicallocation, and one school from each pair was randomlyassigned to either an intervention or a control condi-tion. All parents of students were sent an informationsheet describing the project and an informed consentform to be completed and returned by parents. A goodconsent rate was obtained for each grade level: Grade6, 79.36%, and Grade 9, 77.62%. See Lock and Barrett

(2003) for further details.

Program evaluationLong-term follow-up. Inthis study, students were assessed at two time intervals:24-month follow-upand36-month follow-up.This datawill be compared with Lock and Barretts (2003) 12-month follow-up data to evaluate change over time. Allquestionnaire assessmentswere completed withinclassgroups, within normal school hours. A postgraduate re-search assistant readthe instructionsand questionnairesaloud to all students while other project staff walkedaround the classroom assisting students who requiredhelp or indicated they did not understand one of thequestions. Students were informed that all question-naire responseswere confidential. Questionnaires werepresented in a counterbalanced order within the assess-ment package, with each schoolreceiving a different or-dering of questionnaires, across each data collectionpoint.

Program implementation. The FRIENDS in-tervention (discussed later) was implemented withinschools assigned to the intervention condition as partof the curriculum within the subject areas of health andphysical education or social and personal develop-

ment. The intervention consists of 10 sessions of ap-proximately 70 min each, with one session scheduledper week over a 10-week term. There are two boostersessions in the program, which were implemented inthe following term. Two developmentally tailored ver-sions of the program were implemented: FRIENDS forChildren (Barrett et al., 1999a) was offered to Grade6 intervention participants and FRIENDS for Youth(Barrett et al., 1999b) was implemented with Grade 9intervention participants. The FRIENDS program is abrief cognitivebehavioral intervention designed andvalidated as an individual or group-based treatment forclinically anxious children (Barrett et al., 1996; Shortt,

Barrett, & Fox, 2001). The program, described in de-tail by Barrett (1999), assists children and youth inlearning important skills and techniques that help themto cope with and manage anxiety and emotional dis-tress through the application of learned coping andproblem-solving skills. The FRIENDS program wasimplemented by teachers with the assistance of clini-

cally trained psychology postgraduate students follow-ing a 1-day standardized teacher-training workshop.Teachers were the main facilitator for the sessions,with the psychology students assisting children whenneeded. An earlier study reported that there were nodifferences in postintervention outcomes for studentswho received the intervention led by teachers and stu-dents who received the intervention led by psycholo -gists (see Barrett & Turner, 2001). The program alsoincorporates four evening sessions for parents, whichare scheduled at regular intervals throughout the 10weeks of the program. These psychoeducational ses-

sions provided parents with an opportunity to learnabout the program and to discuss parenting and rein-forcement strategies. FRIENDS is an acronym for thedifferent skills taught (F = feeling worried; R = relaxand feel good; I = inner helpful thoughts; E = exploreplans; N = nice work, reward yourself; D = dont forgetto practice; and S = stay calm for life!).

Prior to implementing the program, group leaderswere each given a program fidelity checklist to recordwhether they completed each activity within the ses-sion. Of the 18 teachers who implemented the inter-vention, only 5 returned fidelity checklists. Adherenceto the intervention content ranged from 72.3% to91.66%.

Measures

Spence Childrens Anxiety Scale (SCAS). TheSCAS (Spence, 1997) is a 44-item scale assessing anx-iety symptoms. Six subscales, corresponding to Diag-nostic and Statistical Manual of Mental Disorders (4thed.; American Psychiatric Association, 1994) anxietydisorders are calculated from the anxiety items and aTotal Anxiety score (used in this study) is obtained by

summingall subscales. Participants rate each symptomon a 4-point scale corresponding to the frequency withwhich they experience each symptom, and higherscores reflect a greater number of anxiety symptoms.Spence (1998) and Spence et al. (2003) reported highinternal consistency in community child (Cronbachs = .92) and adolescent populations (Cronbachs =.92), respectively, and 6-month testretest reliability of .60 for children (Spence, 1998) and 12-week testre-test reliability of .63 for youth (Spence et al., 2003).Good convergent and discriminant validity wasalso re-ported. Analysis of internal consistency wasconductedfor this sample at 12-month follow-up, with results in-

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dicating high internal reliability (Cronbachs = .89)for this measure.

Revised Childrens Manifest Anxiety Scale(RCMAS). The RCMAS (Reynolds & Richmond,1985) provides a measure of anxiety symptomatology.The questionnaire contains 37 items, 9 of which form aLie scale. For each item, the child is asked to respondyes or no. This measure has been found to havehigh internal consistency and testretest reliability, aswell as showing convergent and divergent validity(Reynolds & Richmond, 1985). The internal consis-tency for this measure was high, based on responsesfrom this sample at 12-month follow-up, with aCronbachs of .85.

Childrens Depression Inventory (CDI). De-pressive symptoms were assessed using the 27-itemCDI (Kovacs, 1981). Items assess depressive symp-

toms such as sadness, self-blame, loss of appetite, in-terpersonal relationships, and school adjustment. Foreach item, participants choose a statement from threeresponse alternatives, witheach increasing in symptomseverity. Higher scores reflect more severe symptoma-tology. In this study, and in line with other researchstudies (e.g., Hannon, Rapee, & Hudson, 2000;Shochet et al., 2001; Weiss et al., 1991), one item per-taining to suicidal ideation was omitted due to con-cerns expressed by school personnel and parentgroups. In comparing childrens scores in samples withand without the suicide item, Weiss et al. (1991) re-

ported that deletion of the suicide item did not signifi-cantly alter CDI scores. Cole, Hoffman, Tram, andMaxwell (2000) reported high internal consistency in acommunity sample of children and youth (Cronbachs = .90) and 6-month testretest reliability of .66. In-ternal consistency for this measure based on this sam-ple at 12-month follow-up indicated high internal reli-ability (Cronbachs = .89).

Results

Attrition and Missing Data

Patterns of missing data from 12-month follow-upto 24-month follow-up and 36-month follow-up wereexamined to determine dropout and absenteeism ratesto assess potential influences of these factors on thelong-term outcomes. At 24-month follow-up, therewere no differences in the frequency of missing dataacross between grade (34% missing Grade 6, 33%missing Grade 9), gender (34% missing male, 33%missing female), or students at high risk (32% missing)and in the healthy range (34% missing). There weresignificant differences between the intervention andthe control conditions, with the control condition hav-

ing significantly more missing data (44%) than the in-tervention group (25%), 2(1, 669) = 26.09, p < .001.

At 36-month follow-up there were no differences inthe frequency of missing data between grade (47%missing Grade 6, 46% missing Grade 9), gender (49%missing male, 43% missing female), or students at highrisk (44% missing) and in the healthy range (47%

missing). There were significant differences betweenthe intervention and the control conditions, with thecontrol condition having significantly more missingdata (54%) than the intervention group (41%), 2(1,669) = 10.98, p < .01. Reasons for attrition at each timepoint were absenteeism from school on the day of assessment, students leaving the school, and absentee-ism from class due to extracurricular activities thatwere occurring at the time of assessments (i.e., sportsmeetings, music classes, learning assistance). Controlschools were less likely to provide additional opportu-nities to screen children who were missing from class.

Single imputation via expectation maximizationmethod in SPSS was used for missing data in all analy-ses.

Risk Group Status

Participants were classified as high risk based on el-evated scores (above a specified cutoff) on either theSCAS or the CDI. Given there were significant gradeand gender differences within this sample on the SCASat preintervention, this study used separate cutoffs forgrade and gender. The cutoffs used reflected the scoreabove which 10% of the normative sample scored(Spence, 2005), which closely paralleled the meanscores of the top 10% of this sample. The cutoff for theCDI was 14 across all students given that there were nosignificant grade or gender differences on the CDI atpreintervention in this sample. Table 1 presents the fre-quency and percentage of students at high risk acrossgrade and intervention conditions at each time point.Chi-square tests revealed significant differences be -tween the intervention and control conditions at 36-

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UNIVERSAL SCHOOL-BASED ANXIETY PREVENTION PROGRAM

Table 1. Frequency and Percentage of Students at High Risk Across Intervention Conditions for Each Follow-UpTime Point

12 Months 24 Months 36 Months

n % n % n %

Total Intervention 59 16 49 17 22 12 a

Female 34 58 29 59 13 59Male 25 42 20 41 9 41

Total Control 62 21 40 25 26 31 a

Female 31 50 24 60 b 13 42Male 31 50 16 40 b 13 50

aSignificance between intervention and control groups at 36 months, p < .001. bSignificancebetween females andmaleswithin the controlcondition at 24 months, p < .05.


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month follow-up, 2(1, 261) = 13.57, p < .001, withsignificantly more students in the control condition athigh risk. There were equal girls to boys at high risk within the intervention and control conditions at eachtime point, except at 24-month follow-up, when therewere significantly more girls at high risk within thecontrol condition, 2(1, 162) = 3.65, p < .05.

Long-Term Follow-Upof Universal Prevention Effects

Prior to evaluating prevention effects across timeand intervention condition, a three-level (schools, stu-dents, and occasions) multilevel analysis was con-ducted across the dependent variables (CDI, SCAS,RCMAS) to examine whether there was a cluster-ing effect of schools. The results indicated that theschools level of data accounted for less than 5%of total variance across dependent measures; hence it

was concluded that there was no clustering effect of schools. Further analyses were conducted using uni-variate analysis of variance covarying preinterventiongroup differences (analyses of covariance) on all de-pendent measures, given that these group differenceswere significant and not controlled for in Lock andBarretts study (2003). To evaluate the long-term pre-vention effects of the FRIENDS program on measuresof anxiety and depression, 2 (group: intervention orcontrol) 2 (grade: Grade 6 or Grade 9) 2 (gender) 2 (risk: high risk or healthy) 3 (time: 12-month fol-low-up, 24-month follow-up, 36-month follow-up) re-peated-measures analyses of covariance were con-ducted. As a result of multiple comparisons beingexamined, Bonferroni adjustments, based on studentst statistic, were used in SPSS for the repeated-measuresanalyses to adjust the observed significance level andcontrol for experimentwise error due to the multiplecomparisons.

Results of these analyses found no significant out-comes on the CDI. On the SCAS, however, there was asignificant Group Grade interaction, F (1, 193) =9.25, p < .005, partial eta squared = .05. Simple effectsanalyses of group differences within each grade leveldemonstrated that there were significant intervention

group differences on the SCAS for Grade 6 students,F (1, 96) = 7.48; p < .01. Grade 6 students within the in-tervention condition scored significantly lower on theSCAS ( M = 9.53, SE = 0.88) across time compared toGrade 6 students in the control condition ( M = 17.07,SE = 2.61). There were no significant interventiongroup differences for Grade 9 students on the SCAS.

On the RCMAS, there was also a significant Group Grade interaction, F (1, 193) = 8.63, p < .005, partialeta squared = .04. Simple effects analyses of group dif-ferences within each grade level demonstrated thatthere were significant intervention group differencesfor Grade 6 students, F (1, 96) = 4.43; p < .05. Across

time, Grade 6 students within the intervention condi-tion scored significantly lower on the RCMAS ( M =4.67, SD = 0.45) than Grade 6 students in the controlcondition ( M = 7.63, SD = 1.34). There were no signifi-cant intervention group differences on the RCMAS forthe Grade 9 students. There was also a significant Time Group Gender effect on the RCMAS measure of

anxiety, F (2, 386) = 7.37; p < .005, partial eta squared= .04. To examine this interaction further, univariateanalyses were conducted separately for girls and boys.Results revealed a significant Time Group inter-action for girls on the RCMAS, F (2, 186) = 4.07; p

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