This study examined the influence of maternal anxiety on the treatment outcome of anxious children. Forty-eight clinically anxious children (aged 6–14 years) were classified into two groups based on the presence of an anxiety disorder diagnosis in their mother. Diagnostic data at posttreatment showed that children with anxious mothers responded significantly less favourably to cognitive behavioural therapy (CBT) than did children with nonanxious mothers (28% vs. 58% improved, respectively). At 12-month follow-up, 68% of children with anxious mothers improved, compared to 79% of children with nonanxious mothers. This difference was not significant. Findings were not consistent across outcome measures. This study also investigated the changes in maternal anxiety across child treatment. Prior to treatment, diagnostic data showed that 60% of mothers met criteria for an anxiety disorder. At posttreatment, 21% of these mothers were free of their primary diagnosis. There was also a significant reduction in self-reported maternal anxiety across treatment that was maintained at follow-up. Theoretical and clinical implications of the findings are discussed.

Objectives: Validated treatments for adults with bulimia nervosa (BN) and related presentations are scarce, and the current most evidenced treatment — cognitive behaviour therapy for eating disorders — is resource intensive and has suboptimal remission rates; there is, therefore, a need to evaluate the effectiveness of other approaches for treating such conditions in routine NHS services. Design: Data from nine patients in an NHS eating disorder service who received compassion-focused therapy (CFT) for BN or bulimic presentations were analysed retrospectively. Methods: Patients routinely completed a validated scale of eating disorder severity (the EDE-Q) at baseline and end of treatment. Results: All five scales of the EDE-Q showed a mean significant reduction (N = 9), indicating a significant reduction in eating disorder symptomatology, and individual analyses showed clinically reliable reduction in seven out of nine patients’ EDE-Q scores. Conclusions: This is the first article to report a case series of patients who benefitted significantly from receiving CFT for their eating disorder. Limitations of this study are considered along with future directions for research into effective treatments for eating disorders.

Contemporary cognitive theories of obsessive-compulsive disorder (OCD) propose that certain types of dysfunctional beliefs and assumptions play a salient role in the genesis and persistence of OCD (e.g., Clark, 2004; Rachman, 1993, 1997; Salkovskis, 1985). The present study aimed to examine whether the three proposed dysfunctional beliefs — inflated sense of responsibility, thought suppression, and thought-action fusion — play a significant role particularly on the persistence of obsessive–compulsive (OC) symptoms, as compared to other emotional disorders, such as symptoms of depression. The participants of the present study were 109 undergraduate university students, who completed a set of questionnaires, including The Responsibility Attitude Scale (RAS), The Thought Action Fusion Scale (TAF), The White Bear Suppression Inventory (WBSI), The Maudsley Obsessive–Compulsive Inventory (MOCI), and The Beck Depression Inventory (BDI). After a 4-week interval, participants were again asked to complete the MOCI and BDI. Two separate hierarchical regression equations were formulated to examine the factors significantly accounting for the residual changes from Time 1 to Time 2 assessments of OC and depressive symptomatologies. Results of these analyses indicated that while thought suppression (WBSI scores) played a significant role on the persistence of both OC and depressive symptoms across time, the role of inflated sense of responsibility (RAS scores) was specific to the persistence of OC symptoms.

School refusal is a complex and heterogeneously determined and experienced behaviour problem. Due to its complexity and heterogeneity, a multimethod and multisource approach to assessment is required. The approach is described as a hypothesis-testing approach which uses developmentally sensitive and empirically validated procedures. Clinical-behavioural interviews, structured diagnostic interviews, self-reports, reports of significant others, self-monitoring, and behavioural observations are recommended. Issues associated with these procedures are reviewed.

Research into the efficacy of cognitive behaviour therapy (CBT) has repeatedly demonstrated that it is a useful method for alleviating the symptoms of clinical depression. However, the underlying mechanism of the recovery process has remained a matter of debate in the literature. Although at no point in the literature has it been stated that cognitions ‘cause’ depression, this has been a strong implication in the design of many of the studies. The lack of consensus on the issue of causation is due partly to the lack of a co-ordinated approach to investigating the process of cognitive change and other variables in the depressive patient. Also the failure of many research designs to eliminate alternative hypotheses has led to confusion and debate about the direction which CBT research should take. The overall effect has limited the possibilities for an integrated model of depression. This paper looks at the various working models of depression in the literature and suggests the direction for future investigators' testing of these models.

Cognitive-behavioural models of psychosis have been widely discussed in the literature, with a focus on the beliefs about the voices that are a component of auditory hallucinations. This study examines the ability of beliefs about the voices to predict the course of psychiatric symptomatology in psychosis over a 1-month period, compared with changes in depressive symptomatology. Thirty people with schizophrenia or schizo-affective disorder participated in this study. Their mental state functioning, depression, and beliefs about their voices were assessed in interview. Mental state functioning and depression were assessed again after 1 month, in addition to antipsychotic medication compliance over the previous month (rated by self and the psychiatrist). The strongest predictor of a worsening of psychiatric symptoms over the month was increased depression in the previous month. Using p < 0.1 criteria to offset possible Type II errors in the small sample, a person's belief that their voices were very powerful was also predictive of psychiatric deterioration. The ways in which beliefs about the power of the voices can be challenged in cognitive-behaviour therapy with psychosis is discussed, as are directions for future research.

Objective: This pilot study explored the feasibility and preliminary efficacy of a therapist-facilitated telecare cognitive behavioural anxiety program delivered through schools to children within rural communities. Method: Sixteen children aged 9–12 years (82.5% male), with a principal diagnosis of an anxiety disorder, and their mothers participated in the pilot study. The treatment program was an adaption of the Cool Kids Child and Adolescent Anxiety Management Program. Treatment was delivered by clinical psychologists and involved 10 weekly sessions with children via an interactive, real-time videoconferencing online platform at their school. Parents also received 4 phone calls during the treatment program. Outcome measures included clinician-rated diagnostic status and child- and parent-reported symptoms and interference. Results: According to combined parent and child reports, 62.5% of children no longer met diagnostic criteria for their primary anxiety disorder, and 31.25% did not meet diagnostic criteria for any anxiety disorder post-treatment. Results indicated that the severity of anxiety symptoms, functional impact of anxiety symptoms, externalising difficulties, and depressive symptoms in children decreased significantly post-treatment, as reported by both parents and children. Conclusions: A telecare model of therapy could be a feasible and effective way of delivering evidence-based intervention to children in rural communities.

This paper is a review of studies on psychological treatments for positive psychotic symptoms, and a detailed description of two of these studies, the Manchester Symptom Project, which aimed to decrease positive symptoms by training patients in effective coping strategies, and the Liverpool Auditory Hallucination project, which aimed to provide a cognitive-behavioural treatment for individuals with persistent and distressing voices. The results from these studies indicate that enduring positive symptoms which have not responded to neuroleptic medication can be effectively treated by psychological methods.

Worry has been defined as a primarily cognitive process closely related to fear or anxiety. This definition is widely accepted by clinicians and researchers investigating worry and is often provided to research participants, especially to children. The present study aimed to empirically test the proposition that both adults and children conceptualise worry as a cognitive process, and that they differentiate it from fear on the basis of worry's relatively stronger association with thinking. Groups of 45 adults and 70 children completed three versions of a worry list questionnaire, reporting on the extent to which they worry about, are afraid of, and think about a list of negative outcomes. Regression analyses showed that in adults, thinking about a negative outcome had a significant unique association with worrying. In children, however, worrying was more strongly associated with fear ratings, especially in the case of physical outcomes. The data suggest that adults and children report on different concepts when they rate their worries via questionnaires. This difference may reflect developmental changes in the worry process itself, or developmental changes in the way individuals interpret and respond to worry list questionnaires. Follow-up studies using alternative methodologies are now needed to further clarify the results.

Many children are reported by parents to exhibit problems of conduct at home, and similarly many children are reported by teachers to exhibit conduct problems at school. Surprisingly, very little research has examined the extent to which children exhibit behavioural problems in the clinical range at both home and school. The current study examined the co-occurrence of problems at home and school in a sample of 189 children in schools in Victoria. The total sample consisted of (a) 124 children whose parents responded to invitations to participate distributed through schools, and (b) 65 children who had been referred to various agencies because of conduct problems. The occurrence of problems at home was assessed using the Child Behaviour Checklist (Achenbach & Edelbrock, 1983), and problems at school were assessed using the Teacher Report Form (Achenbach & Edelbrock, 1986). For the school sample, 7 children (5.6%) exhibited conduct problems in both settings (scores in the borderline/ clinical range), with 27 children (21.7%) exhibiting them in one setting only. For the clinic sample, 39 children (60.0%) exhibited problems in both settings, with 21 children (32.3%) exhibiting them in one setting only. The results of this study indicate the need for interventions that can be used consistently across home and school settings, as well as independently in single settings when warranted.

This study compared the effectiveness of prompts (signs) and posted feedback as litter control strategies in two university cafeterias. Patronage and litter rates were monitored daily throughout the second term of the academic year. Prompts, prompts and posted feedback, and posted feedback were presented sequentially within a multiple baseline across settings experimental design. While litter rates initially declined in the presence of prompts, the addition of posted feedback did not have an additive effect; however, subsequent removal of prompts produced further reductions in litter rates, which were still evident during follow-up 5 weeks later. Results suggest that posted feedback is an effective and inexpensive method of Utter control.

One means by which Intolerance of Uncertainty (IU) purports to contribute to anxiety is by increasing Threat Perception (TP). This process was examined by comparing two different definitions of uncertainty: ambiguity versus unpredictability. N = 104 participants were measured for IU and then made worry and TP estimates for four different scenario types: Ambiguous Scenarios (where an outcome could be interpreted as threatening), Unpredictable Positive Scenarios (where a surprising and positive outcome was anticipated), as well as Positive and Negative Scenarios (with certain outcome). Both Ambiguous and Unpredictable Positive Scenarios more strongly predicted the relationship between IU and worry scores than (certain) Positive or Negative Scenarios. The relationship between IU and ‘ambiguous worry’ was largely explained by TP estimates, whereas the relationship between IU and ‘Unpredictable Positive Worry’ was largely independent of TP. Results suggest ambiguity and unpredictability are differentially explained by TP such that they produce different types of response. The authors argue ambiguity and unpredictability are explanatory components within IU.

This study evaluated the reliability and factor structure of the NEO Five-factor Inventory (NEO-FFI) among a sample of Australian adolescents (N = 459). With the exception of openness, the factors had good internal consistency. Item-level factor analyses using varimax and oblique rotation were used to examine the factor structure of the NEO-FFI. Visual inspection of the factor structures revealed a pattern that gave preliminary support for the five-factor model. However, statistical indices for factor structure did not support a five-factor model. Items for Conscientiousness and Neuroticism had the highest factor loadings and the fewest conflicting cross-loadings on the other factors. The discussion focuses on the importance of external validation of the traits from the five-factor model with other behavioural indicators.

There is evidence suggesting that obsessive–compulsive disorder (OCD) in adults may be associated with an impaired ability to recognise the facial expression of disgust (Sprengelmeyer et al., 1997a; Woody, Corcoran, & Tolin, in press). It has been suggested that this impairment begins in childhood when the recognition of emotional expressions is being learnt (see Spengelmeyer et al., 1997a). This study compared the recognition of facial affect in children aged around 11 years with a diagnosis of obsessive–compulsive disorder (OCD; n = 11), other anxiety disorders (n = 20), and nonclinical children (n = 19), adapting the methodology of Sprengelmeyer et al. Disgust was most commonly misclassified as anger by children in all three groups. However, children with OCD did not show any evidence of a recognition deficit for disgust in comparison to either control group. Unexpectedly, however, children with OCD recognised expressions of surprise more accurately than nonclinical children. Recognition of disgust or any other emotion was not related to child self-reported anxiety symptoms. Given the observed differences in some studies with adults, future research may benefit by examining older adolescents and young adults to determine when these effects may first be noticed.

Traditionally, mental health professionals and school authorities have found school refusal to be a perplexing and challenging problem. Relevant to an understanding of school refusal, we initially review some important developmental-normative considerations. The clinical features, epidemiology, and etiology of school refusal are also briefly discussed. We then describe a number of behavioural strategies that have been used in the management of school refusal. Finally, we review the research support for the efficacy and acceptability of behavioural strategies in the treatment of school refusal.

This paper reviews the recent behavioural research on instruction of children and young adults with mental retardation in schools settings and community-based school programs. Instructional research in 12 skill areas (motor, self-care, communication, social skills, choice making, school behaviours, health and safety skills, home management, leisure skills, community use, vocational skills, and academics) meeting specified criteria on population (age and disability), location of instruction, functionality of skill, and research integrity was identified in 11 journals from 1990 through 1996. The pool of identified research is discussed by skill category and by intervention method, with critical comments made regarding strengths and weaknesses. Conclusions are drawn for practitioners and future researchers.

The use of visual analysis alone to determine the presence of significant and generalizable effects in typical behavioural interventions is subject to a series of possible errors which result in high levels of unreliability when data are analysed in this way. The presence of autocorrelation in most behavioural data poses a serious threat to visual and traditional analysis of such data, a threat which can be avoided by use of the more appropriate interrupted time-series (TMS) statistics. Although previously suggested as reasons for not using TMS procedures, the issues of model-identification and number of data points required for TMS are discussed and shown to be invalid arguments against the use of TMS. A case is made for visual analysis of behavioural data as an appropriate procedure only under certain constrained clinical conditions.

General practitioners have been suggested as occupying a position in the community that offers considerable potential for reducing the prevalence of health risk behaviours. Green, Eriksen, and Schor (1988) have proposed that if general practitioners are to effectively adopt a role in modifying patient health risk behaviours, a number of prerequisite conditions must be met. Using the model proposed by Green et al., this paper reviews the literature to describe the circumstances under which general practitioners currently practise this role. The review focuses on the circumstances relating to practitioner modification of one patient health risk behaviour: smoking. Research detailing the extent of practitioner involvement in the modification of this risk behaviour is also reviewed. The paper concludes by discussing the opportunities available for behavioural scientists to facilitate general practitioners' adoption of a role in patient smoking cessation.

The present study explored whether particular discrepancies among an individual's self-beliefs, as described by Higgins’ (1987) Self-Discrepancy Theory, were differentially related to the two broad situational domains of social anxiety: performance and social interaction anxiety. Fifteen people (4 males) with a primary diagnosis of GSP from Macquarie University's Emotional Health Clinic, and 25 undergraduate psychology students from Macquarie University (8 males) with mean chronological ages of 31.7 and 20.6 years respectively, participated in the study. As predicted, the study found that the ‘actual/other:ought/other’ self-discrepancy was uniquely related to performance anxiety, the ‘actual/own:ought/other’ self-discrepancy was uniquely associated with social interaction anxiety, and the ‘actual/own:ideal/own’ self-discrepancy was uniquely associated with depression. The results are discussed in terms of their unique contribution to Self-Discrepancy Theory research, the current empirical debate regarding the existence of subtypes within social phobia, and their implications for the cognitive models and treatment of social anxiety.

Translating existing internet-based cognitive-behavioural therapy (iCBT), along with the use of transdiagnostic and self-guided formats, may prove to be a cost-effective option of disseminating iCBT. Only recently have encouraging findings been reported for a self-guided delivery. This study assessed the feasibility of a French and self-guided version of an existing English iCBT course, called the Wellbeing Course, for the treatment of anxiety and depression. Existing ICBT programs have not yet been delivered in French, although this language is spoken worldwide. Thirty-one participants were included in a single group pre-post open trial with a 3-month follow-up. Feasibility outcomes were attrition, treatment adherence, acceptability, and preliminary efficacy. Primary outcome measures were the Patient Health Questionnaire 9-item (PHQ-9) and the Generalised Anxiety Disorder 7-item (GAD-7). Nearly 75% of the participants completed the program. Over 80% of the participants provided posttreatment and follow-up data. All study completers reported that they would recommend the Wellbeing Course to a friend having similar problems. Significant reductions in symptoms of anxiety and depression were found following treatment, consistent with earlier studies. These preliminary findings support the use of the assessed strategies to facilitate the cross-cultural dissemination of iCBT for a more universal access to quality psychological care.