Social Phobia (SP) is a psychological disorder characterised by an excessive and persistent fear of negative evaluation in social or performance situations that interferes with daily functioning. Cognitive models of SP (Clark & Wells, 1995; Hofmann, 2007; Rapee & Heimberg, 1997) emphasise the role of negative images of the self as an important factor in the maintenance of SP. While empirical research has demonstrated the link between negative self-imagery and social anxiety, many aspects of this cognitive factor are yet to be understood. Currently, there is limited research investigating the impact of different types of self-imagery and their effects on social anxiety and performance. Further research assessing the relationships between self-imagery and other maintaining processes proposed in cognitive models is also warranted. This review assesses the literature focusing on self-imagery in social anxiety, including qualitative, empirical, and preliminary treatment studies to date. Recommendations for future research and the use of imagery-based rescripting methods in the treatment of SP are also discussed.

This single-arm, open-label study aimed to investigate the efficacy of a cognitive-behavioural group training based on acceptance and commitment therapy (ACT) on cognition in drug-naïve children with attention deficit hyperactivity disorder (ADHD). Thirty-six children with ADHD aged 8–13 were invited to participate in the 9-month ACT training programme, which consisted of 26 weekly sessions of group therapy lasting 90 min each. Their parents also received 12 sessions of ACT-based parent training, every 2 weeks. The outcome measure for the present study was the change in the cognitive performance assessed by a battery of computerised task. The cognitive outcome of children receiving ACT-group intervention was compared to that of an external untreated control group of children with ADHD. No significant improvements were observed in any of the cognitive measures. This preliminary study suggests that the 9-month ACT-group training programme might not have positive effects on cognitive difficulties usually occurring in ADHD. Future randomised controlled trials with larger sample sizes are required to shed more light on this issue.

The Fear Questionnaire (FQ) has been widely used both nationally and internationally in the anxiety disorder literature. Research from a variety of centres advocating its psychometric properties and clinical utility is now available; however a critical and integrated review has been lacking. This paper offers an integration of empirical research for cross-cultural comparison and as a testament of the FQ itself. A refined FQ is also proposed to enhance its utility.

The purpose of this study was to examine the convergent validity and test–retest reliability of the Oxford Physical Activity Questionnaire (OPAQ), a self-administered questionnaire designed to assess the activity patterns of adolescents. The test–retest reliability of the OPAQ was assessed by administering the questionnaire on two occasions separated by 1 week (N = 87, mean age = 13.1 ± .9). Intraclass correlation (ICC) was used to examine the test–retest reliability of the OPAQ. The convergent validity of the OPAQ was evaluated using Caltrac accelerometers worn consecutively for 4 days (N = 51, mean age = 12.6 ± .5). Spearman's rank-order correlation was used to examine the convergent validity of the questionnaire. ICCs ranged from .76 to .91 and reliability was higher for males (r = .89) than females (r = .78). Correlations between self-reported physical activity and Caltrac accelerometer counts were related to vigorous physical activity (r = .33, p = .01) and moderate to vigorous activity (r = .32, p = .02). The OPAQ has excellent test–retest reliability and acceptable validity in comparison to other measures of youth physical activity.

Post-event processing (PEP), the act of engaging in a detailed, self-focused, and negative analysis of a prior social situation, has been hypothesised to contribute to the maintenance of social phobia (Clark & Wells, 1995). In light of this proposal, the present study investigated whether deliberate engagement in PEP as opposed to distraction following a speech task elicits unhelpful effects on emotion, cognition, and behaviour in a subsequent speech task in high and low socially anxious participants. The PEP manipulation instructed participants to focus on the anxious thoughts, images, feelings, and somatic sensations relating to the first speech. Contrary to hypotheses, results demonstrated that engaging in PEP as opposed to distraction led to a number of constructive outcomes such as: increased willingness among low socially anxious participants to give the second speech, a reduction in negative performance appraisals and underestimation of performance among high socially anxious participants, and better self-perceived speech quality irrespective of social anxiety level. However, there were no effects of response condition on anxiety, performance appraisals, observable behaviour, and negative cognitions. The findings underscore the need for additional research identifying the precise contents, construals, and processing modes that distinguish between adaptive and maladaptive forms of PEP.

In a pilot evaluation study, effectiveness of a 20-week dialectical behavioural therapy (DBT) skills training group program was explored for adult clients with borderline personality disorder (BPD; N = 140). Subjective ratings of depression, anxiety and BPD symptomatology were obtained pre and post group therapy. Objective measures of service utilisation levels were obtained for the 6 months prior to group therapy, the duration of therapy, and the 6 months following therapy. Group completers (n = 68) showed reductions in depression, anxiety and BPD symptomatology, as well as in the number of emergency department attendances. Completers with previous high service utilisation had decreases in telephone counselling calls and inpatient days during therapy, and fewer emergency department attendances post therapy. Completers had larger decreases in service utilisation than noncompleters (n = 72). Simultaneous engagement in individual DBT was related to higher group completion than was individual therapy as usual, but it did not impact on level of service utilisation or psychological functioning. This quasi-experimental pilot study suggests that DBT groups may improve psychological functioning and decrease service utilisation for BPD clients, particularly those with high service utilisation. The treatment warrants systematic evaluation.

This study aimed to compile existing evidence about the proposed relationships among variables at three stages of the model of therapeutic engagement (MTE): patient intention to engage in cardiac rehabilitation (CR), CR initiation, and sustained engagement. This model has not been tested in any rehabilitation setting. Therefore, this systematic literature review is key to future research and application of MTE to predict and enhance patient engagement in CR. Model-centric systematic literature reviews have been conducted for each stage of the MTE. A coherent approach to understanding and monitoring the process of patient engagement in CR is absent. Few relevant studies included in the model-centric reviews met the criteria: eight in stage 1, four in stage 2, and six in stage 3 of the MTE. In total, the tenets of the MTE were supported in patient intention to engage in CR. However, there was less evidence quantifying the proposed relationships among variables that impact on CR initiation and sustained engagement. There is a scarcity of research examining rehabilitation engagement in depth to better understand the complicated process contributing to behavioural outcomes. No decision-support models currently exist to alert patients and healthcare provider to the factors that influence non-engagement.

Childhood obesity treatment programs only result in moderate outcomes in the short term and do not reduce risk for future weight gain. Therefore, in the current study, Approach Avoidance Training (AAT) with motivational game elements will be added to an inpatient childhood obesity program with the aim of improving outcomes. Forty-one children (10–15 years) in the final months of an inpatient treatment program were randomised to either the AAT plus care-as-usual condition group or to a care-as-usual-only control group. During the 10 sessions, the children were trained to approach healthy food stimuli and to avoid unhealthy food stimuli. Treatment outcomes were child performances on tasks of AAT, implicit attitudes and attentional bias, self-report ratings on craving symptoms, and weight loss maintenance after leaving the clinic (12-week follow-up). Changes over time were not significantly different between conditions for the measures of automatic processes, craving, and weight loss maintenance. Possible accounts for the null findings, including sample size, influence of game elements, point of time in therapeutic process, limitations of the setting, and the control group are discussed. More research is needed before firm conclusions can be drawn about the clinical usefulness of CBM for weight control in childhood obesity.

Relapse prevention is a multimodal, cognitive-behavioural approach to treating, among other types of clients, child molesters. Rather than positing a cure as the outcome of treatment, it emphasises self-management and personal responsibility for avoiding or coping with situations that threaten self-control. The motivation to use these self-control strategies is likely to vary according to beliefs about the causes of their offending behaviour, particularly as a function of the degree to which they are seen as controllable. Fifteen child molesters, classified as preferential or situational type, and familial or nonfamilial, from the Kia Marama unit at Rolleston Prison reported on their causal beliefs concerning their offence-related behaviour at four points in their description of their most typical or recent relapse. This assessment was carried out at four points in the 35-week relapse-prevention based treatment program.

All participants made clinically positive changes in their causal ascriptions over treatment. Preferential participants judged the cause of their offending to be less controllable, and more stable at the time of offence, and more global than situational offenders. Compared with non-familial participants, incestuous participants evaluated the cause of their offending to be less stable at the time of their offence and less global across all the assessment points. The results are discussed in terms of the utility of attributional assessment as an interim measure of progress, particularly with respect to motivation to avoid reoffending.

Crime impacts upon the community at multiple levels, causing distress and loss for the victims, and feelings of insecurity for the public, as well as adding to the drain on financial resources for governments. This makes the accurate identification of risk of reoffending and the determination of efficacious rehabilitation strategies imperative. Key principles in cognitive and behavioural psychology can contribute to this task. This paper will review the issue of risk assessment and describe the applicability of functional analysis to forensic psychology. Two studies by the authors will be used to illustrate concepts raised in this review. The paper will conclude with a model that may help guide the realistic implementation of detailed individual functional analyses of offenders' behaviour.

Anxiety disorders in young children are highly prevalent and increase the risk of social, school, and familial problems, and also of psychiatric disorders in adolescence and adulthood. Nevertheless, effective interventions for this age group are lacking. One of the few available interventions is the Fun FRIENDS program. We examined whether young children with anxiety disorders showed less anxiety after participating in Fun FRIENDS. Twenty-eight clinically anxious children (4–8 years old) participated in the cognitive behavioural Fun FRIENDS program. The program consists of 12 weekly 1.5-hour sessions and was provided in groups of 3 to 5 children. At preintervention and direct postintervention, parents completed the Anxiety Disorders Interview Schedule for Children and Child Behavior Checklist. Clinically and statistically significant decreases were found in number of anxiety disorders, symptom interference, emotional and behavioural problems, internalising problems, and anxiety problems. The decrease in anxious/depressed problems and externalising problems was not significant. Furthermore, higher preintervention anxiety levels predicted more treatment progress, whereas sex and age did not. The Dutch version of Fun FRIENDS is promising in treating anxiety disorders in young children. Randomised controlled trials are needed to draw definite conclusions on the effectiveness of Fun FRIENDS in a clinical setting.

This study reported on the efficacy of Reciprocal Skills Training (RST), a family-based treatment modality for childhood externalising disorders. Children (N = 57) ranging from 7 to 12 years old who fulfilled diagnostic criteria for oppositional defiant disorder were randomly allocated to RST (in either a hospital or clinical setting) or a waiting-list control group. At posttreatment, no significant differences were observed across the two treatment settings. Results indicated that 95.5% of children in the hospital setting and 72.2% of children in the clinical setting no longer met criteria for oppositional defiant disorder, compared to 30% of children on the waiting list. Children in the treatment groups also obtained significantly lower scores on the Externalising scale of the Child Behaviour Checklist, compared to the waiting-list group. In addition, mothers' levels of stress and depression were significantly reduced at posttreatment, compared to mothers of children on the waiting list. These findings suggest that RST is an effective treatment modality for children displaying externalising behaviours, as well as for their mothers. The results are discussed in terms of limitations of the current study and future directions for research and clinical practice.

Assessment and feedback of relationship strengths and challenges is a widely used brief approach to couple relationship education (CRE). It can be fully automated through the internet, with couples self-interpreting the feedback. This study assessed whether therapist guidance of couples to interpret the report and develop relationship goals enhanced the benefits of the feedback. Thirty-nine couples seeking CRE were randomly assigned to either self-interpretation of an internet-based relationship assessment report (RELATE), or therapist-guided interpretation of the same report (RELATE+). Participants were assessed on relationship satisfaction and psychological distress pre- and post-CRE, and at 6-month follow-up. RELATE and RELATE+ were not reliably different in outcome. Couples in both conditions sustained high relationship satisfaction and showed an overall decline in psychological distress. However, consumer satisfaction was substantially higher for the RELATE+ condition than the RELATE condition.

Proponents of behavioural intervention have often advocated consultation as a means for disseminating behavioural innovation to nonpsychologists. However, experience suggests that the benefits of consultative arrangements are mostly localised, and that widespread dissemination is unlikely to be achieved through this process. The current “crisis in education” in the United States is given as an example of the limited effectiveness of dissemination through consultation. An alternative approach is examined, which aims to disseminate behavioural science knowledge to nonpsychologist practitioners during the formative stages of their professional education. This alternative, dissemination through foundation education, is illustrated by describing recent initiatives at La Trobe University. Several potential concerns that behaviour analysts may have about the dissemination of behavioural innovation to nonpsychologists are examined, including concern that behavioural scientists may lose their distinctiveness, the fear that behavioural scientists may be “giving away” valuable expertise, the conviction that behavioural scientists must retain control over behavioural innovation, the belief that dissemination will result in misuse of behavioural innovation, and the claim that it is futile to disseminate behavioural science knowledge because it is not valued by other health professionals. These various concerns were found to be unwarranted.

Cardiophobic persons repeatedly present with complaints of chest pain and heart palpitations accompanied by fears of having a heart attack and of dying. They focus attention on their heart when experiencing stress and arousal, perceive its function in a phobic manner, and continue to believe they suffer from an organic heart problem despite repeated negative medical tests. To reduce anxiety, they seek continuous reassurance, make excessive use of medical facilities, and avoid activities believed to bring on symptoms. This article analyses the evidence for viewing cardiophobia as a phobic disorder in its own right rather than merely a problem of non-organic chest pain with some overlay of anxiety and depression. Despite some overlapping symptoms shared with persons who suffer from panic disorder, illness phobia, and extreme health anxiety, a number of central and defining features of cardiophobia are identified to differentiate cardiophobia from other anxiety disorders. An integrative model for understanding the origin and maintenance of cardiophobia (Eifert, 1990) is summarised and some treatment recommendations are derived from this model to target the central problems of persons with cardiophobia. Directions for future research are also discussed.

The Adolescent Risk-taking Questionnaire (ARQ) was developed to comprehensively assess adolescent risk-taking beliefs and behaviours. Research has shown that it is a reliable instrument with strong construct validity. The current study investigated the convergent and discriminant validity of the ARQ by comparing responses of a sample of 52 male adolescents from a juvenile justice centre and 211 school-attending male adolescents. Consistent with past research, the juvenile justice centre youth reported significantly higher levels of depression and less optimal levels of parent attachment compared to school-attending youth. Convergent validity of the ARQ was demonstrated through significant relationships between attachment and risk-taking. Specifically, those adolescents with less optimal parent attachment were more likely to engage in risk-taking behaviour and were less likely to perceive the behaviours included in the ARQ as risky compared to those with more optimal levels of parent attachment. Discriminant validity of the ARQ was demonstrated through significant differences between the two groups on risk beliefs and behaviours. Responses on the ARQ indicated that youth from the juvenile justice centre were significantly more likely to engage in risky behaviours, if given the opportunity, than school-based youth. They also perceived the behaviours to be less risky. It was concluded that the ARQ has good convergent and discriminant validity.

The present study evaluated the efficacy of an Assertive Community Treatment (ACT) program for the seriously mentally ill. Outcomes of the program were assessed at baseline and 12-month follow-up and were compared with that of a control group, which received standard community care. Thirty-six subjects with serious mental disorders participated in the study. Dependent measures included number of hospital admissions and hospital bed days per year, life skills, quality of life, and psychiatric symptoms. Results of 2 x 2 (treatment/control group x baseline / 12-month follow-up) repeated measures ANOVAs indicated that, after 1 year, both treatments lead to a significant reduction in hospital admissions and bed days, and to improvement in life skills. ACT subjects evidenced a greater decrease in psychiatric symptoms compared to control group subjects. In general, markedly more ACT subjects showed reliable clinical change in life skills, quality of life, and psychiatric symptoms than control subjects. Although the ACT did produce greater clinical change than standard case management, it did not produce statistically greater improvement across most domains of functioning in the short term.

Some recent developments in the use of interrupted time-series analysis (ITSA) are described with particular reference to the detection of effects with short data series such as those often encountered in applied behaviour analysis. The necessity to perform the sometimes troublesome model-identification procedure is questioned, and the likely incidence of Type 1 and 2 errors is discussed. Conclusions are drawn to suggest that ITSA may be safely applied to data that are typical of those collected in applied behaviour analysis.

While structured behavioural interviews are often used in the assessment of problem behaviours among persons with developmental disabilities, there are no data on the reliability of this assessment methodology. In the present study, the reliability of a 15 item interview protocol was determined by comparing the answers provided by different staff concerning the aggressive behaviours displayed by 18 persons with severe disabilities. Agreement was generally low with an overall mean of 43% across clients and questions. The results suggest that information obtained from structured behavioural interviews should be verified by direct observation.

This article presents the current state of knowledge in deliberate-self harm (DSH). DSH presents as a comorbidity with a number of personality disorders and psychopathologies, but is also relatively common in the psychologically healthy population. Over the past 10 years, attention has shifted from the investigation of DSH as a cardinal or comorbid symptom of psychopathology to an attempt to understand the behaviour itself, without reference to other psychopathological processes. It is argued that this development in understanding the aetiology of DSH has not been matched by developments in treatment or management of DSH, with the majority of treatment programs targeting larger syndromes of which DSH is a symptom. Treatment regimes aimed at reducing DSH appear to be either untested or demonstrably unsuccessful.