A 64-year-old male who met criteria for social and generalised anxiety was treated using a brief behavioural activation (BA) approach. The intervention was delivered in twelve weekly 60-minute individual sessions. The effects of the intervention were assessed using a simple A-B-C phase change with repeated measurement design. Change in reported anxiety was recorded across phases. Decreased scores in self-reported anxiety measures were obtained and significant clinical improvement was maintained during a 4-month no treatment maintenance phase. This preliminary investigation suggests BA could be an efficient and effective treatment for anxiety and that replications are warranted.

Anxiety disorders occur at an increased rate in children with asthma; however, there is only a small evidence base to support specific psychological treatments for these children. The current study evaluated the efficacy of a pilot cognitive behavioural treatment (CBT) group intervention for children with asthma and a comorbid anxiety disorder in a case series design. Five children (aged 8–11 years old) with asthma and a comorbid anxiety disorder and their mothers took part in eight 1-hour group treatment sessions. Primary outcomes measures were anxiety diagnosis and asthma-related quality of life. Secondary outcome measures were asthma symptom control and parent quality of life associated with caring for a child with asthma. Three of the participants no longer met diagnostic criteria for an anxiety disorder following treatment and three different participants reported a reliable improvement in asthma-related quality of life. Two participants reported a reliable improvement in asthma symptom control. Three mothers reported an improvement in caregiver quality of life. The findings provide preliminary proof of concept evidence for the efficacy of a CBT intervention for children with asthma and clinical anxiety.

Objective: This study examined whether differences in habitual negative self-thinking and coping strategies might contribute to the age differences in worry and depression. Method: 60 undergraduate students (age range: 18–24 years, M = 19.10, SD = 1.3) and 45 community-dwelling older adults (age range: 60–89 years, M = 73.5, SD = 7.5) participated. Participants completed self-report measures of worry, depression, negative self-thinking, and coping styles. Results: We replicated previous findings that older adults were less worried and less depressed than younger adults. Older adults also reported engaging in less habitual negative thinking and using more problem solving as a coping strategy than younger adults. Furthermore, negative self-thinking and problem-solving skills were found to partially mediate age differences in worry and fully mediate depression scores. Conclusions: These results suggest that habitual negative thinking and problem-solving skills play a role in explaining the lower rates of worry and depression in older populations.

Explicit measures of disgust and threat overestimation have consistently been found to be involved in contamination aversion. However, evidence of the involvement of these factors at the implicit level is mixed, and the role of both responses has not been looked at concurrently. This study aimed to compare the ability of implicit and explicit measures of disgust and threat overestimation to predict contamination aversion and whether this depends on the type of contaminant. Sixty-five participants completed explicit and implicit measures of disgust and threat overestimation, as well as several measures of contamination aversion, including obsessive-compulsive tendencies, and contamination fear and avoidance of contaminants directly associated with disease (direct contaminants) and harmful substances (harm contaminants). It was found that both explicit disgust and explicit threat overestimation predicted contamination-fear obsessive-compulsive tendencies. Explicit disgust predicted contamination fear and avoidance of direct contaminants, whereas explicit threat overestimation predicted contamination fear and avoidance of harm contaminants. The involvement of implicit processes was weak, with some suggestion of difficulty disengaging predicting avoidance of contaminants. Implications for understanding dysfunctional contamination aversion are discussed.

Chronic illnesses in children and adolescents present difficulties for the individual and family. A family systems perspective can provide directions for assessment and intervention with these children and their families. A review is made of research on family interventions for children with juvenile rheumatoid arthritis, cancer, and insulin-dependent diabetes mellitus (IDDM), and the influence of intervention on health outcomes is discussed. Few family interventions, particularly behavioural family interventions, have been rigorously evaluated, but multisystemic models show promise for improving children's health outcomes and family adaptation to chronic illnesses.

The present paper argues that discussion of the role of reasoning in clinical neuropsychology has been largely restricted to a debate over the reliability and validity of end-stage decision-making. This has sometimes led to heated debate, but has not resulted in any careful consideration of either the process of clinical reasoning or the cognition of the clinician. There is already a wealth of theory and research on the kinds of errors typical of human judgement and decision-making. Moreover, much of this work is particularly relevant for neuropsychology, being frequently based on research on medical diagnosis. This literature is briefly reviewed, with examples that demonstrate the relevance of research in this area for clinical neuropsychology. Then, a step-by-step approach is taken to examining the process of clinical neuropsychological assessment, with consideration at each step of some of the issues that arise demanding clinical reasoning. Finally, the article is briefly summarised and some implications for clinical training are advanced.

In recent years researchers and clinicians have paid increasing attention to posttraumatic stress disorder (PTSD) in children and adolescents. Issues of definition and evaluation are discussed and studies of children subsequent to natural disasters, accident, war, sexual abuse and human-made traumas are reviewed. Issues relating to treatment and “debriefing” are also discussed.

The long-term outcome (mean follow-up period 5.7 years) for 20 patients with anorexia nervosa was assessed on a comprehensive battery of self-report inventories and a structured clinical interview. Two thirds of the cohort were improved to a clinically significant degree at follow-up, but the majority still showed higher than normal scores on inventories of anorexic symptomatology, social maladjustment, anxiety, and hostility. The remaining one third were unimproved and demonstrated a broad range of impairment including distorted attitudes toward eating, overconcern about body shape, poor social functioning, high levels of anxiety, hostility, depression, and external locus of control. Moderate to strong correlations were found across outcome measures. Longer duration of eating difficulties before presentation was a strong predictor of poor long-term outcome, suggesting a chronic relapsing form of the disorder occurred in a subgroup of patients.

In an attempt to facilitate the dissemination and regular implementation of behaviour treatments in real-world settings, research has examined staff attitudes that may pose barriers to these treatments. The purpose of the study reported in this paper is to examine the construct validity of perceived organisational barriers to behavioural programs. One hundred and eighteen staff working in community-based treatment programs for adults and children with severe mental illness completed the Barriers to the Implementation of Behavior Therapy Test. An analysis from a previous study (Corrigan, Kwartarini, & Pramana, 1992) identified two reliable and valid factors that suggested perceived organisational barriers: institutional constraints and insufficient collegial support. Results of a confirmatory factor analysis on data from this study supported the earlier factor structure. Research participants also completed team functioning measures of individual staff burnout, collegial network satisfaction, organisational culture, and team leadership. Attitudes about institutional constraints and insufficient collegial support were found to be associated with burnout, collegial network satisfaction, and organisational culture. Strategies for disseminating behavioural programs must target organisational barriers too.

Four sexually abused girls participated in a 12-session group training program focused on improving interpersonal problems identified by the girls' teachers. Prior to and following the intervention, the girls underwent role-play assessment of their behaviour in relevant social situations with peers and teachers, and completed a self-report measures of perceived self-concept. For two of the girls, teachers completed checklists of their behavioural functioning before and after the intervention. On the role-play measure, the girls showed improvement on all of the trained behaviours (with peers and teachers), and evidenced behavioural improvements on untrained (generalisation) scenes. In addition, the girls reported improvements in perceived academic competence, peer functioning, appearance, and global self-concept following the training program. The study provides an example of a behavioural skills-training approach to address interpersonal deficits that may be shown by sexually abused children.

This review outlines the main theoretical and methodological issues relating to worry. The relationship of worry to anxiety and problem solving is discussed. Three models of worry are described: attention bias (Mathews, 1990), fear avoidance (Borkovec, Shadick, & Hopkins, 1991), and Tallis and Eysenck's (1994) stage model. Worry's proposed role in inhibiting emotional processing is discussed, and unresolved methodological and theoretical issues are considered. It is concluded that worry is elusive and difficult to study but greater understanding of worry is necessary.

Behaviour analysis and therapy is based on the investigation of functional relations between behaviour and its controlling variables. This article focuses on the description of the functional relation and methods used for its research. In particular it presents unpublished data to illustrate how the continuous measurement of independent variables aids the identification of functional relations, research into generalization (a major problem area in behaviour analysis and therapy) and the development of parametric analyses. The implications of comprehensive functional analyses are discussed.

We assessed the effects of the Controlling Alcohol and Relationship Enhancement (CARE) program, an early intervention combining reduction of hazardous alcohol consumption and enhancement of couple relationships. Thirty-seven hazardous drinking couples were randomly allocated to either the CARE program or to a control condition. CARE couples improved their communication more than controls, but couples in both conditions reduced hazardous drinking to a similar extent. CARE is a potentially useful means of promoting positive relationship communication in hazardous drinking couples.

Whilst nearly all couple relationships start out happy, half of all marriages end in divorce. Relationship education is a potentially effective strategy to reduce the prevalence of relationship problems and divorce. The substantial empirical research on the determinants of relationship satisfaction shows that there are key relationship skills, such as communication and conflict management skills, which impact on the course of relationship satisfaction and stability. Relationship education can teach couples these key relationship skills, and this may prevent relationship problems. However, relationship education is not targeted at those couples who need it most. Research needs to be focused on the effects of relationship education for couples at high risk for relationship problems. The reach of education programs to couples can be enhanced by developing flexible delivery education programs. Relationship education programs also need to promote coping with stressful events that often lead to relationship problems, such as the transition into step-families, the onset of chronic illness, and unemployment.

This paper undertakes a conceptual and methodological examination of construct validation from the viewpoint of a scientific realist philosophy of science. It is argued that there is an important need to revise our thinking about the methodology of construct validation and to incorporate the revisions into clinical psychological practice. After a brief characterisation of construct validation, the paper points out the inadequacies of operationalism and cautions against the heavy appeal to definitions in science. Thereafter, psychology's standard construct validation strategies of hypothetico-deductive testing and null hypothesis significance testing are criticised, and the importance of abductive reasoning for construct validation is spelled out.

The current study provided psychometric information on the parent and child version of the Behavioural Inhibition System (BIS)/Behavioural Approach System (BAS) scale. Parent-child agreement was evaluated (N = 217, 7.5 to 14 years, 50% boys). Moreover, absolute and rank order stability of mother-reported BIS/BAS scores over a 2-year period were assessed (N = 207, 5.5 to 11 years at baseline, 49% boys). Only full measurement invariant (sub-)scales were considered in the parent-child agreement and longitudinal stability assessment. Parent and child ratings were found to be measurement invariant but discrepant on BAS Drive and BAS Reward Responsiveness. In younger children, child ratings on BAS Drive tended to be higher than parent ratings, whereas in older children, child ratings tended to be lower than parent ratings. Further, the discrepancy between the BAS Drive ratings of fathers and children was higher than the discrepancy between the BAS Drive ratings of mothers and children. Finally, the study results suggested 2-year absolute and rank order stability of the measurement-invariant, mother-reported BIS and BAS Drive scores in children aged 5.5 to 11 years at baseline.

The case history of a woman with severe and enduring anorexia nervosa and obsessive–compulsive disorder (OCD) with contamination fears is presented. These contamination fears centred on her fear of contamination by fat and fatty substances as she worried about gaining weight. Previous treatment with graded exposure had shown no clinically significant benefits. She was admitted to a specialist unit for the treatment of OCD as an inpatient. Due to the previous failure of the recognised psychological treatments for OCD it was decided to use the new psychoeducational approach of danger ideation reduction therapy (DIRT). This treatment resulted in an improvement in her OCD symptoms despite the fact that the emphasis of the treatment was on the risk of bacteria and dirt. It is believed that this is the first documented case of DIRT being used for a patient with anorexia nervosa and OCD.

A system of assessing social competence based on empirical analysis of a sample of non-referred subjects was applied to a group of subjects referred for social skills training. Scores obtained with the system discriminated between the referred and non-referred subjects. Data also supported the use of the system to evaluate changes which occurred during the course of the training program. However, this finding was not uniform across all subjects. Discussion centres on the variables which might account for this lack of uniformity and on further applications for the system as a research and therapy tool.

The traumatic stress field has expanded dramatically over the last 10 years. This paper provides a review of progress in three areas from the domain of posttraumatic stress responses. First, recent developments in diagnosis are discussed, with particular reference to the proposed diagnostic criteria for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition; American Psychiatric Association, in press). Second, a theoretical formulation based on cognitive processing principles is presented and, where available, empirical support for such a conceptualisation is provided. Third, the implications of a cognitive processing paradigm for treatment are discussed briefly, with reference to recent research findings. Suggestions for future development of the field are provided.

The Cognitive Behavioural Therapy Group Program at Central Coast Mental Health Specialty Clinics includes treatments for generalised anxiety disorder, panic disorder and depression. This study provides empirical validation for hypotheses developed in clinical controlled studies; that is, that cognitive-behaviour therapy provided benefits in the treatment of anxiety and depression in a service setting. This would be reflected in decreases in the symptoms of anxiety and depression and increased self-esteem. Participants (N = 139) were referred to Specialty Clinics, Central Coast Mental Health Services for treatment for depression and/or anxiety in CBT groups. They were tested on the BDI, STAI and the SERS at three time points, prior to entering the group, at termination of the group and at 3-month follow-up. Depression and anxiety symptoms decreased and self-esteem increased between pre- and post-group and the trends continued to 3-month follow-up.