The Self-Regulatory Executive Function (S-REF) model of affective dysfunction (Wells & Matthews, 1994) suggests that metacognitive beliefs are important for initiating and maintaining repetitive thought processes in emotional disorders. Rumination is reported by socially anxious individuals, yet it is not known whether this group endorse positive beliefs about the utility of rumination. We predicted that higher levels of social anxiety would be positively associated with stronger positive metacognitive beliefs about rumination. In Study 1 (N = 250 undergraduates), a measure of social anxiety was positively correlated with a measure of positive metacognitive beliefs about rumination, even when controlling for gender and level of depression. Given this result, we then attempted to replicate the finding in another sample, as well as test whether positive metacognitive beliefs about rumination would mediate the relationship between social anxiety and trait rumination. In Study 2 (N = 124 undergraduates), a social anxiety composite measure was positively correlated with a measure of positive metacognitive beliefs about rumination, even when controlling for gender, level of depression and level of rumination. Positive metacognitive beliefs about rumination were also shown to partially mediate the relationship between social anxiety and trait rumination. These results support the S-REF model and provide a potential account of why socially anxious individuals engage in rumination. Implications for the treatment of social anxiety are discussed.

This study was designed to test whether there is a functional relationship between sensory stimulation and stereotyped movements (SM). Four children with autism and intellectual disability (according to DSM-IV criteria) who showed stereotyped movements were studied. The Short Sensory Profile was used to define whether a child perceived stimulation within each sensory modality as aversive, attractive, or neutral. The Stereotyped and Self-Injurious Movements Interview was used to identify each child's repetitive movements. Children were then exposed to sensory stimuli that were neutral, aversive or attractive. Results indicate that children: (a) initiate or increase stereotyped movements immediately following the onset of an aversive stimulus, (b) terminate or decrease stereotyped movements following the onset of an attractive stimulus and (c) initiate or increase stereotyped movements during periods of neutral stimulation. We conclude that stereotyped movements are functionally related to sensory stimulation; individuals who frequently engage in stereotyped movements may do so in order to cope with under-stimulation and aversive over-stimulation.

Recently, death anxiety, or dread of death, has been proposed as a key transdiagnostic process underlying the anxiety disorders, depressive disorders, somatic disorders, and trauma and stressor-related disorders. In fact, it has been argued that death anxiety underlies all psychopathology, and is more fundamental than perfectionism, a process which was previously considered the root of mental illness. However, there has been a paucity of research examining the relationship between death anxiety and the eating disorders, although these conditions have been found to be strongly related to perfectionism. The present study therefore aimed to examine whether death anxiety is related to disordered eating, and whether death anxiety is a better predictor of disordered eating than perfectionism. A sample of 164 participants (132 female), average age 33.55 years (SD = 15.45 years), completed an online survey comprising background questions (age, sex, diagnosed psychiatric disorder), the Eating Attitudes Test — 26 item version (EAT-26), the Almost Perfect Scale — Revised (APS-R), the Rosenberg Self-Esteem Scale (RSES), and the Death Anxiety Scale (DAS). The findings of a hierarchical multiple regression analysis with EAT-26 as the dependent variable, age entered at Step 1, the RSES and APS-R entered at Step 2, and the DAS entered at Step 3 showed that only death anxiety and self-esteem were independent predictors of disordered eating at Step 3. A simultaneous multiple regression analysis was subsequently run with age and the APS-R alone as predictors of EAT-26 scores. This analysis showed that perfectionism was only a predictor of disordered eating when death anxiety and self-esteem were not included in the regression model. Death anxiety and self-esteem both appear to be important transdiagnostic processes.

The present study examined the cognitive inhibition hypothesis (Kindt, Bierman, & Brosschot, 1997) which asserts that young children lack the ability to inhibit the processing of threat, but develop this with age. To examine this issue, high spider fearful children (N = 170) and low spider fearful children (N = 215) aged 7—11 years were tested by means of an emotional Stroop task. It was hypothesised that a processing bias for spider-related stimuli would be present in all 8- and 9-year-old children. That is, it was expected that responses to spider words would be slower compared to responses to control words. Furthermore, it was hypothesised that this processing bias would decrease with age in low fearful children, whereas it would persist in high fearful children. No support was found for these hypotheses. Instead of the predicted processing bias, data showed the reverse pattern; that is, children responded faster to spider words compared to control words. It is proposed that the reverse bias results from avoidance. More precisely, children may evade the processing of spider stimuli through fast responding.

In Australia, acculturating adolescents from a non-English speaking background (NESB) face two important challenges: developing a cultural identity and establishing a set of cultural values. These challenges are achieved by balancing a native and Australian orientation. It was expected that NESB adolescents who did not achieve these tasks would experience poor mental health. This study focused on adolescents because a significant relationship between cultural identity, cultural values and mental health in this group will highlight a need for sensitivity to such cultural and developmental issues. Two hundred and sixty-three NESB adolescents completed questionnaires that assessed cultural identity (Australian and native), cultural values (individualism and collectivism), state mental health (depression, anxiety and stress) and trait mental health (positive affectivity [PA] and negative affectivity [NA]). Results indicated that high Australian pride and high native pride are associated with lower depression, anxiety, stress and NA, and higher PA. Results also indicated that adolescents high on individualism and collectivism reported lower depression and stress, and higher PA. Furthermore, adolescents with a separated cultural identity (high native pride and low Australian pride) reported the highest levels of depression, but adolescents with separated cultural values (high collectivism and low individualism) reported the lowest levels of depression and anxiety. We concluded that cultural identity and cultural values are differentially related to mental health, and such relationships, albeit moderate, emerge during adolescence.

With the recent exponential increase in Internet use, there are concerns about obstacles to gaining access to this potentially beneficial technology. To understand the psychological factors that might be offering barriers to Internet use, the present study considered age, attitudes towards computers, gender, education and social isolation as potential predictors of Internet usage. A sample of 158 adults completed questionnaires about computer anxiety, loneliness and Internet use. Time spent in activities associated with entertainment, communication, information searches and commerce, and overall time spent on the Internet were analysed using multiple regression. It was difficult to predict overall Internet use, but possible to predict specific categories of use. Better-educated participants were more likely to use the Internet for communication. Men, the young, and the lonely used the Internet more for entertainment. Those with lower computer anxiety used the Internet for information searches, and men were more likely than women to use the Internet for commercial purposes. It is suggested that computer anxiety and education may constrain the use of specific applications but Internet use otherwise follows pre-existing tendencies or interests.

Physical inactivity is a risk factor for a number of chronic diseases, including cardiovascular disease. Interventions designed to reduce the prevalence of physical inactivity have focused primarily on either adoption of physical activity or noncompliance and relapse, and no interventions have been reported which cover adoption, compliance, maintenance, and relapse, particularly within the clinical setting. The Fresh Start program, a multiple risk factor intervention program for the reduction of cardiovascular disease risk factors in general practice patients, was developed to cover all aspects of the adoption and maintenance of habitual physical activity, using Prochaska and DiClemente's Transtheoretical model. The evaluation of the program on cardiovascular disease risk factors and behaviours provided the opportunity to evaluate the impact of a staged program on patient physical activity behaviour. The program was evaluated in a randomised controlled trial in Sydney's Western, South-western, and Wentworth regions with 80 volunteer general practitioners and 758 volunteer patients between January 1991 and January 1993. Self-reported physical activity data were used as the basis for estimating energy expenditure due to leisure-time physical activity. The results failed to show any differences between groups over time, as a function of patients' baseline stages of change, and as a function of baseline activity levels. There were some indications, however, that the least active would respond to doctor-based advice to increase their physical activity, and that doctor advice would lead to a progression in intention to change in approximately 20% of patients. Limitations of the study, the program, and physical activity intervention in the clinical setting are discussed.

There were two aims of the research with 190 Australian clinical psychologists: (1) to investigate the construct validity of the Therapist Belief Scale (TBS), and (2) to examine the relative contribution of demographics, workplace variables, and individual factors to burnout. Construct validity was examined using exploratory and confirmatory factor analyses and associations between the variables. Multivariate regressions were used to examine the relative contributions to burnout. The TBS showed three factors related to distress, inflexibility, and control, all of which were significantly associated with lower levels of personal accomplishment. Multivariate analyses showed emotional exhaustion to be associated being a woman, working for the government, having less personal resources, and endorsing more therapist beliefs related to control. Higher levels of personal accomplishment were significantly associated with a lower annual income, not having a mixed caseload, having more personal resources, and endorsing lower levels of therapist beliefs related to inflexibility and control.

This article presents a panel discussion on the integration of collaborative empiricism, specifically Socratic Questioning, into cognitive behaviour therapy. The panel comprised experts in research and practice who had been invited as keynote presenters for the 34th National Conference for the Australian Association of Cognitive and Behaviour Therapy, held in Sydney, Australia. Experts responded to questions regarding (a) the definition of Socratic dialogue, and (b) whether the purpose of Guided Discovery using Socratic Questioning is to impart information, correct, or dispute patient cognitions. The session was well attended by mental health professionals from around the globe and the panel enjoyed the opportunity to discuss questions and comments from those in attendance. This article presents this exchange so that the broader AACBT membership may benefit from the ideas and comments generated.

The limited communicative abilities of young children with autism and developmental disabilities may be enhanced by augmentative communication systems such as the Picture Exchange Communication System (PECS). Both children and adults can learn to use PECS, but research is inconsistent in establishing the degree to which PECS training transfers reliably from the training setting to other settings, for example, regular classrooms, and home. Three 5–6 year-old children, diagnosed as autistic and/or developmentally disabled, were given 1:1 PECS training at school, structured to enhance generalisation and transfer. Concurrent observations were made in their regular classroom and at home to probe the extent of generalisation. All three acquired the ability to request a preferred object or activity by exchanging a picture symbol with a communicative partner. In tests of transfer and generalisation, a multiple-baseline across subjects design showed no use of PECS symbols either in the classroom or at home prior to training, with spontaneous initiations of picture exchange (transfer) occurring to a slight to moderate degree in the classroom and to a slight degree at home. Even with PECS training structured to enhance transfer, functionally significant degrees of generalisation of training may be difficult to achieve, and cannot be assumed to occur.

General practice is a critical setting for the identification, assessment, treatment, follow-up and onward referral of smokers. General practitioners (GPs) are in a unique position to play a part in reducing preventable morbidity and mortality attributable to tobacco use. During the past decade, numerous trials have been conducted in general practice and have shown that GP intervention with smokers has a variable degree of success depending on the intensity of contact. Although there are many positive reasons for GP involvement, there are also barriers to implementing smoking cessation strategies in general practice. In this paper we discuss some of these issues. The Stages of Change framework developed by Prochaska and DiClemente (1986) has been used to describe the stages a smoker goes through in the process of becoming a non-smoker. However, the incorporation of smoking cessation interventions in a GP's routine practice also involves a process of psychological change. In this paper, therefore, we apply the Stages of Change model to GPs' recognition, uptake and maintenance of smoking cessation interventions.

The efficacy of prolonged single sessions of live graded exposure (LGE) and computer-aided vicarious exposure (CAVE) for spider phobia was examined in a single-blind, controlled trial. Forty participants diagnosed with specific phobia (spiders) received a prolonged single-session treatment of either therapist-aided LGE comprising exposure only or CAVE, or were assigned to a waiting list. Phobic symptomatology was measured at pre- and post-treatment, and at 1-month follow-up on a range of behavioural and subjective assessments. The results showed that the single-session therapist-aided LGE was superior to both CAVE and the waiting-list control. In contrast with previous findings of comparability between LGE and CAVE, and superiority of CAVE over placebo, the present study found no significant differences between the CAVE and waiting-list groups, with the exception of subjective units of distress, providing little support for single-session CAVE treatment.

The present study examined processing bias in children suffering from anxiety disorders. Processing bias was assessed using of the emotional Stroop task in clinically referred children with separation anxiety disorder (SAD), social phobia (SP), and/or generalised anxiety disorder (GAD) and normal controls. The aims of the present study were twofold: (a) to test whether clinically anxious children show a bias towards threat stimuli, and (b) to examine whether this bias is domain-specific. No evidence was obtained for either an anxiety-related bias towards threat, or a domain-specificity effect. Clearly, these findings diverge markedly from adult studies and stress the importance of further research on anxiety-related information processing in children.

Social skills training (SST) has emerged as one of the most widely practiced methods of psychiatric rehabilitation. The purposes of this article are to review the research about its effects, propose guidelines for its practice, and discuss several related methodological and clinical issues such as promoting generalisation, predicting the degree of benefit, and integrating training with other rehabilitation services. The research suggests that SST, when conducted using appropriate curricula and teaching techniques, helps individuals with schizophrenia acquire relevant interpersonal and instrumental skills. Generalisation of these skills can be promoted by simultaneously linking training to the opportunities, prompts, and consequences needed to perform the skills in the extra-training environments. Long-term SST appears to be necessary in order to produce significant improvements in community functioning. The article concludes with suggestions for future clinical research.

The purpose of this study was to test whether children and adolescents with anxiety disorders exhibit selective processing of threatening facial expressions in a pictorial version of the emotional Stroop paradigm. Participants named the colours of filters covering images of adults and children displaying either a neutral facial expression or one displaying the emotions of anger, disgust, or happiness. A delay in naming the colour of a filter implies attentional capture by the facial expression. Anxious participants, relative to control participants, exhibited slower colour naming overall, implying greater proneness to distraction by social cues. Children exhibited longer colour-naming latencies as compared to adolescents, perhaps because young children have a limited ability to inhibit attention to distracting stimuli. Adult faces were associated with slower colour naming than were child faces, irrespective of facial expressions in both groups, possibly because adults provide especially salient cues for children and adolescents. Inconsistent with prediction, participants with anxiety disorders were not slower than healthy controls at naming the colours of filters covering threatening expressions (i.e., anger and disgust) relative to filters covering faces depicting happy or neutral expressions.

This study investigated the relationship between attachment, mood and deliberate self-harm (DSH) in a nonclinical population (n = 114). In addition to a range of risky behaviours, the most commonly reported DSH behaviours were Head-banging (47%), Hitting (46%), Scratching (38%) and Cutting (34%). Those who engaged in DSH had poorer quality of attachment to both parents but not peers, and higher levels of depression, anxiety and stress. Path analysis was then used to examine the interaction between attachment, mood and DSH. The impact of the quality of attachment on DSH was found to be mediated by stress, which suggests that DSH may be a maladaptive coping mechanism. Attachment to father and peers was found to be more influential than attachment to mother. Our findings suggest that DSH may be more prevalent in the community than previously recognised, and that attachment, which is currently neglected in DSH research, warrants further investigation in both clinical and nonclinical populations.

In this article we report the use of a simple, nonprogrammed, syllable timed speech procedure to treat stuttering in a 3-year-old boy with a 2-year history of stuttering. The treatment involved the boy and his parents visiting the clinic 7 times, and the parents modelling syllable timed speech 2 to 6 times per day for 5- to 10-minute intervals in and around the home. After 7 weeks, clinic measures and objective, blinded measures of speech beyond the clinic showed stuttering frequency below 1.0% syllables stuttered. Along with low severity ratings made by the parent each day, this meets the stuttering criteria of another, proven treatment for early stuttering intervention. However, in this study reduction in stuttering was achieved with a simpler and more cost efficient procedure. With the caveat that this is a nonexperimental case report, we discuss its potential implications.

Objective: The aim of the current study was to compare the effects of instructed cognitive reappraisal, acceptance and emotional suppression on state anger after provocation among individuals with high trait anger. The moderating effects of trait emotion regulation (ER) styles were also examined. Method: Adults (N = 102) with elevated levels of trait anger were randomised to one of three ER conditions. Participants in both the reappraisal and emotional suppression conditions reported a decline in state anger and systolic blood pressure (SBP) post-anger provocation, whereas participants in the acceptance group did not experience a substantial decline in state anger or SBP post-anger provocation. Trait suppression was further found to enhance the effects of instructed suppression, while trait tolerance augmented the effects of instructed reappraisal. Conclusions: Support was found for the use of reappraisal and emotional suppression as adaptive strategies to cope with anger arousal in the short term after provocation.

The effectiveness of The Incredible Years parent-training program with a small sample of four high risk solo mothers in a public clinic setting was assessed. All families had a number of risk factors for early drop-out and poor outcomes. Mindful of resource limitations in the public setting, economical strategies were used to enhance attendance rates and engagement. For the outcome evaluation, a multiple baseline across participants design was used. Participants attended a 2-hour group treatment session weekly for twenty weeks, with booster sessions at 2 months and 4 months following treatment. Participants had sons aged between 6 years and 9 years diagnosed with ADHD. Family functioning was assessed from a pretreatment interview schedule, measures of child behaviour and parent and family functioning. Participants also completed program satisfaction and program evaluation measures. Results showed: (a) all mothers engaged with and finished the program, (b) improvement in family functioning, (c) improvements in some teacher and parent reports of child behaviour, (d) increased parenting confidence, (e) reduced stress and depression levels for most parent participants, and (f) reports of better parent–child relationships. Additionally, participants all reported being highly satisfied with the program. Findings overall support the use of easy to do engagement strategies and the use of the Incredible Years parent-training program as an effective, low cost and early step intervention for families at higher risk in a day-to-day practice setting. The use of this intervention in an overall stepped care approach is considered and discussed.

Parents’ adjustment, co-parenting conflict, and parenting style are often intervention targets for parents following divorce. However, little is known about how these three aspects together relate to child outcomes. The aim of this study was to examine how parent adjustment (distress and anger), parenting conflict, and parenting style (laxness and over-reactivity) predict child internalising, externalising, and prosocial behaviours. Participants were a community sample of 109 divorced parents with a child aged 4–17 years. Results showed that increased parental distress and co-parent conflict predicted increased child emotional and behavioural problems; and increased lax parenting also predicted increased externalising behaviour problems. However, greater prosocial behaviour was predicted only by lower lax parenting. The results highlight the differential impact of parenting factors on child outcomes following divorce and have implications for the content and tailoring of interventions for divorced parents.