The appraisal model of obsessive-compulsive disorder (OCD) suggests that six key appraisal domains contribute to the aetiology and maintenance of OCD symptoms. An accumulating body of evidence supports this notion and suggests that modifying cognitive appraisals may be beneficial in reducing obsessive-compulsive symptomatology. This literature review first summarises the nature of OCD and its treatment, followed by a summary of the existing correlational and experimental research on the role of cognitive appraisal processes in OCD across both adult and paediatric samples. While correlational data provide some support for the relationship between cognitive appraisal domains and OCD symptoms, results are inconclusive, and experimental methods are warranted to determine the precise causal relationship between specific cognitive appraisal domains and OCD symptoms.

The obsessive-compulsive core dimensions model posits that compulsions are driven by harm avoidance, or to counteract a sense of incompleteness, known as ‘not just right experiences’ (NJREs). Evidence suggests NJREs are associated with obsessive-compulsive disorder (OCD) symptoms and maladaptive perfectionism. However, manipulations of NJREs have focused on the visual system, and have not been examined in the context of arousal fears associated with anxiety sensitivity (AS). This study examined the relationship between OC symptoms, perfectionism, and AS using in vivo manipulations of NJREs across visual, auditory, and tactile sensory modalities. Using a 2 (NJRE vs. JRE) × 2 (AS vs. no AS) between-subjects design, participants (N = 132) completed behavioural tasks designed to elicit NJREs and assess task discomfort and urge to counteract sensory-specific stimuli. Strong relationships were observed between task ratings and self-report measures of NJREs, incompleteness, OCD symptoms, maladaptive perfectionism, and AS. Those in the NJRE conditions gave significantly higher task ratings compared to JRE conditions; however, there was no main effect for AS. While maladaptive perfectionism and AS were significant predictors of task performance, there was no interaction between the two. The results confirm and extend research suggesting a strong association between NJREs and incompleteness motivations, as well as sensory-affective disturbance in OCD.

This systematic review investigates evidence on the association between body image concerns and weight-related behaviours of adolescents and emerging adults. It includes peer-reviewed journal articles reporting research involving body image concerns and weight-related behaviours of adolescents and emerging adults, published between 2005–2017, and located through systematic searches from four databases. This review includes studies from 11 countries or regions: United States (n = 13), Asia (n = 9), Europe (n = 8), Middle East (n = 3), South America (Brazil; n = 3), Canada (n = 3), Australia (n = 1), New Zealand (n = 1), Trinidad (n = 1), Turkey (n = 1) and Seychelles (n = 1); 24 different countries (n = 1); three Asian countries and the United States (n = 1). Out of 46 studies included in this review, 45 studies reported a positive association between body image concerns and weight-related behaviours. Adolescents and emerging adults who misperceived their weight engaged in weight-related behaviours. Higher body dissatisfaction had a significant association in the development of eating disorders and extreme weight-loss behaviours. Body image concerns play a significant role in adolescents and emerging adults engaging in weight-related behaviours. Experimental research designs are required to determine the causality of this association. Evidence strongly suggests policy makers and public health practitioners contemplate strategies to promote positive body image and healthy weight-related behaviours among adolescents and emerging adults.

Social anxiety disorder (SAD) is characterised by a marked and persistent fear of social/performance situations, and a number of key environmental factors have been implicated in the aetiology of the disorder. Hence, the current article reviews theoretical and empirical evidence linking the development of SAD with parenting factors, traumatic life events, and aversive social experiences. Specifically, research suggests that the risk of developing SAD is increased by over-controlling, critical and cold parenting, an insecure attachment style, aversive social/peer experiences, emotional maltreatment, and to a lesser extent other forms of childhood maltreatment and adversity. Moreover, these factors may lead to posttraumatic reactions, distorted negative self-imagery, and internalised shame-based schemas that subsequently maintain SAD symptomatology. However, further research is necessary to clarify the nature, interactions, and relative contributions of these factors. It is likely that SAD develops via a complex interplay of biological and environmental factors, and that multiple aetiological pathways underlie the development of the disorder.

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.

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.

The experience of paediatric asthma is associated with increased stress and emotional difficulties for both the child and family. The current study aimed to qualitatively explore parents’ views of their child's asthma experience, from initial diagnosis onwards, to enhance our understanding of how families emotionally adjust and adapt to the diagnosis and management of asthma. Semi-structured interviews were conducted with 17 parents of children (<18 years) with physician-diagnosed asthma. Questionnaires were used to capture demographic information and anxiety symptom status of parents (State Trait Anxiety Inventory — Form Y [STAI-Y1/Y2]) and children (Spence Children's Anxiety Scale — Parent reported [SCAS-P]). Grounded theory was used to analyse the results. Analysis saw three themes emerge as important in understanding the impact of asthma on the family: (1) the experience of obtaining an asthma diagnosis, (2) parents’ belief in their competence to manage asthma, and (3) parents’ behaviour in response to the asthma. A model was developed that posits adaptive parental adjustment to asthma is determined in part by the circumstances around the time of diagnosis, the level of knowledge and skills, and the controllability of the asthma. This model can guide medical and allied health professionals to specific areas where intervention may reduce stress and emotional difficulties associated with asthma and its management for affected families.

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.

Binge eating is a distressing symptom common to bulimia nervosa (BN), anorexia nervosa binge/purge subtype (AN-BP) and binge-eating disorder (BED). Over the last 40 years, many attempts have been made to conceptualise this symptom in terms of its antecedents, function, triggers, consequences, and maintaining factors. Cognitive theories of binge eating have evolved as new evidence has emerged. This literature review summarises the main and most influential cognitive models of binge eating across different eating disorder presentations. Many theories have examined binge eating in the context of restriction or compensatory behaviours, as is often observed in cases of BN. Few theories have examined binge eating as it occurs in BED specifically. The long-term efficacy of cognitive behavioural therapy (CBT) treatment based on these models leaves much to be desired, and indicates that there may be maintaining factors of binge eating not addressed in the typical CBT treatment for eating disorders. More recent cognitive models of binge eating propose possible maintaining beliefs, but further study is required to validate these models. Suggestions for future research are presented.

Psychological and educational interventions are valuable adjuncts in the management of adult atopic dermatitis. We performed a systematic review and meta-analysis of randomised controlled trials (RCTs) of the efficacy of these interventions. Twelve articles published between 1986 and 2013 were identified through electronic searches. The methodological quality was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions, version 5.1.1 (Higgins & Green, 2015). A random-effects model was used to estimate the standardised mean difference (SMD). No significant difference was found in eczema severity determined in three RCTs (124 participants; SMD, -0.29; 95% CI [-0.64, 0.07]) and dropout rate in five RCTs (198 participants; relative risk, 0.66; 95% CI [0.20, 2.17]). Education via online video was significantly superior to handouts in ameliorating eczema severity in one RCT (80 participants). We conclude that, rather than a combination of these interventions with conventional therapy being of no value, the data did not have sufficient power to provide evidence-based conclusions.

Background: Consumer perceptions of care are a key measure of service quality. The Consumer Perceptions of Care (CPoC) survey is often used to assess patients’ evaluations of the quality of services received. Aims: The study explored the factor structure of the CPoC, the relationships between perceived quality of care, empowerment, perceived treatment outcomes, and symptom change, as well as the effect of allowing patients to self-identify during the CPoC survey on their ratings of perceptions of care. Methods: In the first phase of the current study, 2,125 psychiatric inpatients were surveyed about their perceptions of care, and their symptoms were also measured at both admission and discharge. The second phase examined 720 inpatients who had given consent so that perceptions of care could be compared with outcome data. Results: Increased levels of empowerment were associated with favourable ratings of perceived treatment outcomes. Although perceived treatment outcomes and empowerment were correlated with actual symptom change, these correlations were small. Furthermore, the influence of self-identification on ratings of perceptions of care was found to be small. Conclusions: Examining patients’ perceived and actual treatment outcomes may provide mental health service providers with a more nuanced perspective of the hospital experiences of their patients.

Self-related constructs feature prominently in cognitive models of both social anxiety and depression. However, few studies have simultaneously investigated the unique relationship between self-related constructs and social anxiety and depression, while also controlling for the association between the two variables. In the present study, 522 undergraduate students completed measures of maladaptive self-beliefs, self-esteem, self-criticism, self-focused attention, self-concept clarity, social comparison, and social anxiety and depression. Bivariate correlations demonstrated that self-related constructs not only significantly correlated with social anxiety but also with depression and other self-variables. When entered simultaneously, multiple regression analyses indicated that maladaptive self-beliefs were uniquely and positively associated with social anxiety and depression, while self-esteem and self-concept clarity were uniquely and negatively associated with social anxiety and depression. A unique positive association between private self-consciousness and depression was also found. Maladaptive self-beliefs and self-esteem were the constructs most strongly associated with social anxiety and depression respectively. These findings underscore the importance of a negative self-concept even in subclinical presentations and suggest that several key self-related constructs may represent transdiagnostic vulnerability factors linking social anxiety and depression. Future research should continue to uncover unique relationships between self-related variables and social anxiety and depression in both clinical and non-clinical samples.

Professor Jay Spencer Birnbrauer peacefully passed away on November 1, 2017, aged 83, in Perth, Western Australia. Known to his friends and colleagues in Australia as ‘Birny’, he was a pioneer of applied behaviour analysis on both the Australian and world stage. He contributed to the development of behaviour-analytic technology for children with intellectual and developmental disabilities in the 1960s and played a central part in the formation of the Australian Behaviour Modification Association (known today as the Australian Association for Cognitive and Behaviour Therapy) in the 1970s. He was a purist in the field of applied behaviour analysis (ABA) and was relentless in his efforts to see ABA being provided to children with a developmental disability and their families. Birny's influence in Australia, and particularly Western Australia, was mainly imparted through his role with the Master of Applied Psychology program at Murdoch University. His most widely known piece of work, the Murdoch Early Intervention Program, was an early and important replication of Lovaas's evaluation of early intensive behavioural intervention for children with autism. Birny contributed significantly to our field and to many people's lives. He is remembered often and fondly by his many friends and colleagues.

This study examined factors influencing parent willingness to use D-Cycloserine (DCS) for treating child anxiety. N = 222 parents were given information about using DCS to treat anxiety. They were then asked to rate their willingness to allow their child to take DCS/antibiotics for mild anxiety, severe anxiety, or an infection. The associations between willingness to use DCS and parental trait anxiety, demographics, as well as specific concerns regarding the medication, were examined. Parents could also provide written responses regarding their attitudes to DCS, which were analysed for themes. Parents reported concerns regarding potential side-effects from DCS. More severe anxiety was associated with more willingness to consent; however, parents were more willing to use antibiotics to treat an infection than DCS to treat their child's anxiety. The degree of perceived benefit from DCS was most strongly associated with parents’ willingness to use it. Overall, parents expressed mixed views, reporting they would consider using DCS to treat their child; however, they had significant concerns about it. Results suggest providing parents with information explaining how DCS works, its risks and potential benefits may increase its acceptability.

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.