The effect of short-term food deprivation on the reinforcing value of coffee was examined, utilising behavioural choice methodology. Four women with bulimia nervosa and six healthy controls underwent one food-deprivation day (19 hours) and one nondeprivation day. Subjects made significantly more attempts to earn coffee, earned more points toward coffee, and drank more grams of coffee when food deprived than when nondeprived. The effect was observed in both bulimic and control women. There was a significant diagnosis-by-deprivation interaction with reference to grams of coffee consumed, with bulimic women consuming over twice as much coffee when deprived than nondeprived. The results are discussed with reference to the role of food deprivation in the pathogenesis of substance abuse.

The prevalence of depressive symptoms in Year 10 students in two metropolitan high schools, and the implication of a short-term, school-based group intervention to assist students in coping with depression are described. A total of 260 students were screened using a multistage, multimethod procedure that resulted in 16% and 20% of students in each school meeting criteria for depression. Nine students identified as depressed from one school formed an initial treatment group and a matched wait-list control group was formed from students in the second school. Dependent measures included self-report measures of depression and self-concept, teacher ratings of classroom participation and demeanour, and school records of academic performance and absenteeism. Clinical improvements that maintained were noted for just over half of those in the initial treatment group, whereas no such changes occurred in the control group. Differences at follow-up were statistically significant, although not immediately posttreatment. Some improvements were also recorded for participation and demeanour in class. A subsequent, less intensive intervention with 12 students with more severe depressive symptoms from the second school was less effective. The results are discussed in relation to variations in delivery of the intervention program, and the severity and nature of problems experienced by the students who participated in each intervention.

A comprehensive cognitive-behavioural treatment program for incarcerated child molesters is described. This program operates within Kia Marama, a medium-security unit for sex offenders in the New Zealand prison system. It lasts 32 weeks and includes a four-week assessment process both before and after the 24 weeks of intensive treatment. Treatment covers a variety of issues including distorted cognitions, sexual issues, victim empathy, social skills, problem solving, life skills, stress management, and relapse-prevention training. In addition, when offenders are released they are supervised by professionals trained in relapse-prevention procedures. As this program began in late 1989, it is too early to properly estimate its success, but similar programs in North America have produced promising outcome data, and what tentative evidence we have to date suggests that the program is valuable.

Clinical observation and retrospective and prospective studies of relapsing psychosis have demonstrated that early symptoms of decompensation are observable in one half to two thirds of patients over a period of 1 to 4 weeks. Whilst the sensitivity of prodromal symptoms is established, their specificity is less certain, particularly at the first episode. The appearance of an “at risk” mental state, if not leading to decompensation, may nevertheless be part of a “transitional” stage to psychosis that is affected by psychological factors concerning the attributions that are made about a change in mental life. The research on prodromal signs is reviewed, with three areas of focus: prodromes as continuous versus discrete phenomena, sensitivity and specificity, and early intervention studies. A psychological model of the transitional process is described with case examples, together with an exploration of its implications for early intervention, again illustrated by case material.

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.

This paper examines the predictive value of self-efficacy and strength of temptations in determining whether a person will try to give up smoking, and successfully do so for at least one day. Participants were 62 smokers calling a quit-smoking telephone service. They were assessed by self-report questionnaires by telephone. Fifty-six per cent had made an attempt to stop smoking within 3 weeks. Measures of self-efficacy to quit smoking and strength of temptations to smoke were not closely related. Multivariate analyses revealed that after intention to quit entered the equation, self-efficacy was inversely related to making a quit attempt, as was temptation strength and extent of addiction. This study extends previous work that showed self-efficacy has a complex relationship with making quit attempts by showing that self-efficacy operates quite differently from strength of temptations. This may be because measures of self-efficacy, when made in the context of intention to act, contain a motivational component as well as an assessment of skills to resist temptations.

We examined salivary reactivity in 11 women with simple phobia of spiders and 11 controls in response to a spider and a neutral cue. No differences in salivary reactivity were observed across diagnosis or conditions. Clear reactivity in heart rate, systolic blood pressure, and subjective units of distress were observed. Salivary reactivity was unrelated to any other measure of reactivity. These results suggest that a decrease in salivation is not a universal response to acute anxiety.

This paper reviews the literature on cognitive-behavioural treatment of bulimia nervosa, including the rationale and procedure for including an exposure plus response-prevention component. Comparisons of the full cognitive-behavioural therapy package to no treatment, other forms of psychotherapy, and pharmacotherapy are evaluated. The evidence suggests that cognitive-behavioural therapy is a relatively effective treatment for bulimia nervosa, although long-term outcome is still far from optimal.

This study examined the effects of tactile stimulation on self-injurious behaviour (SIB) in a 10-year-old boy with developmental disabilities. SIB occurred at high rates during unstructured play, suggesting an automatic reinforcement, sensory stimulation function. Noncontingent application of an alternative source of tactile stimulation produced only modest reductions in SIB, but contingent removal of the objects used to obtain tactile stimulation produced clinically significant reductions.

Substance abuse in schizophrenia is a significant management problem for both clients and treatment agencies, impacting on psychotic symptoms, medication adherence, and participation in training and employment. However, there is little published work on the treatment of drug abuse in this population. This paper describes a cognitive-behavioural intervention for alcohol and cannabis abuse which integrates substance abuse treatment with other aspects of psychosis management.

This paper considers the question “What is a psychological unit?”. The ubiquity of units in daily life and in science is considered. The assumption that the individual human being or animal is the psychological unit is examined and rejected. The units represented by the data collected in operant laboratories are interpreted as a subset of the well-defined changes that individual human beings or animals can bring about. The departure of this interpretation from the traditional interpretation in terms of the behaviour of the organism is acknowledged. The paper concludes by noting the relation of the present interpretation of operant research to the problem of identifying psychological units.

The study examined the reliability with which experienced psychologists assigned functions to behaviours of people with intellectual disability using information about sets of problem behaviours and sets of antecedent situations. The study found good consistency in assigning functions, showing that reliable judgments about functions of behaviours can be made even when information is not available about consequences of the behaviours. The approach enabled reliable distinctions to be made between functions that have not previously been examined in the literature.

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.

Preliminary data are provided on two new instruments in the field of traumatic stress, namely the Penn Inventory and the post-traumatic stress disorder (PTSD) module of the Composite International Diagnostic Interview (CIDI). The Penn Inventory is a 26-item self-report scale developed for use with a range of trauma populations. The CIDI-PTSD is a draft module currently being trialed and eventually to be included in the full version of the CIDI interview. Participants comprised 30 Australian Vietnam combat veterans, who also completed the Impact of Event Scale and the Mississippi Scale for PTSD (M-PTSD). The Penn Inventory demonstrated good congruent validity and was comparable to the M-PTSD in diagnostic accuracy. Both scales tended to overdiagnose. The CIDI-PTSD performed disappointingly, showing relatively low sensitivity and specificity. Implications for the appropriate use of these instruments are discussed.

Many of Australia's most serious and distressing mental health problems are related to the breakdown of traditional family support structures. Regardless of age, people who live in families with high levels of interpersonal conflict, violence, poor communication and inadequate care are at increased risk for a variety of mental health problems. This paper summarises the main recommendations of a scientific advisory committee on families and mental health, which prepared the Healthy Families, Healthy Nation: Strategies for Promoting Family Mental Health in Australia (Sanders, 1995). The paper argues for the importance of better utilisation of existing knowledge concerning family support and intervention programs and for the importance of a preventive focus in the provision of family oriented mental health services. We also highlight some of the unresolved issues that should become a focus of future research.

Extinction is a well-researched behavioural procedure that is used to reduce in frequency, or eliminate, behaviour that is judged to be inappropriate or excessive. Typically, the procedure is implemented contingent upon the exhibition of the behaviour targeted for change. In the present study, the effects of an accidental extinction procedure on pokey players' behaviour are discussed. Extinction is deemed “accidental” in that the procedure came into effect as the result of a power failure. Results demonstrate a gradual reduction in attempts to operate the poker machines over the extinction period, as well as an increase in the collateral behaviours of beverage (primary alcohol) consumption, cigarette lighting, and social interactions. Implications of this study for further research are discussed.

Research reported in the last two issues of Behaviour Change, and elsewhere, shows that cognitive behaviour therapy significantly improves a number of the problems suffered by people with schizophrenia. However, behaviour therapy alone does not constitute adequate care of schizophrenia, and inadequate mental health services undermine the effective implementation of behaviour therapy, in Australia, mental health services for people with severe psychiatric disorders such as schizophrenia are grossly inadequate, but are planned to change substantially in the late 1990s. Changes include a significant shift in resources toward community-based care, expansion of the range of treatment and rehabilitation services available, and increased integration of service provision across government and nongovernment sectors. These planned changes present a challenge to those interested in behaviour therapy to go beyond narrowly focused interventions to develop effective systems of rehabilitation.

In 1990, 13 regionally based Behaviour Intervention Support Teams (BISTs) were established in Victoria to assist agencies providing support to persons with an intellectual disability who exhibited challenging behaviour. A primary function of the BISTs was to conduct intensive interventions for clients with severe challenging behaviours. The outcomes of the interventions conducted by eight of these teams were monitored over the period from 1991 to 1993. During this time, a total of 134 such interventions were completed by the teams. Many outcome measures were used for each intervention. These included direct observational measures of the challenging behaviours, measures of skill acquisition by the clients, and satisfaction with the results by caregivers. It was concluded that the interventions resulted in a high rate of success (approximately 75%). Additionally, it was concluded that the use of regionally based specialist teams was an effective way of treating severe challenging behaviours that had previously proven difficult to manage.