Generalized anxiety patients were randomly allocated to Cognitive-Behaviour Therapy, Diazepam or Placebo and managed in a primary care setting. Treatments were balanced for degree of psychologist/patient contact. A range of outcome measures, including patient self report, psychologist assessor and general practitioner ratings were used. Large variations within group response to treatment emerged. At the end of active treatment the superiority of Cognitive-Behaviour Therapy was suggested. Post-study psychotropic prescription and psychological treatment was assessed at a 12-month follow-up. The Cognitive-Behaviour group revealed the lowest incidence of subsequent treatment interventions.

It is argued that the attentional strategies of phobic patients have important consequences for how they cope with anxiety. The literature indicates that focused attention to anxiety cues is important for long-term emotional habituation but that it is made difficult by anxiety. Questionnaire studies of agoraphobics reliably identified factors concerned with attentional strategies of coping with anxiety, and showed that they were distinct from self-talk strategies. The effect of anxiety levels on the use and perceived helpfulness of these strategies was also explored. Finally, the implications of an attentional framework for exposure treatments of phobic anxiety are discussed. It is suggested that the questionnaire may be a useful way of measuring patients' attentional strategies in clinical work.

A clinically-oriented description is provided of the Discretized Analog or Discan method (Singh and Bilsbury, 1984) for obtaining reliable and precise measures of subjectively experienced dysfunction variables whose possible values form a continuum. The method can provide a 14-point ordered categorical scale with only four reference levels which represent some of the possible values of intensity of the variable. The process of Discan administration consists of a series of repeated comparisons of the true or perceived level with one or two reference levels at a time. It therefore allows for use of elaborate descriptive statements for reference levels. It is recommended following Shapiro (1961, 1975) that the reference levels be ideographic, ipsitive and should reflect ordered steps of recovery from the dysfunction. Discan overcomes several limitations of the commonly used rating scales. An application of Discan to the MSB relaxation technique is presented as an illustration.

This paper describes and compares two relaxation training procedures with moderately and severely mentally handicapped people. Abbreviated Progressive Relaxation is a widely used procedure while Behavioural Relaxation Training is a relatively recent development which the authors felt might be more suitable for mentally handicapped people since it does not require a conceptual awareness of internal states of anxiety. While both relaxation procedures produced improvements, Behavioural Relaxation Training was significantly better than Abbreviated Progressive Relaxation. In addition to this the results during treatment showed Abbreviated Progressive Relaxation to produce very variable effects from session to session. In contrast the effects of Behavioural Relaxation Training were quick and consistent.

In a series of 51 previously sexually abused women who entered therapy 94% were found to be sexually dysfunctional. It is proposed that these dysfunctions may stem from certain mood disturbances, interpersonal problems, and sexual stresses, that are associated with the earlier traumatic experience of sexual abuse and its surrounding circumstances.

This study investigated short latency cardiac and electrodermal responses in obsessional subjects with cognitive rituals. Three key phrases from anxiety provoking and from neutralizing ruminations were selected as discrete stimuli and presented through a loudspeaker. In addition, three relatively novel phrases were employed. Whereas the anxiety provoking phrases elicited cardiac acceleration, decreases in heart rate followed the novel stimuli. These data suggest that defensive and orienting responses had been elicited by anxiety provoking and novel stimuli, respectively. In contrast, only minimal cardiac reactions were evoked by phrases from the neutralizing rituals. For the electrodermal data, no reliable distinction between the three categories of stimuli was observed. The possible utility of this paradigm as a measure of treatment outcome is discussed.

A component analysis of the room manager role (Porterfield et al., 1980) was performed in a series of four experiments. The subjects were one nursing staff and 13 severely and profoundly mentally handicapped young adults. The experiments took place in a hospital adult training unit. Five components (presence of toys in the room, providing a toy, replacing toys, prompting, and the full room manager role) were compared. Increases in the proportion of time on task were associated with the antecedents; praising had no effect. For residents with high Vineland Social Age regularly replacing toys was associated with the greatest increase in the proportion of time on task. For residents with low Vineland Social Age prompting was associated with the greatest increase in proportion of time on task. Implications for modification of the room manager role are considered and limitations to the present study discussed.