Previous studies have shown that when normal subjects are instructed to think of a white bear (“forced” expression instructions), they do so more frequently when they have previously suppressed the thought of a white bear than when they have not suppressed this thought. It has been proposed that this rebound effect of thought suppression provides a laboratory model for the development of real-life obsessions. The present studies were undertaken in order to explore further the tenability of this model. Rebound effects were evaluated when more “liberal” expression instructions (“you might think of a white bear, but you don't have to”) were used. In Experiment 1, no evidence was obtained to suggest that suppression results in a heightened frequency and/or accelerated rate of white bear thoughts during a subsequent expression period (with “liberal” instructions). Interestingly, initial suppression lead to an immediate and stable increase of thought related electrodermal fluctuations. In Experiment 2, it was found that successful suppressors (few target thoughts during suppression) report fewer white bear thoughts during expression (with “liberal” instructions) than unsuccessful suppressors (many target thoughts during suppression). Assuming that the ecological validity of “liberal” expression instructions is greater than that of “forced” instructions, the present findings cast doubt on the claim that the rebound effect mimics the etiology of obsessions. The findings also suggest that it may be the immediate counter-productive effects of suppression that are relevant to theories concerned with obsessions.

In a recent questionnaire study Watts (1989) examined coping strategies including attentional and “self talk” strategies used by agoraphobics. This paper reports the findings of a revised coping with anxiety questionnaire administered to over 200 agoraphobic subjects to examine two issues raised by the Watts' study: firstly, the existence of discrete factors related to distraction techniques and focused attention to anxiety cues; and secondly, perceived levels of voluntary control in relation to different coping strategies. The results partially confirmed the factor analytic results obtained by Watts, although there was no evidence for discrete attentional factors related to distraction or calm focused attention. There was evidence consistent with the claim that self talk strategies are largely under voluntary control. The implications of the results for treatment are discussed.

While Cognitive Behavior Therapy (CBT) has been widely used for treatment of childhood disorders, the process underlying the success of CBT in this area is still unclear. This paper attempts to examine empirically the above issue, using the literature from 1974 to 1989 to see whether there is support for the underlying changes in cognitive processes that are assumed to mediate the therapy. The results show that while CBT is relatively effective in treating some childhood disorders, there is little empirical evidence to support the underlying cognitive models of childhood disorders.

The ability of health locus of control, causal attributional, and secondary symptom variables to predict response to an integrated behavioural and psychodynamic treatment of agoraphobic in-patients, both immediately and one year after treatment, was investigated (N = 36). It was hypothesized that patients who retained an external locus of control during treatment would be likely to relapse after treatment. Further, it was hypothesized that tendencies to externalize locus of control, to attribute bad events to internal, stable, and global causes, and to attribute good events to external, unstable, and specific causes, would influence the treatment process in a negative way. It was also hypothesized that high levels of secondary symptoms, that is depression and general anxiety, would inhibit progress. None of these hypotheses were consistently supported by the results. This indicates that more precise and sophisticated models of agoraphobia development and treatment process are needed.

Adjuvant Psychological Therapy (APT), a cognitive behavioural treatment, has been developed to alleviate cancer-related anxiety and depression. It is being evaluated in a controlled study of patients with early cancer, but has not been used previously in patients with terminal cancer. This case report describes the use of APT in a severely anxious and depressed male patient with terminal carcinoma of the colon. His psychological progress until death is reported. Although no firm conclusions can be drawn from a single case, the results obtained were sufficiently encouraging to warrant a systematic study of APT in emotionally distressed patients with terminal illness.

Substitution of a happy ending to a recurrent stereotypic nightmare and subsequent assisted rehearsal produced immediate cessation of a previously frequent nightmare and consequent removal of associated fear and distress.

Space phobia is a rare syndrome characterized by a fear of absent visuospatial support and of falling, which is noted to be quite unresponsive to treatment. We report a case of space phobia which was successfully treated using behavioural methods and remained much improved at nine months follow-up.

A multi-component intervention programme comprising 12 sessions is described which successfully enabled an Olympic archer to overcome performance related anxiety.