Background: Initial therapy appointments have high nonattendance rates yet the reasons remain poorly understood. Aims: This study aimed to identify positive and negative attitudes towards therapy that predicted initial attendance, informed by a perceptual control theory account of approach-avoidance conflicts in help-seeking. Method: A prospective study was conducted within a low intensity CBT service using first appointment attendance (n = 96) as an outcome. Measures included attitudes towards therapy, depression and anxiety scales, and demographic variables. Results: Endorsement of a negative attitude item representing concern about self-disclosure was independently predictive of nonattendance. Positive attitudes predicted increased attendance, especially endorsement of motives for self-reflection, but only among less depressed individuals. Conclusions: Self-disclosure concerns contribute to therapy avoidance and having goals for self-reflection may represent approach motivation for therapy; however, the latter has less impact among more highly depressed people.

Background: There is increasing interest in the provision of cognitive behaviour therapy (CBT) to people with intellectual disabilities. A small number of studies have begun to address therapy process issues. Aims: The aim of this paper is to contribute to process research through the development of a taxonomy of question types for use in analysing therapy interactions in CBT for people with intellectual disabilities. Method: A taxonomy of CBT question types was adapted and applied to the transcriptions of session 4 and 9 of 15 CBT therapy dyads. Results: The taxonomy was reliably applied to the data. Therapists used significantly more questions in session 4 than in session 9, therapists used fewer questions in the final quarter of all sessions, and therapists used more questions with people with higher IQ scores in session 4 but not in session 9. Conclusions: The taxonomy of questions is reliable and may be used in future studies of CBT therapy process with people with intellectual disabilities.

Background: One of the primary differences between Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) for anxiety is the approach to managing negative thoughts. CBT focuses on challenging the accuracy of dysfunctional thoughts through cognitive restructuring exercises, whereas ACT attempts to foster acceptance of such thoughts through cognitive defusion exercises. Previous research suggests that both techniques reduce the distress associated with negative thoughts, though questions remain regarding the benefit of these techniques above and beyond exposure to feared stimuli. Aims: In the present study, we conducted a brief experimental intervention to examine the utility of cognitive defusion + in-vivo exposure, cognitive restructuring + in-vivo exposure, and in-vivo exposure alone in reducing the impact of negative thoughts in patients with social anxiety disorder. Method: All participants completed a brief public speaking exposure and those in the cognitive conditions received training in the assigned cognitive technique. Participants returned a week later to complete a second exposure task and self-report measures. Results: All three conditions resulted in similar decreases in discomfort related to negative thoughts. ANOVA models failed to find an interaction between change in accuracy or importance and assignment to condition in predicting decreased distress of negative thoughts. Conclusions: These preliminary results suggest that changes in perceived importance and accuracy of negative thoughts may not be the mechanisms by which cognitive defusion and cognitive restructuring affect distress in the short-term.

The author list previously published for this article was incomplete when received by the journal. It should also have included Gerard Leavey, University College London, UK, as an author, as follows:

Marc Serfaty, Anna Ridgewell, Vari Drennan, Chris R. Brewin, Gerard Leavey, Anwen Wright, Gloria Laycock, Martin Blanchard.

Background: Few studies have explored the metacognitive components of anger, and at present there is no metacognitive framework on anger incorporating both positive and negative beliefs about anger and distinct maladaptive processing routines, such as rumination. Aims: The aim of the present preliminary studies was to apply a metacognitive framework to anger and put forward a new anger self-report scale, the Metacognitive Anger Processing (MAP) scale, intended as a supplement to existing measures of anger disposition and to enhance anger treatment targets. Method: The new measure was tested in a nonclinical and a clinical sample together with measures of anger and metacognition to establish factor structure, reliability, concurrent, and convergent validity. Results: The MAP showed a reliable factor structure with three factors - Positive Beliefs about anger, Negative Beliefs about anger, and Rumination; good internal reliability, and test-retest reliability. The subscales showed positive correlations with anger and the pattern of correlation with the general metacognitive measure supported the idea that the MAP represents dimensions of metacognition as it relates to anger. Conclusions: The present data indicate that positive as well as negative beliefs are involved in the tendency to ruminate about angry emotions. Clinical interventions may benefit from an exploration of the patient´s experience of anger, as structured by the MAP's factors and their interrelationships. The psychometric properties of the MAP should be further investigated in clinical samples using larger test batteries and objective measures of aggression.

Thank you very much to all those reviewers who participated in the peer-review process for Behavioural and Cognitive Psychotherapy during 2015.

Background: It is likely that disrupted early parent-child relationships, eating disorder related cognitions and negative self-beliefs are relevant to some women who are overweight/obese. Aims: This study tested the hypotheses that disrupted parent-child relationships would be linked to higher body mass index (BMI) and that this relationship would then be mediated by cognition. Method: A group of women were recruited from the community and completed measures of eating disorder (ED) thoughts, negative self-beliefs, and parental bonding. Individual body mass indices (BMIs) were calculated. Results: One hundred and eighteen women completed the study. There was a relationship between parental bonding and higher BMI. As hypothesized, the relationship between parental bonding (as measured by maternal care, and paternal overprotection) and BMI appeared to be mediated by a range of ED thoughts, and some negative self-beliefs. Conclusion: The cognitions measured here, both ED related cognitions and negative self-beliefs, may be a useful target when considering psychological treatment for women who are overweight or obese.