This article discusses the problem of jealousy in couple relationships. The clinical presentations are summarised, and the question of what is morbid jealousy is addressed. Issues in the assessment of jealousy in couples are discussed, with suggestions for the areas to be covered. A framework for the formulation of the problem is proposed. Finally, the clinical treatment of morbid jealousy is reviewed. A treatment approach is described, which includes relationship enhancement work and a range of specific techniques.

Examined the effects of comorbid externalising disorders (i.e., attention-deficit/hyperactivity disorder [ADHD], oppositional defiant disorder [ODD], conduct disorder [CD]) on the long-term outcome (7.4 years) of individuals treated for anxiety disorders as youth. Ninety-four anxiety-disordered children (aged 8-13) were provided with a 16-session manual-based cognitive behavioural treatment (CBT). Assessments were completed at pretreatment, posttreatment, 1-year posttreatment (see Kendall, et al., 1997) and for 88 of the original 94 subjects at 7.4-years posttreatment (see Kendall, Safford, Flannery-Schroeder, & Webb, in press). At pretreatment, all participants received principal anxiety diagnoses (generalised anxiety disorder, separation anxiety disorder, social phobia). Nineteen had comorbid externalising disorders (11 ADHD, 7 ODD and 1 CD). These 19 subjects were matched on age (within an average of 3 months), gender and race with 19 previously treated youths who were not comorbid with an externalising disorder. Examining parent- and child-reports, respectively, comparable rates of comorbid versus non-comorbid cases were free of their principal anxiety disorder at the 7.4-year follow-up on all dependent measures. Parents of anxiety-disordered children with a comorbid externalising disorder reported higher levels of child externalising behaviour than did parents of anxiety-disordered children without comorbidity. Comorbid children reported greater self-efficacy in coping with anxiety-provoking situations than did non-comorbid children. Thus, it appears that overall anxiety-disordered children with and without comorbid externalising disorders showed comparable improvements following CBT.

A safety behaviour is an overt or covert strategy employed in order to prevent a feared outcome from occurring. These behaviours can, however, prevent the disconfirmation of unhelpful beliefs, and may make the feared outcome more likely to occur (Salkovskis, 1991). The current study extends Harvey's (2002a) investigation of safety behaviours in insomnia by developing a questionnaire measure designed to assess the use of safety behaviours that are employed to promote sleep and cope with tiredness. A development sample of 132 individuals with and without insomnia was employed to develop the 32-item Sleep-Related Behaviours Questionnaire (SRBQ). The SRBQ showed good internal consistency and was able to discriminate normal sleepers from those with insomnia. Interestingly, most safety behaviours were associated with impairment in both sleep and daytime functioning. This highlights that day- and night-time processes may be interlinked in insomnia, and stresses the importance of research and treatment focusing on both the day and night. Future research is needed to further investigate the psychometric properties of the SRBQ, and to explore the relationships between safety behaviours and dysfunctional beliefs about sleep.

This study developed and evaluated a puppet interview that allows children to self-report on temperamental constructs. Structured child self-report measures are rarely utilised in clinical assessment of young children under the age of 7—8 years. Given that clinical assessment is often characterised by low convergence between raters, such a measure may offer important contributions. The present study developed and evaluated a measure based on items from the Colorado Childhood Temperament Inventory and reports two studies with child participants aged 4 to 5 years. Independent observations of the children were also made. Results showed moderate levels of internal consistency and stability, and convergence between child self-report and teacher/parent raters was low, but similar levels of agreement were achieved between adult informants. The puppet interview thus showed some potential but highlighted the difficulties of self-report in young children within a multiple informant framework in clinical assessment.

This paper describes the first trial of danger ideation reduction therapy (DIRT) in an adolescent patient with severe, treatment resistant obsessive-compulsive disorder (OCD). This case study also represents the first published data on DIRT for any individual outside the Anxiety Disorders Clinic at the University of Sydney, where the treatment package was originally developed. KP was a 16-year-old girl with a 4-year history of obsessive-compulsive disorder. She was primarily concerned with contamination and presented with associated washing and avoidance behaviour. KP met Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association [APA], 1994) criteria for OCD, oppositional defiant disorder and major depressive disorder. She had also had previous diagnoses of attention-deficit/hyperactivity disorder and motor tics. KP had received considerable treatment for OCD prior to the current trial, including 12 months of outpatient treatment at the local community health centre, a 4-week inpatient admission to a private hospital in Sydney and a 16 week inpatient admission to Rivendell Adolescent Unit in Sydney. All previous treatments involved a combination of pharmacotherapy (clomipramine [up to 125mg[, sertraline [up to the 200mg], fluvoxamine [up to 200 mg], risperidone [up to 2.5 mg] and chlorpromazine [25-50 mg prn]), and attempts to administer exposure-based treatment. KP had failed to benefit from all previous treatment attempts. However, following 16 sessions of DIRT, KP experienced substantial improvement, approximating symptom-free status on all measures. Importantly, these improvements were maintained at 12-month follow-up. The DIRT package was also effective in reducing depression and anxiety scores on self-report measures over the follow-up period. There were no substantial differences between posttreatment and 12-month follow-up scores on any of the measures given.