Schizophrenia is a multifaceted disorder that can affect many aspects of the sufferer's life. Recent advances in the use of cognitive—behaviour therapy as an adjunct treatment for schizophrenia have been shown to result in significant improvements in psychotic symptoms. However, to date, much less attention has been paid to other co-morbid and emotional disorders that often co-exist with psychosis and that can be a severe burden to the sufferer. This article briefly reviews clinical trials of cognitive—behavioural treatments for schizophrenia and their outcome and then goes on to describe clinically important co-morbid or associated clinical problems: social anxiety, posttraumatic stress disorder (PTSD), depression and suicide risk. Because the psychotic symptoms usually receive priority, there has been little in the cognitive—behavioural literature on the nature and treatment of these co-morbid disorders. The nature of these problems and issues relating to their treatment are discussed.

The specific phobias in children, such as night-time fears and animal phobias, should not be underestimated since they cause personal distress to the child and also much interference with daily activities. Intervention plans should be informed by multimethod assessment, using tools that are empirically sound and developmentally sensitive. This article selectively reviews a number of assessment tools including structured diagnostic interview schedules, standardised instruments such as anxiety or fear self-report questionnaires, and behavioural tasks. An overview is given of the main intervention approaches, from a behavioural perspective, including traditional behavioural intervention procedures such as systematic desensitisation and its variants, cognitive–behavioural therapy, and behavioural family therapy. The authors also present recent developments in psychodynamic treatment for phobic and anxious children. Finally, we present conclusions on the empirical standing of the various treatment approaches and also examine the important issue of treatment outcome prediction.

This review evaluates five explanations for why social phobics perceive a discrepancy between performance requirements and their own abilities. There is little evidence to suggest that social phobia is associated with perfectionistic performance standards (possibility 1), perfectionistic standards in social situations (possibility 2), or perceptions of perfectionistic standards in others (possibility 3). Possibility 4, that social phobics set rigid performance standards, requires additional research. Support is provided for possibility 5, however, which proposes that social phobics perceive their own performance abilities negatively. Subsequently, it is concluded that low self-related beliefs account for the discrepancy between social phobics' perceptions of performance requirements, and their perceptions of their performance abilities. This conclusion is discussed in the context of contrasting models of social phobia, and implications for treatment are considered.

Support for the efficacy of cognitive—behavioural therapy (CBT) for anxious youth has accumulated. Significant treatment effects are observed and maintained over the long term for the majority of children receiving individual, family or group-based treatments. Nevertheless, all children do not improve. In fact, there is evidence to suggest that a significant percentage of children continue to experience anxiety following treatment and will seek additional treatment for their anxiety. This article will review the substantial evidence for CBT, the current information available on predictors of outcome and mechanisms of change. The article will also discuss the need for adequately powered randomised clinical trials that continue to refine and evaluate treatments for anxious children in an effort to improve outcomes for those children whose needs are not being met by our current treatments.

In the present study, responses of 197 people who were receiving chemotherapy at two outpatient clinics and who completed a questionnaire about the presence and origin of blood-injection-injury (BII) fear were examined. From this sample, 36 participants (18.9%) reported ‘strong feelings of fear, disgust or discomfort’ towards the sight of blood, receiving injections or both. Of the 36, 7 participants (19.4%) had first noticed these concerns while they were receiving chemotherapy, and a further 19 (52.8%) reported noticing them during a traumatic experience unrelated to treatment. A subgroup of 22 participants completed the Origins Questionnaire (Menzies & Clarke, 1993). Of these participants, 7 (31.8%) were classified as having an associative onset, and 6 (27.7%) were classified as nonassociative. Only 1 participant with an associative onset attributed the fear to trauma related to chemotherapy. From these data, it appears that while a large minority of the chemotherapy patients who completed the questionnaire experienced distress associated with blood and injections, in the majority of cases the onset of these fears was not attributable to trauma associated with chemotherapy.

The aim of this study was to determine the efficacy of the four telephone contact sessions that are prescribed as an integral component of the Group Triple P parenting program, and to compare the efficacy of Group Triple P to a waitlist control group. Parents of children aged 2 to 8 years were randomly assigned to one of three conditions: the usual Group Triple P program, consisting of four group sessions and four telephone calls (n = 16); a modified Group Triple P condition, consisting of just the four group sessions (n = 17); or a waitlist control condition (n = 16). Pre- and post-intervention assessments were conducted using the Eyberg Child Behavior Inventory (ECBI), the Depression Anxiety Stress Scales (DASS) and the Parenting Scale (PS). Statistically and clinically significant main effects were found for attending either the full Triple P or the modified Triple P program on both the DASS and the ECBI, but not on the participant's perception of their parenting style (PS). We conclude that (a) the four telephone sessions are not an essential component for the initial effectiveness of the Group Triple P program (though further research needs to explore whether they impact on maintenance of gains), and (b) that Group Triple P is effective in bringing about change, as measured using these self-report instruments.

In this study, selective memory-processing of self-referent and other-referent information in depressed children was examined. A control group (N = 50) and a depressed group (N = 22) were given two intentional self-referent encoding tasks, in which participants were presented with positive and negative adjectives. In the first experiment, participants were given self-referent and structural instructions. The second experiment included a self-referent instruction and an other-referent instruction. The encoding tasks were followed by a recall task. The results of the first experiment supported the selective processing hypothesis for self-referent information in depressed children and adolescents. However, the recall ratios of positive and negative information after focusing on self and others in the second experiment revealed that depressed children diverted their attention away from negative self-referent information and displayed memory-processing similar to nondepressed children.

Randomised controlled outcome studies have demonstrated the efficacy of imaginal desensitisation in inpatient settings. The purpose of this study was to evaluate the effects of a prerecorded audiocassette version of the imaginal desensitisation procedure that was designed for home-based use in reducing gambling urges and behaviours on a sample of diagnosed pathological gamblers who sought treatment at a university teaching hospital at 2-month follow-up. Pretreatment to 2-month follow-up repeated measures revealed a significant reduction in visual analogue scale ratings of urge, preoccupation and perceived self-control over gambling; indices of actual gambling behaviour; and psychometric measures of anxiety, depression and impulsivity. A prerecorded audiocassette version of imaginal desensitisation for home use represents a cost-effective approach in the management of pathological gambling.

This study examined whether nonclinical obsessions and nonclinical compulsions relate differently to cognitive and mood factors such as responsibility, perfectionism, trait anxiety and depressed mood. Two hundred and three nonclinical undergraduate psychology students (70.4% females, 29.6% males, mean age = 18.7, SD = 1.1) completed questionnaires. After controlling for the relationship between obsessions and compulsions, obsessions were found to relate significantly more strongly to depressed mood, trait anxiety, socially prescribed perfectionism and responsibility than compulsions. Conversely, compulsions were found to relate more strongly to self-oriented perfectionism than obsessions. These results were interpreted as providing support for the notion that obsessive-compulsive disorder (OCD) is maintained by a conflicted mental representation of the self and the world. Obsessions were interpreted as reflecting an overdeveloped vigilance for threat, responsibility and need for social approval. Compulsions were interpreted as emanating from the belief that the self is self-sufficient and resourceful, and that the world is ordered and systematic. Implications for the treatment of OCD were discussed.

There is evidence to suggest that illness representations are associated with chronic illness outcomes. Accordingly, several authors have recommended that interventions aimed at improving illness outcomes should include an illness-representations component. While a few researchers have attempted to develop such interventions for chronic illness and chronic pain, no such intervention has been developed for individuals with systemic lupus erythematosus (SLE), a chronic auto-immune illness which results in a variety of negative physical and psychological symptoms. This article reports on a pilot program that investigated the feasibility of a cognitive and behavioural—based intervention for treating SLE which included an illness-representations-change component. The effectiveness of the intervention compared to usual treatment for SLE was evaluated. Also investigated was whether changed illness representations had a beneficial effect on physical health and psychological wellbeing. It was found that the intervention did change participants' treatment control and emotional representations, and that perceived stress was reduced following the intervention. The importance of these findings is discussed, two rival hypotheses for the findings obtained are explored and directions for future research are suggested.

In the present study, parent–child interactions with anxious children were compared to parent–child interactions with the anxious children's nonsymptomatic siblings and parent–child interactions with nonclinic children. Participants included 33 anxious children, their parents and siblings, and 14 nonclinic children and their parents. Parent–child interactions were observed during two discussion tasks related to anxiety-provoking or challenging situations. Parent–child interactions were coded for the following variables: control, warmth, reward of coping behaviour and task involvement. Consistent with previous research, parents in the anxious group showed more control, less paternal warmth and less maternal reward of coping behaviour toward their anxious child compared to parents of nonclinic children. Parent–child interactions with the anxious child were similar to parent–child interactions with the nonsymptomatic sibling, with the exception of fathers who exhibited more control toward their anxious child. Parent–sibling interactions, however, also resembled the nonclinic parent–child interactions, with mothers of anxious children showing more control toward their nonsymptomatic child than mothers of nonclinic children. These findings suggest that the relationships of each parent and their anxious child may be influenced by how the parent and child interact with each other. Suggestions for future research are discussed.

Recent cognitive models of trauma response predict that negative trauma appraisals are central to the development of psychopathological stress reactions. Fifty-nine civilian survivors of motor vehicle accidents (MVA; n = 24) and nonsexual assaults (n = 35) were assessed within 4 weeks of their traumatic event for acute stress disorder (ASD), prior traumatic events and prior mental health contact, and were administered the Anxiety Sensitivity Index and the Posttraumatic Cognitions Inventory. Participants who were diagnosed with ASD displayed more maladaptive appraisals about their functioning following their trauma and reported higher levels of concern regarding anxiety symptoms than those who were not diagnosed with ASD. Negative beliefs were strongly associated with acute stress severity. These findings are discussed in the context of cognitive mechanisms that may influence maladaptive adjustment following trauma.

Cognitive variables hypothesised to be mediating obsessive—compulsive behaviour include an overestimation of the probability and consequences of danger, a sense of overinflated personal responsibility for harm to oneself or others, a belief in the overimportance of thoughts, a lack of confidence in memory, an intolerance of uncertainty and a need to control thoughts. In the present study, the relationship between these variables and improvement in OCD symptoms was examined. Fourteen obsessive—compulsives with checking concerns completed a 12-session treatment program of exposure and response prevention (ERP). Before and after treatment, subjects completed the Maudsley Obsessional-Compulsive Inventory (MOCI) and a self-rating of severity (SER), and each week they completed the Yale-Brown Obsessive Compulsive Scale (YBOCS) and answered seven questions that were used to rate their beliefs in the six cognitive domains outlined above. Changes in perception of danger, intolerance of uncertainty and need to control thoughts all correlated significantly with improvement in symptoms. Moreover, significant changes in these variables occurred immediately prior to or concurrent with major symptom improvement, supporting the possibility that they are mediators of the disorder. Changes in ratings of responsibility, overimportance of thoughts and confidence in memory were not related to improvements in compulsive checking on any scale and, in the case of responsibility, ratings actually increased (i.e., worsened) in the week prior to major improvement in symptoms. For most subjects, major reductions in responsibility ratings only took place after symptom reduction. The implications of these findings for the role of these variables in mediating obsessive—compulsive checking are discussed.

The efficacy of cognitive—behavioural therapy (CBT) for the treatment of childhood anxiety has mainly been demonstrated in university-clinic settings. This study aimed to evaluate the effectiveness of CBT for the treatment of childhood anxiety in a community mental health service, compared with standard treatments (‘Treatment as Usual’ [TAU]) 'child psychotherapy, family therapy and eclectic treatments. Fifty-four children with anxiety disorders, aged from 7 to 14 years, were randomly assigned to either a CBT or TAU group. CBT and the standard treatments were provided by 18 experienced therapists, and the mean number of treatment sessions was 12. Baseline and follow-up measures at 3, 6 and 12 months included an interview based on criteria in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) that was conducted by a clinical psychologist who was blind to the treatment conditions, and standardised anxiety measures (parent, child and teacher reports). Significant improvements were found on all anxiety measures over time, but no significant differences were found between CBT and TAU. The challenge of conducting such research in community settings is discussed.

In Australia, acculturating adolescents from a non-English speaking background (NESB) face two important challenges: developing a cultural identity and establishing a set of cultural values. These challenges are achieved by balancing a native and Australian orientation. It was expected that NESB adolescents who did not achieve these tasks would experience poor mental health. This study focused on adolescents because a significant relationship between cultural identity, cultural values and mental health in this group will highlight a need for sensitivity to such cultural and developmental issues. Two hundred and sixty-three NESB adolescents completed questionnaires that assessed cultural identity (Australian and native), cultural values (individualism and collectivism), state mental health (depression, anxiety and stress) and trait mental health (positive affectivity [PA] and negative affectivity [NA]). Results indicated that high Australian pride and high native pride are associated with lower depression, anxiety, stress and NA, and higher PA. Results also indicated that adolescents high on individualism and collectivism reported lower depression and stress, and higher PA. Furthermore, adolescents with a separated cultural identity (high native pride and low Australian pride) reported the highest levels of depression, but adolescents with separated cultural values (high collectivism and low individualism) reported the lowest levels of depression and anxiety. We concluded that cultural identity and cultural values are differentially related to mental health, and such relationships, albeit moderate, emerge during adolescence.

The aim of the current pilot study was to examine the effectiveness of the FRIENDS program (a cognitive–behavioural intervention for children and adolescents with anxiety) within a community-based clinic in Brisbane, Australia. A total of 18 children participated in the study and completed the FRIENDS program at Pathways Health and Research Centre, an innovative research-based psychology clinic for children, adolescents and families. All participants either met criteria for an anxiety disorder (N = 11) or were experiencing subclinical symptoms of anxiety (N = 7) before commencing the intervention. Before and following treatment, participants were assessed using a diagnostic interview and completed a number of self-report questionnaires. Results indicated that 73% of the participants who met criteria for an anxiety disorder before the intervention were diagnosis-free following treatment. Positive treatment effects were also found for questionnaire data, indicating that there were significant reductions on self-report levels of anxiety and depression following treatment. The outcome of this research suggests that the FRIENDS program is an effective treatment for children with anxiety, and results from this community trial replicate findings from controlled treatment trials.

Little is known about the prevalence of having been bullied in adults with versus adults without an anxiety disorder, so a pilot comparison was undertaken. A questionnaire on recall of having been bullied was completed by 81 attenders of a behavioural psychotherapy unit for anxiety disorders and by 81 attenders of a dental clinic who had no psychiatric problems but who were similar to the anxiety disorder group in gender, marital and employment characteristics. Recall of being bullied was significantly more common in the anxiety disorder referrals than in the dental patients. Results warrant testing of whether being bullied as a child increases the likelihood of developing an anxiety disorder in later life, controlling for demographic, personality and ethnic variables.

The n = 1 research design and the ethos underpinning it have importantly contributed to applied behaviour analysis since its inception. Many papers in Behaviour Change (BC) using this methodology have been of value to practitioners in the field, as well as to researchers and teachers. However, the rate of publication of n = 1 papers in BC has decreased during the last decade. The present article first documents that decline in rate of publication, then raises some issues for discussion about why this has occurred. Comments from the wider readership are invited in an effort to resurrect this valuable and informative clinical research tradition.

The theory of evolution has transformed biology from a largely descriptive science to a causal one. However, few psychologists have a thorough understanding of evolution. As a result, psychologists tend not to consider evolutionary explanations for the phenomena they investigate, or they present flawed evolutionary arguments that violate fundamental principles of evolutionary theory. The primary objective of this article is to outline the basic principles of evolution as they relate to the study of behaviour in general. The article then goes on to demonstrate the application of evolutionary theory to the study of human behaviour in particular, and concludes with a discussion of problems that can occur when evolutionary theory is applied incorrectly.

Parents of children with anxiety disorders (n = 45) and parents of nonclinical children (n = 33) were interviewed regarding the rearing of two children in their family. The purpose of the study was to determine whether overprotective parenting, according to parent report, occurs specifically in the context of relationships with the anxiety-disordered child or whether parents also perceive themselves to be overprotective of the anxious child's sibling. Self-reports of overprotection by parents of anxious children were also compared to self-reports of overprotection by parents of nonclinical children. Mothers in the clinical group were more likely to report that they were more protective of the anxious child than they were to report being either more protective of the sibling or equally protective of both children. Both mothers and fathers in the clinical group were no more likely than nonclinical parents to perceive themselves as being more protective overall than other parents.