Romme and Escher (1989) reported that 70% of voice hearers began to hear voices following a traumatic event. This study was therefore designed to examine the effects of trauma on predisposition to auditory and visual hallucinations in the general population. The study also examined the role of beliefs about voices and metacognitive beliefs about thoughts in predisposition to hallucinations, and tested the specific hypothesis that dissociative experiences would predict predisposition to auditory hallucinations. Sixty-four non-clinical subjects were asked to complete questionnaires assessing interpretations of voices, predisposition to hallucinations, metacognitive beliefs, PTSD symptomatology, experience of trauma, trauma-related cognitions and dissociative experiences. The study found an association between trauma-related measures (negative cognitions about the world and all dissociation variables) and predisposition to both auditory and visual hallucinations. It was found that participants who had experienced certain specific life events scored significantly higher on predisposition to auditory hallucinations (bereavement, physical assault and emotional abuse) and on predisposition to visual hallucinations (bullying). Multiple regression analyses demonstrated that both metacognitive beliefs and dissociative processes explained significant proportions of the variance in predisposition to both auditory and visual hallucinations. These results suggest an association between trauma and predisposition to auditory hallucinations. The theoretical and clinical implications of the findings are discussed.

Happy New Year! As the first issue of volume 31 thuds onto your mat, we are happy to declare the increase in page numbers a success in every respect. As you know, we have increased our published volume by 25% in order to keep up with the growing number of good quality manuscripts. The flow has continued, and in fact continues to increase. At the same time, after a bit of a hiccup, we have a working website that carries the additional material that usually accompanies brief clinical reports. For those of you thinking of submitting brief clinical reports, this is important because it means that you will no longer have to post out fuller reports or supporting documents. Also, documents posted in this way will be citable publications. (However, it is also important to note that the rules restricting “double publication” apply to such material).

Thirty-seven (37) couples experiencing child behavior problems and concurrent marital conflict were randomly assigned to one of two variants of a group parent training program, either Standard Group Triple P (SGTP; n=19) or Enhanced Group Triple P (EGTP; n=18). SGTP incorporated 8 sessions (4 group sessions and 4 telephone consultations) and taught parents to identify the causes of child behaviour problems, promote children's development, manage misbehavior and plan ahead to prevent child behavior problems in “high risk” parenting situations. Families in the EGTP condition received SGTP plus 2 additional group sessions of parent support training that taught partners to support one another to parent as a team. These additional sessions included information and active skills training in communication skills; giving and receiving constructive feedback; holding casual conversations; supporting each other when problems occur; holding problem solving discussions; and improving relationship happiness. There were significant improvements from pre- to post-intervention for both conditions, on measures of disruptive child behavior, dysfunctional parenting style, conflict over parenting, relationship satisfaction and communication. No differences, however, were found between the two conditions, with both the EGTP and the SGTP programs resulting in similar outcomes. In the main, initial treatment effects for both mothers and fathers were maintained at 3-month follow-up.

Effects of structured worry interviews were examined among analog-GAD and nonanxious college students. Thirty-four analog-GAD and 29 nonanxious control participants generated sequences of possible catastrophic outcomes for each of six worry topics using the Catastrophizing Interview Technique (Vasey and Borkovec, 1992). Threat ratings for each topic were collected, and ratings of subjective distress, likelihood of the feared outcome, and perceived control over the feared outcome were obtained immediately following each interview. Results indicated that the analog-GAD group rated the worry topics of achievement, social relations, and economics as more threatening than their nonanxious counterparts. The analog-GAD group also generated more catastrophizing steps and reported higher levels of negative mood following the worry interviews. In addition, the eventual fear underlying each worry was determined by coding the content of the final outcome step from each interview. Results from the coded interview responses indicated that fears of negative emotion and of failure were the most frequently coded categories in each of the six topical domains for the analog-GAD group. Although there was no difference in the proportion of negative emotion codes between analog-GAD and nonanxious groups, the analog-GAD group did receive a greater proportion of failure codes than the nonanxious control group. Results largely replicated the findings of Vasey and Borkovec in an analog-GAD sample. In addition, results suggest that fear of negative emotion underlies worry in general, regardless of diagnostic status, while fears of failure or ineffectiveness are more specific to GAD.

In order to function effectively in our day-to-day lives we must all take risks. These risks may be as simple as crossing a road or as complex as deciding whether or not to purchase a new home. The behaviour of individuals with Obsessive Compulsive Disorder (OCD) has been variously described as “harm-avoidant” (Cloninger, 1987) or “risk-aversive” (Carr, 1974). Despite the use of different terminology, there is consensus that individuals with OCD avoid taking risk. Further information regarding the type and extent of risks avoided has been difficult to obtain due to limitations in defining and therefore measuring the concept. Few studies have examined the concept of risk-taking with populations outside the United States, and none could be identified that examined risk-taking with OCD populations in Australia. In an effort to clarify the role of risk-taking behaviour in Obsessive-Compulsive Disorder, this study extended upon earlier work of Steketee and Frost (1994). This study administered a revised version of the Everyday Risk Inventory (ERI), developed by Steketee and Frost (1994) to assess risk-taking behaviour in an obsessive-compulsive population. Consistent with the original ERI (Steketee & Frost, 1994), the Australian adaptation of the ERI (ERI-AUS) produced sound internal consistency. As expected, we found that clinical OCD outpatients scored significantly lower on the ERI-AUS as compared to their non-clinical counterparts, and a clear linear trend emerged when risk-taking in people exhibiting sub-clinical OC symptoms was considered. Results suggested a potential inverse relationship between OCD symptoms and risk-taking. The cross-cultural comparison of the Australian non-clinical and American non-clinical (Steketee & Frost) samples revealed significantly higher rates of risk-taking for the latter group. The findings suggest that the concept of risk can be measured effectively with the ERI-AUS, and that further studies examining risk-taking are warranted.

Experiential training and personal therapy have rich traditions in various therapies as strategies to enhance self-awareness and therapist skills. However, personal experiential work has not traditionally been part of cognitive therapy (CT) training. The purpose of the present study is to map the impact of personal experiential work on CT skills in a group of CT practitioners. Fourteen cognitive therapists undertook training courses utilizing a structured approach to self-practice of CT techniques, known as self-practice/self-reflection (SP/SR). Six therapists from one training group engaged in “co-therapy” sessions with a partner, while eight therapists from another training group practised CT techniques on their own. Both groups engaged in regular written reflections about their experience. Follow-up 1-5 months after the courses identified six areas of self-reported skill enhancement: Refinement of specific CT skills; Enriched communication of the conceptual framework of CT; Increased attention to the therapeutic relationship; Empathic attunement; Therapist self-reflection; and Therapeutic flexibility. The results suggested that SP/SR enhances the “professional artistry” of therapists, a finding consistent with literature suggesting that reflection is a key process in the development of therapist expertise. It is concluded that SP/SR represents a promising training strategy for cognitive therapists.

The present study examined the recall of material representative and non representative of schemata for social and evaluative situations. Socially anxious (n = 24) and nonanxious (n = 25) individuals were presented with three positively valenced and three negatively valenced prose passages describing common social and evaluative scenarios. Eight of the sentences in each passage described events representative of the schema content of most individuals, whereas three of the sentences in each passage described events that are not representative of typical schema content. Participants completed a free recall task in both immediate (i.e. 2 minutes) and delayed (i.e. one week) recall conditions. Although there were no group differences as a function of type of content (i.e. schematic, non-schematic), socially anxious individuals were less likely than nonanxious individuals to accurately recall the gist of passages containing negative information in the immediate recall condition. In all, this study provided little evidence for the influence of maladaptive schema content on memory for threatening material in anxious individuals, but it added to an increasingly large literature suggesting that some types of anxiety are associated with an avoidance of processing emotional material.

Recent cognitive behavioural models of obsessive compulsive disorder (OCD) suggest that the misinterpretation of the meaning of intrusive thoughts plays a pivotal role in the escalation of these thoughts to clinical obsessions, but less attention has been paid to why only certain intrusive thoughts become the focus of these misappraisals. Theoretical speculation suggests that thoughts that have relevance for an individual's value system or sense of self may be particularly salient and upsetting for people. The role of thought appraisal and contradiction of valued aspects of self were examined in a nonclinical population. It was hypothesized that participants reporting on upsetting intrusive thoughts would appraise these thoughts negatively and would report that these thoughts contradict important aspects of self to a greater degree than participants reporting on less upsetting intrusive thoughts. Participants (N = 64) were randomly assigned to report on either the most or least upsetting intrusive thought they had experienced. They completed questionnaires on appraisals of these thoughts, valued aspects of self, and contradiction of self. Consistent with predictions, participants reporting on more upsetting thoughts appraised these thoughts in a more negative manner and reported that these thoughts contradicted valued aspects of self to a greater degree than participants in the least upsetting thought group. These results support Salkovskis' (1985) and Rachman's (1997, 1998) cognitive behavioural models of OCD, and suggest that the degree of contradiction of self may help us understand why some obsessional thoughts are much more upsetting than others.

How do somatic causal attributions for symptoms relate to treatment seeking behaviour in Irritable Bowel Syndrome (IBS)? How might a tendency to make somatic attributions influence an individual's cognitive representation of their illness once a diagnosis of IBS is established? In Study 1 attributions about symptoms were investigated in treatment-seekers and non treatment-seekers with IBS. Treatment-seekers had an increased tendency to make somatic attributions for both gastrointestinal symptoms and physiological symptoms characteristic of anxiety and depression, although they did not differ from non treatment-seekers in the severity of these symptoms or in their reports of psychological distress. Treatment-seekers also perceived themselves to be significantly less resistant to illness and to be significantly more likely to have poor health in the future than non treatment-seekers. In Study 2, 20 treatment seekers with chronic symptoms of IBS completed measures of mood and of the degree to which they viewed a range of symptoms as a part of their IBS. Physiological symptoms of anxiety and depression were seen as a part of IBS by a considerable proportion of the sample. Higher levels of depression were associated with an increased tendency to see physiological symptoms of anxiety and depression and even symptoms of colds as “a part of” IBS. It is concluded that a somatic attributional style may contribute both to initial treatment seeking for symptoms of IBS and the subsequent maintenance and exacerbation of the disorder once a diagnosis is established.

The extent to which cognitive behaviour therapy can be used with children is unclear. In meta analyses older children and teenagers seem to derive greater benefit than young children. This may be because the cognitive immaturity of young children means that they cannot manage the cognitive demands of cognitive behaviour therapy. This paper seeks to establish how well children aged 7-8 and aged 10-11 can complete a task requiring them to distinguish between thoughts and behaviours (based on Greenberger & Padesky, 1995). Half of the children were provided with a visual cue and half were not. The effects of age, the visual cue, and verbal IQ on performance were examined. Seventy-two children were randomized to the cue and no-cue condition and individually tested during school time. Both age groups performed well and there was a significant difference between older and younger children, with the older children performing better. Visual cues did not aid performance. Verbal IQ was significantly associated with performance in the younger but not the older children. The implications of these results for the delivery of cognitive behaviour therapy with children and future research are discussed.

The present study surveyed a sample of 116 Australian therapists who identified themselves as working primarily with traumatized clients. Outcome variables were measures of vicarious traumatization (VT), burnout and trauma symptomatology (intrusion and avoidance). A measure of beliefs about the therapeutic process was constructed for the present study and examined along with other predictor variables, namely years of experience as a therapist, percentage of time spent in clinical work with clients, predominant client group, and recent and direct exposure to trauma in the therapist. Therapist beliefs were found to predict vulnerability to VT and burnout, supporting a cognitive model of therapist distress. Implications of the findings for maintaining therapist health are discussed.

The study tested the hypothesis, derived from Teasdale and Barnard's (1993) Interacting Cognitive Subsystems (ICS) model, that two commonly used techniques in cognitive therapy, automatic thought records (ATRs) and behavioural experiments (BEs), would have their primary impact on different cognitive subsystems. Teasdale (1997a, b) has suggested that while ATRs tend to impact on a logic-based propositional information processing system, BEs impact on a more holistic implicational system, which has extensive links with emotion. Quantitative and qualitative data derived from three groups of participants undertaking cognitive therapy training courses, who practised ATRs and BEs on themselves, supported Teasdale's theory. Differences were found in participants' ratings of behaviour and belief change, with BEs being perceived as more powerful and compelling than ATRs, as predicted by the theory. There were also qualitative differences in participants' experiences of the two techniques, suggestive of different modes of processing. The data indicated the particular importance of the therapist's role in BEs. In order to provide a more comprehensive account of ATRs and BEs, it was suggested that Teasdale's theory could profitably be extended to include the role of the therapist in promoting adaptive oscillation between the implicational and propositional modes.

The acceptability of behaviour management methods has become an important area of concern. However, most research has focused on behaviour support plans. This study evaluated the acceptability of a restrictive procedure used in dentistry: the hand over mouth technique. Two-hundred-and-eighteen members of the general public rated one of eight vignettes using the Treatment Evaluation Inventory. A 3-factor independent groups design evaluated the effects of child disability (average intelligence or moderate learning disability), intervention method (relaxation training and reinforcement or hand over mouth) and behavioural outcome (child became less distressed or child remained distressed). A significant main effect of treatment outcome was found, and effective treatments were rated as more acceptable than ineffective treatments. There was a marginal effect of treatment type, hand over mouth being rated as less acceptable than the use of reinforcement and relaxation. Where child behaviour problems are marked, the public's ratings of acceptability are largely influenced by the outcome of treatment.

Based on the relationship between cognitive intrusions and auditory hallucinations established by Morrison and Baker (2000) and Morrison, Haddock and Tarrier (1995) the present study examines the possible effect of the repeated suppression of self-discrepant thoughts on the vividness of auditory illusions in a sample from a non-clinical population. Sixty-one participants were randomly assigned to a suppression of thoughts group (n = 31) or a focalization of thoughts group (n = 30) with different levels of self-discrepancy. After carrying out the task over a period of 48 hours, participants were presented with non-vocal auditory stimulation and asked to state whether they heard any verbalizations, and if so, how clearly. Results show how the repeated suppression of self-discrepant thoughts has a considerable effect on the vividness of illusions (F(1, 50) = 16.09; p < 0.001). The implications of these results for psychological therapy are analysed, with special emphasis on the importance of a research line based on acceptance.

The Novaco Anger Scale is the only scale published that allows for the measurement of anger with relation to Novaco's (1976) widely used model of anger management. This paper is the first to present a statistical analysis of the factor structure of this scale. From a sample of healthcare employees and outpatients with problems with anger control, a factor solution was identified. It is suggested that the items loading on this scale contribute to valid assessment of anger. The implications for the use of the NAS are considered.

The project aims to investigate the efficacy of a preventive cognitive behavioural intervention delivered via the Internet to individuals at risk of developing anxiety disorders. There is increasing evidence that suggests anxiety sensitivity may act as a premorbid risk factor for the development of anxiety pathology and panic disorder. Eighty-three university students with elevated anxiety sensitivity were randomly allocated to either an intervention group (n = 43), who worked through the Internet based program over a period of 6 weeks, or a waitlist control group (n = 40). Significant treatment effects were found for anxiety related cognitions and symptoms of depression, and a non-significant trend for anxiety sensitivity. These outcomes were related to expectancy but not to program utilization. Implications for the prevention of anxiety via the Internet are discussed.

The motivational interviewing skills code (MISC) was used to review 86 audiotaped interactions between clinicians and patients participating in a smoking cessation intervention. Intraclass correlations (ICCs) were completed for two of the MISC elements: global evaluations and behavior counts. Results indicate 75% of the global ratings yielded ICCs in the good to excellent range, while only 44% of the behavior counts yielded this level of accuracy. Adherence scores were created to form overall ratings of clinician adherence to using motivational interviewing and 80% of these competence measures yielded ICCs in the good to excellent range. Specific recommendations regarding modifications for the MISC are suggested based on the data presented.

Greenberg, Rice and Elliott (1993) elaborate in detail different applications of the two-chair method within an experiential therapy framework. In the present paper we present an adapted two-chair method for use in cognitive therapy. The principal aims of the adapted method are to elaborate a positive self-schema that has an emotional (“lived”) quality, and to use this experience to create a new model of self as emotionally and cognitively varied and changing. Procedurally, the first two steps are to (1) summarize the negative self-schema (Chair 1) and (2) draw out a positive self-schema (Chair 2). In Steps 3 and 4 the client remains in Chair 2 and is encouraged to accept the two self-schemata, and to integrate them both within a broader, more diverse metacognitive model of self. We present key themes from analysis of two clients' reflections on the method, which highlight issues of generalization and the process of change, and conclude with clinical and research implications.

Excessive responsibility has been proposed as a cognitive factor in obsessive-compulsive symptoms. In the present study the relationships of Salkovskis' measure of Responsibility Attitudes (RAS) (Salkovskis et al., 2000) with the total scale and the subscales of the PI-WSUR (Burns, Koertge, Formea, & Sternberger, 1996) measure of obsessive compulsive symptoms, as well as with a measure of depression (CES-D), were studied with a sample of 356 students (108 males and 248 females). As expected, the correlation between RAS and PI-WSUR was stronger than the correlation between RAS and CES-D, supporting the specific role of excessive responsibility in obsessive-compulsive symptoms. Among the subscales of PI-SWUR the strongest correlation of RAS was with Obsessional Thoughts About Harm to Self/Others (OTAHSO) and then with Checking. The OTAHSO was the only PI-WSUR subscale to show a significant partial correlation with RAS when other subscales and CES-D scores were taken into consideration. These results indicate that responsibility attitudes may play quite different roles in relation to different obsessive-compulsive symptom domains and that cognitive theory should take this more explicitly into account.

The present study presents the development and validation of the Social Interaction and Performance Anxiety and Avoidance Scale (SIPAAS), a self-report questionnaire to assess the level of distress and avoidance in a wide range of performance and social interaction situations, and the Social Phobia Safety Behaviours Scale (SPSBS), a self-report questionnaire designed to evaluate in-situation safety behaviours in which social phobics engage to try to prevent social catastrophe. The psychometric adequacy of both scales was evaluated in three different samples: social phobic patients, other anxiety disordered patients, and normal population. Both scales were normally distributed and were shown to possess high levels of internal consistency and temporal stability. They reliably discriminate patients with generalized social phobia from patients with non-generalized social phobia, other anxiety disordered patients, and normal population. Both subscales of the SIPAAS have shown high correlations with other measures of social anxiety (SAD, FNE), whereas the SPSBS has shown low to moderate correlations with SAD and FNE. It appears that these new self-report scales are reliable, valid and useful measures of social phobia for clinical and research purposes.