The Adolescent Risk-taking Questionnaire (ARQ) was developed to comprehensively assess adolescent risk-taking beliefs and behaviours. Research has shown that it is a reliable instrument with strong construct validity. The current study investigated the convergent and discriminant validity of the ARQ by comparing responses of a sample of 52 male adolescents from a juvenile justice centre and 211 school-attending male adolescents. Consistent with past research, the juvenile justice centre youth reported significantly higher levels of depression and less optimal levels of parent attachment compared to school-attending youth. Convergent validity of the ARQ was demonstrated through significant relationships between attachment and risk-taking. Specifically, those adolescents with less optimal parent attachment were more likely to engage in risk-taking behaviour and were less likely to perceive the behaviours included in the ARQ as risky compared to those with more optimal levels of parent attachment. Discriminant validity of the ARQ was demonstrated through significant differences between the two groups on risk beliefs and behaviours. Responses on the ARQ indicated that youth from the juvenile justice centre were significantly more likely to engage in risky behaviours, if given the opportunity, than school-based youth. They also perceived the behaviours to be less risky. It was concluded that the ARQ has good convergent and discriminant validity.

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.

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 study presents the results of preliminary findings on the continuing effect of cognitive-behavioural treatment groups (CBT) for Chinese people in Hong Kong with depression at 6-month follow-up. Data from 18 of the 48 CBT group participants was analysed using repeated-measures ANOVAs. The same questionnaire was administered to the participants at the pretest, posttest, and 6-month follow-up test. The findings reveal that participants continued to maintain significantly fewer symptoms of depression and dysfunctional rules, and significantly more adaptive coping skills and positive emotions when their follow-up test scores were compared to their pretest and posttest scores. Effect size statistics showed mostly medium differences in all of the above outcome measures between the pretest and posttest, and between the pretest and follow-up test (Cohen's d = 0.51–.77). A statistical approach to clinical significance revealed that in the follow-up test, over 60% of the participants could be considered clinically recovered or clinically remitted. Lastly, the results of hierarchical multiple regression analyses provided some evidence of a linkage between cognition and depression among the participants at posttest and follow-up. This study appears to support the continuing effect of CBT groups for Chinese people in Hong Kong with depression at a 6-month follow-up.

Objectives: Although cognitive–behaviour therapy for insomnia (CBT-I) has been shown to be effective for primary insomnia, the impact of CBT-I on insomnia comorbid with psychiatric conditions is largely unknown.

Design: A multiple baseline design with 2–3 weeks of baseline, 6 weeks of CBT-I, and a 3-week follow-up was employed.

Methods: Four patients with insomnia comorbid with both anxiety and depressive disorders participated. Sleep onset latency (SOL), wake time after sleep onset (WASO), total sleep time (TST), the Insomnia Severity Index (ISI), the Beck Anxiety Inventory (BAI), and the Beck Depression Inventory (BDI-II) were used as outcome measures.

Results: Improvements in SOL, WASO, and TST were observed for all the four patients. Based on ISI, there were reductions for all the patients (32–92%), three patients responded to treatment, and two patients remitted. Based on BAI, reductions on anxiety were observed for all the patients (40–76%), three patients were treatment responders, and two patients remitted. Based on BDI-II, all the patients experienced reductions in depression (36–53%), three patients responded to treatment, and one patient remitted.

Conclusions: CBT-I was able to reduce insomnia and co-morbid anxiety and depression, thus providing preliminary evidence for using CBT-I on insomnia co-morbid with psychiatric conditions.

Porirua (a suburb in Wellington, New Zealand) is a problem area for child restraint use and has been targeted by a variety of government-initiated, and largely ineffective, traffic safety campaigns in recent years (e.g., Gouldsbury, 1999). The present study attempted to increase child restraint use in cars at two Porirua Kindergartens, one predominantly Pacific Nations (Kindergarten A), and the other predominantly New Zealand European (Kindergarten B), by providing parents with information packages and vouchers for free child seat rental. An increase in correct child seat use was not observed at either kindergarten, although all unrestrained children observed during baseline at the predominantly New Zealand European kindergarten changed to wearing seat belts after the intervention. This finding suggests that income limitations per se are not the primary factor maintaining child seat non-use. Discussion focuses on the contradictory findings provided by both previous survey and observational research on the effect of ethnicity and income on child seat use. Potential crosscultural differences in the existence and salience of verbal community effects that may maintain child seat use through the avoidance of social punishment contingencies from other parents within the kindergarten are considered as one possible explanation for the present findings.

Despite substantial evidence of the detrimental effects of ruminative self-focus, paradoxically (as noted and reviewed by Watkins, 2004) there are clear suggestions that under some circumstances self-focused attention can actually promote well-being and confer benefits. We sought to replicate the findings of Watkins (2004) that adopting an abstract/analytical mode of processing following a negative event results in increased spontaneous intrusions of the event; that is, results in poor emotional processing. In the current study 57 low (BDI-II ≤ 7) and 59 high (BDI-II ≥ 12) dysphoric undergraduate participants viewed a four minute emotion-eliciting video, were randomly assigned to an analytical, experiential, or distraction processing condition, then monitored the frequency of video-related intrusions. Results indicated the effectiveness of the video in inducing moderately distressing intrusions, and suggest that the hypothesised effects of ruminative self-focus on intrusion severity may be dependent upon the self-referential nature of the material to be processed. Results did support previous findings (Williams & Moulds, 2007) that intrusion-related distress is not merely a function of intrusion frequency. Directions for future investigations of the cognitive processes that are important in the maintenance of depressive disorders are discussed.

Psychological mindedness (PM) has long been considered to be an important mediator of therapy outcome. However, to date, definitions of PM have been typified by linguistic imprecision and lack of conceptual clarity. Further, most definitions and measures of PM have approached the task from a psychodynamic perspective, thus limiting the use of this construct by clinicians and researchers from other theoretical perspectives. In this paper, previous definitions and self-report measures are reviewed and a new definition proposed. It is argued that PM is best conceptualised as a form of metacognition: a predisposition to engage in metacognitive acts of inquiry into how and why people behave, think, and feel in the way that they do. A new model, based on this definition, suggests that PM may be assessed by measuring individuals' metacognitive processes of self-reflection and insight, circumventing many of the problems associated with previous self-report measures of PM. Research into individual differences in propensity for PM, self-reflection, and insight may well provide the clinician with additional tools with which to facilitate purposeful, directed change in both clinical and nonclinical populations.

This paper describes the development and preliminary findings of a program designed to prevent the development of anxiety and depressive symptoms in children aged 10 to 13 years. Using a universal prevention approach, a total of 594 children were randomly assigned on a class-by-class basis to either a 10-session family group CBT program (FRIENDS) routinely implemented as part of the school curriculum, or to a comparison group. Pre-post intervention changes were examined universally, and for children who scored above the clinical cut-off for anxiety at pretest. Results revealed that children in the FRIENDS intervention group reported fewer anxiety symptoms, regardless of their risk status, than the comparison group at posttest. In terms of reported levels of depression, only the high anxiety group who completed the FRIENDS intervention evidenced improvements at posttest. Overall, these preliminary results appear to support the benefits of a school-based universal cognitive-behavioural intervention program. Implications of this study are discussed, and long-term follow-up measures are currently underway.

Cognitive behaviour therapy concentrates on strategies to assist clients in changing their thoughts and/or their behaviour. The aim of this paper is to discuss research findings from the addictions field indicating that an effective approach to therapy is to enhance motivation for change. Research into stages and processes of change, decision making, and motivational interviewing is reviewed. The paper concludes by suggesting ways in which this research can be used by therapists to increase the likelihood that clients will engage in change and maintain change over time.

The study investigated whether obese children are more impulsive than lean children, taking into account the multidimensionality of the construct. Responses of 41 overweight children were compared to those of 40 lean children. The Stop Task, Circle Drawing Task and Opposite Worlds Task were administered to measure executive inhibitory control, and the Maudsley Index of Childhood Delay Aversion and the Door Opening Task were administered to measure motivational inhibitory control. On the Stop Task, the overweight children showed less inhibitory control. On the Opposite Worlds task, we found no significant difference, whereas on the Circle Drawing Task an unexpected group difference was found. Although on the Door Opening Task the overweight children showed greater reward sensitivity, they were equally motivated to wait on the Maudsley Index of Childhood Delay. We conclude that the findings were different depending on the measure used, but that they suggest that overweight children can be characterised by a decrease in executive and motivational inhibitory control.

This pilot study evaluated the addition of 1 to 6 sessions of cognitive–behavioural therapy (CBT) for patients of a mental health acute assessment and treatment team. A pre-post design for 12 months of consecutive referrals used the Health of the Nation Outcome Scale (HONOS), Depression, Anxiety, Stress Scales (DASS), and patient satisfaction. Forty-two patients who attended CBT were compared with 19 patients who were referred but did not attend therapy due to refusal, referral to another service, or loss to follow-up. With a mean of 3.2 sessions, HONOS scores improved by a mean of 1.02 SD in patients who attended CBT and 0.72 SD in nonattenders. DASS results showed a mean reduction of 0.55 SD in symptoms of depression, anxiety and stress in those who attended. Patients' overall satisfaction averaged 4.7/5. Results showed brief CBT was feasible in this setting, with high patient satisfaction and some evidence of improved patient outcomes compared with usual care.

The present study investigated whether children with high symptom levels of either social phobia (SP), separation anxiety disorder (SAD), or generalised anxiety disorder (GAD) are characterised by a specific set of dysfunctional interpretations that are consistent with the cognitive model of their specific fear (“content-specificity of interpretations”). It was also examined whether such cognitive bias is predominantly activated in those ambiguous situations that are relevant for the pertinent fear (“content-specificity of situations”). Children high on symptoms of SP, SAD, and GAD and low-anxious control children were exposed to stories describing ambiguous situations and asked to give their interpretations and action plans. Results showed that high-anxious children displayed a negative cognitive bias compared to control children, but did not differ from controls with respect to the action plans given. Some evidence was found for the content-specificity of this cognitive bias. That is, consistent with the hypothesis of content-specificity of interpretations, children high on SAD reported more interpretations consistent with the content of their fear than children high on SP and GAD. Further, children high on SP and SAD predominantly displayed a negative cognitive bias in response to respectively social and separation situations. Children high on GAD did not show content-specificity for interpretations or situations. The theoretical implications of these findings are briefly discussed.

Day treatment programs (DTP) for eating disorders are being recognised as having therapeutic benefits. However, research is needed to evaluate the effectiveness of DTP to establish their validity. This article reports on the evaluation of a pilot DTP in an Australian mental health setting, which utilised an integrative approach combining evidence-based treatments such as dialectical-behavioural therapy and intensive short-term dynamic psychotherapy offered in a group-based setting. Comparison of pre- and post-treatment data outcome measures for eating disorder pathology and comorbid symptoms was undertaken. Patient satisfaction was also evaluated using qualitative methods. Results indicated a significant reduction in depressive symptoms post-treatment, along with a high degree of satisfaction with the treatment. Limitations of this study, along with the implications of the findings and directions for future research, are discussed.

In this article we report the use of a simple, nonprogrammed, syllable timed speech procedure to treat stuttering in a 3-year-old boy with a 2-year history of stuttering. The treatment involved the boy and his parents visiting the clinic 7 times, and the parents modelling syllable timed speech 2 to 6 times per day for 5- to 10-minute intervals in and around the home. After 7 weeks, clinic measures and objective, blinded measures of speech beyond the clinic showed stuttering frequency below 1.0% syllables stuttered. Along with low severity ratings made by the parent each day, this meets the stuttering criteria of another, proven treatment for early stuttering intervention. However, in this study reduction in stuttering was achieved with a simpler and more cost efficient procedure. With the caveat that this is a nonexperimental case report, we discuss its potential implications.

This study examined the influence of maternal anxiety on the treatment outcome of anxious children. Forty-eight clinically anxious children (aged 6–14 years) were classified into two groups based on the presence of an anxiety disorder diagnosis in their mother. Diagnostic data at posttreatment showed that children with anxious mothers responded significantly less favourably to cognitive behavioural therapy (CBT) than did children with nonanxious mothers (28% vs. 58% improved, respectively). At 12-month follow-up, 68% of children with anxious mothers improved, compared to 79% of children with nonanxious mothers. This difference was not significant. Findings were not consistent across outcome measures. This study also investigated the changes in maternal anxiety across child treatment. Prior to treatment, diagnostic data showed that 60% of mothers met criteria for an anxiety disorder. At posttreatment, 21% of these mothers were free of their primary diagnosis. There was also a significant reduction in self-reported maternal anxiety across treatment that was maintained at follow-up. Theoretical and clinical implications of the findings are discussed.

Cognitive behavioural models suggest that individuals abandon their weight loss efforts because they fail to achieve their weight loss goal, their perceived benefits of weight loss (primary goals), or both. There are currently no published tools available to adequately measure primary goals. The purpose of the current study was to explore the factor structure and to evaluate the psychometric properties of the Primary Goals for Weight Loss Questionnaire (PGWLQ). One hundred and twenty-seven overweight and obese adult females actively trying to lose weight completed the PGWLQ. A four-factor solution (Comfort & Mobility; Fitness; Health & Illness; Participation & Activity) provided the best fit for the physical items, and a five-factor solution (Body Image & Self-esteem; Clothing Options & Fashion; Work Productivity & Opportunity; Social Life & Desirability; Sexual Confidence) provided the best fit for the psychosocial items. All PGWLQ factors demonstrated good convergent and discriminant validity. The PGWLQ demonstrated excellent internal consistency and weak to moderate test–retest reliability. Results of the present study suggest that the PGWLQ may be a promising research and clinical tool and further refinement of the PGWLQ and investigation of its factor structure is warranted.

The present article describes two experimental studies investigating whether individual differences in intolerance of uncertainty (IU) predict worry in response to uncertain situations. In both studies, undergraduate students completed the Intolerance of Uncertainty Scale (IUS; Freeston, Rheaume, Letarte, Dugas, & Ladouceur, 1994) and then completed an intelligence task, which was thought to elicit feelings of uncertainty. After completing the task, state worry was measured. Results of both studies showed that there were positive correlations between IUS scores and task-related state worry. Furthermore, Study 2 showed that individual differences in IU only were predictive of worry in a situation that elicits low to medium levels of uncertainty, and not in a situation high in uncertainty. Thus, only under certain conditions IU-related personality characteristics seem to be predictive of worrisome thoughts.

The present paper argues that discussion of the role of reasoning in clinical neuropsychology has been largely restricted to a debate over the reliability and validity of end-stage decision-making. This has sometimes led to heated debate, but has not resulted in any careful consideration of either the process of clinical reasoning or the cognition of the clinician. There is already a wealth of theory and research on the kinds of errors typical of human judgement and decision-making. Moreover, much of this work is particularly relevant for neuropsychology, being frequently based on research on medical diagnosis. This literature is briefly reviewed, with examples that demonstrate the relevance of research in this area for clinical neuropsychology. Then, a step-by-step approach is taken to examining the process of clinical neuropsychological assessment, with consideration at each step of some of the issues that arise demanding clinical reasoning. Finally, the article is briefly summarised and some implications for clinical training are advanced.

This study investigated the relationship between attachment, mood and deliberate self-harm (DSH) in a nonclinical population (n = 114). In addition to a range of risky behaviours, the most commonly reported DSH behaviours were Head-banging (47%), Hitting (46%), Scratching (38%) and Cutting (34%). Those who engaged in DSH had poorer quality of attachment to both parents but not peers, and higher levels of depression, anxiety and stress. Path analysis was then used to examine the interaction between attachment, mood and DSH. The impact of the quality of attachment on DSH was found to be mediated by stress, which suggests that DSH may be a maladaptive coping mechanism. Attachment to father and peers was found to be more influential than attachment to mother. Our findings suggest that DSH may be more prevalent in the community than previously recognised, and that attachment, which is currently neglected in DSH research, warrants further investigation in both clinical and nonclinical populations.