Social Phobia (SP) is a psychological disorder characterised by an excessive and persistent fear of negative evaluation in social or performance situations that interferes with daily functioning. Cognitive models of SP (Clark & Wells, 1995; Hofmann, 2007; Rapee & Heimberg, 1997) emphasise the role of negative images of the self as an important factor in the maintenance of SP. While empirical research has demonstrated the link between negative self-imagery and social anxiety, many aspects of this cognitive factor are yet to be understood. Currently, there is limited research investigating the impact of different types of self-imagery and their effects on social anxiety and performance. Further research assessing the relationships between self-imagery and other maintaining processes proposed in cognitive models is also warranted. This review assesses the literature focusing on self-imagery in social anxiety, including qualitative, empirical, and preliminary treatment studies to date. Recommendations for future research and the use of imagery-based rescripting methods in the treatment of SP are also discussed.

Secure attachment is characterised by a secure base script regarding the attachment figure as a source for support. Having such a cognitive script should affect the stability of state attachment. Specifically, incongruent attachment-related information should get assimilated to this secure base script, leading to state attachment scores that hardly fluctuate. For children without a script, state attachment should vary depending on the quality of attachment-related interactions. Two diary studies were carried out in 9- to 13-year-old children. Results suggested that with assimilation: (1) securely attached children fluctuated less in their daily attachment-related appraisals; (2) fluctuations were related to conflicts with mother; (3) this relation was stronger for less securely attached children. Consequently, these studies further support the secure base script hypothesis and provide insight into the interplay of trait and state components of attachment-related appraisals.

This article presents a panel discussion on the integration of collaborative empiricism, specifically Socratic Questioning, into cognitive behaviour therapy. The panel comprised experts in research and practice who had been invited as keynote presenters for the 34th National Conference for the Australian Association of Cognitive and Behaviour Therapy, held in Sydney, Australia. Experts responded to questions regarding (a) the definition of Socratic dialogue, and (b) whether the purpose of Guided Discovery using Socratic Questioning is to impart information, correct, or dispute patient cognitions. The session was well attended by mental health professionals from around the globe and the panel enjoyed the opportunity to discuss questions and comments from those in attendance. This article presents this exchange so that the broader AACBT membership may benefit from the ideas and comments generated.

Social anxiety disorder (SAD) is a psychological disorder characterised by an excessive and persistent fear of social or performance situations, which interferes with daily functioning. Cognitive models of SAD (Clark & Wells, 1995; Hofmann, 2007; Rapee & Heimberg, 1997) emphasise the importance of negative pre- and post-event rumination as a maintaining factor in the cycle of SAD. While the link between negative rumination and SAD is well supported by empirical research, little is understood about this cognitively important process; thus, research investigating the predictors of negative rumination in SAD is important to consider. Within the current literature, performance appraisal appears to be the most likely unique cognitive predictor of post-event rumination. There is limited research into cognitive predictors of pre-event rumination. Treatments targeting this maintaining factor are important to consider. Suggestions for future research examining the cognitive models of SAD by experimentally manipulating perceived social standards in order to examine the impact of high and low perceived social standard on appraisal processes (i.e., threat appraisal and performance appraisal), state social anxiety, and negative pre-event and post-event rumination, are proposed. Implications for theoretical models and efficacious treatments for SAD are discussed.

Nighttime fear, including fear of monsters and the dark, is common. For most children and adolescents, nighttime fears are transient. However, approximately 10% experience severe nighttime fear that negatively impacts sleep, adjustment, and family life. Research conducted in the 1980s indicates that cognitive-behavioural therapy can reduce nighttime fear in as few as three sessions. The aims of the present study were to replicate and extend earlier research by evaluating a cognitive-behavioural treatment package for children's severe nighttime fear, and address methodological issues in previous studies. A manualised, multi-component treatment package was developed, based on current evidence-based practice for the treatment of children's anxiety. Interventions included graded exposure, muscle relaxation, cognitive restructuring, and social and material reinforcement. Treatment was individually tailored and delivered via weekly modules. A multiple baseline across-subjects design was utilised. Four ‘families’ — one parent and one child — participated; children's ages ranged from 6 to 10 years. Families attended five weekly intervention sessions and a 1-month follow-up. Multiple outcome measures were administered pre- and post-treatment. All children displayed changes consistent with reduced nighttime fear following treatment, including fewer phobic symptoms, reduced general fear, and improved nighttime and general behaviour. These changes were maintained at follow-up. Parents reported a high degree of satisfaction with the program and would recommend it to other families. The results support the effectiveness of manualised, parent-assisted treatment for nighttime fear in as few as three sessions. In cases of severe nighttime fear, therapist support is recommended. Treatment implications for children with complex presentations are discussed.

Repetitive negative thinking (RNT) has been confirmed as a transdiagnostic phenomenon, but most measures of RNT are contaminated with diagnosis-specific content. The first aim of this study was to examine the structure of an anticipatory version of the Repetitive Thinking Questionnaire (RTQ-Ant) as a trans-emotional measure of anticipatory RNT. The original RTQ was completed with reference to a past stressor, whereas the RTQ-Ant instructs respondents to link their responses to a future stressor. The second aim was to test if the associations between a range of emotions (anxiety, depression, shame, anger, general distress) and the original post-stressor version of the RTQ would be replicated. Undergraduates (N = 175, 61% women) completed the RTQ-Ant, along with measures of various emotions, with reference to upcoming university exams. Principal axis factor analysis yielded many similarities between the original post-event RTQ and the RTQ-Ant, and some differences. The RTQ-Ant was comprised of two subscales: the RNT subscale measures engagement in repetitive thinking, negative thoughts about oneself, and ‘why’ questions; and the Isolated Contemplation (IC) subscale included items referring to isolating oneself and reflecting on negative thoughts, feelings, loneliness, and listening to sad music. RNT was more strongly related to negative emotions than IC. The RTQ-Ant appears to be a reliable measure of anticipatory RNT that is associated with a broad array of emotions.

It has recently been asserted that a paradigm shift is emerging in the delivery of parenting programs. Specifically, it has been suggested that interventions from the field of interpersonal neurobiology represent sophisticated alternatives to positive parenting interventions based on social learning models and behavioural principles, and better reflect how contemporary practitioners consider parenting. We examine this assertion, dispel a number of myths, and conclude that characterisations of positive parenting programs are frequently misleading and do not adequately reflect contemporary models of practice. There is little justification to support the claim that the field should abandon this ‘paradigm’. Indeed, there has been a considerable expansion in the evidence base supporting positive parenting programs and the emergence of a public health framework that blends universal and indicated interventions that can greatly increase the reach and lower the costs of delivering parenting interventions.

Depression is associated with increased cardiac morbidity and mortality in people with and without cardiac risk factors, and this relationship is, in part, mediated by heart rate variability (HRV). Increased heart rate and reduced HRV are common in depressed patients, which may explain their higher cardiac risk. This pilot study investigated whether mindfulness-based cognitive therapy (MBCT) promoted objective changes in (1) HRV, and (2) depressive symptoms and quality of life, in mental health outpatients. Twenty-seven adults meeting criteria for DSM-IV Axis I disorders completed an 8-week MBCT program. Data were collected on three occasions, 8 weeks apart; twice before and once after MBCT. Participants completed the Short Form-36 and the Center for Epidemiological Studies Depression Scale (CES-D) at each test period. Heart rate and HRV were measured during electrocardiographic monitoring before and after a cognitive stressor. At baseline, 78% of participants met criteria for depression (CES-D ≥16). Multivariate analyses revealed a significant treatment effect for SF-36 physical summary score and depression (as a dichotomous variable), but not for HRV. This pilot study highlights the immediate psychological and health benefits of MBCT. Low power may have influenced the lack of a finding of an association between HRV and MBCT. However, the feasibility of the study design has been established, and supports the need for larger and longer-term studies of the potential physiological benefits of MBCT for cardiac health.

Individuals with obsessive-compulsive disorder (OCD) experience a significant deterioration in quality of life (Fontenelle et al., 2010; Kugler et al., 2013) and marked functional impairment (Markarian et al., 2010). Despite this, a large proportion of these individuals do not seek any type of help (Goodwin, Koenen, Hellman, Guardino, & Struening, 2002; Mayerovitch et al., 2003). The current study investigated the barriers to seeking OCD treatment using an online survey that was completed by 86 participants living in Australia who identified as having OCD. Results showed that the three main barriers to seeking OCD treatment were: (a) preference for handling problems alone; (b) cost of treatment; and (c) lack of knowledge about available mental health treatment. Individuals who reported receiving an OCD diagnosis (n = 57) demonstrated more severe symptoms, poorer quality of life and higher symptom intrusiveness than those who had not received a diagnosis (n = 29). Furthermore, significant associations were found between religious affiliation and barriers to treatment where greater religious attendance was correlated with a higher likelihood of identifying cultural factors as a barrier to OCD treatment. Additionally, higher levels of religious attendance were associated with a greater understanding of where to go for OCD treatment, not wanting to handle problems alone, and recognising that symptoms are a problem. This article considers approaches to overcoming barriers to accessing effective evidence-based treatment for people with OCD symptoms, and highlights future directions for research.

This study explored the moderating effect of body dissatisfaction (BD) on the relationship between perfectionism and weight restricting and control behaviours (WRCBs). A sample of 167 female undergraduates completed self-report measures of perfectionism, BD and WRCBs. BD was not found to moderate the relationship between either perfectionism and dieting, or perfectionism and exercise. Instead, BD uniquely predicted both dieting and exercise, as did the perfectionism dimensions of self-oriented perfectionism, concern over mistakes, parental standards, and organisation. BD moderated the relationship between perfectionism and purging for analyses involving self-oriented perfectionism, concern over mistakes, and doubts about actions, such that there was a significant positive association between perfectionism and purging when BD was high but not low. Perfectionism and BD are important in different ways to WRCBs. The importance of measuring multiple dimensions of perfectionism and differentiating between the various types of WRCBs is highlighted.

The study examined the relative efficacy of group acceptance and commitment therapy (ACT) for generalised anxiety disorder (GAD) compared to group cognitive-behavioural therapy (CBT). Fifty-one individuals with GAD were randomly allocated to a 6-week intervention, either ACT or CBT. Participants were assessed at pre-treatment, post-treatment, and 3-month follow-up on symptom measures, quality of life, and process measures. Data from 38 participants (19 in each group) were available at post-assessment, indicating significant improvements on all measures for both treatment conditions. Treatment gains were maintained at follow-up, with significant further improvements in anxiety, depression and stress symptoms for both groups. While no between-group differences were found at treatment completion, a significant interaction indicating steeper reduction in worrying symptoms (d = .79) from pre- to post-assessment was found for the ACT group compared to the CBT group. Furthermore, in relation to worrying, at treatment completion 78.9% of participants in the ACT group achieved reliable change compared to 47.4% of participants in the CBT group. However, both groups showed equivalent reliable change rates of 60% at the follow-up assessment. The results suggest that group ACT was as efficacious as group CBT. While participants in the ACT group maintained treatment gains at follow-up, participants in the CBT group continued to improve between post-assessment and follow-up.

Studies on the efficacy of parent training programs have mostly been conducted with preadolescents, with only a few studies investigating family treatment models in adolescents. In this article, a study is described that evaluates Standard Teen Triple P (Positive Parenting Program), a behavioural family intervention for parents of 11- to 16-year-old teenagers. Participants were 46 families with a teenager who was experiencing detectable behavioural and emotional problems. Compared to parents in the waitlist control condition, parents participating in the intervention condition reported decreased levels of teen disruptive behaviours and parent adolescent conflict, as well as a reduction in the use of ineffective parenting strategies and conflict over child-rearing issues. These positive changes were maintained at the 3-month follow-up. Results suggest that Standard Teen Triple P is a promising parenting intervention for tackling adolescent externalising problems.

Many individuals seeking treatment for social anxiety disorder (SAD) also meet criteria for a comorbid depressive disorder. Little is known, however, about how a comorbid depressive disorder affects social anxiety treatment. This study examined 61 participants with SAD and 72 with SAD and a comorbid depressive disorder (SAD+D) before and after 12 weeks of cognitive behavioural group therapy (CBGT) for social anxiety. Although patients with SAD+D reported more severe symptoms of social anxiety and depression at pretreatment, treatment was similarly effective for individuals with SAD and SAD+D. However, individuals with SAD+D continued to report higher symptom severity at post-treatment. Interestingly, CBGT for social anxiety also led to improvements in depressive symptoms despite the fact that depression was not targeted during treatment. Improvement in social anxiety symptoms predicted 26.8% of the variance in improvement in depressive symptoms. Results suggest that depressive symptoms need not be in remission for individuals to benefit from CBGT for social anxiety. However, more than 12 sessions of CBGT may be beneficial for individuals with comorbid depression.

Physical activity is positively related to various indices of quality of life and is found to reduce symptoms in individuals with chronic pain. This manuscript presents findings from a post hoc analysis investigating whether treatment-related improvements from psychological treatment for chronic pain are mediated by changes in physical activity (PA). Secondary analyses sought to determine predictor variables of PA in patients with chronic pain and to determine the relationship between objective and self-report measurements of PA. The effect of psychological treatment on physical activity was assessed using accelerometers in a sample of participants with chronic pain in a randomised controlled trial comparing 8 weeks of acceptance and commitment therapy (ACT) to cognitive behavioural therapy (CBT). Participants wore actigraph accelerometers for 7 consecutive days at baseline, post-treatment, and at 6-month follow-up. Hierarchical linear modelling analyses found that the variance in physical activity was not significantly predicted by time (b = 104.67, p = .92) or treatment modality (b = −1659.34, p = .57). Women had greater increases in physical activity than did men (b = 6804.08, p = .02). Current ‘gold standard’ psychological treatments for chronic pain were not found to significantly increase physical activity, an important outcome to target in the treatment of physical and mental health. These results suggest that tailored interventions with greater emphasis on exercise may complement psychological treatment for chronic pain. In particular, gender-tailored interventions may capitalise on physical activity differences found between men and women.

Cognitive processes are considered integral to the conceptualisation of emotional disorders and distress. Contemporary models have emphasised the importance of individual differences in the interpretation of internal events, including emotions. Maladaptive beliefs about emotional experience may motivate unhelpful control strategies, and impact negatively on psychological wellbeing. Building on existing measures of emotion, an integrative scale was developed to assess a range of maladaptive beliefs about the experience of negative emotions. Psychometric evaluation provided preliminary support for the reliability and validity of the Affect Intolerance Scale (AIS). Furthermore, the scale demonstrated a unique relationship with clinical symptomatology (i.e., depression, anxiety, stress and worry) above and beyond existing measures assessing dimensions of emotional experience. Potential utility of the measure for clinical practice and avenues for future research are discussed.

Objective: This study examined whether differences in habitual negative self-thinking and coping strategies might contribute to the age differences in worry and depression. Method: 60 undergraduate students (age range: 18–24 years, M = 19.10, SD = 1.3) and 45 community-dwelling older adults (age range: 60–89 years, M = 73.5, SD = 7.5) participated. Participants completed self-report measures of worry, depression, negative self-thinking, and coping styles. Results: We replicated previous findings that older adults were less worried and less depressed than younger adults. Older adults also reported engaging in less habitual negative thinking and using more problem solving as a coping strategy than younger adults. Furthermore, negative self-thinking and problem-solving skills were found to partially mediate age differences in worry and fully mediate depression scores. Conclusions: These results suggest that habitual negative thinking and problem-solving skills play a role in explaining the lower rates of worry and depression in older populations.

Dissemination of evidence-based parenting programs in developing countries is warranted, but prior to dissemination, the cultural appropriateness of programs needs to be assessed. This study provides an evaluation of the level of acceptability among Indonesian parents and the efficacy of a brief parenting program, the Triple P-Positive Parenting seminar. Thirty Indonesian parents of children aged 2–12 years old residing in Australia participated in the study. A 90-minute Triple P seminar with minimal changes in the format was delivered to parents in Indonesian. Parents reported a high level of acceptability and satisfaction with the program content. The efficacy of the program was also explored. Parents reported less frequent use of dysfunctional parenting practices, particularly permissive parenting style, and reduction in the intensity of child emotional and behavioural problems 3 weeks after the seminar. The effect was maintained at 3-month follow up. The results suggest that the Triple P seminar is acceptable and useful for Indonesian parents. Substantial changes in the content of the parenting program may not be necessary. Translated materials, culturally relevant examples and opportunity for questions appeared sufficient for parents. Future studies are required, including randomised controlled trials and larger sample sizes.

Although function-based interventions have been shown to be effective, the methods utilised to carry out functional behaviour assessments (FBA) have practical limitations. This study explored the relative utility and feasibility of three FBA methods in a school setting to inform a function-based intervention to reduce problem behaviour in a boy with autism. The study consisted of (1) indirect and direct assessments, (2) a modified functional analysis, and (3) the intervention. New video technology, Behavior Capture, was trialled to facilitate data collection in the classroom. All methods contributed to identifying the function of the problematic behaviour, though only the functional analysis provided conclusive results. A peer-mediated intervention based on these findings conducted in the school playground reduced the problem behaviours. All FBA methods could be applied in the school setting and provided useful information. Novel technology was helpful in facilitating data collection. A naturalistic intervention was successful in reducing problem behaviours and increasing play skills.