The current study examined whether a traditional exposure-based treatment for blood-injection-injury (BII) phobia would be effective at reducing disgust responses to BII stimuli and whether the addition of modules targeting disgust would provide incremental efficacy. Participants, many of whom reported subclinical BII phobia symptoms, underwent one of two single-session exposure protocols, one targeting fear alone, and the other targeting both fear and disgust. Both treatments consisted of education components (fear-only or fear-disgust) and in vivo exposure (fear-only or fear-disgust). Both the fear-only and the fear-disgust treatment groups significantly decreased fear and avoidance behaviour toward BII stimuli over time. The two groups also experienced similar reductions in disgust responses to BII-related stimuli and global as well as domain-specific disgust sensitivity. The effect sizes indicated that the fear-disgust group evidenced greater reduction in symptoms than did the fear-only group. The implications of the results for models of phobia maintenance and treatment are discussed.

This review examines the application of online interventions to the treatment of obesity. The unprecedented prevalence rates of overweight and obesity worldwide are indicative of the need to develop efficacious treatment alternatives. While research suggests that diet, physical activity and behaviour therapy are core components of effective obesity treatment programs, their ability to penetrate large portions of the population is limited. The empirically verified effectiveness of online interventions for disorders such as depression and social phobia, coupled with unparalleled rates of internet access, suggest that online interventions for overweight and obesity are a feasible and logical treatment modality. A limited number of randomised controlled trials reviewed in this article have evaluated the efficacy of this treatment alternative. Results are promising and encourage further use, development and empirical research in this area.

Specific phobias are one of the most prevalent childhood anxiety disorders. Research suggests that phobias in children, such as animal or situational phobias, lead to significant impairments in peer relations, social and academic competence. Hence it is imperative to treat phobias within children and adolescents early to avoid more serious, engrained symptoms later in the lifespan. This review focuses on traditional exposure-based cognitive–behavioural therapies, and the more recent one-session exposure therapy for phobia treatment (Ost, 1987), a procedure that has only begun to be administered to children. Further, controlled trials evaluating the efficacy of 1-session exposure therapy with phobic children are urgently required. We also address challenges for researchers using psycho-education to control nonspecific treatment effects.

This study investigated whether individual differences in obsessive-compulsive symptoms and in thought–action fusion are related to theory of mind abilities. One hundred and ninety-two adult participants completed self-reports of obsessive–compulsive symptoms (OCI-R), thought–action fusion (TAF), private self-consciousness (PSC) and self-reflectiveness (SR) as mentalising abilities, and anxiety and depression. A nonintrospective method examining participants' implicit structure of their lexicon for ‘knowing’ was used to assess theory of mind. Private self-conciousness and SR added to the prediction of OCD symptoms independently of TAF and depression but did not mediate the relationship between TAF and OCD symptoms. Participants high in thought–action fusion gave a greater emphasis to the certainty dimension of the mental lexicon and placed lesser importance on the source of information dimension than those low in TAF. Our results provide preliminary evidence of a relationship between theory of mind and thought–action fusion. People disposed to thought–action fusion are more likely to make a significance judgment about ‘knowing’ based on the degree of certainty than on reference to the source of knowledge. Identifying disruptions to theory of mind abilities in OCD provides links to solid theory and evidence about metacognitive development and may help integrate cognitive processing and cognitive appraisal models of OCD.

Effective treatments for common anxiety and mood disorders exist, yet epidemiological studies reveal that the unmet need for treatment in the community remains high. This study investigates the significance of the initial delay to first seek professional help in this unmet need for treatment in an Australian sample. Help-seeking history was retrospectively reported by 273 new referrals to a specialist anxiety treatment clinic who had a primary diagnosis of an anxiety (78%) or mood disorder (22%). Clinical, demographic and attitudinal variables were tested as potential predictors of length of the delay. Average help-seeking delay was 8.2 years (range 0–72 years). Younger age at symptom onset and slower problem recognition were associated with delayed help-seeking, and older people were more likely to report longer delays. We conclude that delays to first seek treatment are long and contribute significantly to the unmet need for treatment for anxiety and mood disorders, and that lack of problem recognition is a significant barrier to help-seeking.

The experiences of clinicians working with the ASD population suggest that parents of children with autism frequently misattribute their child's behaviour, particularly misbehaviour, to autism and that this can be a barrier in behavioural interventions (Howlin and Rutter, 1987). However, no research on the specific attributions that parents of children with ASD make for their child's behaviour could be found. The current study is an exploration of parental attributions within the ASD population. Fifty-nine families participated in this study. Analysis identified a tendency for parents to generalise attributions about ASD-related behaviour to misbehaviour. In addition, analysis identified a tendency to believe that the child's positive behaviour is more stable and controllable by the child than misbehaviour. A relationship was found between parental autistic traits and a tendency for the parent to attribute responsibility to themselves for ASD-related behaviour and misbehaviour.

The present study investigated whether MI is a mechanism for change in the treatment of obsessive–compulsive disorder (OCD). The Magical Ideation scale (MI), the Obsessive–Compulsive Inventory — Short Version (OCI-SV) and the Padua Inventory were completed by 34 obsessive–compulsive patients pre- and post cognitive–behavioural treatment. Treatment did not target magical styles of thinking. Significant improvements on all three measures of obsessive–compulsive symptoms were demonstrated by t tests over the course of treatment. Improvement in magical thinking was also shown to be significant in t test results. In support of the hypothesis, correlations between MI improvement and improvement on the obsessive–compulsive symptom scales were significant (at a level of .05) suggesting that there is an association between improvement in magical thinking and improvement in obsessive–compulsive symptoms. Notably, a significant negative correlation was obtained between prescores on MI and change scores on the OCD measures. This suggests that high levels of MI are associated with high levels of treatment intractability. High MI appears to be a poor prognostic factor in OCD.

The present study investigated the role of experiential avoidance in posttraumatic stress disorder (PTSD) following war-related stress. Eighty-four civilian war survivors were assigned to one of three PTSD groups — current PTSD, recovered PTSD and non-PTSD. Groups were subsequently compared in regard to experiential avoidance. Results indicated significantly higher rates of experiential avoidance and psychological distress in the current PTSD group as compared with the recovered PTSD and non-PTSD groups. The recovered PTSD and non-PTSD groups did not significantly differ.

The research investigated the effect of mindfulness meditation on the emotional states of depression, anxiety, and stress. Additionally, we explored whether people with varying severity of depression, anxiety, and stress responded differently to mindfulness training. In order to investigate these questions, participants (n = 50) completed the Depression Anxiety and Stress Scale, 21-item version (DASS-21) before and after a 10-week mindfulness meditation program. As predicted, the severity levels of all affective measures have decreased by the end of the meditation course. Participants with severe emotional difficulties at the time of commencing the meditation course demonstrated the most notable improvement over time. These results suggest that mindfulness training is beneficial in reducing the symptoms of subclinical depression and anxiety and can substantially reduce stress. Attentional retraining and self-management aspects of mindfulness meditation, as well as relevant methodological issues are discussed.

The purpose of this study was to examine the convergent validity and test–retest reliability of the Oxford Physical Activity Questionnaire (OPAQ), a self-administered questionnaire designed to assess the activity patterns of adolescents. The test–retest reliability of the OPAQ was assessed by administering the questionnaire on two occasions separated by 1 week (N = 87, mean age = 13.1 ± .9). Intraclass correlation (ICC) was used to examine the test–retest reliability of the OPAQ. The convergent validity of the OPAQ was evaluated using Caltrac accelerometers worn consecutively for 4 days (N = 51, mean age = 12.6 ± .5). Spearman's rank-order correlation was used to examine the convergent validity of the questionnaire. ICCs ranged from .76 to .91 and reliability was higher for males (r = .89) than females (r = .78). Correlations between self-reported physical activity and Caltrac accelerometer counts were related to vigorous physical activity (r = .33, p = .01) and moderate to vigorous activity (r = .32, p = .02). The OPAQ has excellent test–retest reliability and acceptable validity in comparison to other measures of youth physical activity.

There is an urgent need to find strategies to promote positive mental health in the workplace. The current study presents outcomes of a pilot trial of the Promoting Adult Resilience (PAR) program, an innovative mental health promotion program, which is conducted in the workplace over 11 weekly sessions. The PAR program is a strengths-based resilience-building program that integrates interpersonal and cognitive–behaviour therapy (CBT) perspectives. Pre-, post- and follow-up measures on 20 PAR participants from a resource-sector company were compared with a non-intervention-matched comparison group. At follow-up, the PAR group had maintained significant post-test improvements in coping self-efficacy and lower levels of stress and depression, and reported greater work-life fit than the comparison group. The program appeared to be ecologically valid and treatment integrity was maintained. Process evaluations of PAR program showed that skills were rated highly and widely used in everyday life at both post and follow-up measurement times.

The prevalence of anxiety symptoms among South African children is reported to be significantly higher than in other parts of the world. The need for an effective anxiety prevention and early intervention program for use with South African children is urgently needed. The aim of the present study was therefore to determine whether the Australian FRIENDS program could effectively reduce the anxiety symptoms, as measured by the Spence Children's Anxiety scale (SCAS), among a sample of South African children from low socioeconomic background. The program evaluation employed a quasi-experimental, nonequivalent control group design that followed participants (N = 46) over a course of 10 months. Within group effects and between group effects revealed that the FRIENDS program had little statistically significant postintervention effect on the anxiety symptoms of this sample, but had significant effects in the longer term, at 4 months and 6 months follow-up. The implications of these results for the South African context are discussed.

Despite the continuing development of effective cognitive and behavioural interventions for Generalised Anxiety Disorder (GAD) less attention has been paid to the important issue of improving treatment accessibility and affordability. Self-management approaches that utilise the convenience of the Internet may provide a means by which more people can avail themselves of effective treatments. To date, studies examining the effectiveness of such approaches for GAD lag behind the work conducted with other clinical problems. This study describes the response of three individuals with a primary diagnosis of GAD to an Internet-based treatment completed at their own pace. The intervention (‘What? Me Worry!?!; Saulsman, Nathan, Lim, and Correia, 2005) combines several cognitive and behavioural components with the inclusion of a significant metacognitive component. All participants achieved clinically significant improvement on measures of worry, GAD symptomatology, and metacognitions. Moreover, none of the participants met the diagnostic criteria for GAD at the completion of the study. A larger randomised controlled trial of this intervention is indicated.

Thought–action fusion (TAF) refers to the belief that thoughts and actions are linked. While ‘Moral’ TAF refers to the belief that unacceptable thoughts are morally equivalent to overt actions, ‘Likelihood’ TAF is the belief that certain thoughts can increase the probability of some events (related to self or others) to occur. The objective of this study was to compare the schizophrenic patients with nonclinical controls in terms of TAF Likelihood and TAF Moral after controlling for the effects of obsessive compulsive and depressive symptoms, magical ideation and schizotypy. The sample was composed of patients hospitalised for schizophrenia (n = 45) and nonclinical control subjects (n = 41). Thought–Action Fusion Scale, Maudsley Obsessive–Compulsive Inventory, Magical Ideation Scale, Schizotypal Personality Characteristics Subscale and Beck Depression Inventory were administered. Results revealed that after controlling the effects of obsessive–compulsive and depressive symptoms, magical ideation and schizotypy, patients still had higher scores on TAF Likelihood Others but not on Self. Patients also had a tendency to get higher scores on TAF Moral. It is concluded that the study shows the presence of TAF Likelihood Others in schizophrenia even after controlling for the effects of magical ideation, depressive and OCD symptoms and schizotypal characteristics.

The present study describes the outcomes of a manualised treatment for generalised anxiety disorder (GAD) in female adolescents that combined traditional cognitive–behavioural therapy (CBT) with an interpersonal skills (IP) component. The CBT component included psychoeducation, somatic management, cognitive restructuring, exposure therapy and problem-solving. The IP component targeted interpersonal avoidance, passive and aggressive interpersonal styles, and co-rumination. Four female adolescents with a principal diagnosis of GAD participated in 10 weekly 1-hour sessions. Adolescent- and parent-report diagnostic interviews and questionnaires were completed at pre-, mid-, and posttreatment, and at 3-months follow-up. Reductions in GAD and depressive symptoms and improvements in interpersonal functioning for all participants on both adolescent- and parent-report measures suggest that the combination of CBT and IP can benefit adolescent girls with GAD.

Social problem-solving training has been successful in improving maladaptive behaviour and problem-solving skills for individuals with intellectual disability. However, in contrast to individuals without intellectual disability there has been only one study that has examined whether social problem-solving training can improve psychological distress in individuals with intellectual disability and a psychiatric diagnosis. Three participants from a vocational community centre with mild intellectual disability, comorbid mental illness, and challenging behaviour, participated in 15 individually delivered sessions of social problem-solving training. Social problem-solving skill, behaviour, and psychological distress measures were used to assess outcome. All three participants showed improvement in social problem-solving skills, and two participants showed improvement in depression. Improvement was maintained at 4-week follow-up. The results provide preliminary evidence that social problem-solving training could be an effective intervention tool for the treatment of psychological distress in individuals with mild intellectual disability.

Perfectionism can maintain depression, anxiety and eating disorders, yet few studies have evaluated treatments for perfectionism. This study examined the effectiveness of individual cognitive behaviour therapy (CBT) in treating perfectionism in four adults with a diagnosis of either an anxiety disorder or depression. The study used an A-B single case experimental design series with follow-up, and a 3-week pre- and postbaseline phase. Treatment involved 8 sessions and a 2-week follow-up session. Visual inspection of data revealed downward trends in overall perfectionism and clinically significant decreases in perfectionism for two participants. No clinically significant reductions were observed in depressive or anxious symptomatology. CBT for perfectionism warrants further investigation.

The case history of a woman with severe and enduring anorexia nervosa and obsessive–compulsive disorder (OCD) with contamination fears is presented. These contamination fears centred on her fear of contamination by fat and fatty substances as she worried about gaining weight. Previous treatment with graded exposure had shown no clinically significant benefits. She was admitted to a specialist unit for the treatment of OCD as an inpatient. Due to the previous failure of the recognised psychological treatments for OCD it was decided to use the new psychoeducational approach of danger ideation reduction therapy (DIRT). This treatment resulted in an improvement in her OCD symptoms despite the fact that the emphasis of the treatment was on the risk of bacteria and dirt. It is believed that this is the first documented case of DIRT being used for a patient with anorexia nervosa and OCD.

This study aimed to examine the critical roles of exercising and body image satisfaction on social physique anxiety (SPA) among female university students. For this aim, 118 female university students, 58 of whom exercised regularly, participated in the study. The Social Physique Anxiety Scale, Eating Attitudes Test, and Liebowitz Social Anxiety Scale were administered to the participants; their dieting habits were also investigated. Results revealed that approximately half of the participants used at least one unhealthy weight control method in the past 6 months. An analysis of covariance indicated that, after controlling for the effects of abnormal eating behavior, participants who were dissatisfied with their body image and did not participate in a regular exercise activity experienced higher social physique anxiety. However, such a tendency was not found for social anxiety. Thus, these characteristics seem to be specific to social physique anxiety. It was concluded that individuals who have negative view of their appearance were more prone to experience SPA, and they might be avoiding exercise for self presentational purposes. Findings were discussed in the light of literature.

The effectiveness of The Incredible Years parent-training program with a small sample of four high risk solo mothers in a public clinic setting was assessed. All families had a number of risk factors for early drop-out and poor outcomes. Mindful of resource limitations in the public setting, economical strategies were used to enhance attendance rates and engagement. For the outcome evaluation, a multiple baseline across participants design was used. Participants attended a 2-hour group treatment session weekly for twenty weeks, with booster sessions at 2 months and 4 months following treatment. Participants had sons aged between 6 years and 9 years diagnosed with ADHD. Family functioning was assessed from a pretreatment interview schedule, measures of child behaviour and parent and family functioning. Participants also completed program satisfaction and program evaluation measures. Results showed: (a) all mothers engaged with and finished the program, (b) improvement in family functioning, (c) improvements in some teacher and parent reports of child behaviour, (d) increased parenting confidence, (e) reduced stress and depression levels for most parent participants, and (f) reports of better parent–child relationships. Additionally, participants all reported being highly satisfied with the program. Findings overall support the use of easy to do engagement strategies and the use of the Incredible Years parent-training program as an effective, low cost and early step intervention for families at higher risk in a day-to-day practice setting. The use of this intervention in an overall stepped care approach is considered and discussed.