A cognitive approach to auditory hallucinations that is based on the models of panic and anxiety developed by Clark (1986), Beck (1976) and Salkovskis (1991) is outlined. It is suggested that auditory hallucinations are normal phenomena, and that it is the misinterpretation of such phenomena that cause the distress and disability that are commonly seen in patients experiencing hallucinations with a diagnosis of schizophrenia. It is also proposed that these interpretations of auditory hallucinations are maintained by safety seeking behaviours (including hypervigilance). The existing literature is reviewed in relation to these hypotheses and found to be largely consistent. The clinical implications of such a model are briefly discussed and a number of testable predictions are made.

Previous research on vulnerability to Post-Traumatic Stress Disorder (PTSD) has been restricted by the absence of prospective studies that measure individual differences prior to traumatization. This study investigated the predictors of analogue post-traumatic intrusive cognitions using a fully prospective design. Non-patient participants completed a range of predictor measures before being exposed to a film about a traumatic fire. Film-induced changes in negative mood were also assessed. Subsequent intrusions were measured both within the experimental session and for a further seven days. The hypothesized predictors were: neuroticism, trait anxiety, extraversion, depression, a general tendency to suppress unpleasant thoughts, beliefs about being “at risk” from fire, mental imagery, self-rated proneness to intrusions and negative mood changes. The results showed that intrusions were predicted by film-induced increases in negative mood, thought suppression tendencies, beliefs about vulnerability to fire and self-rated proneness to intrusive cognitions. The findings are discussed in relation to the literature on thought suppression and cognitive processes in PTSD.

A substantial literature now exists that indicates that cognitive-behaviour therapies are effective for a wide range of psychological problems (See Hawton, Salkovskis, Kirk, & Clark, 1989). However, it is only very recently that cognitive-behaviour therapists have considered people with learning disabilities as suitable clients for this particular approach. The present paper describes some of the challenges that are encountered when applying cognitive-behaviour therapy to this client group.

Morbid jealousy is a potentially disruptive condition that has received little attention. A cognitive-behavioural formulation of morbid jealousy proposes that such individuals possess schema in which there is a perceived threat of loss of their sexual partner. An attentional bias in morbid jealousy was investigated by using a dichotic listening task and the modified Stroop test. Twenty subjects who had met criterion for morbid jealousy were compared with 20 control subjects. In the dichotic listening task, word pairs were presented to each ear simultaneously, and subjects shadowed one channel while identifying target words. Ten percent of the words presented to the non-attended channel were target words, of which half were jealousy-related and half were not. Subjects were not told that the target words were only presented in the unattended channel. In the modified Stroop test, subjects had to name the colour of a series of Os, colour words, emotional words, control neutral words and jealousy-related words. As predicted, jealous subjects showed a superior performance in detecting jealousy-related stimuli in the dichotic listening task and an impaired performance in the colour naming of jealousy-related stimuli in the modified Stroop test, compared to the control subjects and the control conditions. The results of this study add support to the formulation that morbid jealousy involves an attentional bias towards jealousy-related information and this may have clinical implications.

The thorny issue of inappropriate authorship is a well recognized problem in research (Epstein, 1993). Recent editorials and articles in the British Medical Journal (BMJ), Lancet and Journal of American Medical Association (JAMA) have raised its profile amongst our medical colleagues. The current authors feel that clinical psychologists, nurses and other mental health professionals need to be more aware of the complexities of the area. Hence this paper intends to clarify the major concerns regarding proper accreditation and gives some recommendations and guidelines.

This study was designed to investigate the effects of a short-term cognitive-behavioural intervention, as part of a comprehensive medical project of withdrawal from hypnotics, on attitudes toward insomnia. Twenty-four subjects volunteered to participate in a withdrawal project conducted in a sleep clinic for five weeks. All subjects were chronic users of a long-acting hypnotic, and free from other psychotropic drugs. Along with the gradual decrease in hypnotics’ dosage, the programme consisted of sleep evaluations by polysomnography, actigraphic monitoring, daily sleep diaries, and periodical medical examinations. Upon termination of the withdrawal stage, all subjects received a short-term cognitive-behavioural treatment consisting of six sessions and directed at attitude change and correction of misconceptions about sleep and insomnia, and on promoting psychological strategies for coping with the sleep disturbances. Attitudes toward insomnia were measured by the DBAS – Dysfunctional Beliefs and Attitudes about Sleep Scale, administered at three points of time: on the first day of the programme (Time 1), at the termination of the medical withdrawal stage (Time 2), and a week after completion of the short-term cognitive behavioural treatment (Time 3). A multivariate analysis showed a significant effect of the time of measurement on all five subscales of the DBAS. Subsequent analyses indicated that the major change in attitudes was specific to the direct cognitive-behavioural intervention and occurred between Time 2 and Time 3. In follow-ups conducted at 3 and 12 months after completion of the withdrawal project, the majority of the participants (72%) reported refrain from hypnotic use, and regarded the psychological intervention as the major cause of their successful withdrawal from sleeping pills.

A case is described in which the patient’s perfectionistic assumptions seemed to play a major role in perpetuating his anxiety and depression. Techniques to deal with perfectionistic assumptions are discussed, and the various effects that perfectionism may have on therapy, both positive and negative, are considered.

Dizziness is a distressing symptom that is often associated with fear and anxiety, as well as organic balance system dysfunction. We report here on the successful treatment of a 68-year-old woman with dizziness and balance problems. Treatment was given within a cognitive behavioural framework, but also included physiotherapy in the form of head movement exercises. Results were evaluated by a balance platform test, a behavioural provocation test and questionnaire data. Positive results were found in each of these three assessment domains.

A portable device providing vibratory feedback was used for reducing excessive vocal loudness in a man with intellectual disability and autistic-like behaviours. The use of the device was combined with reinforcement. The data showed that the device (together with reinforcement) was rapidly effective in reducing the occasions of excessive vocal loudness and maintained the positive effects over time. Implications of the findings and limitations of the study are discussed.