Despite promising findings from problem-solving interventions in the treatment of parasuicide, little is known about problem-solving difficulties that distinguish “Non-Repeaters” from “Repeaters”. The present study examined whether problem-solving ability could be used to identify repeaters of parasuicide. Findings are presented from the follow-up part (N = 35) of a larger investigation (N = 146) of non-consecutive hospital-treated cases of parasuicide, interviewed by the National Suicide Research Foundation in Ireland as part of the WHO/EURO Multicentre Study on Suicidal Behaviour. The median interval from initial to follow-up interview was 15 months. The European Parasuicide Study Interview Schedule (EPSIS II) was used in the follow-up interview. Within this schedule, responses to a questionnaire measuring habitual problem-solving style were analysed. Repeaters scored significantly lower than non-repeaters on the following problem-solving dimensions: Active handling, Comforting cognitions and Seek social support. Repeaters scored significantly higher on the Passive reactions dimension. A logistic regression model including these four problem-solving dimensions correctly identified 79% of the repeaters and 82% of the non-repeaters. Despite the limitations of this sample size, these significant differences in problem solving have implications for the treatment of parasuicide. Further work, using larger samples, is required.

Attention deficits and inflated perceptions of responsibility have been identified as characteristics of people with obsessive-compulsive disorder (OCD). The present study examined the relative importance of responsibility and attention in predicting non-clinical levels of obsessionality. Three hundred Australian university students were screened using the Maudsley Obsessional-Compulsive Inventory (MOCI), and students who scored in the top and bottom 10% of the distribution were selected for participation. The selected participants completed the Responsibility Attitude Scale (RAS) and the Test of Everyday Attention (TEA), along with measures of trait-anxiety and depression. High MOCI scorers exhibited a greater perception of responsibility, and poorer overall attention than low MOCI scorers. These differences remained significant after controlling for trait-anxiety and depression. Logistic regression analyses revealed that responsibility was a stronger predictor of non-clinical obsessionality than was attention. Moreover, attention did not make a significant contribution to the prediction of obsessionality once responsibility had been controlled. Correlations between responsibility and TEA visual selective attention subtests remained significant after controlling for obsessionality. These findings suggest that measures of attention (particularly measures of visual selective attention) may be confounded by responsibility attitudes, thus highlighting the importance of controlling for meta-cognitive variables such as responsibility when investigating attention in OCD.

Cognitive-behavioral models (Clark & Wells, 1995; Rapee & Heimberg, 1997) and recent research suggest that individuals with social phobia (SP) experience both images (Hackmann, Surawy, & Clark, 1998) and memories (Coles, Turk, Heimberg, & Fresco, 2001; Wells, Clark, & Ahmad, 1998) of anxiety-producing social situations from an observer perspective. The current study examines memory perspective for two role-played situations (speech and social interaction) at multiple time points (immediate and 3 weeks post) in 22 individuals with generalized SP and 30 non-anxious controls (NACs). At both time points, SPs recalled the role-plays from a more observer/less field perspective than did NACs. Further, over time, the memory perspective of SPs became even more observer/less field while the memory perspective of NAC remained relatively stable.

This study compared complaints management training and cognitive therapy (reattribution) in treating panic disorder. Both treatment groups received three sessions with initial psychoeducation. Thirty patients with panic disorder took part in the study. Assessments were carried out before and after treatment and again at a 4-week follow-up. Both groups showed similarly significant improvements and maintenance of the clinical change over the follow-up period. It is concluded that the initial psychoeducation, which conveyed to patients the cognitive-behavioural model of panic disorder, contributed to the treatment outcome.

Comorbidity data between Generalized Anxiety Disorder (GAD) and Social Phobia, studies of frequently reported worry themes, and various correlational studies have led to the idea that worries may have a social basis. This study investigates the social basis of worry in three samples with different ages. The samples consisted of 224 high-school students, 607 undergraduate students, and 125 older adults. All participants completed the Worry Domains Questionnaire (WDQ) and the Penn State Worry Questionnaire (PSWQ). We hypothesized that for each sample, the first factor extracted following factor analysis on WDQ items would reflect the most social content, and that social-related factors would be the best predictors of the global tendency to worry as measured by the PSWQ. Results supported the hypotheses with the exception of older adults, for whom the first extracted factor was not as obviously social as for the other two samples. Possible explanations are considered and theoretical and clinical implications are discussed.

The reformulated balanced states of mind (BSOM) model (Schwartz, 1997) proposed new cognitive-affective set-point ratios based on a mathematical model of consciousness (Lefebvre, 1990) to differentiate among pathological, normal and optimal balances. Using data derived from the Affects Balance Scale (Derogatis, 1975), the reformulated set-points were empirically evaluated by tracking changes in affect balance SOM (ratio of positive to total affect) in 66 depressed male outpatients undergoing cognitive-behavior therapy (n = 45) or pharmacotherapy (n = 21). Confidence interval estimations indicated that across treatments both remitted (SOM = .35) and unremitted (SOM = .35) patients had pathological pretreatment affect balances near the predicted set-point (.38). At post-treatment, affect balance for remitted patients (SOM = .74) progressed to a normal dialogue near the predicted set-point (.72), whereas unremitted patients maintained a negative balance (SOM = .41). Using Hamilton and Global Assessment Scale ratings, remitted patients were classified into average and optimal responders. At post-treatment, average responders achieved an affect balance (SOM = .70) near the normal dialogue set-point (.72), whereas optimal responders progressed to an affect balance (SOM = .81) at the optimal dialogue set-point (.81), supporting the theoretical distinction between normal and optimal balance. A mathematically generated measure that distinguishes normality and optimality permits increased quantitative precision in comparative psychotherapy outcome research.

The feasibility of using a self-help treatment manual to assist a cognitive behavioural therapy programme developed with the aim of improving pain coping ability and quality of life, and reducing psychological distress in sickle cell patients was evaluated. Adult patients attending a London hospital outpatient sickle cell clinic were invited to 12-week cognitive behavioural therapy. Outcome was assessed with measures of pain status, health service utilization, psychological coping (Coping Strategies Questionnaire-revised for Sickle Cell Disease), quality of life (Medical Outcomes Survey Short Form 36), and mood (Hospital Anxiety and Depression Scale). Baseline disease severity data were also collected. No significant differences in baseline data were observed between patients who completed cognitive behavioural therapy and “dropouts”. Improvements over baseline at 12 weeks in patients who completed cognitive behavioural therapy were significant. Active coping and use of physician advised methods for pain increased. Emotional responses decreased, general health and vitality improved, while anxiety reduced. This demonstrates that a brief manual-assisted cognitive behavioural therapy programme is feasible in sickle cell disease, and may help to improve coping, quality of life and mood.

Seventy-seven mental health professionals completed a 3-day cognitive behavioural training course for managing hallucinations and delusions in schizophrenia. A questionnaire measuring attitudes and empathy towards working with people who have these symptoms was administered before and after the course. Significant increases in feelings of adequacy, legitimacy, employment related self-esteem, and expectations of work satisfaction were observed after the course and participants displayed high levels of motivation for working with this clinical population at both time points. In addition, the participants showed significant increases in perceived empathy for the experience of hallucinations and delusions. This was a predicted outcome as the course included exercises designed to enhance therapists' understanding of the subjective experience of psychotic symptoms. Empathy is recognized in the wider psychotherapy outcome literature as a therapeutically important variable that influences the formation of a therapeutic alliance but it is a relatively unexamined construct in CBT for psychosis. Further investigations in this area will potentially enhance psychological treatment delivery and subsequent outcomes for people who experience hallucinations and delusions. Furthermore, explication of such “non-specific” therapeutic factors may help to explain some of the transient but beneficial effects of unstructured “control” therapies observed in recent CBT for psychosis outcome trials.

The study examined the effect of guided imagery on overt social behavior of children during free play. Forty withdrawn and rejected first-graders (6 to 8 years of age) were randomly assigned to one of five conditions. Four of them were guided imagery conditions: mastery plus peer acceptance, mastery with no social contingency, coping, and gradual rehearsal. A fifth control condition involved no intervention. It was predicted that the four imagery conditions would increase and maintain positive socialization, but the coping condition would be the most effective. Children under the coping condition, which involved guided imagery of failure to get peer acceptance, but progressively mastering the social interaction and finally being accepted by peers, consistently increased positive socialization behaviors from baseline to post-treatment and follow-up, as compared to gradual rehearsal and control. Both mastery conditions increased socialization at post-treatment, but reverted to baseline levels during follow-up.

Clinical supervision is an integral aspect of training and is essential for accreditation as a cognitive behavioural psychotherapist. A questionnaire survey of a random sample of accredited British Association of Behavioural and Cognitive Psychotherapists (n = 280) is reported, 61% (N = 170) responded by describing their supervision practices in a number of areas. These included the organization of supervision, content, satisfaction, techniques, models, interdisciplinary working and supervision of others. The results indicate that satisfaction levels with supervision were high amongst accredited therapists and that the ratio of time spent in supervision to therapeutic contact is, on average, higher than recommended minimum levels. Supervision was less structured and active than therapy and little use was made of audio/video tapes of therapy sessions within supervision. The level of training for supervisors was highly variable with a substantial proportion having received no formal training in cognitive behavioural psychotherapy supervision. Dual role relationships were also common. Finally, recommendations for further research and practice are made.