Romme and Escher (1989) reported that 70% of voice hearers began to hear voices following a traumatic event. This study was therefore designed to examine the effects of trauma on predisposition to auditory and visual hallucinations in the general population. The study also examined the role of beliefs about voices and metacognitive beliefs about thoughts in predisposition to hallucinations, and tested the specific hypothesis that dissociative experiences would predict predisposition to auditory hallucinations. Sixty-four non-clinical subjects were asked to complete questionnaires assessing interpretations of voices, predisposition to hallucinations, metacognitive beliefs, PTSD symptomatology, experience of trauma, trauma-related cognitions and dissociative experiences. The study found an association between trauma-related measures (negative cognitions about the world and all dissociation variables) and predisposition to both auditory and visual hallucinations. It was found that participants who had experienced certain specific life events scored significantly higher on predisposition to auditory hallucinations (bereavement, physical assault and emotional abuse) and on predisposition to visual hallucinations (bullying). Multiple regression analyses demonstrated that both metacognitive beliefs and dissociative processes explained significant proportions of the variance in predisposition to both auditory and visual hallucinations. These results suggest an association between trauma and predisposition to auditory hallucinations. The theoretical and clinical implications of the findings are discussed.

In order to function effectively in our day-to-day lives we must all take risks. These risks may be as simple as crossing a road or as complex as deciding whether or not to purchase a new home. The behaviour of individuals with Obsessive Compulsive Disorder (OCD) has been variously described as “harm-avoidant” (Cloninger, 1987) or “risk-aversive” (Carr, 1974). Despite the use of different terminology, there is consensus that individuals with OCD avoid taking risk. Further information regarding the type and extent of risks avoided has been difficult to obtain due to limitations in defining and therefore measuring the concept. Few studies have examined the concept of risk-taking with populations outside the United States, and none could be identified that examined risk-taking with OCD populations in Australia. In an effort to clarify the role of risk-taking behaviour in Obsessive-Compulsive Disorder, this study extended upon earlier work of Steketee and Frost (1994). This study administered a revised version of the Everyday Risk Inventory (ERI), developed by Steketee and Frost (1994) to assess risk-taking behaviour in an obsessive-compulsive population. Consistent with the original ERI (Steketee & Frost, 1994), the Australian adaptation of the ERI (ERI-AUS) produced sound internal consistency. As expected, we found that clinical OCD outpatients scored significantly lower on the ERI-AUS as compared to their non-clinical counterparts, and a clear linear trend emerged when risk-taking in people exhibiting sub-clinical OC symptoms was considered. Results suggested a potential inverse relationship between OCD symptoms and risk-taking. The cross-cultural comparison of the Australian non-clinical and American non-clinical (Steketee & Frost) samples revealed significantly higher rates of risk-taking for the latter group. The findings suggest that the concept of risk can be measured effectively with the ERI-AUS, and that further studies examining risk-taking are warranted.

The study tested the hypothesis, derived from Teasdale and Barnard's (1993) Interacting Cognitive Subsystems (ICS) model, that two commonly used techniques in cognitive therapy, automatic thought records (ATRs) and behavioural experiments (BEs), would have their primary impact on different cognitive subsystems. Teasdale (1997a, b) has suggested that while ATRs tend to impact on a logic-based propositional information processing system, BEs impact on a more holistic implicational system, which has extensive links with emotion. Quantitative and qualitative data derived from three groups of participants undertaking cognitive therapy training courses, who practised ATRs and BEs on themselves, supported Teasdale's theory. Differences were found in participants' ratings of behaviour and belief change, with BEs being perceived as more powerful and compelling than ATRs, as predicted by the theory. There were also qualitative differences in participants' experiences of the two techniques, suggestive of different modes of processing. The data indicated the particular importance of the therapist's role in BEs. In order to provide a more comprehensive account of ATRs and BEs, it was suggested that Teasdale's theory could profitably be extended to include the role of the therapist in promoting adaptive oscillation between the implicational and propositional modes.

The project aims to investigate the efficacy of a preventive cognitive behavioural intervention delivered via the Internet to individuals at risk of developing anxiety disorders. There is increasing evidence that suggests anxiety sensitivity may act as a premorbid risk factor for the development of anxiety pathology and panic disorder. Eighty-three university students with elevated anxiety sensitivity were randomly allocated to either an intervention group (n = 43), who worked through the Internet based program over a period of 6 weeks, or a waitlist control group (n = 40). Significant treatment effects were found for anxiety related cognitions and symptoms of depression, and a non-significant trend for anxiety sensitivity. These outcomes were related to expectancy but not to program utilization. Implications for the prevention of anxiety via the Internet are discussed.

The present study presents the development and validation of the Social Interaction and Performance Anxiety and Avoidance Scale (SIPAAS), a self-report questionnaire to assess the level of distress and avoidance in a wide range of performance and social interaction situations, and the Social Phobia Safety Behaviours Scale (SPSBS), a self-report questionnaire designed to evaluate in-situation safety behaviours in which social phobics engage to try to prevent social catastrophe. The psychometric adequacy of both scales was evaluated in three different samples: social phobic patients, other anxiety disordered patients, and normal population. Both scales were normally distributed and were shown to possess high levels of internal consistency and temporal stability. They reliably discriminate patients with generalized social phobia from patients with non-generalized social phobia, other anxiety disordered patients, and normal population. Both subscales of the SIPAAS have shown high correlations with other measures of social anxiety (SAD, FNE), whereas the SPSBS has shown low to moderate correlations with SAD and FNE. It appears that these new self-report scales are reliable, valid and useful measures of social phobia for clinical and research purposes.

Paradoxical Intention (PI) is a cognitive treatment approach for sleep-onset insomnia. It is thought to operate by eliminating voluntary sleep effort, thereby ameliorating sleep performance anxiety, an aroused state incompatible with sleep. However, this remains untested. Moreover, few PI studies have employed objective sleep measures. The present study therefore examined the effect of PI on sleep effort, sleep anxiety and both objective and subjective sleep. Following a seven-night baseline, 34 sleep-onset insomniacs were randomly allocated to 14 nights of PI, or to a control (no PI) condition. Consistent with the performance anxiety model, participants allocated to PI, relative to controls, showed a significant reduction in sleep effort, and sleep performance anxiety. Sleep-onset latency (SOL) differences between PI participants and controls using an objective sleep measure were not observed, although an underlying trend for significantly lowered subjective SOL amongst PI participants was demonstrated. This may relate to actigraphic insensitivity, or more probably confirms recent suggestions that insomniacs readily overestimate sleep deficit, due to excessive anxiety about sleep. Together, results help determine putative mechanisms underlying PI, have important implications for the clinical application of PI, and emphasize the need for further PI research within an experimental cognitive framework.

There is still a lack of indicated prevention programs for couples who, although subjectively concerned about their relationship, do not seek marital therapy. In a previous randomized controlled study, the efficacy of a cognitive-behavioural psychoeducational program delivered on a weekend by two trainers for groups of four couples was established. The program consists of communication and problem-solving training, couples' discussions to clarify their relationship expectations, and exercises to enhance their sensual/sexual relationship. In the current study, the effectiveness of adding two booster sessions with each couple individually one and three months after the weekend training program was investigated. Sixty-two couples were recruited by newspaper announcements. At post assessment, couples emitted significantly more positive and less negative verbal and nonverbal communication behaviours during a conflict discussion task than at pre-assessment, thus replicating the previous findings. At the 1-year follow-up, couples with booster sessions reported significant higher marital satisfaction ratings and fewer problem areas than couples receiving the weekend program only. Booster sessions seem to be effective in enhancing the long-term effectiveness of preventive interventions.

A retrospective analysis was undertaken to determine whether the Ehlers and Clark (2000) model of posttraumatic stress disorder explained PTSD in children involved in road traffic accidents. Children were assessed 6 weeks after their accident and items related to subjective trauma severity, sequelae appraisal, trauma memory, behavioural avoidance and cognitive strategies were examined. Ten of the 14 items, from four of the five areas, were significantly associated with the onset of PTSD. Data from the remaining area, trauma memory, approached statistical significance. These data provide preliminary support for the applicability of the Ehlers and Clark (2000) model to children.

Despite a marked expansion in the methods and applications of cognitive therapy, few specific models exist that delineate the process and means of psychotherapeutic change within cognitive therapy. In the present model, three core conceptual components of change are suggested: interpersonal conscious appraisal, response procedures and therapeutic communication. The subsequent circumplex developed from the core components enables the classification and description of 16 identifiable assessment profiles. Specific hypotheses drawn from the cognitive circumplex are stated concerning levels of functioning, client/problem complexity and typical client interactions. The circumplex is offered as a means of assessing, tracking and evaluating change during cognitive therapy. The structure of the model is consistent with the goals, rationale and expectations of cognitive therapy.

This case study describes the collaborative development of an idiosyncratic cognitive model of the ascent into mania in a patient with bipolar affective disorder. The client held the belief that he could rise above his depression and feelings of low self-esteem through the pursuit of highly demanding goals and rewarding activity. While still depressed and anxious, small increases in positive mood and energy triggered hyper-positive thoughts about himself (e.g. “I am back to my attractive, intelligent and outgoing self again”). Consequently, he engaged in a range of “ascent” behaviours that were consistent with the pursuit of this self-view. The direct effects of these behaviours and their effects on other people led to further increases in positive mood and physiological activation, which in turn triggered more hyper-positive self-relevant thoughts. The client reported that he found the model an extremely useful component of cognitive behavioural therapy.

Two single case studies are described of driving phobia treated with cognitive therapy. Assessment, formulation, risk and practical treatment of this common problem are reported. Self-report measures and a behavioural test evaluated results. Both cases improved significantly and reported that the treatment was acceptable. Recommendations for future research are also made.

The aim of this study was to examine effects of chat-based on-line CBT on a university student's study related behavior and anxiety. The study used a single participant multiple baseline design across three self-recorded behaviors consisting of hours of study, number of pages read, and note-taking quality, accompanied by recordings of daily anxiety levels. After baseline, the participant received 6 × 45 min weekly chat-based on-line sessions of CBT. Results show that the three study behaviors increased, and anxiety decreased. These results appear comparable with those of conventional face-to-face CBT for similar problems, suggesting that chat-based on-line CBT may be an alternative for clients with accessibility or anonymity concerns.

Behavioural and Cognitive Psychotherapy is an international multi disciplinary journal for the publication of original research, of an experimental or clinical nature, that contributes to the theory, practice and evaluation of behaviour therapy. As such, the scope of the journal is very broad and articles relevant to most areas of human behaviour and human experience, that would be of interest to members of the helping and teaching professions, will be considered for publication.