Stuttering is a speech motor disorder that begins in the first years of life and if not treated effectively can have catastrophic effects on the individual. This article briefly describes the disorder, and overviews treatment of stuttering in preschool children. Such treatment is considered far preferable to treatment in adolescence and adulthood. Evidence of the effectiveness of early stuttering treatment from clinical trials is overviewed, along with clinical benchmarks for such treatment. Epidemiological data showing considerable natural recovery are reviewed, and the implications of those data for the timing of early stuttering intervention are considered.

Asperger's syndrome is a relatively newly diagnosed developmental disorder within the autistic spectrum. Children and adults with Asperger's syndrome have an intellectual ability within the normal range but due to their unusual profile of cognitive, social and emotional abilities are vulnerable to the development of a secondary mood disorder. This paper provides an explanation of the abilities associated with Asperger's syndrome, and modifications to cognitive behaviour therapy (CBT) for this very unusual client group. In particular, the paper emphasises the importance of affective education for this clinical population and describes a new strategy used in cognitive restructuring, namely, the emotional toolbox. The paper concludes with a brief description of a current evaluation study of the effectiveness of CBT to treat anxiety and anger in children who have Asperger's syndrome. However, the strategies described in this paper can also be used with adults with Asperger's syndrome and applied to other clinical populations.

This article discusses the problem of jealousy in couple relationships. The clinical presentations are summarised, and the question of what is morbid jealousy is addressed. Issues in the assessment of jealousy in couples are discussed, with suggestions for the areas to be covered. A framework for the formulation of the problem is proposed. Finally, the clinical treatment of morbid jealousy is reviewed. A treatment approach is described, which includes relationship enhancement work and a range of specific techniques.

This article examines the prevalence and prediction of internalising and externalising disorders from temperament and parenting in children aged 4 to 6 years (N = 491). Children were assessed via parent and teacher reports over 14 months and clinical interviews with parents were included at follow-up, along with parent and teacher reports of behavioural and emotional difficulties. Prevalence rates for internalising disorders (8.7%) were higher than for externalising disorders (5.8%), and internalising rates were similar to that found for older children in the same city. Accuracy of prediction of disorders, as well as overall behavioural and emotional difficulties, was low to moderate, and externalising problems were better predicted than internalising problems. The results highlight that while psychological disorders can be predicted from measures of temperament in infancy, the accuracy is too low to recommend these children receive selective prevention and treatment programs.

Social Anxiety Disorder is a heterogeneous and distressing problem for many children and youth. Unravelling its multiple causes is essential for a full understanding of the condition. This selective review focuses on the etiology and maintenance of SAD, and examines research findings in several key areas of investigation: genetic or hereditary factors (twin and family studies), temperament characteristics (behavioural inhibition), and parent-child interactions (attachment, parenting styles). We conclude that genetic influences, behavioural inhibition and parent-child interactions play significant and interactive roles in the development and maintenance of social anxiety disorder. Other influences are also acknowledged, such as peer relationships, social skills deficits and traumatic experience. Ultimately, an understanding of such pathways should facilitate effective early screening and intervention of children at risk for severe social anxiety.

The aim of this study was to assess the relationship between psychological wellbeing and Internet use among adolescents, focussing not only on time spent on the Internet, but also on the relative strength/importance of both face-to-face and Internet friendship networks. A sample of 336 young people aged between 15 and 21 years from a secondary school and a university population were surveyed. Results indicated that females with more online friends were higher on selfesteem and lower on loneliness than females with fewer online friends, but the opposite was true for males. A higher number of online regular friendships seemed to militate against self-esteem and was related to greater loneliness for males. For face-to-face friendships, the effects on wellbeing were in the same direction for males and females, but stronger for males. Those with more face-to-face friendships were higher on self-esteem and less lonely. In addition, young men who rated their online friendship networks as very important were more likely to have lower self-esteem and to be lonely. Actual time spent on the Internet was not a predictor of wellbeing for either sex when online and offline friendship factors were included in the regression equation.

Examined the effects of comorbid externalising disorders (i.e., attention-deficit/hyperactivity disorder [ADHD], oppositional defiant disorder [ODD], conduct disorder [CD]) on the long-term outcome (7.4 years) of individuals treated for anxiety disorders as youth. Ninety-four anxiety-disordered children (aged 8-13) were provided with a 16-session manual-based cognitive behavioural treatment (CBT). Assessments were completed at pretreatment, posttreatment, 1-year posttreatment (see Kendall, et al., 1997) and for 88 of the original 94 subjects at 7.4-years posttreatment (see Kendall, Safford, Flannery-Schroeder, & Webb, in press). At pretreatment, all participants received principal anxiety diagnoses (generalised anxiety disorder, separation anxiety disorder, social phobia). Nineteen had comorbid externalising disorders (11 ADHD, 7 ODD and 1 CD). These 19 subjects were matched on age (within an average of 3 months), gender and race with 19 previously treated youths who were not comorbid with an externalising disorder. Examining parent- and child-reports, respectively, comparable rates of comorbid versus non-comorbid cases were free of their principal anxiety disorder at the 7.4-year follow-up on all dependent measures. Parents of anxiety-disordered children with a comorbid externalising disorder reported higher levels of child externalising behaviour than did parents of anxiety-disordered children without comorbidity. Comorbid children reported greater self-efficacy in coping with anxiety-provoking situations than did non-comorbid children. Thus, it appears that overall anxiety-disordered children with and without comorbid externalising disorders showed comparable improvements following CBT.

We assessed the effects of the Controlling Alcohol and Relationship Enhancement (CARE) program, an early intervention combining reduction of hazardous alcohol consumption and enhancement of couple relationships. Thirty-seven hazardous drinking couples were randomly allocated to either the CARE program or to a control condition. CARE couples improved their communication more than controls, but couples in both conditions reduced hazardous drinking to a similar extent. CARE is a potentially useful means of promoting positive relationship communication in hazardous drinking couples.

A safety behaviour is an overt or covert strategy employed in order to prevent a feared outcome from occurring. These behaviours can, however, prevent the disconfirmation of unhelpful beliefs, and may make the feared outcome more likely to occur (Salkovskis, 1991). The current study extends Harvey's (2002a) investigation of safety behaviours in insomnia by developing a questionnaire measure designed to assess the use of safety behaviours that are employed to promote sleep and cope with tiredness. A development sample of 132 individuals with and without insomnia was employed to develop the 32-item Sleep-Related Behaviours Questionnaire (SRBQ). The SRBQ showed good internal consistency and was able to discriminate normal sleepers from those with insomnia. Interestingly, most safety behaviours were associated with impairment in both sleep and daytime functioning. This highlights that day- and night-time processes may be interlinked in insomnia, and stresses the importance of research and treatment focusing on both the day and night. Future research is needed to further investigate the psychometric properties of the SRBQ, and to explore the relationships between safety behaviours and dysfunctional beliefs about sleep.

Behavioural avoidance tests (BATs) are a cornerstone of objective assessment of phobias. However, live BATs have several disadvantages. They are practically difficult and time-consuming to set up and are not standardised. This study examined two computer-delivered BATs (using slide and video presentations of phobic stimuli respectively): first, in respect to their ability to discriminate fearfuls from nonfearfuls, and second, in terms of convergent validity with a live BAT and the Spider Phobia Questionnaire (SPQ). Sixty-four low (n = 32) and high (n = 32) spider-fearful undergraduate participants were administered the three BATs in counterbalanced order. Results showed that subjective anxiety on all BATs was highly discriminative of low and high spider-fearfuls. The number of steps completed did not discriminate between phobics and nonphobics on the computer BATs. However, there was good convergent validity between the live BAT, the SPQ and both computer-delivered BATs on subjective anxiety. Overall, the live BAT gives a clearer indication of avoidance behaviour while the video BAT assesses subjective anxiety across a wider range of steps. The development of computer-delivered BATs that reliably measure avoidance is necessary before contemplating them as an alternative to a live BAT.

Contradictory evidence exists regarding the benefit of the Internet for social and personal wellbeing, with some studies indicating deleterious effects and others possible social enrichment. The potential for increased social isolation from ‘overinvolvement’ in online activities or, conversely, the Internet's possibilities for enhancing social relationships, may be particularly salient during young adulthood and adolescence because of the special importance of the peer group during this developmental phase. This study was an investigation of the relationships between the levels of identity development, Internet use and social anxiety among a sample of 161 older adolescents/young adults aged between 18 and 25. Results indicated that, for males only, higher levels of social anxiety and less mature identity statuses were associated with more frequent Internet use, specifically time spent in chatrooms, online browsing for personal use, and games. For females (who were in this sample less socially anxious, more identity-developed, and lower users of the Internet than males), social anxiety and identity status were not significantly associated with time spent online. Discussion centred around the potential roles of Internet use in reinforcing already-existing social anxiety or, alternatively, in supporting and maintaining social contacts in those with lower levels of social deficit.

This paper describes the application of danger ideation reduction therapy (DIRT) to a case of atypical obsessive—compulsive disorder (OCD) with prominent magical ideation. Treatment consisted of eight weekly sessions. It was cognitive in nature, did not include any exposure or response prevention, and was aimed solely at reducing threat expectancy. The treatment components were adapted from the original DIRT package for compulsive washing, and comprised attentional focusing, corrective information, cognitive restructuring and the probability of catastrophe estimation task. At posttreatment, the subject demonstrated normal functioning on all assessment measures, and met Jacobson and Truax's criteria for ‘recovery’ on the MOCI, OCI-R, DASS depression scale and DASS stress scale. The findings provide preliminary support for the effectiveness of DIRT in individuals with atypical OCD symptoms characterised by magical ideation. Implications of these findings are discussed.

This study developed and evaluated a puppet interview that allows children to self-report on temperamental constructs. Structured child self-report measures are rarely utilised in clinical assessment of young children under the age of 7—8 years. Given that clinical assessment is often characterised by low convergence between raters, such a measure may offer important contributions. The present study developed and evaluated a measure based on items from the Colorado Childhood Temperament Inventory and reports two studies with child participants aged 4 to 5 years. Independent observations of the children were also made. Results showed moderate levels of internal consistency and stability, and convergence between child self-report and teacher/parent raters was low, but similar levels of agreement were achieved between adult informants. The puppet interview thus showed some potential but highlighted the difficulties of self-report in young children within a multiple informant framework in clinical assessment.

With the recent exponential increase in Internet use, there are concerns about obstacles to gaining access to this potentially beneficial technology. To understand the psychological factors that might be offering barriers to Internet use, the present study considered age, attitudes towards computers, gender, education and social isolation as potential predictors of Internet usage. A sample of 158 adults completed questionnaires about computer anxiety, loneliness and Internet use. Time spent in activities associated with entertainment, communication, information searches and commerce, and overall time spent on the Internet were analysed using multiple regression. It was difficult to predict overall Internet use, but possible to predict specific categories of use. Better-educated participants were more likely to use the Internet for communication. Men, the young, and the lonely used the Internet more for entertainment. Those with lower computer anxiety used the Internet for information searches, and men were more likely than women to use the Internet for commercial purposes. It is suggested that computer anxiety and education may constrain the use of specific applications but Internet use otherwise follows pre-existing tendencies or interests.

The present study involved the random allocation of 22 obsessive-compulsive (OC) washer/cleaners to one of two treatment conditions: Danger Ideation Reduction Therapy (DIRT), or Exposure and Response Prevention (ERP). Participants received 12 1-hour individual clinical sessions and were assessed at pretreatment, posttreatment and at a 6-month follow-up with a battery of 17 measures assessing core obsessive-compulsive disorder (OCD) symptomatology, depression, stress, general anxiety, disease expectancy and perceived responsibility. DIRT subjects experienced significantly greater before to after-treatment reductions in symptomatology on six outcome measures. On 10 of the remaining 11 measures, posttreatment mean scores were lower in the DIRT condition than in the ERP condition, though differences between groups failed to reach significance. Of note, on 3 of the 17 measures, DIRT subjects experienced significantly greater posttreatment to follow-up symptom reduction. Finally, and most importantly, symptom change (regardless of treatment condition) was shown to significantly correlate with change in threat or disease expectancy across the trial. No relationships were found between improvements in perceived responsibility and any of the dependent variables. The findings suggest that DIRT and ERP may be working by reducing specific beliefs in threat; the former treatment being more effective in producing such change than the latter.

While flirting is a relatively underresearched area within psychology, even less is known about how people cyber-flirt. This paper explores how often individuals flirt offline compared to online. Moreover, it attempts to examine how men and women flirt within these different spaces. Five thousand, six hundred and ninety-seven individuals, of which 3554 (62%) were women and 2143 (38%) were men, completed a survey about their flirting behaviour both in face-to-face interactions and in chatrooms. The first hypothesis, which stated that the body would be used to flirt with as frequently online as offline, was partly supported. However, it was found that individuals downplayed the importance of physical attractiveness online. Women flirted by displaying nonverbal signals (offline) or substitutes for nonverbal cues (online), to a greater extent than men. In chatrooms men were more likely than women to initiate contact. It is concluded that cyber-flirting is more than simply a meeting of minds and that future research needs to consider the role of the body in online interactions.

This paper describes the first trial of danger ideation reduction therapy (DIRT) in an adolescent patient with severe, treatment resistant obsessive-compulsive disorder (OCD). This case study also represents the first published data on DIRT for any individual outside the Anxiety Disorders Clinic at the University of Sydney, where the treatment package was originally developed. KP was a 16-year-old girl with a 4-year history of obsessive-compulsive disorder. She was primarily concerned with contamination and presented with associated washing and avoidance behaviour. KP met Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association [APA], 1994) criteria for OCD, oppositional defiant disorder and major depressive disorder. She had also had previous diagnoses of attention-deficit/hyperactivity disorder and motor tics. KP had received considerable treatment for OCD prior to the current trial, including 12 months of outpatient treatment at the local community health centre, a 4-week inpatient admission to a private hospital in Sydney and a 16 week inpatient admission to Rivendell Adolescent Unit in Sydney. All previous treatments involved a combination of pharmacotherapy (clomipramine [up to 125mg[, sertraline [up to the 200mg], fluvoxamine [up to 200 mg], risperidone [up to 2.5 mg] and chlorpromazine [25-50 mg prn]), and attempts to administer exposure-based treatment. KP had failed to benefit from all previous treatment attempts. However, following 16 sessions of DIRT, KP experienced substantial improvement, approximating symptom-free status on all measures. Importantly, these improvements were maintained at 12-month follow-up. The DIRT package was also effective in reducing depression and anxiety scores on self-report measures over the follow-up period. There were no substantial differences between posttreatment and 12-month follow-up scores on any of the measures given.

Binge eating within Binge Eating Disorder (BED) may represent ineffective management of, and inappropriate escape from, strong, dysphoric emotions, but treatments have been slow to incorporate an emotion regulation focus. Eleven women meeting criteria for BED participated in 11 sessions (2 hours per week) of a psychoeducational group program providing training in emotion recognition and management, problem-solving, assertion training, relaxation and stress management. Outcome was evaluated using a multiple-baseline design replicated across groups. Binges were self-monitored daily, and self-report questionnaires assessed wellbeing and emotion regulation at pretreatment, posttreatment and follow-up. Cognitive changes from pre to posttreatment were evaluated by Articulated Thoughts in Simulated Situations. The program was effective in reducing binge eating, alexithymia, stress and depression, and it improved coping and positive cognitions. No participant met criteria for BED at follow-up. The findings provide support for the inclusion of training in emotion recognition and regulation in treatments for BED and for affect regulation models of binge eating.

The number of personal relationships occurring via the Internet is increasing as more people gain access to it. Many of these relationships are romantic in nature, and evidence is accumulating that they have the potential to have an adverse effect on existing face-to-face relationships. This study explored the formation of romantic relationships on their Internet, their nature, and their possible impact on existing marital or de facto relationships in a sample of 75 adults (mean age 42 years, SD = 11.1 years) who responded to an online survey of individuals involved in extradyadic relationships on the Internet. Respondents reported a variety of means of contacting their online partner. More females than males communicated with them daily. Most respondents knew what their partner looked like, most had contacted them by telephone, and a third had met them. Most reported more satisfaction with their online relationship than with their face-to-face one, though few said that it was more important to them than their primary relationship. Although only a quarter of the sample admitted that their online relationship had affected their primary one, those participants reported concealing the truth about the time or nature of their activities, that everyday tasks did not get done, and that levels of sexual intimacy with their primary partner had dropped. The nature of these and other problems suggests that therapists should be aware of the potential for Internet relationships to seriously affect face-to-face relationships.