Risk and protective processes and mechanisms associated with depression in youth are discussed within a developmental–ecological framework. Risk factors at the individual (genetics, biology, affect, cognition, behaviour) and broader contextual levels (e.g., family, school, community) are proposed to interact, leading to the development of depression in youth. Transactions between these individual and contextual factors are suggested to be dynamic and reciprocal, and these transactions are expected to change over time and developmental course. The ‘best bet’ for the prevention of depression may be multicomponent and multilevel interventions that address the multiple risk and protective factors associated with depression. Preventive interventions need to focus on building protective factors within young people themselves, as well as creating health-promoting environments at home and at school. These interventions likely need to be long term and geared towards assisting youth across successive periods of development.

Controlled efficacy/effectiveness trials throughout the world have reached a high standard from a methodological stance, but what do we regard as the ideal or elegant intervention in clinical psychology? This article presents six key points as the gold standards of psychosocial interventions by which treatment efficacy/effectiveness research with children, adolescents and adults might be evaluated: (1) theoretical rationale and conceptualisation of clinical dysfunction, (2) clear problem identification and target client group, (3) program features such as realistic goal setting, flexibility, and time-limited interventions, (4) manual-based treatments, (5) research support including clinically significant outcomes, and (6) acceptability/social validation of clients and society. Finally, we discuss the usefulness of such a framework for mental health professionals and clinical researchers.

The purpose of this article is to open discussion on the appropriate standards for training and practice in cognitive behavioural therapy (CBT) for clinical psychologists. CBT has in recent years become increasingly popular as a brief and effective psychological treatment for mental health problems. Public funding has become available for the provision of CBT for a prescribed number of sessions to people diagnosed with specific psychiatric disorders, and there has been an increasing shift in public mental health services toward more short-term and structured episodic care interventions, many of which are CBT-based. There has also been a corresponding increase in health professionals seeking CBT training and offering psychological services described as CBT. However, there is a lack of formal nationally agreed standards for clinical psychologists in relation to training and practice in CBT, and ethical concerns have been raised about the provision of ‘stand-alone’ brief training to professionals who do not have an undergraduate psychology degree and hence may not have an understanding of the theory and research that underlies CBT. Issues raised in this article include training and practice considerations such as levels of competence, diversity and complexity of CBT, treatment length, ethical considerations and barriers to best practice.

The thesis advanced in this essay is that couple relationship interventions are central to effective therapy with many adult clients. I begin by reviewing a body of evidence that demonstrates the significance of couple relationships in the lives of most adults. A range of circumstances are described in which effective therapy with adults needs to address the couple relationship, even when the couple relationship is not mentioned as a presenting issue. It is concluded that individual psychological adjustment often is best understood when conceptualised within the intimate interpersonal context of the couple relationship.

There is evidence suggesting that obsessive–compulsive disorder (OCD) in adults may be associated with an impaired ability to recognise the facial expression of disgust (Sprengelmeyer et al., 1997a; Woody, Corcoran, & Tolin, in press). It has been suggested that this impairment begins in childhood when the recognition of emotional expressions is being learnt (see Spengelmeyer et al., 1997a). This study compared the recognition of facial affect in children aged around 11 years with a diagnosis of obsessive–compulsive disorder (OCD; n = 11), other anxiety disorders (n = 20), and nonclinical children (n = 19), adapting the methodology of Sprengelmeyer et al. Disgust was most commonly misclassified as anger by children in all three groups. However, children with OCD did not show any evidence of a recognition deficit for disgust in comparison to either control group. Unexpectedly, however, children with OCD recognised expressions of surprise more accurately than nonclinical children. Recognition of disgust or any other emotion was not related to child self-reported anxiety symptoms. Given the observed differences in some studies with adults, future research may benefit by examining older adolescents and young adults to determine when these effects may first be noticed.

Recent investigations have demonstrated a renewed interest in the role of avoidance in depression; however, little is known of which specific forms of avoidance — cognitive, behavioural or experiential — are important in this context. This study examined (a) the relationship between depression, rumination and these subtypes of avoidance, and (b) the proposal that the abstract/analytical nature of ruminative thought is linked to experiential avoidance. A nonclinical sample (N = 101) of undergraduate students completed self-report measures of depression, rumination, avoidance and mood state and viewed a low mood emotion-eliciting video stimulus. Participants' written summary of the film clip was independently rated for the degree to which it was abstract or concrete. Rumination, depression and cognitive, behavioural and experiential avoidance were all significantly correlated and remained so when anxiety was controlled. Further, reduced concreteness of description of the film clip was associated with experiential avoidance and rumination. Taken together, the findings underscore the value of clinicians being attentive to experiential avoidance in the assessment and treatment of depression.

Previous research examining the clinical phenomenology of obsessive–compulsive disorder (OCD) has provided some evidence that OCD might be associated with different clinical correlates at different stages of development. In particular, there appears to be a bimodal distribution in terms of the age of onset of the disorder, a male predominance during childhood and adolescence compared to adulthood, stronger familial aggregation of OCD in early onset cases, and differences in the types of symptoms and the patterns of comorbidity across age groups. This study assessed the continuity in clinical presentation of OCD across three distinct age groups: children, adolescents and adults. It was hypothesised that the sample of children would be predominantly male, and would have a higher familial aggregation of OCD and/or anxiety/depression in first-degree relatives. It was further hypothesised that there would be significant age-related differences in terms of specific symptoms, patterns of comorbidity, OCD severity, functional impairment, and level of insight and distress. The results of this study support the developmental heterogeneity hypothesis, with significant differences occurring across age groups on a number of clinical features of OCD including age at onset, symptoms experienced, comorbidity, severity, insight and impairment. Implications of the findings and future directions for research in this area are discussed.

Elevated anxiety sensitivity and the tendency to catastrophically misinterpret ambiguous bodily sensations has been demonstrated in people who experience nonclinical levels of panic (Richards, Austin, & Alvarenga, 2001), and anxiety sensitivity has been shown to be associated with insecure attachment in adolescents and young adults (Weems, Berman, Silverman, & Saavedra, 2001). This study investigated the relationship between attachment style, anxiety sensitivity and catastrophic misinterpretation among 11 nonclinical panickers and 58 nonanxious controls aged 18 to 19 years. Participants completed the Brief Bodily Sensations Interpretation Questionnaire (BBSIQ), Anxiety Sensitivity Index (ASI) and an attachment questionnaire. The hypothesis that insecurely attached individuals would demonstrate greater catastrophic misinterpretation and higher anxiety sensitivity than securely attached individuals was not supported; however, nonclinical panickers gave more anxiety-related interpretations of ambiguous internal stimuli than nonanxious controls. Results do not support the notion that attachment style is related to anxiety sensitivity or catastrophic misinterpretation (regardless of panic experience). Results do, however, support the notion that anxiety-related misinterpretation of ambiguous somatic sensations precedes the onset of panic disorder.

This article reports on the initial effects of the Early Impact (EI) Program, a preventative program that includes home and school components designed to arrest the development of conduct problems in preschool-aged children. Participants included 455 preschool-aged children enrolled across 10 schools. Schools were randomly assigned to either EI or control conditions. All participants were screened at the commencement of the academic year to determine those children considered more at risk for ongoing conduct problems. Following screening n = 66 children were identified in the intervention group and n = 69 in the control. The intervention commenced in the second term of the academic year and ran over a 10-week period. Teachers involved in the intervention were highly engaged and satisfied with the program design. Improvements were reported at the school level at post-intervention with mixed evidence of durability of change at 6-month follow-up. Parent participants were more difficult to engage and reported no changes in the behaviour of children in the home. The study provides initial evidence of the efficacy of the EI intervention as a means of preventing conduct problems in young children at the school level; however, issues associated with parental engagement and home-based change remain to be solved.

Attention-deficit/hyperactivity disorder (ADHD) is the most recent diagnostic label used to describe a behavioural condition of which the essential features are developmentally inappropriate levels of inattention, impulsivity and overactivity. ADHD has attracted both controversy and attention from the professional and scientific community. However, little is known regarding the explanatory models (implicit theories) of health professionals or of their beliefs regarding the treatment of this condition, specifically the impact of diagnostic labelling on their decisions concerning treatment. This study manipulated the presence versus absence of the diagnostic label ‘ADHD’ in a vignette study describing the symptoms of this condition. The vignette was presented to professionals in the educational, mental health and allied health fields. After reading the vignette, participants were required to complete a questionnaire examining implicit beliefs concerning ADHD. The results confirmed that the presence of the diagnostic label (ADHD) changed the causal explanations by professional groups. However, the presence of the diagnostic label did not significantly change the beliefs about the optimal treatment strategy for this condition.

Effective behaviour change is based on understanding the reasons for difficult behaviour. However, current functional analytic technology is often limited in its effectiveness in the clinical setting because the focus is on labelling and classifying behavioural outcomes rather than conducting a detailed analysis of the manner in which these outcomes assist the client to operate in the environment. The effectiveness of existing functional analytic techniques might be enhanced by moving the focus of the investigation from identifying the consequent variables that impact on behaviour to systematically exploring client–environment interactions as well as the manner in which the client experiences the consequences of his/her actions. One potential method (Valued Outcomes Analysis) that provides a framework for the systematic investigation of the effects of ‘inner skin’ factors on the incidence of behavioural difficulties is described here.

Little research has been undertaken to examine the empirical basis of commonly applied methods of posttrauma intervention. We propose that Pennebaker's work on structured disclosure of trauma provides a suitable analogue to explore questions of interest. The present study asks whether avoidance coping is likely to interfere with abbreviated disclosure of traumatic experiences. Subjects were 118 college students randomly allocated to either a one-session or four-session written trauma-disclosure condition. At 2 months postdisclosure, subjects with high avoidance coping within the one-session condition exhibited significantly more trauma-specific and physical symptoms than all other subjects. Avoidance coping significantly predicted trauma-specific symptoms at 2 months. These findings suggest that single session traumatic disclosure may not be useful for individuals with an avoidance style of coping.

Thought–action fusion (TAF), a belief that one's thoughts can either increase the likelihood of a given event or imply the immorality of one's character, is associated with a range of disorders, but has not yet been investigated in relation to psychosis. We sought to determine whether TAF beliefs are endorsed by individuals with chronic schizophrenia. Twenty-seven adults with chronic schizophrenia completed self-report measures of TAF, magical ideation, delusional beliefs and obsessive–compulsive symptoms. Scores were compared with a gendermatched nonclinical group (n = 27) and associations between self-report measures were investigated for the chronic schizophrenia sample. TAF Likelihood–Others, magical ideation and obsessive–compulsive symptoms were endorsed to a greater extent by those with chronic schizophrenia than by controls. The participants with chronic schizophrenia however, did not generally endorse TAF statements at level greater than ‘neutral’. TAF Moral, magical ideation and obsessive– compulsive symptoms were associated with scores on the delusional beliefs measure. We conclude that TAF beliefs may not especially characterise the thinking styles of those with schizophrenia. These findings await replication using a larger sample.

Few studies have examined the impact of parenting interventions for families in rural and isolated areas who have children with conduct problems, where access to professional services can be difficult. The present investigation compared the effects of three conditions, two levels of self-directed behavioral family intervention: an enhanced self-directed program that combined a self-help program using written materials and a weekly telephone consultation (ESD), a self-help program (SD) and a waitlist control group (WL). At postintervention the ESD group reported significantly lower levels of disruptive behaviour, and lower levels of dysfunctional parenting than the SD and WL controls, and higher levels of consumer satisfaction. At 6 months follow-up the main effects for the ESD group had been maintained. The SD group continued to evidence improvement from postintervention to follow-up such that 65% of children in the ESD condition and 57% of children in the SD condition showed clinical reliable change on measures of disruptive behaviour. Implications of findings and directions for future research are discussed.

This article presents the current state of knowledge in deliberate-self harm (DSH). DSH presents as a comorbidity with a number of personality disorders and psychopathologies, but is also relatively common in the psychologically healthy population. Over the past 10 years, attention has shifted from the investigation of DSH as a cardinal or comorbid symptom of psychopathology to an attempt to understand the behaviour itself, without reference to other psychopathological processes. It is argued that this development in understanding the aetiology of DSH has not been matched by developments in treatment or management of DSH, with the majority of treatment programs targeting larger syndromes of which DSH is a symptom. Treatment regimes aimed at reducing DSH appear to be either untested or demonstrably unsuccessful.

The present article describes two experimental studies investigating whether individual differences in intolerance of uncertainty (IU) predict worry in response to uncertain situations. In both studies, undergraduate students completed the Intolerance of Uncertainty Scale (IUS; Freeston, Rheaume, Letarte, Dugas, & Ladouceur, 1994) and then completed an intelligence task, which was thought to elicit feelings of uncertainty. After completing the task, state worry was measured. Results of both studies showed that there were positive correlations between IUS scores and task-related state worry. Furthermore, Study 2 showed that individual differences in IU only were predictive of worry in a situation that elicits low to medium levels of uncertainty, and not in a situation high in uncertainty. Thus, only under certain conditions IU-related personality characteristics seem to be predictive of worrisome thoughts.

This article offers a preliminary investigation of the delivery of an intensive version of manualised cognitive–behavioural therapy for adolescent obsessive–compulsive disorder (OCD). The aim was to address issues of treatment accessibility within the area, including a shortage of therapists who feel competent and possess the expertise to successfully deliver these protocols. Two male adolescents, with a principal diagnosis of OCD, participated in eight weekly 150-minute sessions. A series of diagnostic, symptom severity, global functioning, and self-report measures were completed at pretreatment, across treatment weeks, at posttreatment, and at 6-week follow-up. Further, monitoring of multiple baselines across behaviours for each adolescent across treatment weeks served to extend results beyond mere end points. Process issues specific to each adolescent, his family, and the therapeutic relationship were considered. Along with the overall outcome results, such information aimed to provide useful data for clinicians interested in implementing the program. Reductions in OCD symptomology and symptom severity for both participants at posttreatment and at 6-week follow-up suggest that an intensive format of treatment delivery might benefit some adolescents.

In this article we report the use of a simple, nonprogrammed, syllable timed speech procedure to treat stuttering in a 3-year-old boy with a 2-year history of stuttering. The treatment involved the boy and his parents visiting the clinic 7 times, and the parents modelling syllable timed speech 2 to 6 times per day for 5- to 10-minute intervals in and around the home. After 7 weeks, clinic measures and objective, blinded measures of speech beyond the clinic showed stuttering frequency below 1.0% syllables stuttered. Along with low severity ratings made by the parent each day, this meets the stuttering criteria of another, proven treatment for early stuttering intervention. However, in this study reduction in stuttering was achieved with a simpler and more cost efficient procedure. With the caveat that this is a nonexperimental case report, we discuss its potential implications.

There is a paucity of treatment-outcome research for problem or pathological gambling. Single-session exposure therapy has been used successfully with a broad range of psychological disorders such as panic disorder and the phobias. This article will describe the use of single-session graded exposure to treat problem gambling with an Electronic Gaming Machine (EGM) gambler. Pretreatment to 6-month follow-up repeated measures showed a significant reduction in client-rated gambling severity, that is, showed a significant reduction in client-rated gambling severity (Gambling Severity Checklist [GSCL]), the Symptom Checklist-90-Revised (SCL-90-R) and the Beck Depression Inventory (BDI). This case demonstrates a novel intervention which is brief, convenient and accessible to the client, and which resulted in gains maintained over the medium-term. This promising single case indicates the need for further research to determine whether positive benefits are realised in larger randomised control designs.

Despite the popular belief that chocolate adversely affects young children's behaviour, there have been no direct investigations into the behavioural response to chocolate consumption. This study investigated the effect of chocolate ingestion on the behaviour of 26 preschool children. Dried fruit was consumed in a separate condition to control for nonspecific factors, such as excitement and novelty, associated with the effects of receiving positive substances. Children were observed while they listened to a short story, immediately before and 30 minutes after they ate chocolate or fruit. The children's behaviours were videotaped and scored by two blind raters who coded their behaviours according to six objective and two subjective measures. There were no significant behavioural changes due to consumption of either chocolate or fruit on subjective and objective ratings. These findings raise questions about the popular perception that chocolate promotes poor attention and increased activity in preschool children.