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An increasing number of mobile phone users check their phones at any time and place, even during in-person interactions. Such behaviors that interrupt social interactions have been described as phubbing. The present study focused on phubbing behaviors within the context of parent-child households and aimed to examine the associations among parents' phubbing, the parent-child relationship, children's self-esteem, and problematic mobile phone use (PMPU) by adolescents. The structural equation model results based on the data collected from 1,721 secondary students revealed that parents' phubbing was not only directly associated with children's PMPU but also indirectly associated with PMPU through the mediating roles of the parent-child relationship and children's self-esteem after gender and age were controlled. These findings suggest a possible underlying mechanism for the relationship between parents' phubbing and children's PMPU, and could thus inform interventions to prevent or decrease PMPU among adolescents. Limitations and implications are discussed.

In this study the effectiveness of the condensed Dialectical Behavior Therapy Skills Training Group (DBTSTG) was compared to the Cognitive Therapy Group (CTG) in reducing depression and suicide reattempt and modifying emotion regulation strategies among those with borderline personality disorder (BPD). A total of 82 depressed BPD college students with a suicidal history within the past 6-months were randomly allocated to DBTSTG or CTG. Both groups had similar reductions in suicide reattempts and depression after the intervention and 6-month follow-ups. However, the CTG showed improvements in cognitive errors, but the DBTSTG revealed increases in acceptance and decreases in suppression scores. Both groups were effective in decreasing depression and suicide reattempt in BPD college students, probably through increasing adaptive antecedent-focused or response-focused strategies of emotion regulation, respectively.

Interpersonal needs are associated with suicide. However, no interpersonal needs questionnaire has been validated in Asia. The psychometric properties of the Interpersonal Needs Questionnaire were examined in a sample of 340 young male adults in Singapore. This questionnaire measures proximal causes of desire for suicide using the extent to which individuals believe that they are a burden to others (perceived burdensomeness) and the extent to which they believe their needs are not met (thwarted belongingness). Confirmatory factor analysis found that a two-factor model of perceived burdensomeness and thwarted belongingness provided an adequate fit for the data. Internal consistency was excellent. Concurrent, convergent, predictive, and discriminant validity was demonstrated. The findings showed that the Interpersonal Needs Questionnaire provides a valid measure of interpersonal needs in young Asian males. Thus, the instrument can be utilized to test the interpersonal psychological theory of suicidal behavior.

Currently, cognitive behavioral therapies appear to be one of the most studied treatments for gambling problems and studies show it is effective in treating gambling problems. However, cognitive behavior models have not been widely tested using statistical means. Thus, the aim of this study was to test the validity of the pathways postulated in the cognitive behavioral theory of gambling behavior using structural equation modeling (AMOS 20). Several questionnaires assessing a range of gambling specific variables (e.g., gambling urges, cognitions and behaviors) and gambling correlates (e.g., psychological states, and coping styles) were distributed to 969 participants from the community. Results showed that negative psychological states (i.e., depression, anxiety and stress) only directly predicted gambling behavior, whereas gambling urges predicted gambling behavior directly as well as indirectly via gambling cognitions. Avoidance coping predicted gambling behavior only indirectly via gambling cognitions. Negative psychological states were significantly related to gambling cognitions as well as avoidance coping. In addition, significant gender differences were also found. The results provided confirmation for the validity of the pathways postulated in the cognitive behavioral theory of gambling behavior. It also highlighted the importance of gender differences in conceptualizing gambling behavior.

This study examined psychological well-being and coping in parents of children with ASD and parents of typically developing children. 73 parents of children with ASD and 63 parents of typically developing children completed a survey. Parents of children with ASD reported significantly more parenting stress symptoms (i.e., negative parental self-views, lower satisfaction with parent-child bond, and experiences of difficult child behaviors), more depression symptoms, and more frequent use of Active Avoidance coping, than parents of typically developing children. Parents of children with ASD did not differ significantly in psychological well-being and coping when compared as according to child's diagnosis. Study results reinforced the importance of addressing well-being and coping needs of parents of children with ASD.

The study aimed to strengthen the scarce literature on self-help treatments for Problem Gambling (PG) by comparing the effectiveness of a Self-Help Cognitive Behavioral Treatment (SHCBT) program (n = 23) with a 6-week Waitlist condition (n = 32) in problem gamblers. Participants were community volunteers with gambling problems and were randomly allocated to the Waitlist and treatment conditions. Results showed significant improvements at post-treatment in gambling behaviors including frequency of gambling, average amount gambled per day and PG symptoms as well as a number of gambling correlates including psychological states (e.g., depression, anxiety and stress), gambling cognitions, gambling urges, gambling related self-efficacy, satisfaction with life, and quality of life among those who completed the SHCBT program, when compared with the waitlist condition. The effect size (partial η 2) ranged from .25 to .57 for all assessed outcomes that showed significant improvement from pre- to post-treatment. It was concluded that a self-help CBT program can be beneficial for treating community problem gamblers.

The aim of this study was to investigate the efficacy of an Internet-based cognitive behavioural therapy program (I-CBT) for the treatment of problem gambling, when compared to a waitlist control and an active comparison condition consisting of monitoring, feedback, and support (I-MFS). Participants (N = 174) were randomly allocated to the three conditions. Variables of interest were gambling outcome and related mental health measures. Participants in the active conditions (I-CBT and I-MFS) completed six online modules. Both I-CBT and I-MFS conditions resulted in significant treatment gains on gambling severity. However, I-CBT was also associated with reductions in a range of other gambling-related and mental health outcomes. Compared with I-MFS, I-CBT produced greater effects across seven outcomes measures, relating to gambling urges, cognitions, stress, and life satisfaction. I-CBT participants also rated the program as significantly more satisfactory. Treatment gains observed for both active conditions were found to be stable through to 12 month follow up. The results indicate that the benefits of I-CBT were more than simply the non-specific effects of engaging in online treatment or receiving motivation, feedback, and support. Online treatments for gambling may be a valuable tool in increasing help-seeking and treatment engagement in this population, and be integrated as part of stepped care approaches to treatment.

Background and aims: abnormal cognitions are among the most salient domain-specific features of gambling disorder. The aims of this study were: (a) to examine and validate a Spanish version of the Gambling-Related Cognitions Scale (GRCS; Raylu & Oei, 2004) and (b) to examine associations between cognitive distortion levels, impulsivity, and gambling behavior. Methods: this study first recruited a convenience sample of 500 adults who had gambled during the previous year. Participants were assessed using the Spanish version of GRCS (GRCS-S) questionnaire, the UPPS-P impulsivity questionnaire, measures of gambling behavior, and potentially relevant confounders. Robust confirmatory factor analysis methods on half the sample were used to select the best models from a hypothesis-driven set. The best solutions were validated on the other half, and the resulting factors were later correlated with impulsivity dimensions (in the whole n = 500 factor analysis sample) and clinically relevant gambling indices (in a separate convenience sample of 137 disordered and non-disordered gamblers; validity sample). Results: this study supports the original five-factor model, suggests an alternative four-factor solution, and confirms the psychometric soundness of the GRCS-S. Importantly, cognitive distortions consistently correlated with affect-or motivation-driven aspects of impulsivity (urgency and sensation seeking), but not with cognitive impulsivity (lack of premeditation and lack of perseverance). Discussion and conclusions: our findings suggest that the GRCS-S is a valid and reliable instrument to identify gambling cognitions in Spanish samples. Our results expand upon previous research signaling specific associations between gambling-related distortions and affect-driven impulsivity in line with models of motivated reasoning.

This study explored the moderating and mediating influences of self-acceptance and tolerance to others in the relationship between mindfulness and subjective well-being. In total, 301 (130 males) university students completed the Five-Facet Mindfulness Questionnaire, Index of Well-being, Self-acceptance Questionnaire, and Tolerance Scale. The results showed that the positive link between mindfulness and subjective well-being was significantly mediated by self-acceptance only. Tolerance played a moderating role. The implications of the results for relevant research and mindfulness training were discussed.

Background: This study aimed to explain how quality of life changes during psychotherapy, using a cognitive-behavioural theoretical framework, and examined whether changes in symptoms or changes in cognitions were more influential with regard to quality of life change. Three different hypotheses were tested that might explain the mechanisms by which quality of life changes during group cognitivebehaviour therapy (CBT) for anxiety and depression. Methods: 127 outpatients with anxiety and/or depression enrolled in a four-week group CBT programme participated. Measures of anxiety and depression symptoms, cognitive change, and quality of life were administered at baseline and post-treatment. Baseline to post-treatment change scores were calculated and entered into multiple regression analyses. Results: Reductions in anxiety and depression symptoms were related to increases in quality of life, whereas cognitive changes were not consistently related to changes in quality of life. Limitations: The main limitation was that the study's design was not able to assess whether changes in cognitions or symptoms preceded changes in quality of life, as all variables were measured at the same two points in time. Conclusions: These results provided evidence that quality of life changes as a result of or, simultaneously with, symptom change. It appears that group CBT does not improve quality of life through strategies designed to change patients' cognitions.

Background: Clinical depression is often preceded by social withdrawal, however, limited research has examined whether depressive symptoms are alleviated by interventions that increase social contact. In particular, no research has investigated whether social identification (the sense of being part of a group) moderates the impact of social interventions. Method: We test this in two longitudinal intervention studies. In Study 1 (N¼52), participants at risk of depression joined a community recreation group; in Study 2 (N¼92) adults with diagnosed depression joined a clinical psychotherapy group. Results: In both the studies, social identification predicted recovery from depression after controlling for initial depression severity, frequency of attendance, and group type. In Study 2, benefits of social identification were larger for depression symptoms than for anxiety symptoms or quality of life. Limitation: Social identification is subjective and psychological, and therefore participants could not be randomly assigned to high and low social identification conditions. Conclusions: Findings have implications for health practitioners in clinical and community settings, suggesting that facilitating social participation is effective and cost-effective in treating depression.

This study examined the relationships between risk (i.e., gambling cognitions, gambling urges, psychological distress) and protective factors (i.e., life satisfaction, resilience, gambling refusal self-efficacy) and problem gambling among 310 Singaporeans aged between 18 and 73 years. Data on demographics, risk and protective factors, and gambling behavior were collected through electronic and paper surveys. Hierarchical multiple regression was employed to assess the contributions of the risk and protective factors in predicting problem gambling. Three risk factors (i.e., gambling cognitions, gambling urges, psychological distress) and two protective factors (i.e., resilience, gambling refusal self-efficacy) were found to significantly and uniquely predict problem gambling. Furthermore, the risk factors significantly interacted with the protective factors to moderate gambling severity. Gambling refusal self-efficacy shows significant protective effects against problem gambling, while the effects of resilience on gambling vary across settings. Both factors need to be taken into account in the understanding of problem gambling.

The present study evaluated the psychometric properties and factor structure of the Satisfaction With Life Scale (SWLS) in a sample of clinical outpatients in Malaysia. The SWLS is a measure designed to assess subjective life satisfaction. Four hundred eighty-three participants (283 with psychiatric illnesses and 200 with other medical illnesses) completed the SWLS and other self-report instruments. Results of the EFA and CFA supported the fit for the one-factor model as the best-fitting model. The internal consistency of the SWLS (α = 0.86) was found to be high. Correlational analyses showed that SWLS had adequate concurrent validity. Scores on SWLS, which differentiated psychiatric patients and medical patients, supported criterion validity. The logistic regression analyses showed good discriminative validity of SWLS. The SWLS is a reliable and valid instrument to measure the satisfaction with life among psychiatry and clinical outpatients in Malaysia.

Background Schizophrenia which is perhaps the most disabling and puzzling form of a mental disorder is often conceptualized as ‘gila’ (lunacy or madness) by the Malaysian society. The debilitating nature of the disorder and recurrent relapse of its psychotic episodes have often been misunderstood and lead to confusion among the family members, who play the role as primary caregivers. While expressed emotion (EE) has been widely studied in the Western world, it is not well understood in Malaysia. Objectives This study aimed at investigating the predictive role of relatives’ EE index and components as well as personality traits in relapse among schizophrenia patients in Kuala Lumpur and Klang Valley, Malaysia. Methods A total of 160 subjects consisting of 80 patients diagnosed with chronic schizophrenia and 80 relatives were recruited to participate in Phase 1 of the study. Only patient-participants were followed-up 6 months later for Phase 2 of the study in order to check for possible relapse. The Family Questionnaire (FQ) and the short scale Eysenck Personality Questionnaire-Revised (EPQ-R) were administered to measure relatives’ EE and personality traits, respectively. Patients’ were considered to relapse if they were readmitted into psychiatric wards 6 months post-hospital discharge. Results The findings revealed that the odds for patients to relapse were increased by 8 times when relatives demonstrated high-EE level. Relatives’ critical comments (CC) turned out to be the strongest predictor with the odds to relapse increased by 12% when they demonstrated an increase in CC level. Relatives’ personality traits particularly the extraversion trait also turned out to be the significant direct predictor to patients’ relapse. Our results showed that a unit decrease in extraversion trait score predicted the odds for patients to relapse by 23%. Discussions Our findings supported the Western findings on the significant role of relatives’ high-EE level particularly the CC scale on the course of schizophrenia. The novelty of the current finding was demonstrated in the significant role of relatives’ extraversion trait that directly predicted patients’ relapse. Results also indicated the feasibility of EE in predicting relapse among schizophrenia patients in Klang Valley, Malaysia.

The concept of self-compassion originated from Buddhism, but very little is known about the utility and functions of this concept among Buddhists. Four hundred and eleven individuals (179 Buddhists and 232 non-Buddhists) completed the survey packages using the self-compassion scale (SCS; Neff in Self Identity 2(3):223-250, 2003a. doi: 10.1080/15298860309027 ). Confirmatory factor analysis showed that the original six dimensions of the SCS were not replicated by both samples, and further analysis of the intra-correlations within dimensions of SCS and relationships between SCS and other variables showed unexpected results specific to Buddhists. Among Buddhists, the dimensions of self-kindness and common humanity neither showed negative correlations with their opposite dimensions nor were associated with better emotional outcomes. In addition, these two dimensions were not predicted by the regular practice of loving-kindness meditation. This study argued that the ideas of self-compassion reflected in the SCS are theoretically different from the ideas of Buddhism, and further implications for measuring and clinically applying self-compassion were discussed.

The present study examined the role of positive outcome expectancy in the relationship between peer/parental influence and Internet gaming addiction (IGA) among adolescents in Taiwan. Two thousand, one hundred and four junior high students completed the Chen Internet Addiction Scale for IGA, Parental Influence for IGA, peer influence for IGA, and Positive Outcome Expectancy of Internet Gaming Questionnaire. Results showed that the three types of peer influences (positive attitudes toward Internet gaming, frequency of Internet game use, and invitation to play) and positive outcome expectancy were significantly and positively correlated with IGA. Moreover, peer influence was also positively correlated with positive outcome expectancy. On the other hand, positive outcome expectancy and parental influences had a low correlation. Structural equation modeling analysis revealed that positive outcome expectancy did not mediate the relationship between either type of parental influences and IGA, and only the parent's invitation to play Internet games directly predicted IGA severity. However, peers' positive attitude or the frequency of peers' Internet game use positively predicted IGA and was fully mediated through positive outcome expectancy of Internet gaming. In addition, the frequency of peers' invitation to play Internet games directly and indirectly predicted IGA severity through a partial mediation of positive outcome expectancy of Internet gaming. The overall fit of the model was adequate and was able to explain 25.0 percent of the variance. The findings provide evidence in illuminating the role of peer influences and positive outcome expectancy of Internet gaming in the process of why adolescents may develop IGA.

Objective: The aim of this study was to assess 12 month outcomes of Australian combat veterans with post-traumatic stress disorder (PTSD) who participated in a 6 week group-based CBT programme at the Toowong Private Hospital. The study population included 496 consecutive admissions to the programme between 1999 and 2008. Method: Self-report measures of PTSD, depression, anxiety, anger, alcohol use, relationship satisfaction and quality of life parameters were collected at intake and 3, 6 and 12 months post intake. Results: Statistically significant and sustained improvements were noted in 12 month outcome measures for PTSD, depression, anxiety, alcohol use, anger, and quality of life. PTSD symptom reduction occurred consistently each year for 9 years and exhibited an aggregated effect size of 0.68. Conclusions: This naturalistic research demonstrates that treatment administered under clinical conditions produces equivocal magnitudes of positive change in terms of PTSD symptoms when compared with existing efficacy data in individual and group treatments. Further, these symptomatic gains are sustainable and consistently reproducible. The benefits noted from group therapy were seen as independent of whether or not individual treatment was in place.

The effect of stimulus valence and arousal on facial electromyographic (EMG) asymmetry was investigated to inform the debate about two contrasting hypotheses of emotion: the right hemisphere dominance hypothesis and the valence hypothesis. EMG was recorded from the left and right corrugator and zygomaticus muscles while participants (N = 21) viewed blocks of negative and positive pictures that were high or low in arousal. Ratings of valence and arousal were taken before and after each of the four emotion blocks. Corrugator muscle activity yielded evidence for left hemi-face dominance during high and low arousal negative picture blocks whereas zygomaticus muscle activity yielded evidence for right hemi-face dominance during high arousal positive picture blocks, especially early during the picture sequence. This pattern of results is consistent with the valence hypothesis.

Aim: The aim was to investigate whether high catecholamine (CA) excreters would respond less well to a group cognitive behaviour therapy (CBT) treatment for depression than others. Method: A sample of 70 adults with depression symptoms participated in a 12-week course of group CBT. Participants’ 24 hour urinary catecholamine levels at pre-therapy and post-therapy were used to classify them as High (N = 10); Low (N = 33) or Mixed (N = 27) according to a cut-off one standard deviation above a published mean for healthy adults. Beck Depression Inventory (BDI) and cognitions questionnaire (Automatic Thoughts Questionnaire; Beck Hopelessness Scale and Dysfunctional Attitudes Scale) were used. Results: Repeated measures ANOVA analyses showed an equal rate of mood improvement in all three groups over the course of CBT, despite the fact that the High excreters were on average more depressed throughout the study. Changes in depression symptoms were mirrored by improvements in cognitive measures in the three catecholamine groups. Conclusion: This study indicates that adults showing a biological marker of depression (elevated catecholamine levels) are equally able to benefit from CBT treatment as adults without this marker.

Background: The study aimed to assess the effectiveness of group and individual formats of a combined motivational interviewing and cognitive behavioral treatment (CBT) program for problem gamblers (PGs) using a randomized controlled design. Method: One hundred and two PGs were randomly assigned to individual or group CBT conditions. Twenty-eight of these participants were randomly allocated to a 6-week waitlist control condition prior to receiving the designated treatment. Results: At post-treatment, there were significant improvements in all dependent variables (frequency and amount gambled, gambling urges, gambling cognitions, negative psychological states, and life satisfaction) for both the treatment conditions but not for the waitlist condition. Individuals that completed the individual (compared to group) treatment condition generally had higher effect sizes for gambling correlates. Therapeutic gains for gambling correlates were generally maintained at 6-month follow-up. Conclusions: A combined motivational interviewing and CBT program applied in group or individual format can improve PG behaviors, as well as gambling correlates.

This naturalistic study investigated the mechanisms of change in measures of negative thinking and in 24-h urinary metabolites of noradrenaline (norepinephrine), dopamine and serotonin in a sample of 43 depressed hospital patients attending an eight-session group cognitive behavior therapy program. Most participants (91%) were taking antidepressant medication throughout the therapy period according to their treating Psychiatrists' prescriptions. The sample was divided into outcome categories (19 Responders and 24 Non-responders) on the basis of a clinically reliable change index [Jacobson, N.S., & Truax, P., 1991. Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.] applied to the Beck Depression Inventory scores at the end of the therapy. Results of repeated measures analysis of variance [ANOVA] analyses of variance indicated that all measures of negative thinking improved significantly during therapy, and significantly more so in the Responders as expected. The treatment had a significant impact on urinary adrenaline and metadrenaline excretion however, these changes occurred in both Responders and Non-responders. Acute treatment did not significantly influence the six other monoamine metabolites. In summary, changes in urinary monoamine levels during combined treatment for depression were not associated with self-reported changes in mood symptoms.

The purpose of this study was to assess the utility of the Arabic translation of the Alcohol Use Disorders Identification Test (AUDIT) among a sample of male Muslim prisoners (N = 107) in Dubai, United Arab Emirates (UAE). Confirmatory factor analysis indicated a two-factor model to be the best fit of the data. Good internal reliability (alpha =.91) and predictive validity were also observed. While the limitations of the study are observed, these promising results suggest that the Arabic version of the AUDIT is a reliable and sound measure of alcohol use disorders among prisoners in the UAE.

Previous research has established efficacy of cognitive behavioral therapy (CBT) for anxiety disorders, yet it has not been widely assessed in routine community clinic practices. Efficacy research sacrifices external validity to achieve maximum internal validity. Recently, effectiveness research has been advocated as more ecologically valid for assessing routine clinical work in community clinics. Furthermore, there is a lack of effectiveness research in group CBT. This study aims to extend existing research on the effectiveness of CBT from individual therapy into group therapy delivery. It aimed also to examine outcome using not only symptom measures, but also measures of related symptoms, cognitions, and life quality and satisfaction. Results from a cohort of patients with various anxiety disorders demonstrated that treatment was effective in reducing anxiety symptoms to an extent comparable with other effectiveness studies. Despite this, only 43% of individuals showed reliable change, and 17% were 'recovered' from their anxiety symptoms, and the post-treatment measures were still significantly different from the level of anxiety symptoms observed in the general population.

Cultural variables (e.g., cultural values, acculturation and attitudes towards seeking professional assistance) have been found to play important roles in the initiation and maintenance of numerous mental health and substance related problems. However, there is a significant lack of empirical studies investigating the relationships between these cultural variables and gambling behavior. Thus, this study assessed whether these cultural variables could predict gambling behavior among 233 Chinese residing in Australia. Several questionnaires were used in the study including the South Oaks Gambling Screen (SOGS), the Asian Values Scale (AVS), Attitudes towards Seeking Psychological Help Scale (ATSPHS) and the modified version of the Cultural Life Style Inventory (CLSI). Results showed that although adherence to Asian values could not predict gambling behavior, acculturation (i.e., cultural shift and cultural incorporation) could negatively predict gambling behavior. Furthermore, the interpersonal openness subscale of ATSPHS could predict gambling behavior. Implications of these findings are discussed.

Despite cultural, social, religious, and legal constraints on Muslim Arab nationals living in the Arabian Peninsula against the consumption of alcohol or drugs, usage and dependence do exist. The aim of this paper is to provide a systematic review, compiling and critiquing the literature in this interesting yet neglected area. Information about the current status of alcohol and substance abuse research and knowledge in the Arabian Gulf region will be presented, providing an accessible synopsis of available papers. A systematic review of English and Arabic language literature was conducted by searching electronic databases (1975-2007) and conducting hand searches of Arab published journals. Only studies investigating alcohol and/or substance use or abuse issues with participants (1) of Arab nationality, (2) living in an Arabian Gulf country, and (3) of Muslim faith were included. Within this literature, the majority of research has been conducted with clinical male participants. The most commonly abused drugs are alcohol, heroin, and hashish. Literature investigating the substance use domain with people who are not seeking treatment for addiction is extremely limited. Although the research is largely in its infancy, it does however confirm alcohol and substance abuse in Muslim, Gulf Arab nationals. We strongly urge that further research into substance use and abuse in this region is conducted. Community investigations assessing the prevalence, magnitude, and associated problems with alcohol and substance abuse and also research into valid and reliable measurements in these countries are warranted.

Obstructive Sleep Apnoea (OSA) is a common sleep disorder associated with significant health, quality of life and psychosocial problems. The aims of this review are to investigate the contribution of psychological constructs and theory to the assessment and treatment of OSA. Adherence to CPAP treatment remains a primary concern for improving treatment outcomes for OSA. Modifiable, psychological constructs of self-efficacy, coping, social support, treatment satisfaction and self-reported daytime sleepiness improve the prediction of CPAP adherence. These predictors are particularly robust in the context of a theoretical model. Social Cognition Theory (SCT) and Health Belief Model (HBM) are emerging as promising psychological models for understanding patient acceptance and adherence to CPAP treatment. An overview of psychologically informed interventions for CPAP use is presented. Education-based interventions have promise, but the strongest and robust findings are emerging from theory-driven interventions. Specifically, Cognitive-Behaviourally informed interventions and Motivational Interventions demonstrate consistent and large effect sizes in improving CPAP adherence rates.

Background The Epworth Sleepiness Scale (ESS [Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991;14(6):540–5]) has been used frequently to assess daytime sleepiness, particularly in the context of clinical sleep disorders. Its psychometric properties are still unclear, particularly when used to evaluate sleep propensity in patients with obstructive sleep apnoea. Methods The present study used confirmatory factor analysis (CFA) to investigate a potential single-factor structure of the ESS in a sample of 759 Australian patients with a diagnosis of obstructive sleep apnoea by the treating physicians. Results CFA results from showed that the original single-factor structure proposed by Johns [Johns MW. Reliability and factor analysis of the Epworth Sleepiness Scale. Sleep 1992;15(4):376–81] did not adequately fit the data. A re-specified single-factor solution provided a good fit for data, and this improved fit was confirmed on a second CFA. Conclusions The findings suggest that standard scoring of the ESS should be interpreted cautiously for patients with obstructive sleep apnoea.

This paper reports on the development and psychometric properties of a Gambling Refusal Self-Efficacy Questionnaire (GRSEQ). Two hundred and ninety-seven gamblers from both normal and clinical populations completed an initial set of 31-items of which 26 were selected for inclusion in the final version of the GRSEQ. A series of factor analyses showed four clear factors accounting for 84% of the variance. These factors can be summarised as situations and thoughts associated with gambling, the influence of drugs on gambling, positive emotions associated with gambling and negative emotions associated with gambling. The GRSEQ total score and factors scores showed high internal consistency (Cronbach's alpha ranging from 0.92 to 0.98). Participants experiencing problems with gambling scored significantly lower on the GRSEQ, and discriminant analyses showed that the scale is able to correctly classify the non-problem (i.e., community and student samples) and problem gamblers (i.e., clinical sample). Furthermore, the GRSEQ showed significant negative relationships with other gambling-related variables (gambling urge and gambling-related cognitions) and negative mood states (depression, anxiety and stress) and was shown to be sensitive to change in treatment of pathological gambling. The results suggest that the GRSEQ is a useful measure of gambling refusal self-efficacy that is suitable for assessment of gamblers from both normal and clinical populations.

The effects of alcohol expectancies (AE) and drinking refusal self-efficacy (DRSE) in predicting alcohol consumption in Caucasians has been well studied. However, the role of AE and DRSE in Asian students is still not well understood. This study reported on this using Caucasian (n = 98) and Asian (n = 92) student samples. Participants completed the Alcohol Use Disorder Identification Test (AUDIT) to measure their hazardous alcohol consumption, and the drinking expectancy profile (DEP) to assess their alcohol related expectancies and ability to resist drinking in certain situations. Results showed that Caucasians reported significantly higher confidence, higher sexual interest, and higher tension reduction expectancies than Asians. Conversely, Asians significantly expected cognitive enhancement and negative consequences more than Caucasians. Relative to Caucasians, the Asian sample also reported that they would be more able to refuse alcohol when under social pressure. Results from regression analyses showed that for the Caucasian sample, AE, DRSE and their interactions were significant predictors of alcohol consumption. For the Asian group, the only significant effect to emerge was that DRSE was negatively related to alcohol consumption. The clinical implications of the differential pattern of results between the samples are discussed in terms of self-efficacy and negative consequences of alcohol consumption, especially when dealing with university aged individuals.

A major weakness of the Mood and Anxiety Symptom Questionnaire (MASQ) is that its discriminant validity has not been demonstrated in a clinical population of anxiety and mood disorder patients. This paper, using 470 anxiety and mood disorder patients, assessed the discriminant validity of the MASQ. The MASQ subscales showed statistically significant discriminant validity, but their maximum ability to discriminate is low at 70%. Overall it was concluded that the MASQ had very weak clinical utility in differentiating anxiety and mood disorder patients, and gave rise to doubts as to the tripartite structure of the MASQ. When using the MASQ, future researchers should be mindful of its limitations when applied in a clinical population.

This study expanded earlier work conducted by this laboratory by examining the independent and interactive effects of avoidant coping strategies, positive and negative alcohol expectancies and self-efficacy, in predicting volume and frequency of alcohol consumption in a sample dependent on alcohol (n = 296). Coping strategies were found to be salient predictors of frequency of drinking, while venting emotion interacted with negative expectancies to predict both volume and frequency of drinking. Venting emotion was also found to interact with drinking refusal self-efficacy in predicting volume of alcohol consumed. These interactions are discussed in terms of the cognitive and behavioural mechanisms thought to underlie drinking behaviour. (c) 2006 Elsevier Ltd. All rights reserved.

This study reported on the validation of the psychometric properties, the factorability, validity, and sensitivity of the Dysexecutive Questionnaire (DEX) in 3 clinical and nonclinical samples. A mixed sample of 997 participants--community (n = 663), psychiatric (depressed [n = 92] and anxious [n = 122]), and neurologically impaired (n = 120)--completed self-report questionnaires assessing executive dysfunction, depression, anxiety, stress, general self-efficacy, and satisfaction with life. Before analyses the data were randomly split into 2 subsets (A and B). Exploratory factor analysis performed on Subset A produced a 3-factor model (Factor 1: Inhibition, Factor 2: Volition, and Factor 3: Social Regulation) in which 15 of the original 20 items provided a revised factor structure that was superior to all other structures. A series of confirmatory factor analyses performed on Subset B confirmed that this revised factor structure was valid and reliable. The revised structure, labeled the DEX-R, was found to be a reliable and valid tool for assessing behavioral symptoms of dysexecutive functioning in mixed community, psychiatric, and neurological samples.

Gambling cognitions have constantly been associated with the development and maintenance of problem gambling. Despite researchers reporting high rates of gambling and problem gambling among the Chinese, little is known about the role of gambling cognitions among Chinese individuals (Raylu & Oei, 2004a). This is partly because there is a lack of validated instruments to assess gambling cognitions in this population. Thus, the purpose of the present study was to examine and validate the Gambling Related Cognitions Scale-Chinese version (GRCS-C), which was based on the 23-item Gambling Related Cognitions Scale (GRCS; Raylu & Oei, 2004b). Confirmatory Factory Analysis (CFA) using 422 Chinese participants (166 Male, 256 Female; Mean age = 32.28 years) from the general community (221 living in Australia and 201 living in Taiwan) confirmed that a five-factor model was a good fit for the data. The Cronbach's alpha coefficient for the overall scale was .95, and ranged from .83 to .89 for the five factors. Concurrent, discriminant, and predictive validities of the GRCS (Chinese version) were also good suggesting that the GRCS-C is a valid and reliable instrument for assessing gambling cognitions among non-clinical Chinese samples.

Background: In 1992, Frisch et al (Psychol Assess. 1992;4:92- 10 1) developed the Quality of Life Inventory (QOLI) to measure the concept of quality of life (QOL) because it has long been thought to be related to both physical and emotional well-being. However, the psychometric properties of the QOLI in clinical populations are still in debate. The present study examined the factor structure of QOLI and reported its validity and reliability in a clinical sample. Method: Two hundred seventeen patients with anxiety and depressive disorders completed the QOLI and additional questionnaires measuring symptoms (Zung Self-rating Depression Scale, Beck Anxiety Inventory, Fear Questionnaire, Depression Anxiety Stress Scale-Stress) and subjective well-being (Satisfaction With Life Scale) were also used. Results: Exploratory factor analysis via the principal components method, with oblique rotation, revealed a 2-factor structure that accounted for 42.73% of the total variance, and a subsequent confirmatory factor analysis suggested a moderate fit of the data to this model. The 2 factors appeared to describe self-oriented QOL and externally oriented QOL. The Cronbach alpha coefficients were 0.85 for the overall QOLI score, 0.81 for the first factor, and 0.75 for the second factor. Conclusion: Consistent evidence was also found to support the concurrent, discriminant, predictive, and criterion-related validity of the QOLI. (c) 2006 Elsevier Inc. All rights reserved.

Background: This study extended that of Kwon and Oei [Kwon, S.M., Oei, T.P.S., 2003. Cognitive change processes in a group cognitive behavior therapy of depression. J. Behav. Ther. Exp. Psychiatry, 3, 73-85], which outlined a number of testable models based on Beck's cognitive theory of depression. Specifically, the current study tested the following four competing models: the causal, consequential, fully and partially interactive cognitive models in patients with major depressive disorder. Methods: A total of 168 clinically depressed outpatients were recruited into a 12-week group cognitive behaviour therapy program. Data was collected at three time points: baseline, mid- and at termination of therapy using the ATQ DAS and BD1. The data were analysed with Amos 4.01 (Arbuckle, J.L., 1999. Amos 4.1. Smallwaters, Chicago.) structural equation modelling. Results: Results indicated that dysfunctional attitudes, negative automatic thoughts and symptoms of depression reduced significantly during treatment. Both the causal and consequential models equally provided an adequate fit to the data. The fully interactive model provided the best fit. However, after removing non-significant pathways, it was found that reduced depressive symptom contributed to reduced depressogenic automatic thoughts and dysfunctional attitudes, not the reverse. Conclusion: These findings did not fully support Beck's cognitive theory of depression that cognitions are primary in the reduction of depressed mood. (c) 2006 Elsevier B.V. All rights reserved.

The present study assessed the influence of group processes on clinical outcomes of patients with anxiety and depression following group Cognitive Behavior Therapy (CBT). Five group environment variables were measured: cohesion, leader support, expressiveness, independence, and self-discovery. One hundred and sixty two patients attended a group CBT program and were assessed at pre and post-treatment. Results provided evidence for the effectiveness of group therapy as patients reported significantly lower depression and anxiety at the conclusion of treatment. Expressiveness was the only predictor of post-treatment anxiety, whereas leader support, expressiveness, and independence were significant predictors of post-treatment depression. Overall, findings suggest that the patients benefited from high levels of expressiveness and independence within their therapy group. In contrast, they failed to benefit from high levels of leader support, whereas both group cohesion and self-discovery appeared to be unrelated to outcome.

Objective: The objective of the present study is to test the validity of the integrated cognitive model (ICM) of depression proposed by Kwon and Oei with a Latin-American sample. The ICM of depression postulates that the interaction between negative life events with dysfunctional attitudes increases the frequency of negative automatic thoughts, which in turns affects the depressive symptomatology of a person. This model was developed for Western Europeans such as Americans and Australians and the validity of this model has not been tested on Latin-Americans. Method: Participants were 101 Latin-American migrants living permanently in Brisbane, including people from Chile, El Salvador, Nicaragua, Argentina and Guatemala. Participants completed the Beck Depression Inventory, the Dysfunctional Attitudes Scale, the Automatic Thoughts Questionnaire and the Life Events Inventory. Alternative or competing models of depression were examined, including the alternative aetiologies model, the linear mediational model and the symptom model. Results: Six models were tested and the results of the structural equation modelling analysis indicated that the symptom model only fits the Latin-American data. Conclusions: Results show that in the Latin-American sample depression symptoms can have an impact on negative cognitions. This finding adds to growing evidence in the literature that the relationship between cognitions and depression is bidirectional, rather than unidirectional from cognitions to symptoms.

Aims The aims of this study are to develop and validate a measure to screen for a range of gambling-related cognitions (GRC) in gamblers. Design and participants A total of 968 volunteers were recruited from a community-based population. They were divided randomly into two groups. Principal axis factoring with varimax rotation was performed on group one and confirmatory factor analysis (CFA) was used on group two to confirm the best-fitted solution. Measurements The Gambling Related Cognition Scale (GRCS) was developed for this study and the South Oaks Gambling Screen (SOGS), the Motivation Towards Gambling Scale (MTGS) and the Depression Anxiety Stress Scale (DASS-2 1) were used for validation. Findings Exploratory factor analysis performed using half the sample indicated five factors, which included interpretative control/bias (GRCS-IB), illusion of control (GRCS-IC), predictive control (GRCS-PC), gambling-related expectancies (GRCS-GE) and a perceived inability to stop gambling (GRCS-IS). These accounted for 70% of the total variance. Using the other half of the sample, CFA confirmed that the five-factor solution fitted the data most effectively. Cronbach's alpha coefficients for the factors ranged from 0.77 to 0.91, and 0.93 for the overall scale. Conclusions This paper demonstrated that the 23-item GRCS has good psychometric properties and thus is a useful instrument for identifying GRC among non-clinical gamblers. It provides the first step towards devising/adapting similar tools for problem gamblers as well as developing more specialized instruments to assess particular domains of GRC.

This study investigated the role of both negative and positive cognitions in predicting panic severity in an international sample of patients diagnosed with panic disorder (with and without agoraphobia). One hundred and fifty-nine patients were administered the Brief Bodily Sensations Interpretation Questionnaire (BBSIQ), the Self-efficacy to Control Panic Attacks Questionnaire, and the Panic and Agoraphobia Scale (PAS) prior to receiving treatment. Regression analyses indicated that both catastrophic misinterpretation of bodily sensations and panic self-efficacy independently predicted panic severity. The influence of panic self-efficacy upon panic severity remained significant even after controlling for the presence or absence of agoraphobia. There was no evidence to suggest a moderating relationship between the two cognitive factors. Results are discussed in terms of the need to consider both negative and positive cognitions in cognitive accounts of panic disorder.

The Quitting Time for Alcohol Questionnaire (QTAQ) was developed by Oei et al. in 1999 to provide a tool that could assess the reasons why a person would cease drinking in a single episode. While this tool was observed to have good psychometric properties, including reliability and validity, the findings have not been replicated, in particular, confirmatory factor analysis has not been provided. This study, using 300 community drinkers, attempted to address this shortcoming. Confirmatory factor analysis supported Oei et al.'s [Addict. Behav. 24 (1999) 383.] research, indicating that the community sample had a three-factor underlying structure, leading to one total score. The findings show that the QTAQ is a valid and reliable instrument for assessing reasons why people cease drinking in a single session.

Hofstede's dimension of national culture termed Masculinity-Femininity [Hofstede (1991). Cultures and organizations: software of the mind. London: McGraw-Hill] is proposed to be of relevance for understanding national-level differences in self-assessed agoraphobic fears. This prediction is based on the classical work of Fodor [Fodor (1974). In: V. Franks & V. Burtle (Eds.), Women in therapy: new psychotherapies for a changing society. New York: Brunner/Mazel]. A unique data set comprising 11 countries (total N = 5491 students) provided the opportunity of scrutinizing this issue. It was hypothesized and found that national Masculinity (the degree to which cultures delineate sex roles, with masculine or tough societies making clearer differentiations between the sexes than feminine or modest societies do) would correlate positively with national agoraphobic fear levels (as assessed with the Fear Survey Schedule-III). Following the correction for sex and age differences across national samples, a significant and large effect-sized national-level (ecological) r = +0.67 (P = 0.01) was found. A highly feminine society such as Sweden had the lowest, whereas the champion among the masculine societies, Japan, had the highest national Agoraphobic fear score. (C) 2003 Elsevier Science Ltd. All rights reserved.

Objective: Expectancies about the outcomes of alcohol consumption are widely accepted as important determinants of drinking. This construct is increasingly recognized as a significant element of psychological interventions for alcohol-related problems. Much effort has been invested in producing reliable and valid instruments to measure this construct for research and clinical purposes, but very few have had their factor structure subjected to adequate validation. Among them, the Drinking Expectancies Questionnaire (DEQ) was developed to address some theoretical and design issues with earlier expectancy scales. Exploratory factor analyses, in addition to validity and reliability analyses, were performed when the original questionnaire was developed. The object of this study was to undertake a confirmatory analysis of the factor structure of the DEQ. Method: Confirmatory factor analysis through LISREL 8 was performed using a randomly split sample of 679 drinkers. Results: Results suggested that a new 5-factor model, which differs slightly from the original 6-factor version, was a more robust measure of expectancies. A new method of scoring the DEQ consistent with this factor structure is presented. Conclusions: The present study shows more robust psychometric properties of the DEQ using the new factor structure.

The circular process model is a psychobiological model of depression, in which it is postulated that catecholamines and negative cognitions interact to influence depression. Since its publication, there have been no empirical tests to support or refute the model. This study tested the model in 92 depressed adult outpatients with non-bipolar non-psychotic depression. There were no significant bivariate correlations among the biochemical and cognitive measures. However, the interactive model was supported by results of two out of three hierarchical regression analyses, in which the biochemical-by-cognitive interactive terms significantly predicted depression after the main effects of each variable were accounted for. These findings show sufficient evidence in support of the Circular Process Model to warrant further testing over the treatment period.

The current study tested the model proposed by Campbell and Oei (2010), and assessed the separate components of the model to best explain the intergenerational transference of alcohol use behaviour. Results revealed an adequate fit of all three models with significant differences between the Cognitive and Behavioral Models, and the Full Cognitive Model. Results suggest that cognitions are not a direct means by which parental drinking behaviour is transferred to their offspring however the parental behaviour impacted on their children's behaviour via their alcohol cognitions.

The influence of an individuals' belief in their ability to resist drinking alcohol has recognised importance in understanding the pattern of drinking behaviours among Caucasian samples. Measures used to investigate this construct, such as the drinking refusal self-efficacy questionnaire-revised (DRSEQ-R; [Oei, T. P. S., Hasking, P. A.,Young, R. M. (2005). Drinking refusal self-efficacy questionnaire-revised (DRSEQ-R): A new factor structure with confirmatory factor analysis. Drug and Alcohol Dependence, 78, 297-307.]) have been widely used and have established psychometric properties. However, the exploration of the utility of this questionnaire with samples of different ethnicity, religion and living in different countries remains scarce. In the current study, Arab Muslim samples living in the United Arab Emirates and Oman (n=356) and Asian predominately Muslim samples living in Malaysia and Indonesia (n=256) were used. Exploratory and confirmatory factor analysis demonstrated that the DRSEQ-R has a three factor structure. Internal consistency ranged from alpha .96 to alpha .86 and validity was good. This study offers evidence of the utility of this measure with Arab and Asian samples.

Objective: We report on the changes in cognitions as a result of cognitive—behaviour therapy (CBT), in 35 recovered and 32 non-recovered mood disordered patients who had undergone a 12-week group CBT program for depression. Method: An end-of-therapy cut-off score of 10 on the BDI was used to define recovered and non-recovered patients. ANOVA analyses were conducted to explore possible main effects of recovery status and time on various clinical measures, including cognitions and activity levels. Results: Mean mood and activity self-rating measures were significantly higher for the recovered as compared to the non-recovered patients over the course of the program. Similarly, scores on the Automatic Thoughts Questionnaire (ATQ) for recovered patients were within the non-clinical range, in contrast to their non-recovered counterparts. In addition, recovered patients improved significantly in their Hopelessness scores, and there was a change in the expected direction in their Dysfunctional Attitudes Scale scores, although this was not significant. Conclusion: These results are consistent with the proposition of cognitive theory (i.e. the remediation of negative cognition plays a significant role in recovery from depression during CBT).

Objective: The present study aimed to examine the discriminatory ability of alcohol expectancies and drinking refusal self-efficacy and to identify the differential role of these constructs in social and problem drinkers. Method: Drinkers (N = 276) were self-selected from general (n = 185) and clinical (n = 91) populations to complete a 40-minute questionnaire that asked about alcohol expectancies, drinking refusal self-efficacy, consumption, degree of dependence and demographics. Results: The results showed that in social drinkers both the expectancy and self-efficacy constructs were reliably able to discriminate between types of drinker. Expectancy was related to consumption in social drinkers, but did not appear to account for a significant proportion of the variance in problem drinkers. Conclusions: The findings are discussed in terms of a two-process model of drinking behavior that suggests that expectancies operate differently in social and problem drinkers.

The negative impact of maternal cigarette smoking during pregnancy on the growth and development of the foetus has been well documented. However, the long-term effects of the subsequent cognitive and physical development of the child are less clearly understood. This article presents a critical review of the literature on this topic. The review shows that the effects of prenatal exposure to smoking on children's physical development are mediated by a dose-response relationship. Although the observed effects are long term, they are small and may have no major functional importance. The evidence on the long-term consequences of intellectual function is still unclear. One reason is that very few studies have looked at the long-term consequences of maternal smoking on both physical and cognitive development. More effort is needed to investigate this important issue.

Objective: This study developed and compared separate estimates of the number of heavy drinkers (the in-need population for alcohol treatment interventions) across eight local regions in Queensland. Method: Estimates were based on: (i) a self-report population survey of alcohol consumption; and (ii) an application of the Ledermann log-normal distribution of consumption model to liquor sale figures. Results: Estimates based on the 1989–1990 National Health Survey (NHS) data indicated that 10.98% (n = 83 880) of adult male drinkers and 1.25% (n = 6581) of adult female drinkers in Queensland (total = 90 461) were on average drinking the equivalent of six or more standard drinks a day in the week prior to the survey (4.74% of Queensland adult drinkers, n = 90,461). Estimates based on the Ledermann model indicated that 12.18% of adult Queensland drinkers (n = 232,283) were drinking six or more standard drinks a day. Estimates based on the Ledermann model were 157% larger than estimates based on NHS data (i.e. a difference of 141 821 heavy drinkers), with large variations in the two estimates across local regions. Conclusion: The NHS data appears to underestimate the population of heavy drinkers, whereas the Ledermann model overestimates it. In this situation, it seems preferable to use the more conservative self-report survey estimates.

Research into the efficacy of psychotherapy has often reported equivalence in treatment outcome when comparing different therapies. These findings have been interpreted as evidence for what are variously termed placebo, common or nonspecific processes. We suggested that this issue is best examined in comparison of specific and nonspecific processes in the action of a specified therapy and disorder. No comparisons of this nature have yet been reported in relation to cognitive therapy for depression. This study compared specific processes (automatic thoughts and dysfunctional attitudes) and major common processes (satisfaction with therapy and client evaluation of therapist) in the action of a group cognitive therapy for depression. Sixty patients suffering from major depression received a 12 week course of group cognitive therapy. Results from hierarchical regression suggested that the specific processes of cognitive therapy were more associated with reduction in depression than common processes which contributed to the prediction of reduction in depression via specific processes.