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This paper presents a conceptual framework, based on training in self-regulation, for the normalization of sexual behavior in individuals with developmental disabilities. Four features of such an approach include acquiring appropriate sexual behaviors, generalizing skills, discriminating appropriate contexts, and evaluating one's actions. (DB)

The current study evaluates the factor structure of the Disgust Scale-Revised (DS-R) in eight countries: Australia, Brazil, Germany, Italy, Japan, the Netherlands, Sweden, and the United States (N = 2,606). Confirmatory factor analysis is used to compare two different models of the DS-R and to investigate the invariance of the factor structure of the DS-R across countries and gender. A three-factor solution consisting of three different but interrelated disgust factors (a 12-item core disgust factor, an 8-item animal-reminder disgust factor, and a 5-item contamination disgust factor) best accounted for the data in all countries except the Netherlands. Relative to the United States, the three-factor solution is invariant in Australia, Brazil, and Japan but not in Germany, Italy, the Netherlands, and Sweden. The three-factor solution is also invariant across gender in most countries. The implications of these cross-cultural findings for promoting a more valid and reliable assessment of disgust dimensions, as assessed by the DS-R, are discussed. Keywords: Disgust Scale--Revived; disgust sensitivity; cross-culture; factor structure

An online thought-suppression paradigm was developed to test predictions of ironic process theory. Participants concentrated on or suppressed a particular semantic category. Semantic activation was indexed by the latency to name words from the category. In Experiments 1 and 2, an analog intrusion was introduced while participants were trying to suppress the information. Results consistent with ironic process theory were observed using words with polar opposites in Experiment I and words without polar opposites in Experiment 2. To determine whether these effects were dependent on the analog intrusion. Experiment 3 replicated Experiment 1 without the intrusion. Concentration generated semantic activation. but suppression exacerbated this activation. The data imply that hyperaccessibility results from efforts to suppress, whereas the processes of thought suppression identified by ironic process theory require the presence of material inconsistent with a desired cognitive state. Keywords: thought suppression, ironic process theory, mental control

To replicate and extend the finding that distraction facilitates between session anxiety reduction (Oliver & Page (2003)), 27 spider phobics underwent three 10-min sessions of in vivo exposure followed by one 10-min exposure session at a 4-week follow-up, while having either stimulus-relevant focused conversation or stimulus-irrelevant distracting conversation with the experimenter. Physiological arousal and subjective anxiety were measured during exposure, and self-efficacy, perceived control and performance on a behavioural task were measured at pre-treatment, post session-3, and follow-up. Monitoring and blunting coping styles were also measured at pre-treatment to assess their impact on treatment outcome. Despite equal physiological activation between the groups, those who underwent distracted exposure showed greater reductions in subjective fear within and between sessions, and showed greater increases in self-efficacy ratings, internal perceived control and performance on a behavioural task. Coping style did not interact with the effect of distraction or focusing during exposure, however blunters had less subjective anxiety reduction overall, particularly when they underwent focused exposure. Results are discussed in terms of the emotional processing model and self-efficacy theory. Keywords: Distraction; Exposure; Fear reduction; Spider phobia; Emotional processing; Self-efficacy; Perceived control; Coping style

Objectives: A key feature of blood‐injection‐injury (BII) phobia is activation of disgust responses, in addition to fear. Yet, standard treatments have largely neglected addressing disgust responses. The disorder is further complicated by fainting in 75% of sufferers. Moreover, treatments have been traditionally delivered in an individual format, which may not be as efficient as group treatment. The aim of this study was to develop a group‐based programme for BII phobia, with components targeting fear, disgust, and fainting, to determine feasibility and effectiveness of such an intervention. Methods: Participants took part in an 8‐session, group‐based Cognitive Behavioural Therapy (CBT) programme for BII phobia (N = 40). The key outcome measure was the Multidimensional Blood/Injury Phobia Inventory, which assesses a range of phobic stimuli and responses (including fear, disgust, and fainting). Results: There were significant improvements, with large effect sizes, across symptoms over the course of treatment. Participants with higher disgust sensitivity reported higher pre‐treatment symptom severity and greater life interference than those with lower disgust scores. Despite this, neither pre‐treatment disgust sensitivity nor fainting history impacted on treatment response. For the first time, however, we showed that greater reductions in disgust to BII stimuli were associated with greater overall symptom reductions, highlighting the importance of disgust in the treatment of this disorder, and potentially others. Conclusion: Despite the heterogeneous nature of BII phobia, this group‐based, modified CBT intervention was effective in reducing a variety of phobic responses, including fear, disgust, and fainting. Practitioner points: Disgust is a key maintaining factor in blood‐injection‐injury phobia, which clinicians should consider in their assessment and treatment of this disorder. There is little in the existing literature to guide clinicians in this regard.This study examined a novel group treatment for blood‐injection‐injury phobia which included strategies to target disgust, in addition to traditional CBT strategies to address fear and fainting.The treatment was feasible and acceptable. Symptoms of fear, disgust, and fainting reduced significantly over treatment.Changes in disgust symptoms were associated with overall symptom changes, however a control group is needed to determine the effects of individual treatment components and to make more robust conclusions about the benefits of this enhanced approach. [ABSTRACT FROM AUTHOR]

Brief versions of Dialectical Behaviour Therapy (DBT) may enhance patient outcomes in diverse service settings. This study examined the effectiveness of two DBT-informed treatments for diagnostically heterogeneous groups in routine practice: 5-day group training in DBT skills (DBT-5) and a 12-week DBT program (DBT-12). : Depression, anxiety, stress, borderline symptoms, self-esteem, and general mental wellbeing were measured at pre-and post-treatment in a sample of inpatients and outpatients (N=395). Rates of clinically significant change on these measures were calculated and effect sizes benchmarked against prior DBT outcome studies. Readmission rates were used to measure treatment response maintenance. : Scores on all measures improved significantly from pre- to post-treatment. DBT-5 and DBT-12 yielded similar effect sizes compared to prior DBT outcome studies. At least 43.5% of patients were classified as recovered or improved regarding borderline symptoms at the end of both DBT-5 and DBT-12. Readmission rates were also low (5%–6.8%). Brief DBT-informed treatments may offer a fast reduction in symptoms and quicker return to functioning. [ABSTRACT FROM AUTHOR]

Background: Identifying the interaction between dispositional and dynamic risk factors is necessary in understanding, predicting, and managing suicide risk. Interpersonal factors have consistently been linked to suicidal ideation over short‐term periods. Additionally, distress tolerance may be a relevant dispositional protective factor against stressful events. Methods: Seven hundred and seventeen psychiatric inpatients (Male = 30.31%, Average Age = 40.71 years, Min = 14, Max = 82) self‐reported their distress tolerance at hospital admission, and interpersonal needs and suicidal ideation on a daily basis. Dynamic structural equation modelling was used to examine whether within‐level dynamics were moderated by distress tolerance. Results: Both perceived burdensomeness and thwarted belongingness were significantly associated with same‐day suicidal ideation. Higher distress tolerance was associated with weaker daily associations between suicidal ideation and both perceived burdensomeness and thwarted belongingness. Distress tolerance was also associated with lower variability in suicidal ideation. Moderating effects were also evident when lifetime suicide attempts were added as a covariate, which was associated with stronger associations between interpersonal dysfunction and suicidal ideation, and higher variability in ideation. Conclusions: Distress tolerance may be important to consider when examining the dynamic relationships between suicidal ideation and proximal factors. Psychotherapy that specifically targets distress tolerance may be effective in reducing reactivity to interpersonal stressors. [ABSTRACT FROM AUTHOR]

Assessments for blood-injury-injection phobia measure feared stimuli and overt behaviours, but they have not systematically addressed the symptoms of fear and faintness. The Blood-Injection Symptom Scale (BISS) was developed to overcome this omission. An exploratory factor analysis grouped symptoms triggered by blood and injections into three internally consistent factors (faintness, anxiety and tension). A confirmatory factor analysis replicated the factor structure in a new sample. To test the construct validity of the BISS, an attempt was made to reproduce Ost's (1992, Journal of Abnormal Psychology, 101, 68-74) finding that fear was stronger among people with concerns about injections, while faintness was stronger among people with concerns about blood. A community sample of 80 individuals with concerns (i.e. fear or fainting) about blood or injections completed the BISS. Controlling faintness, individuals with concerns about injections reported more fear than people with concerns about blood. In contrast, controlling for fear, the latter reported more symptoms of faintness. These data suggest that the BISS generates stable and internally consistent subscales useful in the measurement of symptoms elicited by blood and injections.

Conditioned flavor preferences in humans have implications as possible indicators of chronic alcohol dependence development. The medicinal effect of these preferences indicates the role of environmental effects on alcohol dependence development. Only drinkers who exhibit early morning malaise and relief drinking show clear flavor preferences and significant reduction in alcohol consumption.

Background: Self-harm is a significant public health issue, and both our understanding and ability to predict adverse outcomes are currently inadequate. The current study explores how preventative efforts could be aided through short-term prediction and modelling of risk factors for self-harm. Methods: Patients (72% female, Mage = 40.3 years) within an inpatient psychiatric facility self-reported their psychological distress, interpersonal circumstances, and wish to live and die on a daily basis during 3690 unique admissions. Hierarchical logistic regressions assessed whether daily changes in self-report and history of self-harm could predict self-harm, with machine learning used to train and test the model. To assess interrelationships between predictors, network and cross-lagged panel models were performed. Results: Increases in a wish to die (β = 1.34) and psychological distress (β = 1.07) on a daily basis were associated with increased rates of self-harm, while a wish to die on the day prior [odds ratio (OR) 3.02] and a history of self-harm (OR 3.02) was also associated with self-harm. The model detected 77.7% of self-harm incidents (positive predictive value = 26.6%, specificity = 79.1%). Psychological distress, wish to live and die, and interpersonal factors were reciprocally related over the prior day. Conclusions: Short-term fluctuations in self-reported mental health may provide an indication of when an individual is at-risk of self-harm. Routine monitoring may provide useful feedback to clinical staff to reduce risk of self-harm. Modifiable risk factors identified in the current study may be targeted during interventions to minimise risk of self-harm. [ABSTRACT FROM AUTHOR]

The application of Cognitive Behavioural Therapy (CBT) skills are believed to be a mechanism of therapeutic change in treatment. Research has shown that the application of CBT skills affects outcomes, however, the way these relationships may change during treatment has not been explored. In this study, a naturalistic observational approach is used to examine the relationships between patients' wellbeing, symptoms, and the application of CBT skills throughout treatment. It is hypothesized that the application of CBT skills would lead to an increase in patients reported wellbeing, and a decrease in symptoms. Additionally, it was hypothesized that the application of CBT skills affects wellbeing and symptoms at different points in therapy. A sample of 584 patients in a two-week CBT treatment completed session-to-session measures of wellbeing, symptoms, and their application of CBT skills. Results of an autoregressive cross-lagged path analysis indicated that in the early stages of treatment the application of CBT skills predicted patient wellbeing but not symptoms. At the later stages of therapy, the application of CBT skills predicted both patient wellbeing and symptoms. At no point in treatment did patient wellbeing or symptoms predict the later application of CBT skills. Implications and future directions for research are discussed. [ABSTRACT FROM AUTHOR]

Objective: This study presents rates of suicide thoughts and behaviours of police and emergency services personnel around Australia. In addition, it examines personal (i.e. mental health, substance use) and working environment risk and protective factors. Method: A stratified random sample of personnel from 33 Australian emergency services organisations were invited to participate in a mental health and wellbeing survey. In total, 14,868 Australian ambulance, fire and rescue, police and state emergency services employees participated and self-reported any suicidal thoughts, plans and/or attempts in the 12 months prior to the survey or at any stage in their life. Logistic regressions assessed factors associated with suicidal thoughts and behaviours. Results: Employees reported notably higher rates of suicidal thoughts and plans than the general Australian adult population, but not attempts. Male, single/divorced, non-heterosexual or longer-serving employees reported higher rates of suicidal thoughts and behaviours across each sector. Perceptions of stigma regarding mental health conditions from others in the workplace, negative impact of work on one's private life and low meaning of work were associated with suicidal thoughts, while bullying significantly differentiated who planned and attempted suicide from those who reported suicidal thoughts only. Higher resilience and social support were associated with lower suicidal thoughts, while intermittent explosive anger and illegal drug use were associated with higher rates of suicidal thoughts. Post-traumatic stress disorder symptoms significantly differentiated who planned suicide, while misuse of prescription drugs and psychological distress differentiated who attempted suicide from those who only reported suicidal thoughts. Conclusion: Amid inherently stressful occupations, it is important that workplaces function in a way that supports their personnel. Access to mental health services should be promoted and readily available to personnel. [ABSTRACT FROM AUTHOR]