Search

Psychology is a high burnout profession; however, little empirical research has examined the emotional labour (i.e., surface acting, deep acting, expression of naturally felt emotions) of psychologists who provide psychological therapy. The present study examined whether a relationship exists between emotional labour and wellbeing (operationalised as burnout and affective symptoms) in this sample, and whether individual or work-related factors moderate this relationship. 113 Australian psychologists who provide regular psychological therapy responded to an anonymous, online, cross-sectional survey. This survey collected information on demographic and workplace variables; it also contained measures of emotional labour and wellbeing. The results indicated that, at a bivariate level, surface acting was a significant predictor of adverse wellbeing; deep acting had no predictive qualities; and the expression of naturally felt emotions was a significant predictor of improved wellbeing. Surface acting appeared to be the most salient predictor, and its relationship to burnout was moderated by compensation type. Reported rates of burnout were high within our sample, and our findings suggest that the masking of emotions by psychologists (i.e., surface acting) may be a contributing factor to adverse wellbeing. These findings carry implications for psychological training and practice. What is already known about this topic: Psychologists work in emotion-eliciting environments, which can necessitate the regulation of their emotions. Across industries, burnout arises when demands exceed resources; for psychologists, this may include instances in which the emotional demands of their work exceed their capacity to regulate effectively. Emotional labour, or the regulation of emotions in the workplace, is a reliable predictor of adverse wellbeing in the general working population; however, there has been little empirical examination of emotional labour in psychologists. What this topic adds: Psychologists who provide therapy report high rates of burnout. Psychologists adopt each emotional labour strategy (surface acting, deep acting, expression of naturally felt emotions) at comparable rates to previously published rates for workers in other work domains. Surface acting is a salient predictor of burnout in psychologists, even when controlling for the engagement in deep acting or the expression of naturally felt emotions. [ABSTRACT FROM AUTHOR]

Background: One reason that motivational interviewing (MI) is thought to translate well to a variety of treatment domains is due to the focus on client ambivalence. Aims: Therefore, the current study aimed to explore the construct of ambivalence in the context of MI and cognitive behavioural therapy (CBT) for social anxiety disorder (SAD). Method: Participants were 147 individuals diagnosed with SAD who were randomised to receive either MI or supportive counselling prior to receiving group CBT for SAD. Results: The results suggested that MI was not related to decreases in general ambivalence or treatment ambivalence, although an indicator of treatment ambivalence was found to predict worse treatment outcome. Conclusions: The findings suggest that three sessions of MI prior to CBT may not decrease ambivalence in participants with SAD, which may underscore the potential importance of tackling ambivalence as it arises during CBT. [ABSTRACT FROM AUTHOR]

Objectives Design Methods Results Conclusions A life interference measure specifically designed for young adults with anxiety and depressive symptoms does not currently exist. This paper describes the development and psychometric evaluation of a brief self‐report measure of life interference associated with young adult anxiety and depression, the Child Anxiety and Depression Life Interference Scale – Young Adult version (CADLIS‐YA).Cross‐sectional, correlational and exploratory factor analysis (EFA).Five‐hundred and thirty‐two participants aged 18–24 years recruited from an undergraduate and community sample completed the CADLIS‐YA.An EFA supported a three‐factor model describing the impact of young adult anxiety and depression on social life, family and daily life interference. Test–retest reliability and internal consistency were good to excellent. Convergent validity was demonstrated, and the scale differentiated between young adults with and without elevated anxiety and depressive symptoms. Support for divergent validity was limited.The CADLIS‐YA is a reliable and valid life interference measure for young adults with symptoms of anxiety and depression. It is potentially suitable for administration in low‐resource research settings and it has promise for use in clinical settings; however, it needs validation in a clinical sample. [ABSTRACT FROM AUTHOR]

Background: We examined whether providing three sessions of treatment based on motivational interviewing (MI) prior to Cognitive Behavioral Therapy (CBT) for Social Anxiety Disorder (SAD) improved outcomes.Methods: Participants diagnosed with SAD (N = 186) were randomly allocated to receive three sessions of MI (MI+CBT; n = 85) or supportive counselling (SC+CBT; n = 101) prior to a 12-week group CBT program. Assessments occurred at baseline, after preparatory treatment, after CBT, and at 6-months follow-up. Outcomes were expectations for change, number of CBT sessions attended, self- and clinician-rated CBT homework completion, and self- and clinician-rated social anxiety severity.Results: Conditions did not differ significantly on expectations for change, number of CBT sessions attended, or clinician-rated homework completion. Self-rated homework completion was greater in MI+CBT than in SC+CBT. Change over time in social anxiety severity did not differ between conditions overall, however, this outcome was significantly moderated by two variables; those in MI+CBT, as compared to SC+CBT, showed significantly poorer outcomes on self-reported social anxiety severity if they were higher in change readiness and significantly better outcomes on clinician-rated social anxiety severity if they were higher in functional impairment.Limitations: Although therapists in MI sessions were rated as behaving more consistently with MI than therapists in SC sessions, some MI consistent behaviors occurred in the SC sessions.Conclusions: Addition of a MI-based discussion prior to evidence-based CBT appears to benefit people with SAD who have high functional impairment but may interfere with outcomes for those higher in readiness for change. [ABSTRACT FROM AUTHOR]

Background: Attention biases figure prominently in CBT models of social anxiety and are thought to maintain symptoms of social anxiety disorder (SAD). Studies have shown that individual differences in pre-treatment attention biases predict cognitive behavioural therapy (CBT) outcome. However, these findings have been inconsistent as to whether vigilance towards threat predicts better or poorer treatment outcome. Adult attachment style is an individual characteristic that may influence the relationship between attention bias and SAD. This study investigates the relationship between attention biases and CBT treatment outcome for SAD. Furthermore, we examined the influence of adult attachment style on this relationship.Method: Participants with a primary diagnosis of SAD completed a passive viewing (measuring vigilance towards threat) and a novel difficulty to disengage (measuring difficulty to disengage attention) eye-tracking task prior to attending 12 CBT group sessions targeting SAD. Symptom severity was measured at pre- and post-treatment. Regression analyses were conducted on a sample of 50 participants.Results: Greater vigilance for threat than avoidance of threat at pre-treatment predicted poorer treatment outcomes. Greater difficulty disengaging from happy faces, compared to neutral faces, predicted poorer treatment outcomes. Attachment style did not moderate these relationships.Limitations: The associations between attention biases and specific components of CBT treatment were not examined. The novel findings regarding difficulty to disengage attention require replication.Conclusions: The findings have implications for the theoretical models of SAD and for the treatment of SAD. [ABSTRACT FROM AUTHOR]

Self-related constructs feature prominently in cognitive models of both social anxiety and depression. However, few studies have simultaneously investigated the unique relationship between self-related constructs and social anxiety and depression, while also controlling for the association between the two variables. In the present study, 522 undergraduate students completed measures of maladaptive self-beliefs, self-esteem, self-criticism, self-focused attention, self-concept clarity, social comparison, and social anxiety and depression. Bivariate correlations demonstrated that self-related constructs not only significantly correlated with social anxiety but also with depression and other self-variables. When entered simultaneously, multiple regression analyses indicated that maladaptive self-beliefs were uniquely and positively associated with social anxiety and depression, while self-esteem and self-concept clarity were uniquely and negatively associated with social anxiety and depression. A unique positive association between private self-consciousness and depression was also found. Maladaptive self-beliefs and self-esteem were the constructs most strongly associated with social anxiety and depression respectively. These findings underscore the importance of a negative self-concept even in subclinical presentations and suggest that several key self-related constructs may represent transdiagnostic vulnerability factors linking social anxiety and depression. Future research should continue to uncover unique relationships between self-related variables and social anxiety and depression in both clinical and non-clinical samples. [ABSTRACT FROM AUTHOR]

A consistent feature across cognitive-behavioural models of social anxiety disorder (SAD) is the central role of the self in the emergence and maintenance of the disorder. The strong emphasis placed on the self in these models and related empirical research has also been reflected in evidence-based treatments for the disorder. This systematic review provides an overview of the empirical literature investigating the role of self-related constructs (e.g., self-beliefs, self-images, self-focused attention) proposed in cognitive models of SAD, before examining how these constructs are modified during and following CBT for SAD. Forty-one studies met the inclusion criteria. Guided by Stopa's (2009a, b) model of self, most studies examined change in self-related content, followed by change in self-related processing. No study examined change in self-structure. Pre- to post-treatment reductions were observed in self-related thoughts and beliefs, self-esteem, self-schema, self-focused attention, and self-evaluation. Change in self-related constructs predicted and/or mediated social anxiety reduction, however relatively few studies examined this. Papers were limited by small sample sizes, failure to control for depression symptoms, lack of waitlist, and some measurement concerns. Future research directions are discussed. [ABSTRACT FROM AUTHOR]

While cognitive behavioral therapy (CBT) is considered an evidence based treatment for a range of disorders, individuals differ in their response to treatment. Research investigating the pre-treatment factors that can predict better response to CBT is important because it allows identified factors to be addressed prior to commencing standard CBT protocols, enables modifications to be made to standard CBT protocols, or provides information about suitability for CBT. Pre-treatment attitudes aligned with therapy is a potential predictor of outcome, yet no self-report measure exists. This three-study paper reports on the development of a short self-report measure of attitudes aligned with CBT, named the CBT Suitability Scale (CBT-SUITS). Items were developed rationally based on theoretical models of CBT. Results in community and treatment seeking samples show that the instrument has a clear factor structure and adequate reliability. Results in community samples show that the instrument measures attitudes distinct from symptom severity and predicts CBT credibility. While further research in clinical settings is needed, the CBT-SUITS is an important measure of attitudes aligned with CBT for use in research and clinical practice. [ABSTRACT FROM AUTHOR]

Objective: The current study systematically reviews evidence for a causal chain model suggested by Miller and Rose to account for the efficacy of Motivational Interviewing (MI). Method: Literature searches were conducted to identify studies delivering MI in an individual format to treat various problem areas. Results: Thirty-seven studies met inclusion criteria. The results suggest that when clinicians utilise MI consistent behaviours, clients are more likely to express language in favour of change. Furthermore, this client language was consistently related to positive client outcome across studies. Conclusions: While the results support some parts of the Miller and Rose model, additional research is needed to confirm the findings in diverse populations. Understanding the mechanisms of MI's effectiveness may maximise the implementation of MI, potentially contributing to better client outcomes. [ABSTRACT FROM AUTHOR]

The present study examined the reciprocal relationships between probability estimates, cost estimates, and social anxiety during a 12-week course of cognitive-behaviour therapy (CBT) for social anxiety disorder (SAD). One hundred and sixty-three individuals with a principal diagnosis of SAD completed a weekly tracking measure that included questions about probability and cost estimates for negative consequences and current levels of social anxiety relating to a hypothetical speech task. Paired-samples t tests revealed that these variables changed from pre-to-post treatment. Cross-lagged path analyses revealed that cost estimates predicted subsequent changes in social anxiety levels early in treatment, over and above previous anxiety ratings, while probability estimates predicted subsequent levels of social anxiety at the final stages of treatment, over and above previous anxiety ratings. Overall, the results indicated that (1) cost bias early in treatment predicts subsequent social anxiety levels, and (2) both probability and cost estimates seem to play important, but seemingly independent, roles as mechanisms of change in CBT for SAD. [ABSTRACT FROM AUTHOR]

Motivational interviewing (MI) has proven useful in the treatment of a variety of mental health problems, however the mechanisms of MI's success within these populations remain unknown. This review is a first attempt to investigate and meta-analyse MI mechanisms of change research conducted with participants who suffer mood, anxiety, psychotic, eating disorders, and comorbid conditions. Twenty studies met inclusion criteria and examined a range of potential MI mechanisms, including patient motivation and confidence, patient resistance, and engagement. Results indicated that while MI did not increase patient motivation more so than did comparison conditions, MI showed a favourable effect on patient engagement variables. However, medium to high levels of heterogeneity were detected for patient engagement, indicating significant differences between studies. Heterogeneity was somewhat explained through subgroup analyses examining the effect of comparison condition and participant diagnosis. Overall, there were few MI mechanisms of change available for review, though the results suggest that patient engagement with treatment may be a potential mechanism of change in populations diagnosed with anxiety, mood, and psychotic disorders. [ABSTRACT FROM AUTHOR]

Support from social networks is generally considered to protect against mental disorder but in some circumstances support for negative behaviours (such as avoidance) may be counterproductive. Given the critical interplay between social anxiety disorder and social interactions, it is surprising that the relationship of support from significant others to this disorder has received so little attention. The current study evaluated the reciprocal relationships between perceived social support and perceived partner support for avoidance behaviours (avoidance support) among a sample of 131 participants with social anxiety disorder who were assessed three times within the context of a treatment outcome study. A new measure of partner support for avoidance behaviours was developed, called the Avoidance Support Measure, and showed adequate internal consistency and construct validity. Correlations at baseline showed significant negative relationships between perceived social support and social anxiety and significant positive relationships between avoidance support and social anxiety. Path analysis showed that perceived social support at Times 1 and 2 negatively predicted future social anxiety at Times 2 and 3. On the other hand, only a single predictive relationship involving avoidance support was significant and showed that social anxiety at Time 1 positively predicted avoidance support at Time 2. These early results point to the different ways that support from significant others might relate to social anxiety and suggest that further work in this area may be fruitful. [ABSTRACT FROM AUTHOR]

The aim of this pilot study was to investigate the impact of the direct treatment of perfectionism on the outcome of perfectionism and eating disorder pathology. Sixty-one participants, attending day hospital treatment, participated in a randomised controlled study, in which treatment as usual (TAU) was compared with TAU combined with a clinician-lead cognitive behavioural treatment for perfectionism (TAU + P). Linear mixed model analysis revealed no significant interaction effects but significant main effects for time on variables measuring eating pathology and perfectionism. Outcomes supported the effectiveness of overall treatment but suggested that adding direct treatment of perfectionism did not enhance treatment. The results are discussed in relation to the existing literature on the treatment of perfectionism. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

The aim of the study was to survey a group of clinicians who identify themselves as experienced in treating social anxiety disorder using cognitive behavioural treatment (CBT) with regard to the characteristics of clients which they think, based on their experience, are predictive of poor or good CBT outcome. Fifty-four practising clinicians responded to an email inviting participation in a research study of clinicians’ opinions about client characteristics that may be important in CBT outcome for social anxiety. Participants completed open-ended questions about, and made ratings of the importance of, client characteristics that they believed impact upon the outcome of CBT for social anxiety disorder. Motivation for seeking treatment, comorbidity, and intellect or reasoning ability were nominated most frequently by clinicians as having an effect on CBT outcome. Acceptance of the CBT rationale/model, ability to take responsibility for change, motivation/reason for seeking treatment, and ability to develop an alliance were all rated by participants as being important in contributing to CBT outcome. The results provide direction for future empirical research on client characteristics as predictors of CBT outcome. [ABSTRACT FROM PUBLISHER]

Background: Peer victimization and anxiety frequently co-occur and result in adverse outcomes in youth. Cognitive behavioural treatment is effective for anxiety and may also decrease children's vulnerability to victimization. Aims: This study aims to examine peer victimization in youth who have presented to clinical services seeking treatment for anxiety. Method: Following a retrospective review of clinical research data collected within a specialized service, peer victimization was examined in 261 children and adolescents (55.6% male, mean age 10.6 years, SD = 2.83, range 6–17 years) with a diagnosed anxiety disorder who presented for cognitive behavioural treatment. Youth and their parents completed assessments of victimization, friendships, anxiety symptoms, and externalizing problems. Results: High levels of victimization in this sample were reported. Children's positive perceptions of their friendships were related to lower risk of relational victimization, while conduct problems were related to an increased risk of verbal and physical victimization. A subsample of these participants (n = 112, 57.1% male, mean age 10.9 years, SD = 2.89, range 6–17 years) had completed group-based cognitive behavioural treatment for their anxiety disorder. Treatment was associated with reductions in both self-reported anxiety and victimization. Results confirm the role of friendships and externalizing symptoms as factors associated with increased risk of victimization in youth with an anxiety disorder in a treatment-seeking sample. Conclusions: Treatment for anxiety, whether in a clinic or school setting, may provide one pathway to care for young people who are victimized, as well as playing a role in preventing or reducing victimization. [ABSTRACT FROM AUTHOR]

The present study explored whether particular discrepancies among an individual's self-beliefs, as described by Higgins’ (1987) Self-Discrepancy Theory, were differentially related to the two broad situational domains of social anxiety: performance and social interaction anxiety. Fifteen people (4 males) with a primary diagnosis of GSP from Macquarie University's Emotional Health Clinic, and 25 undergraduate psychology students from Macquarie University (8 males) with mean chronological ages of 31.7 and 20.6 years respectively, participated in the study. As predicted, the study found that the ‘actual/other:ought/other’ self-discrepancy was uniquely related to performance anxiety, the ‘actual/own:ought/other’ self-discrepancy was uniquely associated with social interaction anxiety, and the ‘actual/own:ideal/own’ self-discrepancy was uniquely associated with depression. The results are discussed in terms of their unique contribution to Self-Discrepancy Theory research, the current empirical debate regarding the existence of subtypes within social phobia, and their implications for the cognitive models and treatment of social anxiety. [ABSTRACT FROM PUBLISHER]

The Personal Experiences Checklist (PECK) was developed to provide a multidimensional assessment of a young person's personal experience of being bullied that covered the full range of bullying behaviors, including covert relational forms of bullying and cyber bullying. A sample of 647 school children were used to develop the scale, and a 2nd sample of 218 children completed the PECK and a battery of measures of bullying (including peer nomination), anxiety, depression, and self-esteem, to provide validity evidence. Test-retest reliability was assessed in a further sample of 78 students. Four factors emerged from a principal axis factoring consistent with the domains of relational-verbal bullying, cyber bullying, physical bullying, and bullying based on culture and were confirmed with confirmatory factor analysis. The data also supported a higher order bullying factor with direct effects on these 4 factors. All PECK scales showed good to excellent internal consistency (Cronbach's a range = .78-.91) and adequate test-retest reliability (range r = .61-.86). Most, but not all, expected relations were found with alternative methods of assessing bullying and measures of psychopathology. Taken together, the PECK provides a promising comprehensive and behaviorally focused dimensional measure of bullying. [ABSTRACT FROM AUTHOR]

Shortened forms of the Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale ISPS) were developed using nonparametric item response theory methods. Using data from socially phobic participants enrolled in 5 treatment trials (N = 456). 2 six-item scales (the SIAS-6 and the SPS-6) were developed. The validity of the scores on the SIAS-6 and the SPS-6 was then tested using traditional methods for their convergent validity in an independent clinical sample and a student sample, as well as for their sensitivity to change and diagnostic sensitivity in the clinical sample. The scores on the SIAS-6 and the SPS-6 correlated as well as the scores on the original SIAS and SPS, with scores on measures of related constructs, discriminated well between those with and without a diagnosis of social phobia, providing cutoffs for diagnosis and were as sensitive to measuring change associated with treatment as were the SIAS and SPS. Together. the SIAS-6 and the SPS-6 appear to be an efficient method of measuring symptoms of social phobia and provide a brief screening tool. [ABSTRACT FROM AUTHOR]

Objective: The risks of anorexia nervosa (AN) are well established. Despite its severity, little certainty exists for practitioners, with ethical and financial limitations yielding few controlled studies establishing effective treatments. Thus, other methods of establishing treatment effectiveness are necessary. This study presents preliminary results of an open clinical trial of a day program for adolescents with AN. Method: Participants were 26 anorectic females, 12-18 years, who completed the ''Transition Program.'' Results: Significant change emerged on measures of weight gain, and behavioral and attitudinal measures of eating pathology. Large effect sizes were evident for weight gain at 6 month follow-up. Preliminary trends suggest that treatment gains on these and other measures of eating pathology were maintained at 6 month follow-up. Discussion: Preliminary results support day program treatment for adolescents with mild-moderately severe eating disorders. Present outcomes are discussed with respect to the dearth of efficacious treatment options for adolescents. [ABSTRACT FROM AUTHOR]

This study examined the relationship between social fears and the three subscales of the Anxiety Sensitivity Index (ASI) in a non-clinical, student sample. In particular, the unique variance that the three ASI factors accounted for in social scrutiny fears, social interaction fears, and fear during a social challenge was investigated. Anxiety Sensitivity-Social Concern (AS-Social Concern) was hypothesised to account for a significant proportion of the variance in social fears compared to the other two subscales. Seventy one university students completed a series of psychological-based questionnaires and participated in a social challenge (videotaped speech task). Contrary to prediction, AS-Social Concern did not account for a unique proportion of the variance in social fears, but AS-Physical Concern and AS-Mental Concern did account for unique variance in social fears. Results are interpreted in light of recent findings on the structure of ASI. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to describe the eAdmissions National Project and provide some insights into a selection of the forms of research which have been conducted to inform the Project effectively. Design/methodology/approach - Four different kinds of studies are described as examples of different themes being pursued towards developing a better understanding of parents'/carers' needs and providing information and guidelines to help local authorities achieve their objectives in relation to online school admissions. Findings - The paper finds that the success of the work undertaken by the National Project is reflected in the increasing numbers of local authorities (LAs) that have already, or are in the process of, offering an online school admissions facility, as well as in the take-up of this service by parents/carers within some of these authorities. Research undertaken by the Project has been key to this success and is now being directed towards the important issue of effecting significant take-up of the online service by all local authorities that have responsibility for education. The outcomes from this research work have been applied to spread good practice, share information with all LAs and inform marketing campaigns. The effects of this research are beginning to be evidenced in the growing take-up of online admissions. Research limitations/implications - While some of the research undertaken is specific to the requirements of the eAdmissions National Project, some of the approaches developed and data gathered may be applicable to projects of a similar nature where online services need to be made available to and taken up by particular sectors of the public. Originality/value - This paper provides a source of information to interested parties on the aims and early achievements of the eAdmissions National Project. Further and more detailed information can be found at www.eadmissions.org [ABSTRACT FROM AUTHOR]

Focuses on a study that examined the validity of social phobia and anxiety inventory (SPAI), social phobia scale (SPS) and social interaction anxiety scale (SIAS). Methodology; Results and discussion.

Background: Predicting response to cognitive behavior therapy (CBT) assists efforts to enhance treatment outcome when predictive factors are modifiable prior to, or during, treatment. The extent to which clients hold beliefs and attitudes consistent with CBT (termed CBT-mindedness) is a relatively new concept with research suggesting it predicts response to CBT amongst small samples of adults with anxiety. This study aimed to investigate CBT-mindedness amongst a larger clinical population receiving internet-delivered CBT (iCBT). Method: 1132 adults with anxiety, depression or mixed anxiety and depression who accessed iCBT with or without therapist support via the THIS WAY UP clinic completed a brief self-report measure of CBT-mindedness along with measures of distress, anxiety, and depression. Measures were completed pre- and post-treatment. Results: The 3-factor structure of the CBT Suitability Scale (CBT-SUITS) was confirmed and scores were unrelated or very weakly related to symptoms/distress. CBT-mindedness increased amongst treatment completers. CBT-mindedness predicted post-treatment distress (but not symptoms), and change in CBT-mindedness predicted lower post-treatment symptoms and distress. Conclusions: The CBT-SUITS represents a psychometrically sound measure of CBT-mindedness. Results amongst this large sample of adults accessing iCBT in a community service indicate that CBT-mindedness (or CBT-mindedness change) is an important predictor of therapy response. [ABSTRACT FROM AUTHOR]

This paper describes the development and psychometric evaluation of a brief self‐report measure (BEACON) to inform universal mental health screening in schools. Items assess symptoms and impairment associated with anxiety and attention/hyperactivity problems (grades 4–11) as well as depression and eating difficulties (grades 6–11), with optional items for suicidality and self‐harm (grades 7–11). Initial item examination based on Item Response Theory (IRT) and classical test theory involved 3844 students in grades 4 through 11 (Study 1) and identified 18 items for grades 4–5 and 31 items for grades 6–11 that fulfilled pre‐set criteria. Study 2 extended testing with 10,479 students in grades 4–11 and added an additional four items assessing impairment associated with eating difficulties for older students (grades 6–11) creating a total of 35 items for grades 6–11. All items, for both grade‐level versions, met the pre‐set criteria for IRT and classical test theory analysis supporting their strength in the measurement of the dimensions of concern. The measure showed good reliability (subscale alphas.87 to.95). Validity was also demonstrated against standard symptom measures, school grades, school absenteeism, and help‐seeking. The BEACON appears to be a psychometrically sound measure to use in the first stage of school‐based screening for mental health problems. [ABSTRACT FROM AUTHOR]

The assumption that participants receiving an ICDW diagnosis of posttraumatic stress disorder (PTSD) will also receive a DSM-IV diagnosis of PTSD was tested. Data were gathered for 1,364 participants using the Composite International Diagnostic Interview (CIDI). The12-month prevalence of PTSD was 3% for DSM-IV and 7% for ICD10 Diagnostic Criteria for Research (ICD10-DCR). The agreement between the two systems was fair (kappa = .50). Forty eight percent of the discrepancies between the systems were accounted for by the additional criterion requiring clinically significant distress or impairment included in DSM-IV. The inclusion of symptoms of general numbing of responsiveness accounted for 18% of the discrepancies. It is concluded that ICD10-DCR PTSD cannot be assumed to be identical to DSM-IV PTSD. [ABSTRACT FROM AUTHOR]

Background and objective: Motivational interviewing (MI) was originally developed to treat problematic drinking but is increasingly integrated into treatment for anxiety disorders. A causal model has been proposed which suggests technical and relational factors may account for the efficacy of MI. The technical hypothesis suggests that therapist MI-consistent behaviours are related to client change talk, and change talk is linked to treatment outcome. Research examining the technical hypothesis has typically been conducted in MI for substance use; therefore, the current study aimed to explore the technical hypothesis in MI for social anxiety disorder (SAD). Method: Participants diagnosed with SAD (n = 85) each received MI prior to receiving group cognitive-behavioural therapy (CBT). MI sessions were coded for behaviours relevant to the MI technical hypothesis. Results: The proportion of MI-consistent therapist behaviours and reflections of change language significantly predicted the proportion of change talk by the client during MI sessions; however, therapist and client behaviours did not predict treatment outcome. Conclusion: The findings support one path of the MI causal model in the context of social anxiety, though indicate that the occurrence of these behaviours during an MI pre-treatment may not extend to predict treatment outcome following CBT. [ABSTRACT FROM AUTHOR]

While CBT is considered efficacious for a range of mental health conditions, identifying pre-treatment predictors of differential response to CBT is an important direction for research. This study investigated whether pre-treatment attitudes aligned with cognitive behaviour therapy (CBT) (termed CBT-mindedness) predicts CBT outcome within a clinical sample of adults diagnosed with social phobia (N = 50). Pre-treatment CBT-mindedness, measured by the CBT Suitability Scale, was found to predict treatment outcome immediately and 3 months following treatment. Higher CBT-mindedness was associated with lower clinician-rated diagnostic severity and client self-reported social anxiety symptoms following CBT. CBT-mindedness predicted self-reported, but not clinician-reported severity, even when controlling for existing client-factors that predict outcome (expectancy for symptom change and treatment credibility). However, CBT-mindedness was not associated with therapy session attendance. Results suggest that pre-treatment CBT-mindedness is a promising predictor of CBT outcome. Clinical implications for this predictor of CBT response are discussed. [ABSTRACT FROM AUTHOR]

Objective The aim of the present study is to assess the bidirectional associations between therapist and client speech during a treatment based on motivational interviewing (MI) for social anxiety disorder. Method Participants were 85 adults diagnosed with social anxiety who received MI prior to entering cognitive behavioral therapy. MI sessions were sequentially coded using the Motivational Interviewing Skill Code 2.5. Results Therapist MI-consistent behaviors, including open questions as well as positive and negative reflections, were more likely to be followed by client change exploration (change talk and counter-change talk). Therapist MI-inconsistent behaviors were more likely to precede client neutral language. Client language was also found to influence therapist likelihood of responding in an MI-consistent manner. Conclusion The findings support the first step of the MI causal model in the context of social anxiety and direct future research into the effect of therapist and client behaviors on MI treatment outcome. [ABSTRACT FROM AUTHOR]

Theoretical models of social anxiety propose that attention biases maintain symptoms of social anxiety. Research findings regarding the time course of attention and social anxiety disorder have been mixed. Adult attachment style may influence attention bias and social anxiety, thus contributing to the mixed findings. This study investigated the time course of attention toward both negative and positive stimuli for individuals diagnosed with social anxiety disorder (SAD) and assessed whether attachment style moderates this relationship. One hundred and thirty participants (age: M=29.03) were assessed using a semistructured clinical interview. Those meeting eligibility criteria for the clinical sample met DSM-IV criteria for SAD (n=90, age: M=32.18), while those in the control sample did not meet criteria for any mental disorder (n=23, age: M=26.04, 11 females). All participants completed self-report measures examining depression, social anxiety, adult attachment style, and completed an eye-tracking task used to measure the time course of attention. Eye-tracking data were analysed using growth curve analysis. The results indicate that participants in the control group overall displayed greater vigilance towards emotional stimuli, were faster at initially fixating on the emotional stimulus, and had a greater percentage of fixations towards the emotional stimulus as the stimulus presentation time progressed compared to those in the clinical group. Thus, the clinical participants were more likely to avoid fixating on emotional stimuli in general (both negative and positive) compared to those in the control group. These results support the Clark and Wells (1995) proposal that socially anxious individuals avoid attending to emotional information. Attachment style did not moderate this association, however anxious attachment was related to greater vigilance toward emotional compared to neutral stimuli. [ABSTRACT FROM AUTHOR]

The use of empirically supported treatment (EST) has been shown to enhance treatment outcome. The purpose of this case study was to suggest that ESTs further encourage effective reconceptualisation and the ongoing delivery of effective treatment, especially in the case of complex or atypical presentations or response to treatment. This report describes the case of an adolescent girl who underwent Maudsley family-based treatment for anorexia nervosa (AN) for a period of 12 months. Atypical response lead to an understanding of her presentation as representing a primary conversion disorder, within which AN symptoms were conceptualised as another somatic conversion of emotional distress. The report details her clinical presentation and management over the course of her illness. The case offers an important opportunity to explore the central role of the use of ESTs in guiding effective treatment delivery. [ABSTRACT FROM PUBLISHER]

This study is a replication and extension of previous research investigating the relationship between specific, maladaptive aspects of perfectionism and social phobia. The Multidimensional Perfectionism Scale (MPS-F; R. O. Frost, P. Marten, C. Lahart, & R. Rosenblate, 1990) was administered to a consecutive series of adult outpatients (N = 61) attending a group-based cognitive–behavioral treatment program for social phobia. MPS-F variables, Concern over Mistakes (CM) and Doubts about Actions (DA), were both associated with social anxiety severity at pretreatment. Despite the theoretical relevance of the CM dimension to social anxiety, the relationship between these two constructs did not remain significant once neuroticism and depression were controlled. Contrary to predictions, CM failed to predict treatment outcome beyond pretreatment social anxiety. Results are discussed in terms of the overlap between perfectionistic concern about mistakes and fear of negative evaluation in social phobia. [ABSTRACT FROM AUTHOR]

The current study developed and examined the performance of a computerized adaptive version of the Social Interaction Anxiety and Social Phobia Scales (SIAS/SPS) and compared results with a previously developed static short form (SIAS-6/SPS-6) in terms of measurement precision, concordance with the full forms, and sensitivity to treatment. Among an online sample of Australian adults, there were relatively minor differences in the performance of the adaptive tests and static short forms when compared with the full scales. Moreover, both adaptive and static short forms generated similar effect sizes across treatment in a clinical sample. This provides further evidence for the use of static or adaptive short forms of the SIAS/SPS rather than the lengthier 20-item versions. However, at the individual level, the adaptive tests were able to maintain an acceptable level of precision, using few items as possible, across the severity continua in contrast to the static short forms. [ABSTRACT FROM AUTHOR]

Background: Cultural factors influence both the expression of social anxiety and the interpretation and functioning of social anxiety measures. This study aimed to test the measurement equivalence of two commonly used social anxiety measures across two sociocultural contexts using individuals with social anxiety disorder (SAD) from Australia and Japan.Methods: Scores on the straightforwardly-worded Social Interaction Anxiety Scale (S-SIAS) and the Social Phobia Scale (SPS) from two archival datasets of individual with SAD, one from Australia (n = 201) and one from Japan (n = 295), were analysed for measurement equivalence using a multigroup confirmatory factor analysis (CFA) framework.Results: The best-fitting factor models for the S-SIAS and SPS were not found to be measurement equivalent across the Australian and Japanese samples. Instead, only a subset of items was invariant. When this subset of invariant items was used to compare social anxiety symptoms across the Australian and Japanese samples, Japanese participants reported lower levels of fear of attracting attention, and similar levels of fear of overt evaluation, and social interaction anxiety, relative to Australian participants.Limitations: We only analysed the measurement equivalence of two social anxiety measures using a specific operationalisation of culture. Future studies will need to examine the measurement equivalence of other measures of social anxiety across other operationalisations of culture.Conclusions: When comparing social anxiety symptoms across Australian and Japanese cultures, only scores from measurement equivalent items of social anxiety measures should be used. Our study highlights the importance of culturally-informed assessment in SAD. [ABSTRACT FROM AUTHOR]

Given the putative importance of maladaptive self-beliefs in cognitive models of social anxiety, there is growing interest in the construct’s influence on social anxiety reduction in treatment. The present study sought to examine whether maladaptive self-beliefs reduce over a 12-week course of cognitive behavioural therapy (CBT) for social anxiety disorder (SAD), and whether change in self-beliefs is an indicator of later change in social anxiety symptom severity within treatment. Participants were 77 individuals with SAD who completed measures of maladaptive self-beliefs every 2 weeks of the treatment protocol and measures of social anxiety each week. Using a dynamic bivariate latent difference score framework, results indicated that maladaptive self-beliefs reduced during CBT for SAD, and that change in maladaptive self-beliefs was a significant predictor of later change in social anxiety symptom severity. Reductions in social anxiety was not a significant predictor of later change in self-beliefs. Findings underscore the importance of maladaptive self-beliefs in the maintenance of social anxiety and in treatment for SAD. Moreover, they permit inferences about the temporal sequence of change processes in therapy and are consistent with CBT therapeutic models suggesting that cognitive change precedes symptom change. [ABSTRACT FROM AUTHOR]

Anticipatory processing, maladaptive attentional focus, and postevent processing are key cognitive constructs implicated in the maintenance of social anxiety disorder (SAD). The current study examined how treatment for SAD concurrently affects these three cognitive maintaining processes and how these processes are associated with each other as well as with symptom change from pre- to posttreatment. The sample consisted of 116 participants with SAD receiving group cognitive behavioral therapy. All three cognitive maintaining processes were measured relative to a speech task and again relative to a conversation task. Across both tasks, the three cognitive process variables demonstrated decreases from pre- to posttreatment. Within the same task, a slower rate of decrease in a specific cognitive process variable from pre- to posttreatment was predicted from higher pretreatment levels of either one or both of the other cognitive process variables. Additionally, higher levels of pretreatment conversation-related anticipatory processing and maladaptive attentional focus predicted a slower rate of decrease in social anxiety symptoms from pre- to posttreatment. Results are consistent with cognitive models of SAD and have important implications for enhancing existing treatments. [ABSTRACT FROM AUTHOR]

The vigilance-avoidance model of attention, which proposes that anxious individuals will initially be vigilant towards, and subsequently will avoid, threatening stimuli (Mogg, Bradley, deBono & Painter, 1997) has received inconsistent support (Armstrong & Olatunji, 2012). Given that attention biases have been identified in studies examining adult attachment style (Dewitte & De Houwer, 2008), the aim of this study is to examine whether adult attachment style influences the relationship between anxiety and attention biases. The present study used a passive viewing eye-tracking task to examine the effect of anxiety and attachment style on attention to emotional images on initial presentation and over time. Participants were randomly allocated to receive either an anxiety induction (speech task) or not and viewed pairs of images (an emotional (either happy or angry) and neutral face) presented for 1.5 seconds. The results indicate that those exposed to the speech task who scored high on the avoidant attachment dimension were more likely to avoid attending to the emotional (angry and happy) stimuli initially and maintained this pattern of attention over the stimulus presentation time. While attachment avoidance moderated the relationship between attention and anxiety, an anxious attachment style did not have a significant effect. Thus, adult attachment style is an important individual difference to consider within the context of anxiety and attention biases. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The aim of the current study was to integrate recent developments in the retraining of attentional biases towards threat into a standard cognitive behavioural treatment package for social phobia. Method: 134 participants (M age – 32.4: 53% female) meeting DSM-IV criteria for social phobia received a 12-week cognitive behavioural treatment program. They were randomly allocated to receive on a daily basis using home practice, either an additional computerised probe procedure designed to train attentional resource allocation away from threat, or a placebo variant of this procedure. Measures included diagnostic severity, social anxiety symptoms, life interference, and depression as well as state anxiety in response to a laboratory social threat. Results: At the end of treatment there were no significant differences between groups in attentional bias towards threat or in treatment response (all p''s > 0.05). Both groups showed similar and highly significant reductions in diagnostic severity, social anxiety symptoms, depression symptoms, and life interference at post-treatment that was maintained and in most cases increased at 6 month follow-up (uncontrolled effect sizes ranged from d = 0.34 to d = 1.90). Conclusions: The current results do not indicate that integration of information processing-derived attentional bias modification procedures into standard treatment packages as conducted in this study augments attentional change or enhances treatment efficacy. Further refinement of bias modification techniques, and better methods of integrating them with conventional approaches, may be needed to produce better effects. [Copyright &y& Elsevier]

Purpose: The Composite International Diagnostic Interview-Short Form (CIDI-SF) is a short disorder-specific diagnostic interview for common mental disorders. Many researchers have been attracted to the CIDI-SF because of its brevity and cost effectiveness. As a result, the CIDI-SF has been used in multiple epidemiological studies and clinical trials. Despite the widespread use, a search of literature has revealed relatively few validation studies. This investigation aims to provide estimates of concordance and discordance between the CIDI-SF disorder modules and the full CIDI, as well as providing evidence regarding the potential screening utility of the CIDI-SF. Methods: The sample comprised 83 patients attending a tertiary referral clinic for anxiety disorders. Patients were administered the CIDI-SF and the full CIDI-Auto and estimates of agreement between the two measures were calculated. Interview transcripts were examined for cases that disagreed on a diagnosis to elicit a likely reason for the lack of agreement between the two measures. Finally, the screening properties of the dimensionally scored CIDI-SF were calculated and compared with the Depression Anxiety Stress Scale. Results: The CIDI-SF tended to overestimate the rate of diagnoses as evidenced by a high degree of false positives. However, the CIDI-SF exhibited favorable screening properties (ruling out non-disordered cases). Conclusions: These results suggest that caution must be taken when using the CIDI-SF as the sole diagnostic instrument in epidemiological research to estimate prevalence and incidence. The CIDI-SF may be more useful for screening out potential candidates in clinical research and psychopharmacological trials. [ABSTRACT FROM AUTHOR]

This article aims to identify the most efficient ways to teach and learn the professional competencies required in clinical psychology. There are a wide variety of influences on clinical psychology curricula that leads to a lack of coherence in aims and methods. When clinical psychology trainees come face-to-face with their first client, they are challenged to integrate their existing declarative knowledge and apply nascent procedural skills. How can clinical programmes better prepare students for these challenges? Because problem-based learning has been widely applied in medical education it is the starting point in answering this question. Systematic literature searches and a narrative literature review were undertaken to identify teaching methods. Little published research reports randomised controlled evaluations of teaching methods in health professions. Much literature presented opinions about teaching methods. Whole-of-programme evaluations of problem-based learning in medical education were retrieved and directed learning or direct instruction techniques were examined in teaching more specific knowledge. Little research was of direct relevance to clinical psychology training. More research is needed into both the efficacy of clinical psychology training and into the specific barriers that trainee clinical psychologists face. In the absence of good quality research, suggestions for teaching methods are provided. [ABSTRACT FROM AUTHOR]

Objective: The present study (Shyness 7) has two aims: Firstly, to replicate an earlier trial showing that a self-guided Internet treatment for social phobia is efficacious, and secondly, to examine whether the addition of self-guided motivational enhancement strategies improves completion rates and clinical outcomes. Method: Randomized controlled trial (RCT) of self-guided Internet-based cognitive behavioural treatment (iCBT), or iCBT plus self-guided motivational enhancement strategies (iCBT+MS), was conducted. An intention-to-treat and last observation carried forward model was used for data analyses. The participants consisted of 108 volunteers with social phobia. The iCBT intervention consisted of two online lessons about symptoms and treatment of anxiety disorders and six lessons about management of social phobia (the Shyness programme) with complex automated reminders. The motivational intervention was based on traditional techniques including understanding and exploring ambivalence about change using a cost-benefit analysis, developing and resolving discrepancy between values and symptoms, and enhancing self-efficacy for change. The main outcome measures were the Social Interaction Anxiety Scale and Social Phobia Scale. Results: More iCBT+MS group participants completed the eight lessons than iCBT group participants (75% versus 56%, respectively), but there were no between-group differences in outcome measures at post-treatment or at 3 month follow up. Large mean within-groups effect sizes (Cohen's d) for the two social phobia measures were found for both the iCBT and iCBT+ MS groups (1.1 and 0.95, respectively), which were sustained at 3 month follow up (1.06 and 1.07, respectively). Both iCBT and iCBT+MS group participants reported that the procedures were highly acceptable. Conclusions: Both self-guided versions of the Shyness programme were reliably efficacious, confirming that people with social phobia may significantly benefit from a highly structured self-guided intervention. The addition of motivational techniques increased completion rates but did not improve clinical outcomes or acceptability. [ABSTRACT FROM AUTHOR]

Abstract: According to cognitive theories, safety-seeking behaviors are crucial in both the maintenance and management of social anxiety. In order to facilitate assessment of these behaviors the Subtle Avoidance Frequency Examination (SAFE) was developed. Three factors emerged from the SAFE, which appeared to reflect active “safety” behaviors, subtle restriction of behavior, and behaviors aimed at avoiding or concealing physical symptoms. The SAFE demonstrated strong internal consistency, good construct validity and the ability to discriminate between clinical and non-clinical participants. In addition, the SAFE was responsive to the effects of treatment. Given its excellent psychometric properties, the SAFE may be useful to further investigate the role of safety strategies in social anxiety and to assess treatment outcomes. [Copyright &y& Elsevier]

Objectives: It has been previously argued that the methodology used by the Composite International Diagnostic Interview version 2.1 to assess the substance-induced and general medical condition exclusion criteria are inadequate. As a result prevalence estimates generated from epidemiological studies using this interview may be underestimated. The purpose of the current study was to examine the substance-induced and general medical condition exclusion criteria in the Australian National Survey for Mental Health and Well-being and determine the impact that they have on prevalence estimates of the common mental disorders. Method: Data from the 1997 Australian National Survey of Mental Health and Well-being were analysed. Frequencies were generated as an indication of how many respondents believed that their psychiatric symptoms were always due to a substance or general medical condition. New DSM-IV prevalence estimates were calculated ignoring the application of the substance-induced and general medical condition exclusion criteria and compared to standard DSM-IV prevalence estimates. Results: The effect of the substance-induced and general medical condition exclusion criteria on final prevalence rates were minimal, with approximately a 0.1% increase when the exclusions were ignored. This equates to a relative difference ranging from no difference for generalized anxiety disorder to an increase of 12% of the base prevalence estimate for agoraphobia. Conclusions: In surveys that use the Composite International Diagnostic Interview version 2.1 the substance-induced and general medical condition exclusion criteria have a minor impact on determining final case definition in the majority of mental disorders. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to examine the association between trauma and posttraumatic stress disorder (PTSD) and substance use disorders and to examine the correlates of substance use disorder plus PTSD comorbidity in the Australian general population.Method: Data were collected from a stratified sample of 10,641 participants as part of the Australian National Survey of Mental Health and Well-Being. A modified version of the Composite International Diagnostic Interview was used to determine the presence of DSM-IV anxiety, affective, and substance use disorders and ICD-10 personality disorders.Results: Substance use disorder plus PTSD was experienced by a significant minority of the Australian general population (0.5%). Among those with PTSD, the most common substance use disorder was an alcohol use disorder (24.1%), whereas among those with a substance use disorder, PTSD was most common among individuals with an opioid use disorder (33.2%). Consistent with U.S. clinical literature, individuals with substance use disorder plus PTSD experience significantly poorer physical and mental health and greater disability than those with substance use disorder alone. In contrast, individuals with PTSD alone and those with substance use disorder plus PTSD shared a remarkably similar clinical profile.Conclusions: It is important that individuals entering treatment for substance use disorder or PTSD be assessed for this comorbidity. The addition of either disorder may present complications that need to be considered for the provision of appropriate treatment. Further research is necessary to ascertain which treatments are most effective in treating comorbid substance use disorder plus PTSD. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to examine the association between trauma and posttraumatic stress disorder (PTSD) and substance use disorders and to examine the correlates of substance use disorder plus PTSD comorbidity in the Australian general population. Method: Data were collected from a stratified sample of 10,641 participants as part of the Australian National Survey of Mental Health and Well-Being. A modified version of the Composite International Diagnostic Interview was used to determine the presence of DSM-IV anxiety, affective, and substance use disorders and ICD-10 personality disorders. Results: Substance use disorder plus PTSD was experienced by a significant minority of the Australian general population (0.5%). Among those with PTSD, the most common substance use disorder was an alcohol use disorder (24.1%), whereas among those with a substance use disorder, PTSD was most common among individuals with an opioid use disorder (33.2%). Consistent with U.S. clinical literature, individuals with substance use disorder plus PTSD experience significantly poorer physical and mental health and greater disability than those with substance use disorder alone. In contrast, individuals with PTSD alone and those with substance use disorder plus PTSD shared a remarkably similar clinical profile. Conclusions: It is important that individuals entering treatment for substance use disorder or PTSD be assessed for this comorbidity. The addition of either disorder may present complications that need to be considered for the provision of appropriate treatment. Further research is necessary to ascertain which treatments are most effective in treating comorbid substance use disorder plus PTSD. [ABSTRACT FROM AUTHOR]

• Psychometrically evaluated Self-Beliefs related to Social Anxiety (SBSA) scale. • In a sample with social anxiety disorder (SAD), the SBSA exhibited three factors. • The SBSA had good internal consistency. • The SBSA had good construct validity and discriminative validity. • SBSA can be used with individuals with SAD in research and clinical contexts. The Self-Beliefs related to Social Anxiety (SBSA) scale assesses maladaptive social-evaluative beliefs, a key aspect in models of social anxiety disorder (SAD) that is frequently measured in research and clinical contexts. The SBSA has been evaluated psychometrically in student samples, but not in a large sample of individuals diagnosed with SAD. The current study tested the psychometric properties of the SBSA in a sample of individuals with SAD pooled from several studies (total N = 284). Results showed that the optimal factor structure for the SBSA was a correlated three-factor model (high standard beliefs factor, conditional beliefs factor, unconditional beliefs factor). The SBSA total and its subscales (formed based on the factors) exhibited good internal consistency. In terms of construct validity, the SBSA total, the high standard beliefs subscale, and conditional beliefs subscale had stronger associations with a measure of social anxiety than with a measure of depression, although the unconditional beliefs subscale was similarly related to both measures of social anxiety and depression. In terms of discriminative validity, the sample of individuals with SAD had higher SBSA total and subscale scores compared with a sample of individuals without SAD (N = 32). These findings provide a psychometric evidence base justifying the use of the SBSA for the assessment of maladaptive social-evaluative beliefs. [ABSTRACT FROM AUTHOR]