Cognitive behaviour therapy for psychosis: current evidence and future directions

The past decade has seen considerable growth in the evidence base of cognitive behavioural therapy for psychosis. Consistent reports of moderate effect sizes have led to such interventions being recommended as part of routine clinical practice. Most of this evidence is based on a generic form of CBT for psychosis applied to a heterogeneous group. An increase in the effectiveness of cognitive behavioural interventions may require new protocols. Such therapeutic developments should be based on the theoretical understanding of the psychological processes associated with specific forms of psychotic presentation. The current evidence base of CBT for psychosis is reviewed, and barriers that have held back the development of this research are discussed.

Safety behaviour: a reconsideration

There is ample evidence that the use of safety behaviour can interfere with the progress of therapy, particularly if exposure is involved. As a result, it is widely asserted that safety behaviour is anti-therapeutic. However, an unqualified rejection of safety behaviour should be reconsidered because we now have theoretical justification, experimental evidence and clinical observations showing that the judicious use of safety behaviour, especially in the early stages of treatment, can be facilitative. Experiments in which escape behaviour facilitated fear reduction, and others in which the use of safety gear facilitated fear reduction, are reviewed. It also appears that safety behaviour does not necessarily prevent disconfirmatory experiences. We propose that additional investigations of the judicious use of safety behaviour will help to elucidate therapeutic uses of safety behaviour in the treatment of anxious and related types of psychopathology. (c) 2007 Elsevier Ltd. All rights reserved.

Training to address attitudes and behaviour of rural bank managers in Madhya Pradesh, India: a programme to facilitate financial inclusion

Given their physical presence in India, banks are arguably well-placed to improve financial inclusion in rural areas. However, uncertain repayment capacities and high transaction costs mean formal financial institutions are often reluctant to lend to the rural poor. Conversely, high transaction costs in dealing with banks are also incurred by clients, through, for example, lengthy, cumbersome and potentially ignominious procedures. Negative attitudes towards poor clients can be an important component of such transaction costs. An applied research project funded by the Enterprise Development Innovation Fund (EDIF-DFID) developed an innovative training programme designed to encourage more positive attitudes of bank staff towards poor clients, and towards their own role in rural poverty alleviation and development. This paper examines the development of the training programme, its implementation, and the results of its evaluation. It is shown that training can bring about attitudinal change, which in turn is reflected in behaviour and social impact. Copyright © 2007 John Wiley & Sons, Ltd.

Discrepancy between parental reports of infants' receptive vocabulary and infants' behaviour in a preferential looking task

Two experiments are described which explore the relationship between parental reports of infants' receptive vocabularies at 1; 6 (Experiment 1a) or 1-3, 1;6 and 1;9 (Experiment 1b) and the comprehension infants demonstrated in a preferential looking task. The instrument used was the Oxford CD1, a British English adaptation of the MacArthur-Bates CD1 (Words & Gestures). Infants were shown pairs of images of familiar objects, either both name-known or both name-unknown according to their parent's responses on the CD1. At all ages, and on both name-known and name-unknown trials, preference for the target image increased significantly from baseline when infants heard the target's label. This discrepancy suggests that parental report underestimates infants' word knowledge.

A preliminary evaluation of cognitive-behaviour therapy for clinical perfectionism: a case series

Objective: The construct of 'clinical perfectionism' has been developed in response to criticisms that other approaches have failed to yield advances in the treatment of the type of self-oriented perfectionism that poses a clinical problem. The primary aim of this study was to conduct a preliminary investigation into the efficacy of a theory-driven, cognitive-behavioural intervention for 'clinical perfectionism'. Design. A multiple baseline single case series design was used. Method: A specific, 10-session cognitive-behavioural intervention to address clinical perfectionism in eating disorders was adapted to allow its use in nine patients referred with a range of axis I disorders and clinical perfectionism. Results: The intervention led to clinically significant improvements in self-referential perfectionism from pretreatment to follow-up for six of the nine participants on two perfectionism measures and for three of the nine participants on the measure of clinical perfectionism. Statistically significant improvements from pre- to post-intervention for the group as a whole were found on all three measures. The improvements were maintained at follow-up. Conclusions: The finding that clinical perfectionism is improved in the majority of participants is particularly encouraging given that perfectionism has traditionally been viewed as a personality characteristic resistant to change. These preliminary findings warrant replication in a larger study.

The influence of changing nicotine to tar ratios on human puffing behaviour and perceived sensory response

Rationale. Smokers modify their smoking behaviour when switching from their usual product to higher or lower tar and nicotine-yield cigarettes. Objective. The aims of the current study were to assess the influence of varying nicotine yields at constant tar yield on human puffing measures, nicotine deliveries under human smoking conditions and the sensory response to mainstream cigarette smoke. These assessments would allow an evaluation of the degree of compensation and the various possible causes of changes, if any. Methods. The participants were 13 regular smokers of commercial or hand-rolled cigarettes. They were tested with four cigarettes, which exhibited a wide range of nicotine to 'tar' ratios at a relatively constant 'tar' yield. Their smoking behaviour was monitored by placing the test cigarettes into an orifice-type holder/flowmeter attached to a custom-built smoker behaviour analyser. In addition, a comprehensive sensory evaluation of the products was carried out. Results. The differences in the nicotine to tar ratios of the samples did not significantly influence the puffing behaviour patterns, i.e. puff number and interval, total and average puff volume, integrated pressure and puff duration. Additionally the pre- to post-exhaled CO boosts were not significantly influenced by the experimental samples used in the study. However, the nicotine yields obtained by the smokers were significantly influenced by the machine-smoked nicotine yields or the nicotine to tar ratios of the samples. The machine-smoked nicotine yields were highly correlated with the nicotine yields obtained under human smoking conditions. For the sensory evaluation, there was only a significant difference between the samples in the intensity of the impact. Conclusion. These observations imply that these puffing variables are not controlled by the nicotine yield of the cigarette.

The impact of parents' expectations on parenting behaviour: an experimental investigation

Over-involved parenting is commonly hypothesized to be it risk factor for the development of anxiety disorders in childhood. This parenting style may result from parental attempts to prevent child distress based on expectations that the child will be unable to cope in a challenging situation. Naturalistic studies are limited in their ability to disentangle the overlapping contribution of child and parent factors in driving parental behaviours. To overcome this difficulty, an experimental study was conducted in which parental expectations of child distress were manipulated and the effects on parent behaviour and child mood were assessed. Fifty-two children (aged 7 - 11 years) and their primary caregiver participated. Parents were allocated to either a "positive" or a "negative" expectation group. Observations were made of the children and their parents interacting whilst completing a difficult anagram task. Parents given negative expectations of their child's response displayed higher levels of involvement. No differences were found on indices of child mood and behaviour and possible explanations for this are considered. The findings are consistent with suggestions that increased parental involvement may be a "natural" reaction to enhanced perceptions of child vulnerability and an attempt to avoid child distress.

Cognitive behaviour therapy for eating disorders

The eating disorders provide one of the strongest indications for cognitive behaviour therapy (CBT). This bold claim arises from two sources: first, the fact that eating disorders are essentially cognitive disorders and second, the demonstrated effectiveness of CBT in the treatment of bulimia nervosa, which has led to the widespread acceptance that CBT is the treatment of choice. In this paper the cognitive behavioural approach to the understanding and treatment of eating disorders will be described. A brief summary of the evidence for this account and of the data supporting the efficacy and effectiveness of this form of treatment will be provided. Challenges for the future development and dissemination of the treatment will be identified.

Behaviour-based authentication in the built enviromnent

This paper proposes a novel method of authentication of users in secure buildings. The main objective is to investigate whether user actions in the built environment can produce consistent behavioural signatures upon which a building intrusion detection system could be based. In the process three behavioural expressions were discovered: time-invariant, co-dependent and idiosyncratic.

A combined Bayesian Markovian approach for behaviour recognition

Numerous techniques exist which can be used for the task of behavioural analysis and recognition. Common amongst these are Bayesian networks and Hidden Markov Models. Although these techniques are extremely powerful and well developed, both have important limitations. By fusing these techniques together to form Bayes-Markov chains, the advantages of both techniques can be preserved, while reducing their limitations. The Bayes-Markov technique forms the basis of a common, flexible framework for supplementing Markov chains with additional features. This results in improved user output, and aids in the rapid development of flexible and efficient behaviour recognition systems.

Closely coupled behaviour in networked robot systems

Multiple cooperating robot systems may be required to take up a closely coupled configuration in order to perform a task. An example is extended baseline stereo (EBS), requiring that two robots must establish and maintain for a certain period of time a constrained kinematic relationship to each other. In this paper we report on the development of a networked robotics framework for modular, distributed robot systems that supports the creation of such configurations. The framework incorporates a query mechanism to locate modules distributed across the two robot systems. The work presented in this paper introduces special mechanisms to model the kinematic constraint and its instantiation. The EBS configuration is used as a case study and experimental implementation to demonstrate the approach.

Using the web graph to influence application behaviour

The Web's link structure (termed the Web Graph) is a richly connected set of Web pages. Current applications use this graph for indexing and information retrieval purposes. In contrast the relationship between Web Graph and application is reversed by letting the structure of the Web Graph influence the behaviour of an application. Presents a novel Web crawling agent, AlienBot, the output of which is orthogonally coupled to the enemy generation strategy of a computer game. The Web Graph guides AlienBot, causing it to generate a stochastic process. Shows the effectiveness of such unorthodox coupling to both the playability of the game and the heuristics of the Web crawler. In addition, presents the results of the sample of Web pages collected by the crawling process. In particular, shows: how AlienBot was able to identify the power law inherent in the link structure of the Web; that 61.74 per cent of Web pages use some form of scripting technology; that the size of the Web can be estimated at just over 5.2 billion pages; and that less than 7 per cent of Web pages fully comply with some variant of (X)HTML.