Behavioral avoidance test for obsessive compulsive disorder.

Few treatment outcome studies of Obsessive Compulsive Disorder (OCD) have employed Behavioral Avoidance Tests (BATs) to assess changes in symptomatology, probably because of the difficulty of constructing such tests for a disorder which has widely varying symptoms. The few studies that have examined the psychometric properties of BATs for OCD have found mixed evidence for validity but good treatment sensitivity. The present study presents psychometric findings for a multi-step/multi-task BAT that assessed percentage of steps completed, subjective anxiety, global avoidance, and rituals. This measure was used with 50 clients diagnosed with OCD whose symptoms varied widely. The BAT demonstrated good convergent and divergent validity, as well as treatment sensitivity according to effect size calculations. A composite score combining steps, anxiety level, avoidance and rituals also performed well in psychometric tests. Strategies to reduce the complexity of scoring are presented, along with examples of several BAT tasks to enable researchers to employ this behavioral measure.

Cognitive therapy of anxiety disorders.

A review of studies of cognitive-behavioral therapy (CBT) for generalized anxiety disorder, panic disorder with and without agoraphobia, and social phobia indicates that CBT is consistently more effective than waiting-list and placebo control groups. In general, CBT has proved more beneficial than supportive therapy as well. Comparisons with active behavioral treatments provide more variable results. Converging evidence suggests that cognitive change may be a strong predictor of treatment outcome, but that such change may be produced by a number of therapeutic approaches. Pretest-posttest change with CBT is depicted in meta-analytic summary form for each disorder.

Lay beliefs about the causes and consequences of smoking cessation maintenance.

Descriptive research has corroborated the Relapse Prevention (RP) model of smoking relapse, but RP interventions have been generally ineffective. This discrepancy might arise from disagreement between the theory and ex-smokers' beliefs about what determines successful maintenance. We therefore asked 100 recent ex-smokers why they believed they would (or would not) be able to abstain for the following year, and what benefits they anticipated if they did. Modal responses were that personal attributes (e.g., willpower) would determine maintenance and that improved physical health would be its most important result. Twelve-month continuous abstinence was more common among those anticipating improved feelings of psychological or physical well-being than among those anticipating a reduction in problems or a diffuse health benefit.