Self-monitoring, a competing response and response cost were used in the successful treatment of a 49 year old female patient with a 19 year history of trichotillomania. Self-monitoring and a competing response produced significant decreases in hair-pulling, but still continued as the patient found it pleasurable at times of stress. The addition of response cost procedures overcame this.

Auditory hallucinations comprise the most common symptoms of schizophrenia. Although antipsychotic medications are helpful, in that they reduce symptoms and the likelihood of relapse, many patients do not benefit from their use. In recent years, psychological interventions have been developed in the West to help such patients. However, cross-cultural studies have shown that the nature and form of auditory hallucinations are affected by cultural differences, suggesting that a patient's cultural background needs to be considered when applying psychological methods. In this study, three schizophrenic patients from Saudi Arabia whose auditory hallucinations persisted despite the administration of antipsychotic medications were given a modified psychological intervention designed to alter the characteristics and content of their hallucinations. The modifications included an emphasis on Islamic doctrine and religion. Two patients benefited from the interventions. The third patient was reluctant to engage with the therapist, probably because the content of his voices was benign. The importance of such modifications when employing psychological intervention for patients from non-Western backgrounds is discussed.

Tinnitus is a symptom of ear disease that may cause psychological distress. We report here on the successful treatment of stress-related tinnitus in a patient with otosclerosis (an ear disease). The patient experienced stress-induced attacks during which tinnitus became unbearable. A cognitive-behavioural treatment programme of 10 sessions was given during two weeks. Results assessed at pre-and post-treatment showed decreased annoyance and increased coping with tinnitus. The attacks became less frequent and easier to handle. The results support the application of cognitive-behavioural treatment in cases with difficult tinnitus.

Biofeedback by means of an anorectal probe or balloon linked to a manometric apparatus can be an effective treatment for childhood faecal retention associated with inappropriate external anal sphincter coordination (obstipation). We report an alternative biofeedback approach in a child with long-standing obstipation. Sphincter tone was detected by digitization instead of manometrically and information on the state of the muscle relayed orally, the child's mother acting as trainer and working at home. Five years of dependency on purgatives for bowel evacuation was reversed in three weeks of this regime. Carer-mediated biofeedback by digitization may prove a low-technology alternative to manometric methods where suitable equipment is unavailable.

The relationship between effectiveness of interpersonal problem-solving and specificity of autobiographical memory was examined for 35 patients admitted to an inner-city District General Hospital following a deliberate drug-overdose. The results replicated those of Evans, Williams, O'Loughlin and Howells (1992) in finding a significant correlation between ineffective problem-solving and the over-general retrieval of autobiographical memories, giving further support to the suggestion that an over-general memory database may underpin the problem-solving deficits characteristic of parasuicide patients. However, the correlation coefficient computed was notably lower than in the Evans et al. study and an attempt is made to explain this discrepancy on the basis of differences in the levels of psychopathology between the patients involved in each study.

The aim of this study is to analyse the type of coping strategies used by patients with post-traumatic stress disorder (PTSD). For that purpose, two groups of war veterans (40 subjects in each group) were compared. The first group was made up of patients with PTSD, and the second (control) group comprised veterans who suffered combat trauma, but did not show any PTSD symptoms. Coping strategies were assessed using the Questionnaire of Coping Responses (McCrae, 1984).

The results show that out of 118 items (examples of coping strategies) 10 show statistically significant differences between the group with PTSD and the one without it. PTSD patients used more maladaptive strategies (avoidance, pseudo-planning, fantasizing, impulsive and depressive behaviour), while subjects from the control group were more likely to use the strategy of controlling impulses.

The aims of this study were to examine the construct validity of a cognitive behavioural treatment model for medically unexplained physical symptoms and to examine potential predictors of treatment outcome. In concordance with the treatment model we used, the extent of hypochondriacal cognitions and psychological distress at baseline appeared to be associated. Change in hypochondriacal cognitions was related to change in psychological distress. The extent of hypochondriacal cognitions after treatment was predictive of the level of psychological distress at one year follow-up. The only baseline variable that predicted a negative treatment outcome was illness behaviour.

This single case study investigates a woman with organic hallucinosis, who was assessed using the Comprehensive Psychopathological Rating Scale (CPRS). She then received cognitive behaviour therapy (CBT) for 11 months. The CBT approach involved engaging the patient and specific symptom targeting. An individual formulation was developed, leading to schema focused intervention and relapse prevention. The subjects total CPRS scores and schizophrenia subscale scores were reduced dramatically.

Body dysmorphic disorder is an illness of generally chronic course which can lead to significant impairment of social functioning, unnecessary plastic surgery and even suicide. It is little understood and treatment regimens have been of uncertain efficacy. Eye movement desensitization and reprocessing (EMDR) is a newly developed psychotherapeutic procedure used in the treatment of post-traumatic stress disorder, grief reactions and generalized anxiety. In this paper we describe its use in seven consecutive cases of body dysmorphic disorder. Improvements were obtained in six of the seven patients, five of whom had a complete resolution of their symptoms.