Behavioral Interventions For Individuals Research Articles

Supplemental Material for Development of a Spirituality-Infused Cognitive Behavioral Intervention for Individuals With Serious Mental Illnesses

Supplemental Material for Development of a Spirituality-Infused Cognitive Behavioral Intervention for Individuals With Serious Mental Illnesses

A Multipronged Intervention for Treatment of Psychotic Symptoms from Post-football Traumatic Brain Injury in an Adolescent Male: A Case Report

Abstract Introduction Traumatic brain injury (TBI) is common in adolescents. TBI can result in impaired cognitive functioning and mood disturbance. In some cases, TBI results in psychotic symptoms. There is little documentation for treatment of psychotic symptoms resulting from TBI. Case presentation The present case study reviews an adolescent male who was seen in an outpatient behavioral health clinic, following a football-related TBI. The TBI resulted in postconcussive syndrome including psychotic symptoms (i.e., visual and auditory hallucinations) and increased anxiety. Management and Outcome The adolescent underwent 12 individual sessions of Acceptance and Commitment Therapy (ACT) and 7 sessions of family therapy for his anxiety and psychotic symptoms. He also underwent Vestibulo-Ocular Therapy. At the end of treatment, the patient's anxiety symptoms and those related to post-concussive syndrome were in remission with no hallucinations experienced for >6 months. Discussion The results provide encouragement for systematic randomized controlled trials of individual and family behavioral interventions as part of an integrated treatment approach for mild TBI.

The associations between domain-specific sedentary behaviours and dietary habits in European adults: a cross-sectional analysis of the SPOTLIGHT survey.

BackgroundSedentary behaviour has been associated with obesity and related chronic diseases. Disentangling the nature of this association is complicated due to interactions with other lifestyle factors, such as dietary habits, yet limited research has investigated the relation between domain-specific sedentary behaviours and dietary habits in adults. The aim of this paper was to examine the association between domain-specific sedentary behaviours and dietary habits in adults and to test the moderating effect of age and gender on this association.MethodsA total of 6,037 participants from five urban regions in Europe completed an online survey, of which 6,001 were included in the analyses. Multilevel mixed-effects logistic regression analyses were used to examine main associations and interaction effects.ResultsAll domain-specific sedentary behaviours, except transport-related sitting time, were significantly related to dietary habits. In general, having a higher sitting time was related to having less healthy dietary habits, especially for television viewing. Gender did not moderate any of the relations, and age was only a significant moderator in the relation between other leisure sitting time and alcohol consumption.ConclusionDomain-specific sitting behaviours were related to unhealthy dietary behaviours. However, the small effect sizes suggest that individual level behavioural interventions focusing on sedentary behaviour will not be sufficient to improve dietary habits. The fact that almost none of the associations were moderated by age or gender suggests that these associations, and possibly also the effects of interventions targeting both behaviours, may hold across age and gender groups.

P.1.h.016 - Measuring sociability of mice using a novel 3-chamber set-up and algorithm of an automated animal behaviour analysis system

We sought to characterize diagnostic and treatment factors associated with receiving a prescription for benzodiazepines at discharge from a psychiatric inpatient unit. We hypothesized that engaging in individual behavioral interventions while on the unit would decrease the likelihood of receiving a benzodiazepine prescription at discharge.This is an observational study utilizing medical chart review (n= 1007) over 37 months (2008–2011). Descriptive statistics characterized patient demographics and diagnostic/prescription frequency. Multivariate regression was used to assess factors associated with receiving a benzodiazepine prescription at discharge.The sample was 61% female with mean age=40.5 (S.D.= 13.6). Most frequent diagnoses were depression (54.7%) and bipolar disorder (18.6%). Thirty-eight percent of participants engaged in an individual behavioral intervention. Benzodiazepines were prescribed in 36% of discharges. Contrary to our hypothesis, individual behavioral interventions did not influence discharge benzodiazepine prescriptions. However, several other factors did, including having a substance use disorder [odds ratio (OR)=0.40]. Male sex (OR=0.56), Black race (OR=0.40) and age (OR=1.03) were nonclinical factors with strong prescribing influence.Benzodiazepines are frequently prescribed at discharge. Our results indicate strong racial and sex biases when prescribing benzodiazepines, even after controlling for diagnosis.

Demographic and clinical factors associated with benzodiazepine prescription at discharge from psychiatric inpatient treatment

ObjectiveWe sought to characterize diagnostic and treatment factors associated with receiving a prescription for benzodiazepines at discharge from a psychiatric inpatient unit. We hypothesized that engaging in individual behavioral interventions while on the unit would decrease the likelihood of receiving a benzodiazepine prescription at discharge. MethodThis is an observational study utilizing medical chart review (n=1007) over 37 months (2008–2011). Descriptive statistics characterized patient demographics and diagnostic/prescription frequency. Multivariate regression was used to assess factors associated with receiving a benzodiazepine prescription at discharge. ResultsThe sample was 61% female with mean age=40.5 (S.D.=13.6). Most frequent diagnoses were depression (54.7%) and bipolar disorder (18.6%). Thirty-eight percent of participants engaged in an individual behavioral intervention. Benzodiazepines were prescribed in 36% of discharges. Contrary to our hypothesis, individual behavioral interventions did not influence discharge benzodiazepine prescriptions. However, several other factors did, including having a substance use disorder [odds ratio (OR)=0.40]. Male sex (OR=0.56), Black race (OR=0.40) and age (OR=1.03) were nonclinical factors with strong prescribing influence. ConclusionBenzodiazepines are frequently prescribed at discharge. Our results indicate strong racial and sex biases when prescribing benzodiazepines, even after controlling for diagnosis.

Public health nurse educators' conceptualisation of public health as a strategy to reduce health inequalities: a qualitative study.

BackgroundNurses have long been identified as key contributors to strategies to reduce health inequalities. However, health inequalities are increasing in the UK despite policy measures put in place to reduce them. This raises questions about: convergence between policy makers’ and nurses’ understanding of how inequalities in health are created and sustained and educational preparation for the role as contributors in reducing health inequalities.AimThe aim of this qualitative research project is to determine public health nurse educators’ understanding of public health as a strategy to reduce health inequalities.Method26 semi-structured interviews were conducted with higher education institution-based public health nurse educators.FindingsPublic health nurse educators described health inequalities as the foundation on which a public health framework should be built. Two distinct views emerged of how health inequalities should be tackled: some proposed a population approach focusing on upstream preventive strategies, whilst others proposed behavioural approaches focusing on empowering vulnerable individuals to improve their own health.ConclusionDespite upstream interventions to reduce inequalities in health being proved to have more leverage than individual behavioural interventions in tackling the fundamental causes of health inequalities, some nurses have a better understanding of individual interventions than take population approaches.

Behavioral Interventions for Individuals with Intellectual Disabilities Exhibiting automatically-Reinforced Challenging Behavior: Stereotypy and Self-Injury

Challenging behaviors (CBs) among those with intellectual disabilities (ID) such as stereotyped behavior (stereotypy) and self-injurious behavior (SIB) are widespread, dangerous, progressive in nature, and can interfere significantly with an individual’s quality of life. When the function of CB is identified, interventions are more successful. This paper reviewed literature on available behavioral interventions for automatically reinforced cases of stereotypy and SIB. Sixteen single-subject studies met the inclusion criteria, and interventions were analyzed according to the topography exhibited. Every intervention successfully decreased the stereotypy or SIB for its participant. This literature review shows that individualized behavioral interventions can be successful at reducing automatically reinforced CBs. Implications for interventions are discussed separately for stereotypy and SIB.

(558) Child pain, function, and psychological outcomes in association with treatment duration in intensive interdisciplinary pediatric pain rehabilitation

We examined the functional, psychological, and pain-related outcomes among children with chronic pain completing an intensive interdisciplinary pediatric pain rehabilitation program. We hypothesized that baseline psychological measures would predict a longer treatment course while baseline pain severity would not correlate with program duration. This outpatient program provides 5-6 hours of daily intensive physical therapy and occupational therapy in addition to yoga, self-regulation training, individual and group behavioral health intervention, group-based music and art therapy, and parent group intervention.

(556) Chronic pain rehabilitation and alcohol use disorder: promising outcomes in an interdisciplinary treatment program

(556) Chronic pain rehabilitation and alcohol use disorder: promising outcomes in an interdisciplinary treatment program

A cognitive behavioral smoking abstinence intervention for adults with chronic pain: A randomized controlled pilot trial

Current evidence suggests it may be difficult for patients with chronic pain to quit smoking and, based on previous formative work, a 7-session individual and group-based cognitive behavioral (CB) intervention was developed. The primary aim of this randomized controlled pilot trial was to test the hypothesis that abstinence at month 6 would be greater among patients with chronic pain who received the CB intervention compared to a control condition. Upon admission to a 3-week interdisciplinary pain treatment (IPT) program, patients were randomized to receive the CB intervention (n=30) or the control condition (n=30). The 7-day point prevalence of self-reported smoking status was assessed at week 3 (upon completion of the 3-week IPT program) and at month 6 in an intent-to-treat analysis. At week 3, 30% (n=9) of patients in the CB condition were abstinent from smoking compared to 10% (n=3) in the control group (P=.104). At month 6, 20% (n=6) of patients who received the CB intervention were abstinent compared to none in the control group (P=.024). At week 3, a significant group by time interaction effect was found where the CB patients experienced greater improvements in self-efficacy from baseline compared to the control group (P=.002). A greater proportion of patients randomized to the CB group completed the IPT program (P=.052). The findings of this pilot trial suggest that integration of a CB-based smoking abstinence intervention into ongoing pain therapy may be an effective treatment for smokers with chronic pain.

Establishing community based cohorts: approaches, methods and challenges

India with a population of 1.2 billion is changing rapidly with increasing literacy, declining sex ratio, huge urban growth, high population density and a rising proportion of young people. Some communicable diseases show a declining trend while others show an upward trend. The proportion of deaths and burden of disease due to chronic disease risk factors are on the rise. Resource limited countries like India face several practical problems, the most prominent being the difficulty to convince policy makers that non-communicable diseases are silent killers. The size and diversity of the population necessitates large cohorts resulting in significant cost escalation. In addition infrastructure, manpower and resource limitations preclude the availability of quality data. The operational and management challenges include consistency of data capture across diverse regions, building and sustaining clinical infrastructure, long term data storage and ethical issues. The scientific requirements in undertaking population based cohort studies in India include identification of susceptible individuals, tracking of migrants and qualitative studies to supplement quantitative data. Mechanisms to ensure community participation like need based benefits for the community, proper feedback and networking with non-governmental organizations and private health care providers are also important. In addition to the information available from routine surveillance, medical records and national programmes, a well planned cohort study can provide incidence rates, predictors of diseases, sub-clinical infections, individual, family and community parameters, in-migration and out-migration, early indications of impending outbreaks, health and treatment seeking behaviour and impact of individual or community level clinical or behavioural interventions. Senior level health managers and experts have identified non-communicable diseases as a public health research priority next only to maternal and child health and it is necessary to initiate population based cohort studies and plan interventions accordingly.

The Feasibility of a Structured Cognitive Training Protocol to Address Progressive Cognitive Decline in Individuals With Vascular Dementia

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, better known as CADASIL, is a rare, genetic form of early-onset vascular dementia. The purpose of this study was to use a modified version of Attention Process Training--II (APT-II; Sohlberg, Johnson, Paule, Raskin, & Mateer, 2001) with an individual with early-stage CADASIL. APT-II, modified to include strategy training, was applied in an A-B, multiple-probe design for an individual who had been diagnosed with early-stage CADASIL. Outcome measures included pre-post neuropsychological testing of attention, memory, and executive function; within-treatment probes of visual and auditory attention; and a measure of subjective experience of cognitive functioning in daily living. The participant demonstrated nominal gains on visual and auditory attention probes but improved performance on several posttreatment measures of processing speed and executive function. The participant also reported substantially improved functional outcomes following the intervention protocol. This case illustrates the potential utility of behavioral intervention for individuals with CADASIL and highlights issues for speech-language pathologists to consider when using structured cognitive training protocols in the setting of progressive cognitive decline. These data suggest that further controlled studies for treating this population are warranted.

Does Session Attendance by a Supportive Significant Other Predict Outcomes in Individual Treatment for Alcohol Use Disorders?

A significant amount of research has supported the efficacy of couple versus individual treatment for alcohol use disorders, yet little is known about whether involving a significant other during the course of individual treatment can improve outcomes. Likewise, several barriers to couple treatment exist and a more flexible approach to significant other involvement may be warranted. This study constituted secondary analyses of the COMBINE data, a randomized clinical trial that combined pharmacotherapy and behavioral intervention for alcohol dependence. Data were drawn from the 16-week individual combined behavioral intervention (CBI), which had 776 participants, 31% of which were female, and 23% were non-white. The current study examined whether attendance by a supportive significant other (SSO) during CBI sessions would predict better outcomes. It was further hypothesized that active SSO involvement, defined by attendance during drink refusal or communication skills training sessions, would predict better outcomes. SSOs attended at least 1 session for 26.9% of clients. Clients with SSOs who attended at least 1 session had significantly fewer drinking days and fewer drinking-related problems at the end of treatment. The presence of an SSO during a drink refusal training session predicted significantly better outcomes, as compared to SSO attendance at other sessions and drink refusal training without an SSO present. SSO attendance at a communication training session did not predict better outcomes. These results suggest that specific types of active involvement may be important for SSO-involved treatment to have greater efficacy than individual treatment.

AT-RISK ALCOHOL USERS SHOW DECREASED SENSITIVITY TO PUNISHMENT SEVERITY IN LEARNING FROM ERRORS

Event Abstract Back to Event AT-RISK ALCOHOL USERS SHOW DECREASED SENSITIVITY TO PUNISHMENT SEVERITY IN LEARNING FROM ERRORS Jennifer L. Moore1*, Sarah Rossiter1, Elizabeth Beadle2 and Robert Hester1 1 University of Melbourne, Psychological Sciences, Australia 2 University of Queensland, Queensland Brain Institute, Australia In non-addicted participants, punishing an error improves learning, with performance improving as a function of the magnitude of negative feedback. Drug addiction, however, has been associated with a diminished capacity to learn from punishment and adapt behaviour. Given the role of punishment in individual and societal level behavioural interventions for addiction, it is important to understand the insensitivity to punishment. While numerous studies have reported higher levels of reward impulsivity in heavy drinkers compared to light drinkers, including under conditions of high risk for punishment, research to date has not examined if the insensitivity to punishment in social drinkers is associated with their poorer learning from negative feedback. The current study administered a novel associative learning task that provided monetary reward and punishment for recall performance to 122 healthy participants (94 females; mean age, 22.10 years) with low (27 females, 7 males (27.9% of the total sample); mean age, 22.47 years), hazardous (26 females, 24 males (41% of the total sample); mean age, 21.45 years) and harmful (16 females, 22 males (31.1% of the total sample); mean age, 21.05 years) levels of alcohol use (classified in accordance with the Alcohol Use Disorders Identification Test (AUDIT) risk grouping; low risk score = 0-7, hazardous risk score = 8 -15, harmful risk score = 16+). The overall mean AUDIT score for the current sample was 12.61 (SD= 7.30; range= 1-29). The majority of participants, at 57.4%, reported drinking 2-3 times per week, with 50.0% of the sample admitting to regular binge drinking (i.e., drinking in excess of 6 drinks during a single session on a weekly basis). Performance on the task indicated that non-dependent, but hazardous and harmful-risk drinkers were less sensitive to the magnitude of punishment than low-risk drinkers, having significantly poorer learning from punished errors. This finding has implications for prevention and rehabilitation approaches for alcohol addiction, and further suggests that deficits in learning from punishment may be a precipitating factor in the development of alcohol addiction. Keywords: addiction research, alcohol use, learning from errors, Punishment sensitivity, alcohol dependency Conference: ACNS-2012 Australasian Cognitive Neuroscience Conference, Brisbane, Australia, 29 Nov - 2 Dec, 2012. Presentation Type: Poster Presentation Topic: Executive Processes Citation: Moore JL, Rossiter S, Beadle E and Hester R (2012). AT-RISK ALCOHOL USERS SHOW DECREASED SENSITIVITY TO PUNISHMENT SEVERITY IN LEARNING FROM ERRORS. Conference Abstract: ACNS-2012 Australasian Cognitive Neuroscience Conference. doi: 10.3389/conf.fnhum.2012.208.00193 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 24 Oct 2012; Published Online: 17 Nov 2012. * Correspondence: Dr. Jennifer L Moore, University of Melbourne, Psychological Sciences, Melbourne, Melbourne, 3010, Australia, moorejlmc@gmail.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Jennifer L Moore Sarah Rossiter Elizabeth Beadle Robert Hester Google Jennifer L Moore Sarah Rossiter Elizabeth Beadle Robert Hester Google Scholar Jennifer L Moore Sarah Rossiter Elizabeth Beadle Robert Hester PubMed Jennifer L Moore Sarah Rossiter Elizabeth Beadle Robert Hester Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Punishing an Error Improves Learning: The Influence of Punishment Magnitude on Error-Related Neural Activity and Subsequent Learning

Punishing an error to shape subsequent performance is a major tenet of individual and societal level behavioral interventions. Recent work examining error-related neural activity has identified that the magnitude of activity in the posterior medial frontal cortex (pMFC) is predictive of learning from an error, whereby greater activity in this region predicts adaptive changes in future cognitive performance. It remains unclear how punishment influences error-related neural mechanisms to effect behavior change, particularly in key regions such as pMFC, which previous work has demonstrated to be insensitive to punishment. Using an associative learning task that provided monetary reward and punishment for recall performance, we observed that when recall errors were categorized by subsequent performance--whether the failure to accurately recall a number-location association was corrected at the next presentation of the same trial--the magnitude of error-related pMFC activity predicted future correction. However, the pMFC region was insensitive to the magnitude of punishment an error received and it was the left insula cortex that predicted learning from the most aversive outcomes. These findings add further evidence to the hypothesis that error-related pMFC activity may reflect more than a prediction error in representing the value of an outcome. The novel role identified here for the insular cortex in learning from punishment appears particularly compelling for our understanding of psychiatric and neurologic conditions that feature both insular cortex dysfunction and a diminished capacity for learning from negative feedback or punishment.

Using Video-based Interventions with Individuals with Autism Spectrum Disorders: Introduction to the Special Issue

The development of high quality user-friendly video capture and editing equipment at relatively low costs has resulted in wonderful opportunities to incorporate video technology into behavioral interventions for individuals with Autism Spectrum Disorders (ASD) (Goldsmith & LeBlanc, 2004). The most common strategy for incorporating video into behavioral intervention is video modeling (VM), which involves having a learner watch a videotape (rather than a live demonstration) of a person correctly performing the target behavior followed by an opportunity to imitate (Delano, 2007). Other video-based behavioral interventions (VBIs) include video-based feedback and video-based discrimination training. In video feedback, a learner and teacher watch video footage of the learner's performance while the teacher provides consequences for appropriate exemplars (e.g., praise or other reinforcers) and for non-exemplars (e.g., corrective feedback and suggestion for alternative behavior) (Thiemann & Goldstein, 2001). In discrimination training, the learner watches video footage that may or may not show their own performance and determines which behavior or category of behavior is exemplified in each scene (e.g., rude or polite, friendly joke or bullying). In the past 20 years, a substantial research literature has amassed to document the beneficial effects of VM for teaching a wide variety of skills to individuals with ASD (Bellini & Akullian, 2007; Delano, 2007). Recently, my students and I coded approximately 40 published studies on VM with individuals with ASD during a 20-year time span (1987-2007) (Dillon, LeBlanc & Geiger, 2009). Over half of those studies targeted social behavior (including social language) (Charlop-Christy, Le & Freeman, 2000; Geiger, LeBlanc, Dillon, & Bates, 2010; Nikopoulos, & Keenan, 2003; Sherer, et al., 2001), with self-help/daily living skills (e.g., Charlop-Christy et al., 2000; Keen, Brannigan, & Cuskelly, 2007) as the second most frequently targeted area. Three of the studies in our special issue represent diversity in the skills targeted with individuals with ASD. Allen, Wallace, Renes, Bowen and Burke demonstrate how video modeling could be used to teach a vocational skill to a young adult with ASD. Allen et al. used a commercial video training tape to teach a man with ASD to effectively use a WalkAround[TM] to interact with customers in a retail warehouse as part of his employment preparation. Given the growing importance of focusing on transition to adulthood and employment opportunities, I am delighted to have the needs of adults with ASD represented in our special issue. Blum-Dimaya, Reeve, Reeve and Hoch also illustrate how video modeling can be used in conjunction with gaming technology to teach modern, age-appropriate leisure skills using a multi-component package. Blum-Dimaya et al. taught children with ASD to play Guitar Hero II[TM] and conceptualized the game-embedded visual displays as a form of simultaneous video modeling where the individual has the opportunity to imitate during, rather than after, the streaming video footage. Not only does this study demonstrate a strategy for teaching a very socially valid target, but it also illustrates that when we categorize our VM interventions using a functional rather than topographical approach, we may actually discover new tools for VBIs. Finally, Charlop, Dennis, Carpenter, and Greenberg demonstrate the effects of video modeling for teaching the most complex multi-component social behavior studied to date. Their participants were able to learn to emit social language responses that were accurate with respect to content, intonation, accompanying gesture, and accompanying facial expressions during their comments about ongoing events. In addition to demonstrating the effectiveness of video modeling, researchers have also examined the characteristics of the VM or the video presentation that are most important to facilitate skill acquisition (e. …

Group and individual cognitive behavioural interventions for anger

There is growing evidence for the efficacy of anger treatment programmes, which aim to reduce inappropriate aggression in people with learning disabilities. To date they have been provided in both group and individual formats, but the differential efficacy of these approaches is yet to be assessed. Individuals with a learning disability and inappropriately expressed anger were assigned to either group or individual treatment or a waiting list control, depending on the availability of treatment options. In this way, 23 participants completed group treatment, 18 individual treatment and 21 were included in a waiting list control. Participants were assessed both before and after treatment using an anger provocation inventory. Improvements were found in the scores obtained on the anger inventory for both the group and individual treatments compared to the control using a 2 by 3 split plot ANOVA. There was no difference between group and individual treatments. These results replicate previous findings that suggest that both group and individual cognitive behavioural interventions are effective treatment options for people with learning disabilities, but do not support either method of delivery as the preferred option. Limitations of the data are discussed.

Approche cognitivocomportementale des patients présentant un premier épisode psychotique

Early interventions in first psychotic episodes are fundamental even when the prognostic is still uncertain. The cognitive and behavioural model, which includes Cognitive Behaviour Therapy (CBT) and psychoeducational training, is as useful at the beginning of the pathology as at the chronic schizophrenic stages. To be effective, the implementation of this model needs to be based on a comprehensive structured therapeutic program and to take into account the patient and the family. As a matter of fact, patient outcome particularly depends on familial support. In this article, the authors describe individual and familial cognitive and behavioural interventions with regards to the stages of evolution of the psychosis (prodromal stage, acute phase, recovery stage, remission, relapse prevention phase). Moreover, the authors emphasize the interest of cognitive remediation therapy to help the patients in their daily tasks and their social interactions.

Individual Cognitive Behavioral Intervention for Anger

There is growing evidence for the efficacy of programs to reduce inappropriate aggression in people with intellectual disabilities. These have been provided in groups and for individuals in forensic settings. People with intellectual disability and inappropriately expressed anger who were referred to a community psychology service were assigned to either individual intervention or a waiting list control. Participants were assessed both before and after treatment using an anger provocation inventory. Improvements were found in the scores obtained on the Anger Inventory for those receiving individual treatment when compared with the control group using a 2-by-2 split plot Analysis of Variance (ANOVA). These results suggest that individual cognitive behavioral intervention may be an effective treatment option in community settings.

Cognition and Suicide: New Horizons

One of the greatest contributions of cognitive and behavioral therapies, in my view, has been the rejection of a “one size fits all” approach in favor of therapeutic strategies patterned after empirically based cognitive–behavioral formulations of specific disorders. The targeting of anxiety sensitivity in panic disorder and worry processes in generalized anxiety disorder are just two of many possible examples. This special section of the International Journal of Cognitive Therapy presents yet another example: cognitive aspects of suicidal ideation and behavior. Recent experience suggests that this is currently one of the fastest growing areas of advancement in CBT. Not long ago, I had the privilege of working with many of the leading authorities in this area to produce a volume on theory, research, and therapy with suicidal individuals (Ellis, 2006). Already, I am acutely aware of its need to be updated! In the opening article in this section, Billy Rutherford and I explore the many facets of this dynamic field, summarizing how the research has advanced from simple univariate analyses of cognitive contributors, such as hopelessness, to current multivariate studies providing insight into how these variables interact with one another. These variables range from constructs familiar to cognitive therapists, such as attitudes and beliefs, to cognitive processes more often associated with cognitive science, such as executive control and memory function. We also describe significant theoretical advances that are bringing coherence and testable hypotheses to the forefront, something historically lacking in suicide research. Finally (and bottom line), we review recent developments in cognitive–behavioral interventions for individuals at risk for suicide and self–harm behaviors. Here, one cannot help but be impressed with innovations that have moved the field a quantum leap from its usual path with suicidal individuals. For it is becoming increasingly apparent that the notion of merely treating the underlying disorder, in hopes that “symptoms” like suicidal ideation and behavior will disappear is short–sighted at best. Current approaches, such as those of Linehan and Beck, now target suicidal behavior directly and specifically, resulting in reductions in those behaviors by as much as half. As you might imagine, we conclude that the future of pursuits in this dynamic arena is bright. In the second article, Rector, Kamkar, and Riskind provide an apt reminder that it behooves us not to limit our inquiries about suicide to depression–related factors such as