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Portions of three commercial citrus orchards were treated for 1 yr with foliar imidacloprid or for 2 yr with a systemic formulation in a replicated plot design to determine the impact of this neonicotinoid on the San Joaquin Valley California citrus integrated pest management (IPM) program. Foliar-applied imidacloprid had little effect on California red scale, Aonidiella aurantii (Maskell); cottony cushion scale, Icerya purchasi Maskell; or citrus red mite, Panonychus citri (McGregor), populations. Short-term suppression of the parasitoids Aphytis melinus DeBach and Comperiella bifasciata Howard; vedalia, Rodolia cardinalis (Mulsant); and the predacious mite Euseius tularensis (Congdon) were observed. Suppression of natural enemies allowed scales and mites to maintain higher populations in the treated areas compared with the nontreated areas. Thus, foliar imidacloprid did not exhibit control of these citrus pest species, and it disrupted biological control. Systemically applied imidacloprid suppressed California red scale and citricola scale populations 2-3 mo after treatment. Suppression of parasitoids of the California red scale also was observed. Thus, treatments of systemic imidacloprid applied in areawide management programs for invasive pests would provide a benefit of California red scale and citricola scale suppression. However, this treatment provided only single-season control of citricola scale, it was somewhat disruptive of biological control, and it did not suppress densities of either scale as low as a treatment of the organophosphate chlorpyrifos for citricola scale or the insect growth regulator pyriproxyfen for California red scale. Insecticides with longer periods of efficacy and greater IPM compatibility than imidacloprid should be used for a sustainable IPM approach in California citrus.

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OBJECTIVE: To compare cognitive behaviour therapy (CBT) with CBT plus medication; medication alone; and placebo in the treatment of adult obsessive-compulsive disorder (OCD). METHOD: Forty-eight participants (43 completers) were recruited into two protocols. In the first protocol, 21 people with OCD were randomly allocated to either a standard medication (fluvoxamine) or standard placebo condition for a 5-month period. Both these groups subsequently received CBT for a further 5 months. In the second protocol, 22 people with OCD received CBT, one group was already stabilized on an antidepressant of choice; the second group was drug naïve. RESULTS: All active treatments, but not the placebo, showed clinical improvement. There was no difference in treatment response to CBT regardless of whether participants had previously received medication or placebo. CONCLUSION: CBT has a more specific antiobsessional effect than medication but CBT plus medication shows greatest overall clinical improvement in mood.

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This study evaluated an inference-based approach (IBA) to the treatment of obsessive-compulsive disorder (OCD) by comparing its efficacy with a treatment based on the cognitive appraisal model (CAM) and exposure and response prevention (ERP). IBA considers initial intrusions in OCD (e.g. "Maybe the door is open", "My hands could be dirty") as idiosyncratic inferences about possible states of affairs arrived at through inductive reasoning. In IBA such primary inferences represent the starting point of obsessional doubt, and the reasoning maintaining the doubt forms the focus for therapy. This is unlike CAM, which regards appraisals of intrusions as the maintaining factors in OCD. Fifty-four OCD participants, of whom 44 completed, were randomly allocated to CAM, ERP or IBA. After 20 weeks of treatment all groups showed a significant reduction in scores on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Padua Inventory. Participants with high levels of obsessional conviction showed greater benefit from IBA than CAM. Appraisals of intrusions changed in all treatment conditions. Strength of primary inference was not correlated with symptom measures except in the case of strong obsessional conviction. Strength of primary inference correlated significantly with the Y-BOCS insight item. Treatment matching for high and low conviction levels to IBA and CAM, respectively, may optimize therapy outcome.

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The aim was to evaluate the efficacy of a manualized cognitive-behavioural program based on habit reversal for the management of chronic tic disorder (CTD) and habit disorder (HD). Forty-seven CTD and 43 HD received a 4-month treatment program. Thirty-eight (22 CTD, 16 HD) were placed on a waitlist control group, which subsequently received treatment. The treatment approach combined awareness training, relaxation (including modification of a tension-producing style of action), and habit-reversal training, with more general cognitive restructuring of anticipations linked to ticcing. Sixty-five percent of completers reported between 75 and 100% control over the tic. At 2-year follow-up, 52% rated 75-100% control. There were also significant changes post-treatment in measures of self-esteem, anxiety, depression and style of planning action. Successful tic/habit modification was associated in CTD and HD groups with successful change in style of planning action. There were no consistent differences in any outcome measures between CTD and HD groups.

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This article reviews the cognitive phenomenology of delusional disorders (DD) and examines the current cognitive models. Some case studies have shown considerable promise concerning the utilisation of cognitive behavioral therapy (CBT) for the treatment of DD, even if this approach is in its infancy. Although the stages of CBT to treat DD are very similar to that of other psychotic disorders, there are also considerable differences. However, it is essential to combine several strategies in order to modify inferences specific to DD. The clinical evaluation of delusions as well as the application of CBT as a treatment is illustrated in two cases with a diagnosis of DD with persecutory subtype. The cases required different time periods for different stages of CBT and highlight the importance of tailoring CBT according to need.

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OBJECTIVE: To evaluate the effect of combining cognitive-behaviour therapy (CBT) and medication in the treatment of obsessive-compulsive disorder (OCD). METHOD: Twenty-nine subjects diagnosed with OCD according to Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria were recruited through the Anxiety Clinic of Louis-H Lafontaine Hospital. They were evaluated at baseline and after treatment on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) by a psychiatrist who was blind to treatment modality. Subjects rated their degree of resistance to their rituals and the strength of their obsessional beliefs. Subjects then received 1 of 4 treatments: medication and CBT simultaneously (n = 9), CBT only (n = 6), medication while on a wait-list for CBT (n = 6), or no treatment while on a wait-list for CBT (n = 5). RESULTS: Multivariate analysis revealed that Y-BOCS scores and clinical ratings significantly improved posttreatment in all groups except the nontreatment wait-list control group. Subjects in the 2 active treatment groups receiving CBT showed reduced strength in their obsessional beliefs. The subsequent administration of CBT to those groups on the wait-list also decreased the strength of their primary obsessional beliefs and beliefs about the consequences of not performing the rituals. CONCLUSIONS: Our results suggest that either CBT or medication alone is more effective than no treatment. The combination of CBT and medication seems to potentiate treatment efficacy, and we found it more clinically beneficial to introduce CBT after a period of medication rather than to start both therapies simultaneously.

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In this paper we outline a cognitive model of Obsessive-Compulsive Disorder (OCD) which proposes that the core belief of OCD evolves through a series of illogical inferences. These faulty inference processes involve inferring the plausibility of events on the basis of irrelevant associations, dismissing actual evidence on the grounds of going beyond surface reality to a deeper reality, and finally inferring that a completely fictional narrative is a remote probability. A therapy aimed specifically at changing these inference processes is illustrated with case examples of OCD clients who had not benefited from conventional behavior therapy. The inference based approach (IBA) complements existing cognitive-behavioral therapy but suggests that in certain cases, the conventional cognitive therapy view of OCD beliefs as exaggerated fears of remote possibilities may actually reinforce the obsessional belief since even remote events are real. The IBA on the contrary suggests that an important goal in therapy is to highlight this confusion found in OCD between imagination and reality and illuminate for the OCD client how their compulsions, far from reassuring them about a remote possibility, actually take them further away from reality and reinforce their imaginary doubt.

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