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Cognitive--behavioral therapy (CBT) is the psychological treatment of choice for panic disorder (PD). However, given limited access to CBT, it must be delivered with maximal cost-effectiveness. Previous researchers have found that a brief computer-augmented CBT was as effective as extended therapistdelivered CBT. To test this finding, this study randomly allocated 186 patients with PD across 2 sites in Scotland and Australia to 12 sessions of therapist-delivered CBT (CBT12), 6 sessions of therapistdelivered (CBT6) or computer-augmented CBT (CBT6-CA), or a waitlist control. On a composite measure, at posttreatment, the outcome for CBT12 was statistically better than the outcome for CBT6. The outcome for CBT6-CA fell between CBT12 and CBT6, but could not be statistically distinguished from either treatment. The active treatments did not differ statistically at 6-month follow-up. The study provided some support for the use of computers as an innovative adjunctive-therapy tool and merits further investigation.Substantial research evidence indicates that the psychological treatment of choice for panic disorder is cognitive-behavioral therapy (CBT) intervention (Barlow, Gorman, Shear, & Woods, 2000;Hofmann & Spiegel, 1999;Otto, Pollack, & Maki, 2000). As a result, there has been a corresponding growth of demand for treatment, an increase in waiting times in some health care systems, and consequently, pressure for more accessible and efficient forms of treatment delivery.This need is further highlighted by the high prevalence of panic disorder (Kessler et al., 1994) as well as by the nature of the condition, which often involves a level of agoraphobic avoidance. This may limit patients' regular clinic attendance and their access to conventional therapist-administered treatment (Co ˆte ´, Gauthier, Laberge, Cormier, & Plamondon, 1994). To date, one of the main alternatives to conventional CBT delivery has involved the use of written self-help materials, or bibliotherapy.Bibliotherapy (Dow, 1982) has proven to be as effective as eight sessions of group or individual CBT (Lidren et al., 1994), although Power, Sharp, Swanson, andSimpson (2000) found a totally self-administered bibliotherapy condition to be significantly less effective on a range of outcome measures compared with "standard" therapist-delivered CBT. This may be related to the inaccessibility and inconvenience of bibliotherapy during daily activities. One possible solution to the limits of bibliotherapy lies in computer-assisted therapy.Computers can increase patient access to treatment programs (Kenardy, McCafferty, & Rosa, 2003); extend therapy to the patient's own environment; and enhance cost-effectiveness, with costs reduced to between one third and one sixth that of conventional behavioral treatment (Kenardy & Adams, 1993;Newman, 2000). Computer programs have been shown to be effective adjuncts to more conventional treatment for a variety of anxiety disorders, including panic disorder, agoraphobia, social phobia, obsessive-compulsive disorder, and gener...

Purpose A mixed methods approach, evaluating triple word form theory, was used to describe linguistic patterns of misspellings. Method Spelling errors were taken from narrative and expository writing samples provided by 888 typically developing students in grades 1–9. Errors were coded by category (phonological, orthographic, and morphological) and specific linguistic feature affected. Grade level effects were analyzed with trend analysis. Qualitative analyses determined frequent error types and how use of specific linguistic features varied across grades. Results Phonological, orthographic, and morphological errors were noted across all grades, but orthographic errors predominated. Linear trends revealed developmental shifts in error proportions for the orthographic and morphological categories between grades 4–5. Similar error types were noted across age groups but the nature of linguistic feature error changed with age. Conclusions Triple word-form theory was supported. By grade 1, orthographic errors predominated and phonological and morphological error patterns were evident. Morphological errors increased in relative frequency in older students, probably due to a combination of word-formation issues and vocabulary growth. These patterns suggest that normal spelling development reflects non-linear growth and that it takes a long time to develop a robust orthographic lexicon that coordinates phonology, orthography, and morphology and supports word-specific, conventional spelling.

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