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Recent theoretical models of social phobia suggest that targeting several specific cognitive factors in treatment should enhance treatment efficacy over that of more traditional skills-based treatment programs. In the current study, 195 people with social phobia were randomly allocated to 1 of 3 treatments: standard cognitive restructuring plus in vivo exposure, an "enhanced" treatment that augmented the standard program with several additional treatment techniques (e.g., performance feedback, attention retraining), and a nonspecific (stress management) treatment. The enhanced treatment demonstrated significantly greater effects on diagnoses, diagnostic severity, and anxiety during a speech. The specific treatments failed to differ significantly on self-report measures of social anxiety symptoms and life interference, although they were both significantly better than the nonspecific treatment. The enhanced treatment also showed significantly greater effects than standard treatment on 2 putative process measures: cost of negative evaluation and negative views of one's skills and appearance. Changes on these process variables mediated differences between the treatments on changes in diagnostic severity.

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Final-year high school students completed the Multidimensional Perfectionism scale and the Depression Anxiety and Stress Scales (DASS) 10 weeks (n = 673) and again 10 days (n = 505) before a major set of examinations. Symptoms of depression, anxiety, and stress were elevated on both test occasions, with more than 20% of the sample falling into the severe range. Self-oriented perfectionism was not strongly related to emotional symptoms. In contrast, socially prescribed perfectionism was positively related to depression and anxiety. Students whose parents were born overseas reported higher levels of socially prescribed perfectionism, and higher levels of depression and anxiety. These findings were interpreted within Higgins' (1987) self-discrepancy theory, which links high externally imposed standards to emotional distress. The results suggest that adolescents who perceive strong external pressure to excel academically are at risk of severe emotional symptoms under examination stress.Empirically, the nature of the relationship between selforiented perfectionism and depression has been inconsistent. In college student samples, a positive relationship between self-The authors wish to acknowledge the assiscance of Dr Julie Enkine in locating interested schools. W e would also like to thank teachers. year coordinators, the Department of School Education, and the students for their cooperation with the project Address for correspondence: Danielle A. Einstein.

Self-help augmented by therapist assistance shows promise as a less resource-intensive method for the management of social phobia. Pure self-help shows limited efficacy for this disorder.