***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The present study compared the efficacy of trauma-focused cognitive behavior therapy ( CBT ) with trauma-focused cognitive therapy ( without exposure ; CT ) for children and youth with posttraumatic stress disorder ( PTSD ) . Children and youth who had experienced single-incident trauma ( N = 33 ; 7–17 years old ) were r and omly assigned to receive 9 weeks of either CBT or CT which was administered individually to children and their parents . Intent-to-treat analyses demonstrated that both interventions significantly reduced severity of PTSD , depression , and general anxiety . At posttreatment 65 % of CBT and 56 % of the CT group no longer met criteria for PTSD . Treatment completers showed a better response ( CBT : 91 % ; CT : 90 % ) , and gains were maintained at 6-month follow-up . Maternal depressive symptoms and unhelpful trauma beliefs moderated children ’s outcome . It is concluded that PTSD secondary to single-incident trauma can be successfully treated with trauma-focused cognitive behavioural methods and the use of exposure is not a prerequisite for good outcome OBJECTIVE Underst and ing for whom , and under what conditions , treatments exert their greatest effects is essential for developing personalized medicine . Research investigating moderators of outcome among evidence -based treatments for anxiety disorders is lacking . The current study examined several theory-driven and atheoretical putative moderators of outcome in cognitive behavioral therapy ( CBT ) and acceptance and commitment therapy ( ACT ) . METHOD Eighty-seven patients with a Diagnostic and Statistical Manual of Mental Disorders ( 4th ed . , text rev . ; DSM-IV-TR ; American Psychiatric Association , 2000 ) anxiety disorder completed 12 sessions of ACT or CBT and were assessed with a self-report measure of anxiety at baseline , post-treatment , and 6- and 12-month follow-up assessment s. RESULTS CBT outperformed ACT among those at moderate levels of baseline anxiety sensitivity , and among those with no comorbid mood disorder . ACT outperformed CBT among those with comorbid mood disorders . Higher baseline neuroticism was associated with poorer outcome across treatment conditions . Neither moderation nor general prediction was observed for baseline anxiety disorder comorbidity , race/ethnicity , gender , age , or baseline severity of the principal anxiety disorder . When including all r and omized participants who completed the pre-treatment assessment ( N = 121 ) , a similar pattern was observed . CONCLUSIONS Prescriptive recommendations for clinical practice and directions for future research are discussed BACKGROUND Panic disorder is a prevalent , often disabling condition among patients in the primary care setting . Although numerous studies have assessed the effectiveness of treatments for depression in primary care , few such studies have been conducted for panic disorder . OBJECTIVE To implement and test the effectiveness of a combined pharmacotherapy and cognitive-behavioral intervention for panic disorder tailored to the primary care setting . DESIGN R and omized , controlled study comparing intervention to treatment as usual . SETTING Six primary care clinics associated with 3 university medical schools , serving an ethnically and socioeconomically diverse patient population . PARTICIPANTS Two hundred thirty-two primary care patients meeting DSM-IV criteria for panic disorder . Comorbid mental and physical disorders were permitted , provided these did not contraindicate the treatment to be provided and were not acutely life threatening . INTERVENTION Patients were r and omized to receive either treatment as usual or an intervention consisting of a combination of up to 6 sessions ( across 12 weeks ) of cognitive-behavioral therapy ( CBT ) modified for the primary care setting , with up to 6 follow-up telephone contacts during the next 9 months , and algorithm-based pharmacotherapy provided by the primary care physician with guidance from a psychiatrist . Behavioral health specialists , the majority inexperienced in CBT for panic disorder , were trained to deliver the CBT and coordinated overall care , including pharmacotherapy . MAIN OUTCOMES MEASURES Proportion of subjects remitted ( no panic attacks in the past month , minimal anticipatory anxiety , and agoraphobia subscale score < 10 on Fear Question naire ) and responding ( Anxiety Sensitivity Index score < 20 ) and change over time in World Health Organization Disability Scale and short form 12 scores . RESULTS The combined cognitive-behavioral and pharmacotherapeutic intervention result ed in sustained and gradually increasing improvement relative to treatment as usual , with significantly higher rates at all points of both the proportion of subjects remitted ( 3 months , 20 % vs 12 % ; 12 months , 29 % vs 16 % ) and responding ( 3 months , 46 % vs 27 % ; 12 months , 63 % vs 38 % ) and significantly greater improvements in World Health Organization Disability Scale ( all points ) and short form 12 mental health functioning ( 3 and 6 months ) scores . These effects were obtained in spite of similar rates of delivery of guideline -concordant pharmacotherapy to the 2 groups . CONCLUSION Delivery of evidence -based CBT and medication using the collaborative care model and a CBT-naive , midlevel behavioral health specialist is feasible and significantly more effective than usual care for primary care panic disorder BACKGROUND Although anxiety disorders are prevalent in older adults , r and omized controlled trials of treatment effectiveness for late-life anxiety are scarce and have focused primarily on the effectiveness of psychotherapeutic interventions . However , recent findings suggest that in some cases , pharmacological treatment may be more beneficial for late-life anxiety disorders . As yet , there have been no systematic studies investigating prognostic factors for the outcome of cognitive behavioral therapy ( CBT ) and pharmacotherapy for late-life anxiety . The objective of the present study was to study long-term treatment outcomes and to explore differential predictors for both short-term and long-term treatment outcomes of sertraline and CBT for late-life anxiety disorders . METHODS Participants of a r and omized controlled trial ( RCT ) comparing sertraline and CBT for the treatment of late-life anxiety were contacted one year after completing their treatment , so that predictors for both short-term and long-term treatment outcome could be established . RESULTS Sertraline showed a greater reduction of symptoms than CBT on anxiety ( Hamilton Anxiety Rating Scale ; HARS ) and worry ( Worry Domain Question naire ) ratings at one-year follow-up . The strongest predictor for short-term CBT outcome was poor perceived health , explaining 40 % of the variance in post-treatment residual gain scores on the HARS . The strongest predictor for long-term CBT outcome was neuroticism , explaining 20 % of the variance in residual gain scores at one-year follow-up . Analyses revealed no significant predictors for treatment outcome in sertraline participants . CONCLUSIONS Our study suggests that long-term use of sertraline might be more beneficial for late-life anxiety than a 15-week CBT program . Poor perceived health and neuroticism are predictive of less improvement after CBT in anxious older adults . Implication s of these findings are discussed OBJECTIVE A pilot study to evaluate the efficacy of a cognitive-behavioral group therapy program for adolescents with social phobia , simplified both in terms of time and labor intensity from a previously studied program ( Social Effectiveness Therapy for Children and Adolescents ) to be more appropriate for a community outpatient psychiatric setting . METHOD Twelve adolescents with social phobia ( ages 13 - 18 ) , diagnosed by DSM-IV criteria and confirmed with Anxiety Disorders Interview Schedule for Children assessment , were r and omly assigned to treatment ( n=6 ) and waitlist ( n=6 ) groups . The waitlist group was subsequently treated , and results were included in the data analysis . Assessment s , including Anxiety Disorders Interview Schedule for Children interviews and self-report Social Phobia and Anxiety Inventory and Beck Depression Inventory II question naires , were performed at baseline and immediately after treatment or waitlist . RESULTS All subjects completed the treatment program . Compared with the waitlist group , treated subjects showed significantly greater improvement in both examiner-evaluated ( Anxiety Disorders Interview Schedule for Children ) and self-reported ( Social Phobia and Anxiety Inventory ) symptoms of social anxiety ( effect sizes [ d ] , 1.63 and 0.85 , respectively ) . No significant change was seen in Beck Depression Inventory II scores for treatment or waitlist groups . CONCLUSIONS This study provides support for the use of simplified cognitive-behavioral interventions for adolescents with social phobia that are practical for community psychiatric setting The present study compared the efficacy of virtual reality ( VR ) in virtuo exposure and in vivo exposure in the treatment of spider phobia . Two treatment conditions were compared to a waiting-list condition . A 3-month follow-up evaluation was conducted in order to assess the durability of the treatment effects . Participants were r and omly assigned to the treatment groups . A total of 16 participants received the in virtuo treatment , and 16 received the in vivo treatment .  The waiting-list condition included 11 participants . Participants received eight 1.5-hour treatment sessions . Efficacy was measured with the Fear of Spiders Question naire , the Spider Beliefs Question naire ( SBQ-F ) , and a Behavioral Avoidance Test ( BAT ) . In addition , a clinician administered the Structured Interview for DSM-IV to assess DSM-IV 's criteria for specific phobia and severity . Clinical and statistically significant improvements were found for both groups . Differences in treatment groups were found on one of five measures of fear : greater improvement on the SBQ-F beliefs subscale was associated with in vivo exposure OBJECTIVE To examine the effects of patient adherence on outcome from exposure and response prevention ( EX/RP ) therapy in adults with obsessive-compulsive disorder ( OCD ) . METHOD Thirty adults with OCD were r and omized to EX/RP ( n = 15 ) or EX/RP augmented by motivational interviewing strategies ( n = 15 ) . Both treatments included 3 introductory sessions and 15 exposure sessions . Because there were no significant group differences in adherence or outcome , the groups were combined to examine the effects of patient adherence on outcome . Independent evaluators assessed OCD severity using the Yale-Brown Obsessive Compulsive Scale . Therapists assessed patient adherence to between-session EX/RP assignments at each session using the Patient  EX/RP Adherence Scale ( PEAS ) . Linear regression models were used to examine the effects of PEAS scores on outcome , adjusting for baseline severity . The relationship between patient adherence and other predictors of outcome was explored using structural equation modeling . RESULTS Higher average PEAS ratings significantly predicted lower posttreatment OCD severity in intent-to-treat and completer sample s. PEAS ratings in early sessions ( 5 - 9 ) also significantly predicted posttreatment OCD severity . The effects of other significant predictors of outcome in this sample ( baseline OCD severity , hoarding subtype , and working alliance ) were fully mediated by patient adherence . CONCLUSIONS Patient adherence to between-session EX/RP assignments significantly predicted treatment outcome , as did early patient adherence and change in early adherence . Patient adherence mediated the effects of other predictors of outcome . Future research should develop interventions that increase adherence and then test whether increasing adherence improves outcome . If effective , these interventions could then be used to personalize care Examined the utility of CBT for childhood obsessive-compulsive disorder ( OCD ) including a preliminary exploration of predictors of response to this form of treatment . A total of 42 youngsters ( mean age 11.8 years , 60 % female , 52 % on medication at baseline ) with DSM-IV OCD were treated openly using a developmentally sensitive treatment protocol based on exposure plus response prevention ( ERP ) . The treatment response rate ( CGI < 2 ) was 79 % with a mean decrease from baseline in NIMH global scores of 45 % . Response was not related to age , gender , baseline medication status , comorbid symptomatology , or therapist experience . Poorer outcome was associated with more severe obsessions and greater OCD-related academic impairment at baseline . When presented in a developmentally appropriate manner , CBT is a useful treatment for childhood OCD . Controlled trials are needed to provide a more rigorous test of this treatment approach and provide better information regarding potential mediators and moderators of outcome BACKGROUND  Generalized social phobia is common , persistent , and disabling and is often treated with selective serotonin reuptake inhibitor drugs or cognitive behavioral therapy . OBJECTIVE We compared fluoxetine ( FLU ) , comprehensive cognitive behavioral group therapy ( CCBT ) , placebo ( PBO ) , and the combinations of CCBT/FLU and CCBT/PBO . DESIGN R and omized , double-blind , placebo-controlled trial . SETTING Two academic outpatient psychiatric centers . PATIENTS Subjects meeting a primary diagnosis of generalized social phobia were recruited via advertisement . Seven hundred twenty-two were screened , and 295 were r and omized and available for inclusion in an intention-to-treat efficacy analysis ; 156 ( 52.9 % ) were male , 226 ( 76.3 % ) were white , and mean age was 37.1 years . INTERVENTIONS Treatment lasted for 14 weeks . Fluoxetine and PBO were administered at doses from 10 mg/d to 60 mg/d ( or equivalent ) . Group comprehensive cognitive behavioral therapy was administered weekly for 14 
    Output:
    
Response rates varied significantly as a function of the properties used to define them .
Measures that incorporated more than one criterion , the combination of a reliable change index with a clinical cutoff ( a clinical ly significant change ) , and intent-to-treat sample s yielded lower response rates at post-treatment .
Blinded independent assessors yielded higher response rates than unblinded assessors .
Our results indicate that such measures are likely to reduce response rates , but may result in a less biased and more accurate representation of improvement and achievement of normative functioning