***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: In the present study , the role of individual response patterns in the treatment of social phobic patients was investigated . Seventy-four patients were diagnosed as social phobics . On the basis of extreme scores on a behavioral test ( the Simulated Social Interaction Test ) and on a cognitive measure ( the Rational Behavior Inventory ) , the response patterns of 39 patients were analyzed , and the patients themselves were classified as either ' behavioral reactors ' or ' cognitive reactors ' . Half of the patients with each response pattern received a behavioral focused treatment , i.e.  social skills training ( SST ) , while the other half received a cognitive oriented treatment , i.e. rational emotive therapy ( RET ) . Patients received group therapy in eight weekly sessions . Within-group differences showed a considerable improvement in all treatment groups . Between-group differences failed to lend support to the hypothesis that treatment that fits a response pattern ( i.e. SST for behavioral reactors and RET for cognitive reactors ) will result in a greater improvement than one that does not Psychological group treatments , such as behavioral or cognitive-behavioral therapy , are generally effective interventions for social phobia . However , a substantial number of individuals discontinue these treatments prematurely . Participant attrition can threaten the validity of treatment outcome studies if attrition during therapy does not occur r and omly . In order to examine this issue , we studied 133 individuals with a principal diagnosis of social phobia who initiated a 12-week behavioral or cognitive-behavioral group treatment for social phobia . Thirty-four participants discontinued therapy prematurely . These dropouts were compared to treatment completers in demographic characteristics , Axis I and II psychopathology , and their attitude toward treatment . The results only showed a small difference between treatment completers and dropouts in their attitude toward treatment : dropouts rated the treatment rationale as less logical than completers at the beginning of treatment . No other differences between dropouts and completers were observed . Therefore , dropouts are unlikely to present a serious threat to the external validity of treatment outcome studies for social phobia Adequate reporting of r and omized , controlled trials ( RCTs ) is necessary to allow accurate critical appraisal of the validity and applicability of the results . The CONSORT ( Consoli date d St and ards of Reporting Trials ) Statement , a 22-item checklist and flow diagram , is intended to address this problem by improving the reporting of RCTs . However , some specific issues that apply to trials of nonpharmacologic treatments ( for example , surgery , technical interventions , devices , rehabilitation , psychotherapy , and behavioral intervention ) are not specifically addressed in the CONSORT Statement . Furthermore , considerable evidence suggests that the reporting of nonpharmacologic trials still needs improvement . Therefore , the CONSORT group developed an extension of the CONSORT Statement for trials assessing nonpharmacologic treatments . A consensus meeting of 33 experts was organized in Paris , France , in February 2006 , to develop an extension of the CONSORT Statement for trials of nonpharmacologic treatments . The participants extended 11 items from the CONSORT Statement , added 1 item , and developed a modified flow diagram . To allow adequate underst and ing and implementation of the CONSORT extension , the CONSORT group developed this elaboration and explanation document from a review of the literature to provide examples of adequate reporting . This extension , in conjunction with the main CONSORT Statement and other CONSORT extensions , should help to improve the reporting of RCTs performed in this field Patients with depression are often excluded from studies on the treatment of social anxiety disorder ( SAD ) , leaving gaps in our knowledge about the impact of depressive affect on treatment for SAD . Patients participated in a r and omized , placebo‐controlled study of treatment for SAD . As in previous studies , patients were excluded from the study if they met criteria for major depressive disorder in the past 6 months . This exclusion notwithst and ing , patients who enrolled in the study exhibited a range of depressive symptoms , permitting an examination of the impact of depressive symptoms on treatment outcome for SAD . Assessment measures included the Clinical Global Impression Scale , Hamilton Rating Scale for Depression , Brief Social Phobia Scale , and Beck Depression Inventory . Higher levels of depressive symptoms were related to more severe social anxiety overall , and to less change in social anxiety symptoms over the course of the study . Patients who were deemed nonresponders to treatment had higher levels of depressive symptoms at pretreatment than those who responded . In addition , patients who dropped out of the study had higher levels of depressive symptoms at pretreatment than those who completed the study . These results suggest that modifications should be made to existing treatments to improve outcomes and decrease attrition in the substantial proportion of patients with SAD who also evidence depressive symptoms . Such modifications are likely to be more important when treating patients with SAD and comorbid major depressive disorder . Depression and Anxiety 22:161–167 , 2005 . © 2005 Wiley‐Liss , This study was a replication of a study on the prediction of treatment outcome in social phobic patients [ Chambless , D. L. , Tran , G. Q. Glass , C.R. ( 1997 ) . Predictors of response to cognitive-behavioral group therapy for social phobia . Journal of Anxiety Disorders , 11 221 - 240 ] . Results at the posttest and the 18-months follow-up were analyzed for DSM-III-R social phobic patients , with either a generalized social phobia ( n = 50 ) or a nongeneralized fear , i.e. fear of blushing , trembling or sweating in social situations ( n = 26 ) . Predictors were pretreatment depression , personality disorder traits , clinician rated severity of impairment and frequency of negative self-statements during social interactions . The criterium variable was ( the residual gain score of ) self-reported avoidance of social situations . In line with Chambless et al. , pretreatment depression showed some predictive value , but smaller and only at the posttest . Change in the frequency of negative self-statements paralleled , but did not predict , change in social phobia symptoms . In contrast with Chambless et al. , clinician rated severity was ( slightly ) predictive for treatment outcome , whereas avoidant personality traits had reverse correlations with outcome in both subgroups . The results are discussed and directions for further research are given Social phobia patients with fear of blushing , trembling , sweating and /or freezing as main complaint ( N = 65 ) were r and omly assigned to either task concentration training ( TCT ) or applied relaxation ( AR ) both followed by cognitive therapy ( CT ) . Measurements took place before and after wait-list , after TCT or AR ( within-test ) , after CT ( post-test ) , at 3-months and at 1-year follow-up . Effects were assessed on fear of showing bodily symptoms ( the central outcome variable ) , social phobia , other psychopathology , social skills , self-consciousness , self-focused attention , and dysfunctional beliefs . No changes occurred during wait-list . Both treatments were highly effective .  TCT was superior to AR in reducing fear of bodily symptoms and dysfunctional beliefs at within-test . This difference disappeared after CT , at post-test and at 3-months follow-up . However , at 1-year follow-up the combination TCT-CT was superior to AR-CT in reducing fear of bodily symptoms , and effect sizes for TCT-CT reached 3 . Furthermore , at all assessment moments TCT or the combination TCT-CT was superior to AR-CT in reducing self-consciousness and self-focused attention . The superior long-term effect of TCT on fear of showing bodily symptoms is explained by lasting changes in attentional focus Ninety individuals with social phobia ( social anxiety disorder ) participated in a r and omized controlled trial and completed cognitive-behavioral group therapy , exposure group therapy without explicit cognitive interventions , or a wait-list control condition . Both treatments were superior to the wait-list group in reducing social anxiety but did not differ from one another at posttest . Changes in estimated social cost mediated treatment changes in both treatment conditions from pre- to posttest . However , only participants who received cognitive-behavioral therapy showed continued improvement from posttest to 6-month follow-up , which was associated with a reduction of estimated social cost from pretest to posttest . These results suggest that cognitive intervention leads to better maintenance of treatment gains , which is mediated through changes in estimated social cost 
    Output:
    
No pre-treatment patient variables were found to predict drop-out .
Consistently across studies , higher levels of pre-treatment symptomatic severity predicted higher levels of end-state symptomatic severity , but not degree of improvement .
There was some evidence that comorbid depression and avoidant personality disorder before treatment negatively influenced post-treatment end-state functioning , but not consistently improvement .
Generally , the results are in line with the conclusion that more disturbed patients with SP both begin and end treatment at a higher symptomatic level but with a similar degree of improvement .