***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: BACKGROUND The objectives of the study were to examine linkages between exposure to childhood abuse and interparental violence and the subsequent development of panic attacks and panic disorder using data gathered on a birth cohort of 1265 New Zeal and young people studied to the age of 21 years . METHOD Data on : ( a ) exposure to child abuse and interparental violence ; ( b ) the development of panic attacks and panic disorder ; and ( c ) other childhood and related factors were gathered over the course of a 21-year longitudinal study . RESULTS After adjustment for childhood and related factors , exposure to childhood physical abuse was associated with a significantly increased risk of later panic attack ( OR 2.3 , 95 % CI 1.1 - 4.9 ) and panic disorder ( OR 3.0 , 95 % CI 1.1 - 7.9 ) ; childhood sexual abuse was associated with a significantly increased risk of panic attack ( OR 4.1 , 95 % CI 2.3 - 7.2 ) and a marginally significant increase risk of panic disorder ( OR 2.2 ; 95 % CI 0.98 - 5.0 ) . Exposure to interparental violence was unrelated to later panic attack or disorder after adjustment . CONCLUSIONS Exposure to childhood sexual and physical abuse was associated with increased risks of later panic attack/disorder even after adjustment for prospect ively assessed confounding factors . However , exposure to interparental violence during childhood was not related to increased risk of later panic attack/disorder after adjustment . These data suggest the need for clinicians to be aware that patients with histories of childhood physical and sexual abuse may be at increased risk for panic during young adulthood Are meta-analyses the brave new world , or are the critics of such combined analyses right to say that the biases inherent in clinical trials make them uncombinable ? Negative trials are often unreported , and hence can be missed by meta-analysts . And how much heterogeneity between trials is acceptable ? A recent major criticism is that large r and omised trials do not always agree with a prior meta- analysis . Neither individual trials nor meta-analyses , reporting as they do on population effects , tell how to treat the individual patient . Here we take a more rounded approach to meta-analyses , arguing that their strengths outweigh their weaknesses , although the latter must not be brushed aside Utilizing a r and om probability sample of Canadian residents aged 15 - 64 ( n = 8116 ) , this study assessed gender differences in the onset of  social phobia  and the moderating influence of gender on indicators of childhood family adversity hypothesized to increase the risk of developing the disorder . Results revealed statistically significant " gender by family adversity " interactions that varied by disorder sub-type . Among males , absence of a parent or other adult close confidant during childhood was associated with an elevated risk of developing social phobia ( all diagnosed cases and the non-generalized sub-type ) . Risk factors unique to females included parental conflict while growing up ( all diagnosed cases ) , childhood physical abuse by a father figure ( generalized sub-type ) , and maternal mania ( non-generalized sub-type ) . Results highlight the importance of distinguishing between social phobia sub-types in gender-based research as well as the use of family adversity measures that capture the parenting behaviors and mental health status of both parents BACKGROUND Subtle and inconsistent differences in hypothalamic-pituitary-adrenal ( HPA ) axis activity have been reported for patients with panic disorder . While these patients show little or no alterations in basal ACTH and cortisol levels , it has been hypothesized that HPA hyperresponsivity was a trait in panic patients when exposed to novel and uncontrollable stimulation . METHODS Thirty-four patients ( 23 females , mean age 35 yrs ) diagnosed with panic disorder were compared to 34 healthy controls matched for age , gender , smoking status , and use of oral contraceptives . Both groups were exposed twice to a potent laboratory stress protocol , the Trier Social Stress Test ( TSST ) on consecutive days .  Free salivary cortisol levels and heart rate responses were repeatedly measured before and following the TSST . In addition , the cortisol awakening response ( CAR ) was assessed to further investigate HPA reactivity in PD patients . RESULTS While the TSST induced similar heart rate stress responses in both groups , cortisol responses were clearly absent in the panic patients with normal responses in the controls ( F(1.96 , 66)=20.16 ; p<0.001 ) . No differences in basal cortisol levels were observed in the extended baseline period . The same cortisol stress non-response patterns were observed when patients with/without comorbid depression , or with/without psychotropic medication were compared . In contrast to their non-response to the psychosocial stressor , panic patients showed a significant CAR . CONCLUSION These findings provide strong evidence to suggest that PD patients present with a striking lack of cortisol responsivity to acute uncontrollable psychosocial stress under laboratory conditions . This unresponsiveness of the HPA axis appears to be rather specific , since a normal CAR in the morning could be documented in these patients . Thus , the present results do not support the hypothesis that PD patients show a trait HPA hyperresponsiveness to novel and uncontrollable stimulation . In contrast , the data provide support for a hyporesponsive HPA axis under emotional stress in PD patients A large body of research has suggested that anxiety sensitivity ( AS ) acts as a specific vulnerability factor in the development of anxiety pathology . More recently , attention has turned to the etiology of AS per se . The present study represents a specific test of a Scar model of AS . A Scar model posits that the experience of distress will affect the vulnerability factor . We were specifically interested in evaluating the effects of a specific stressor ( spontaneous panic ) as well as general distress on changes in AS over time . A large non clinical sample of young adults ( N = 1296 ) was prospect ively followed over a five week highly stressful period of time ( i.e. military basic training ) . Findings were consistent with the Scar model and suggested that the specific stressor of experiencing a panic attack as well as general stressors creating significant anxiety symptoms uniquely contributed to increased levels of AS ( regardless of prior history of panic ) . Moreover , the experience of spontaneous panic in the context of generally low levels of distress ( both anxiety and depression ) appeared to be particularly pernicious in terms of result ing in greater increases in AS . In sum , anxiety-related stressors appear to have the potential to ' scar ' individuals in regard to this cognitive vulnerability factor OBJECTIVE With the exception of a few reports of higher rates of childhood trauma in Vietnam veterans with posttraumatic stress disorder ( PTSD ) , little is known about the influence of previous exposure to trauma on the PTSD effects of subsequent trauma . The authors examine interrelated questions about the effects of previous exposure to trauma . METHOD A representative sample of 2,181 individuals in southeast Michigan were interviewed by telephone  to record  lifetime history of traumatic events specified in DSM-IV as potentially leading to PTSD . PTSD was assessed with respect to a r and omly selected index trauma from the list of events reported by each respondent . RESULTS History of any previous exposure to traumatic events was associated with a greater risk of PTSD from the index trauma . Multiple previous events had a stronger effect than a single previous event . The effect of previous assaultive violence persisted over time with little change . When they examined several features of the previous exposure to trauma , the authors found that subjects who experienced multiple events involving assaultive violence in childhood were more likely to experience PTSD from trauma in adulthood . Furthermore , previous events involving assaultive violence -- single or multiple , in childhood or later on -- were associated with a higher risk of PTSD in adulthood . CONCLUSIONS Previous exposure to trauma signals a greater risk of PTSD from subsequent trauma . Although these results are consistent with a sensitization hypothesis , like the results from previous research on PTSD , they do not address the mechanism of increased responsivity to trauma . Long-term observational studies can further eluci date these observations BACKGROUND Inpatient psychotherapeutic support has been shown to reduce mental health problems in severely injured patients . However , this effect mostly disappears after discharge . The aim of this study was to compare short-term inpatient versus continued long-term outpatient psychotherapeutic support . METHODS Patients with at least two injuries of a combined Abbreviated Injury Scale Severity Score Index≥5 were included in the study . Of 862 screened patients , 113 met all inclusion criteria . They were r and omly assigned to a short-term group ( n=59 ) , where only inpatient support was given , and a long-term group ( n=54 ) , with additional outpatient sessions . The cognitive behavioral treatment was st and ardized by a manual . Psychological assessment for depression , anxiety , and posttraumatic stress disorder ( PTSD ) was performed in written form at the time of inclusion , discharge , and 6 months , 12 months , and 18 months after trauma . RESULTS Forty-one percent ( n=46 ) of all patients completed follow-up visits . The results show that symptoms of depression , anxiety , and PTSD disappeared more often in the long-term group than in the short-term group 1 year after trauma . Differences nearly reach significance for anxiety ( p=0.051 ) and PTSD ( p=0.059 ) . Twenty-one percent of the short-term group patients showed at least one mental health disorder compared with no patients in the long-term group 1 year after trauma ( p=0.035 ) . CONCLUSION Psychotherapeutic support of severely injured patients seems to be more effective in reducing depression , anxiety , and PTSD if extended further into outpatient care . This conclusion should be considered preliminary because of the small number of study patients The common finding linking symptoms such as posttraumatic stress disorder ( PTSD ) and depression with youth victimization ( e.g. , sexual abuse ) might well be artifactual if preexisting psychopathology or disturbed family relationships create a common risk for both later victimization and later symptoms . This study used a longitudinal , prospect i ve design to examine this issue . In a national r and om sample  telephone survey , children 10 to 16 years old were interviewed and then reinterviewed approximately 15 months later about  psychological problems , family relationships  and  victimization  experiences that had occurred in the interim . Victimization in the interim was associated with PTSD-related symptoms and depression measured at Time 2 , even after controlling for these symptoms and the quality of the parent-child relationship at Time 1 . The association was particularly strong for sexual abuse , parental assault , and kidnapping experiences . However , these data also suggest that some of the apparent association found in cross-sectional studies between victimization and psychopathology may be due to prior psychopathology ( but not parent-child relationship problems ) , which puts children at risk for both victimization and later symptoms BACKGROUND This study examined the relationship between potential childhood risk factors and  social phobia  in an epidemiological sample . Identifying risk factors such as childhood adversities can often uncover important clues as to the aetiology of a disorder . This information also enables health care providers to predict which individuals are most likely to develop the disorder . METHODS Data came from the Mental Health Supplement to the Ontario Health Survey of a survey of 8116 Canadian respondents , aged 15 - 64 .  Social phobia  was diagnosed using the Composite International Diagnostic Interview ( CIDI ) . Childhood risk factors were assessed by a series of st and ardized questions . RESULTS A positive relationship was observed between social phobia  and lack of close relationship with an adult , not being first born ( in males only ) , marital conflict in the family of origin , parental history of mental disorder , moving more than three times as a child , juvenile justice and child welfare involvement , running away from home , childhood physical and sexual abuse , failing a grade , requirement of special education before age 9 and dropping out of high school . Many of these variables remained significant after controlling for phobias , major depressive disorder and alcohol abuse . The data also suggest that some childhood risk factors may interact with gender to influence the development of social phobia . CONCLUSIONS Although an association was detected between social phobia  and childhood risk factors , naturalistic prospect i ve studies are needed to clarify the aetiological importance of these and other potential risk factors for the disorder OBJECTIVE The authors investigated whether histories of childhood physical or sexual abuse were reported more frequently in a clinical sample of patients with anxiety disorders than in a matched community comparison sample . METHOD A st and ardized interview with an extensive series of trauma probes was administered to 125 patients with DSM-IV anxiety disorders ( panic disorder , social phobia , or obsessive-compulsive disorder ) and to 125 age- and gender-matched subjects drawn from a r and om community sample . RESULTS Childhood physical abuse was higher among both men ( 15.5 % ) and women ( 33.3 % ) with anxiety disorders than among comparison subjects ( 8.1 % ) . Childhood sexual abuse was higher among women with anxiety disorders ( 45.1 % ) than among comparison women ( 15.4 % ) and was higher among women with panic disorder ( 60.0 % ) than among women with other anxiety disorders ( 30.8 % ) . CONCLUSIONS These findings confirm the association between anxiety disorders and reported childhood physical and sexual abuse and extend earlier findings by pointing to a particular association between sexual abuse and panic disorder in women 
    Output:
    
Emotional traumas were the main risk factor for social anxiety disorder .
However , no specific associations were found for the other ADs .
EET is a risk factor for ADs , underscoring the importance of preventive measures to combat the development of these disorders .