***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: OBJECTIVE Cognitive behavioral therapy ( CBT ) is an empirically supported treatment for social phobia . However , not all individuals respond to treatment and many who show improvement do not maintain their gains over the long-term . Thus , alternative treatments are needed . METHOD The current study ( N = 87 ) was a 3-arm r and omized clinical trial comparing CBT , acceptance and commitment therapy ( ACT ) , and a wait-list control group ( WL ) in participants with a diagnosis of social phobia based on criteria of the Diagnostic and Statistical Manual of Mental Disorders ( 4th ed . ; American Psychiatric Association , 1994 ) . Participants completed 12 sessions of CBT or ACT or a 12-week waiting period . All participants completed assessment s at baseline and posttreatment , and participants assigned to CBT and ACT also completed assessment s 6 and 12 months following baseline . Assessment s consisted of self-report measures , a public-speaking task , and clinician ratings . RESULTS Multilevel modeling was used to examine between-group differences on outcomes measures . Both treatment groups outperformed WL , with no differences observed between CBT and ACT on self-report , independent clinician , or public-speaking outcomes . Lower self-reported psychological flexibility at baseline was associated with greater improvement by the 12-month follow-up in CBT compared with ACT .  Self-reported fear of negative evaluation significantly moderated outcomes as well , with trends for both extremes to be associated with superior outcomes from CBT and inferior outcomes from ACT . Across treatment groups , higher perceived control and extraversion were associated with greater improvement , whereas comorbid depression was associated with poorer outcomes . CONCLUSIONS Implication s for clinical practice and future research are discussed Comm and hallucinations represent a special problem for the clinical management of psychosis . While compliance with both non-harmful and harmful comm and s can be problematic , sometimes in the extreme , active efforts to resist comm and s may also contribute to their malignancy . Previous research suggests Cognitive Behaviour Therapy ( CBT ) to be a useful treatment for reducing compliance with harmful comm and hallucinations . The purpose of this trial was to evaluate whether CBT augmented with acceptance-based strategies from Acceptance and Commitment Therapy could more broadly reduce the negative impact of comm and hallucinations .  Forty-three participants with problematic comm and hallucinations were r and omized to receive 15 sessions of the intervention " TORCH " ( Treatment of Resistant Comm and Hallucinations ) or the control , Befriending , then followed up for 6 months . A sub- sample of 17 participants was r and omized to a waitlist control before being allocated to TORCH or Befriending . Participants engaged equally well with both treatments . Despite TORCH participants subjectively reporting greater improvement in comm and hallucinations compared to Befriending participants , the study found no significant group differences in primary and secondary outcome measures based on blinded assessment data . Within-group analyses and comparisons between the combined treatments and waitlist suggested , however , that both treatments were beneficial with a differential pattern of outcomes observed across the two conditions The development and well-being assessment ( DAWBA ) has been used in various epidemiological studies , whereas the clinical value of the instrument needs support from further studies . In particular , it is important to document how the use of the DAWBA influences clinical decision-making . The present study employed the DAWBA in a consecutive series of 270 new referrals to a large public child and adolescent psychiatric service in Zurich , Switzerl and . ICD-10 based diagnoses were obtained from clinicians for all patients and reliability of DAWBA expert raters was calculated . The DAWBA diagnoses were r and omly disclosed ( n = 144 ) or not disclosed ( n = 126 ) before clinical decision-making . The reliability of DAWBA expert diagnoses was very satisfactory and the agreement under the disclosed versus the non-disclosed condition amounted to 77 versus 68 % for internalizing disorders and to 63 versus 71 % for externalizing disorders . The increment in agreement due to disclosure of the DAWBA diagnosis was significant for internalizing disorders . Access to DAWBA information was more likely to prompt clinicians to add an extra diagnosis . Professional background and degree of clinical experience did not affect diagnostic agreement . Overall , diagnostic agreements between DAWBA expert diagnoses and clinical diagnoses were in the fair to moderate range and comparable to previous studies with other structured diagnostic interviews . The inclusion of the DAWBA into the clinical assessment process had an impact on diagnostic decision-making regarding internalizing disorders but not regarding externalizing disorders Objective The aim of this study was to compare 2 self-help-based interventions ; a coping-oriented approach , applied relaxation ( AR ) and an acceptance-oriented approach , acceptance and commitment therapy ( ACT ) , for persons with chronic pain . Method This study is a r and omized control trial ( N=90 ) with a mixed between-within participants design with repeated measures . Interventions in both conditions comprised an initial face-to-face session , a 7-week manual-based self-help intervention including weekly therapist telephone support and a concluding face-to-face session . Outcome measures included satisfaction with life , depression , anxiety , acceptance of chronic pain , level of function , and pain intensity . Effects were measured at preintervention and postintervention and at 6 and 12 months after the end of intervention . Results The results show that the ACT condition increased their level of acceptance significantly compared with the AR condition . There was also a marginally significant interaction effect regarding satisfaction with life in which the ACT condition had improved in comparison to the AR condition . Further , the ACT condition reported a higher level of function and decreased pain intensity compared with the AR condition . Both conditions improved significantly regarding depression and anxiety . Conclusions A manual-based self-help intervention with weekly therapist support in an ACT format adds value to the treatment repertoire for persons suffering with chronic pain OBJECTIVE We conducted a pilot r and omized trial of telephone-delivered acceptance and commitment therapy ( ACT ) versus cognitive behavioral therapy ( CBT ) for smoking cessation . METHOD Participants were 121 uninsured South Carolina State Quitline callers who were adult smokers ( at least 10 cigarettes/day ) and who wanted to quit within the next 30 days . Participants were r and omized to 5 sessions of either ACT or CBT telephone counseling and were offered 2 weeks of nicotine replacement therapy ( NRT ) . RESULTS ACT participants completed more calls than CBT participants ( M = 3.25 in ACT vs. 2.23 in CBT ; p = .001 ) . Regarding satisfaction , 100 % of ACT participants reported their treatment was useful for quitting smoking ( vs. 87 % for CBT ; p = .03 ) , and 97 % of ACT participants would recommend their treatment to a friend ( vs. 83 % for CBT ; p = .06 ) . On the primary outcome of intent-to-treat 30-day point prevalence abstinence at 6 months postr and omization , the quit rates were 31 % in ACT versus 22 % in CBT ( odds ratio [ OR ] = 1.5 , 95 % confidence interval [ CI ] = 0.7 - 3.4 ) . Among participants depressed at baseline ( n = 47 ) , the quit rates were 33 % in ACT versus 13 % in CBT ( OR = 1.2 , 95 % CI = 1.0 - 1.6 ) . Consistent with ACT 's theory , among participants scoring low on acceptance of cravings at baseline ( n = 57 ) , the quit rates were 37 % in ACT versus 10 % in CBT ( OR = 5.3 , 95 % CI = 1.3 - 22.0 ) . CONCLUSIONS ACT is feasible to deliver by phone , is highly acceptable to quitline callers , and shows highly promising quit rates compared with st and ard CBT quitline counseling . As results were limited by the pilot design ( e.g. , small sample ) , a full-scale efficacy trial is now needed Acceptance and Commitment Therapy ( ACT ) has a growing empirical base in the treatment of anxiety among adults and children with other concerns . This study reports on the main outcomes of a r and omized controlled trial of ACT and traditional cognitive behavioral therapy ( CBT ) in children with a Diagnostic and Statistical Manual of Mental Disorders ( 4th ed . ) anxiety disorder . Participants were 193 children from urban Sydney , Australia , who were block-r and omized to a 10-week group-based program of ACT or CBT or a 10-week waitlist control ( WLC ) .  Completers included 157 children ( ACT = 54 , CBT = 57 , WLC = 46 ; M = 11 years , SD = 2.76 ; 78 % Caucasian , 58 % female ) . Pretreatment , posttreatment , and 3 months posttreatment assessment s included clinician/self/parent-reported measures of anxiety , quality of life ( QOL ; anxiety interference , psychosocial and physical health-related QOL ) , and acceptance/defusion outcomes . Completer and intention-to-treat analyses revealed that ACT and CBT were both superior to WLC across outcomes , reflecting statistically and clinical ly significant differences , with gains maintained at 3 months posttreatment . Both completer and intention-to-treat analyses found ACT and CBT to produce similar outcomes . There was some support for ACT having greater effect sizes for QOL outcomes but not for avoidance/fusion . Although this study does not suggest that ACT is equivalent to CBT or should be adopted in its place , it does provide evidence that ACT might be another empirically supported treatment option for anxious youth . Further research is needed to replicate these findings Background Obesity is a growing epidemic . Weight control interventions can achieve weight loss , but most is regained over time . Stigma and low quality of life are significant problems that are rarely targeted . Purpose A new model aim ed at reducing avoidant behavior and increasing psychological flexibility , has shown to be relevant in the treatment of other chronic health problems and is worth examining for improving the lives of obese persons . Methods Patients who had completed at least 6 months of a weight loss program ( N = 84 ) were r and omly assigned to receive a 1-day , mindfulness and acceptance-based workshop targeting obesity-related stigma and psychological distress or be placed on a waiting list . Results At a 3-month follow-up , workshop participants showed greater improvements in obesity-related stigma , quality of life , psychological distress , and body mass , as well as improvements in distress tolerance , and both general and weight-specific acceptance and psychological flexibility . Effects on distress , stigma , and quality of life were above and beyond the effects due to improved weight control . Mediational analyses indicated that changes in weight-specific acceptance coping and psychological flexibility mediated changes in outcomes . Conclusion Results provide preliminary support for the role of acceptance and mindfulness in improving the quality of life of obese individuals while simultaneously augmenting their weight control efforts BACKGROUND Depression is a highly prevalent disorder , causing a large burden of disease and substantial economic costs . Web-based self-help interventions seem promising in promoting mental health . AIMS To compare the efficacy of a guided web-based intervention based on acceptance and commitment therapy ( ACT ) with an active control ( expressive writing ) and a waiting-list control condition ( Netherl and s Trial Register NTR1296 ) . METHOD Adults with depressive symptoms from the general population were r and omised to ACT ( n = 82 ) , expressive writing  ( n = 67 ) or waiting-list control  ( n = 87 ) . The main outcome was reduction in depressive symptoms assessed with the Center for Epidemiological Studies - Depression scale . RESULTS Significant reductions in depressive symptoms were found following the ACT intervention , compared with the control group ( Cohen 's d = 0.56 ) and the expressive writing intervention ( d = 0.36 ) . The effects were sustained at 6-month and 12-month follow-up . CONCLUSIONS Acceptance and commitment therapy as a web-based public mental health intervention for adults with depressive symptoms can be effective and applicable Objective To assess the relationship between session-by-session mediators and treatment outcomes in traditional cognitive-behavioral therapy ( CBT ) and acceptance and commitment therapy ( ACT ) for social anxiety disorder . Method Session-by-session changes in negative cognitions ( a theorized mediator of CBT ) and experiential avoidance ( a theorized mediator of ACT ) were assessed in 50 adult out patients r and omized to CBT ( n = 25 ) or ACT ( n = 25 ) for DSM-IV social anxiety disorder . Results Multilevel modeling analyses revealed significant nonlinear decreases in the proposed mediators in both treatments , with ACT showing steeper decline than CBT at the beginning of treatment and CBT showing steeper decline than ACT at the end of treatment . Curvature ( or the nonlinear effect ) of experiential avoidance during treatment significantly mediated posttreatment social anxiety symptoms and anhedonic depression in ACT , but not in CBT , with steeper decline of the Acceptance and Action Question naire at the beginning of treatment predicting fewer symptoms in ACT only . Curvature of negative cognitions during both treatments predicted outcome , with steeper decline of negative cognitions at the beginning of treatment predicting lower posttreatment social anxiety and depressive symptoms . Conclusions Rate of change in negative cognitions at the beginning of treatment is an important predictor of change across both ACT and CBT , whereas rate of change in experiential avoidance at the beginning of treatment is a mechanism specific to ACT Existing strategies for coping with food cravings are of unknown efficacy and rely on principles that have been shown to have par 
    Output:
    
Comparisons of Öst 's quality ratings with independent teams rating the same studies with the same scale suggest that Ost 's ratings were unreliable .
In all of these areas ( factual errors ; interpretive errors ; quality ratings ) mistakes and differences were not r and om : Ost 's data were dominantly more negative toward ACT .