You will be presented with a collection of medical randomized controlled trial (RCT) reports addressing a shared clinical question -- for instance, the efficacy of a medical intervention on a disease or condition. Given the titles and abstracts of these reports, your task is to generate the conclusion of the systematic review article synthesizing the key findings. Your conclusion should be a few sentences long. In your response, include only the conclusion and no other text. The RCT reports are below.



Title 1:
Social Interpretation Bias in Children and Adolescents with Anxiety Disorders: Psychometric Examination of the Self-report of Ambiguous Social Situations for Youth (SASSY) Scale
Abstract 1:
Abstract Background Anxiety disorders are among the most common mental health problems in youth , and faulty interpretation bias has been positively linked to anxiety severity , even within anxiety-disordered youth . Quick , reliable assessment of interpretation bias may be useful in identifying youth with certain types of anxiety or assessing changes on cognitive bias during intervention . Objective This study examined the factor structure , reliability , and validity of the Self-report of Ambiguous Social Situations for Youth ( SASSY ) scale , a self-report measure developed to assess interpretation bias in youth . Methods Participants ( N = 488 , age 7–17 ) met diagnostic criteria for social phobia , generalized anxiety disorder , and /or separation anxiety disorder . An exploratory factor analysis was performed on baseline data from youth participating in a large r and omized clinical trial . Results Exploratory factor analysis yielded two factors ( accusation/blame , social rejection ) . The SASSY full scale and social rejection factor demonstrated adequate internal consistency , convergent validity with social anxiety , and discriminant validity as evidence d by non-significant correlations with measures of non-social anxiety . Further , the SASSY social rejection factor accurately distinguished children and adolescents with social phobia from those with other anxiety disorders , supporting its criterion validity , and revealed sensitivity to changes with treatment . Given the relevance to youth with social phobia , pre- and post-intervention data were examined for youth social phobia to test sensitivity to treatment effects ; results suggested that SASSY scores reduced for treatment responders . Conclusions Findings suggest the potential utility of the SASSY social rejection factor as a quick , reliable , and efficient way of assessing interpretation bias in anxious youth , particularly as related to social concerns , in research and clinical setting s. Clinical Trials.gov Number NCT00052078


Title 2:
The Liebowitz social anxiety scale for children and adolescents: an initial psychometric investigation.
Abstract 2:
OBJECTIVE To examine the psychometric properties of a newly developed clinician rating scale , the Liebowitz Social Anxiety Scale for Children and Adolescents ( LSAS-CA ) . METHOD A total of 154 children and adolescents participated in an assessment consisting of a diagnostic interview , the  LSAS-CA  , and other measures of psychopathology and impairment . Sixty-one of these children also participated in a second LSAS-CA administration , by a different rater blind to diagnosis , within 7 days of the initial assessment . RESULTS High internal consistency ( alpha = .90-.97 for full sample and .83-.95 for social phobia group ) and test-retest reliability ( intraclass correlation coefficient = 0.89 - 0.94 ) were obtained for LSAS-CA total and subscale scores .  LSAS-CA scores had stronger associations with measures of social anxiety and general impairment than with a measure of depression .  Subjects with social anxiety disorder had significantly higher  LSAS-CA scores than subjects with other anxiety disorders and healthy controls . A  LSAS-CA cutoff score of 22.5 represented the best balance of sensitivity and specificity when distinguishing between individuals with social phobia and normal controls , whereas a cutoff of 29.5 was optimal for distinguishing social phobia from other anxiety disorders . CONCLUSION Initial findings suggest that the LSAS-CA is a reliable and valid instrument for the assessment of social anxiety disorder


Title 3:
Testing the specificity between social anxiety disorder and drinking motives.
Abstract 3:
This study tested the specificity of the relationship between social anxiety disorder ( SAD ) and coping drinking motives ( versus enhancement drinking motives and social drinking motives ) within the context of a range of potentially confounding variables measured during adolescence ( e.g. , quantity and frequency of alcohol use , coping drinking motives ) and substantively important variables assessed during young adulthood ( e.g. , other anxiety disorders and major depressive disorder ) . A sample of high school sophomores and juniors ( n=717 ) completed measures of substance use and risk factors during adolescence and were then prospect ively followed-up in early- and middle-young adulthood , and psychiatric diagnoses and drinking motives ( i.e. , coping , enhancement , and social ) were assessed each time . Findings indicated that SAD was specifically related to coping motives ( measured during early-to-middle young adulthood ) after controlling for the effects of a range of alcohol and mental health variables . In addition , adolescent variables predicted young adult drinking motives as did major depressive disorder and other anxiety disorders . These findings are discussed within a conceptual framework of the functional role ( e.g. , self-medication ) that drinking motives , and especially coping drinking motives , may play in the etiology of alcohol problems and disorders . Implication s for prevention and treatment interventions are discussed


Title 4:
Errors in Identifying and Expressing Emotion in Facial Expressions, Voices, and Postures Unique to Social Anxiety
Abstract 4:
ABSTRACT The purpose of the present study was to see if 7–10-year-old socially anxious children ( n = 26 ) made systematic errors in identifying and sending emotions in facial expressions , para language , and postures as compared with the more r and om errors of children who were inattentive – hyperactive ( n = 21 ) . It was found that socially anxious children made more errors in identifying anger and fear in children 's facial expressions and anger in adults ’ postures and in expressing anger in their own facial expressions than did their inattentive – hyperactive peers . Results suggest that there may be systematic difficulties specifically in visual nonverbal emotion communication that contribute to the personal and social difficulties socially anxious children experience


Title 5:
Painful consequences of anger suppression.
Abstract 5:
The authors experimentally examined the effects of anger suppression on  pain perception .  On the basis of ironic process theory , they proposed that efforts to suppress experiential or expressive components of anger may paradoxically enhance cognitive accessibility of anger-related thoughts and feelings , thereby contaminating perception of succeeding pain in an anger-congruent manner . Participants were r and omly assigned to nonsuppression or experiential or expressive suppression conditions during mental arithmetic with or without harassment . A cold-pressor task followed . Results revealed that participants instructed to suppress experiential or expressive components of emotion during harassment not only reported the greatest pain levels , but also rated the anger-specific dimensions of pain uniquely strong . Results suggest that attempts to suppress anger may amplify pain sensitivity by ironically augmenting perception of the irritating and frustrating qualities of pain


Title 6:
Publication bias in clinical research
Abstract 6:
In a retrospective survey , 487 research projects approved by the Central Oxford Research Ethics Committee between 1984 and 1987 , were studied for evidence of publication bias . As of May , 1990 , 285 of the studies had been analysed by the investigators , and 52 % of these had been published . Studies with statistically significant results were more likely to be published than those finding no difference between the study groups ( adjusted odds ratio [ OR ] 2.32 ; 95 % confidence interval [ Cl ] 1.25 - 4.28 ) . Studies with significant results were also more likely to lead to a greater number of publications and presentations and to be published in journals with a high citation impact factor . An increased likelihood of publication was also associated with a high rating by the investigator of the importance of the study results , and with increasing sample size . The tendency towards publication bias was greater with observational and laboratory-based experimental studies ( OR = 3.79 ; 95 % Cl = 1.47 - 9.76 ) than with r and omised clinical trials ( OR = 0.84 ; 95 % Cl = 0.34 - 2.09 ) . We have confirmed the presence of publication bias in a cohort of clinical research studies . These findings suggest that conclusions based only on a review of published data should be interpreted cautiously , especially for observational studies . Improved strategies are needed to identify the results of unpublished as well as published studies


Title 7:
Linking self-reported childhood behavioral inhibition to adolescent social phobia.
Abstract 7:
OBJECTIVE Behavioral inhibition in children has been hypothesized to be a risk factor for the later development of social phobia . However , this hypothesis has yet to be demonstrated in a prospect i ve study . The purpose of the study presented here is to test whether behavioral inhibition in childhood constitutes a risk factor for social phobia during adolescence . METHOD The sample consisted of 2,242 high school students assessed over a 4-year period . Assessment s included  self-report question naires ,  structured clinical interviews  , and measurements of  heart rate .  Cox proportional hazards models were used to evaluate risk . RESULTS Social avoidance , a component of behavioral inhibition , predicted onset of social phobia during high school . However , social avoidance was not related to depression in adolescence . Another component of behavioral inhibition , fearfulness , increased the risk for both social phobia and depression . Among subjects who were both socially avoidant and fearful , 22.3 % developed social phobia -- a risk more than four times greater than that for subjects with neither feature of behavioral inhibition . CONCLUSION This prospect i ve study demonstrates that behavioral inhibition in childhood increases the risk of social phobia in adolescence
Study results indicate that children and adolescents with social anxiety disorder or high social anxiety show emotion dysregulation across all five domains of emotion regulation , such as enhanced social avoidance , more safety behaviors , repetitive negative thinking , biased attention and interpretation of social information , and reduced emotional expression .
While enhanced social avoidance seems to be specific to childhood social anxiety , other maladaptive emotion regulation strategies , such as repetitive negative thinking , seem to occur transdiagnostically across different childhood anxiety disorders .