***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: OBJECTIVES The aim of these two studies was to evaluate the effectiveness of the Mindful Self-Compassion ( MSC ) program , an 8-week workshop design ed to train people to be more self-compassionate . METHODS Study 1 was a pilot study that examined change scores in self-compassion , mindfulness , and various wellbeing outcomes among community adults ( N = 21 ; mean [ M ] age = 51.26 , 95 % female ) . Study 2 was a r and omized controlled trial that compared a  treatment group ( N = 25 ; M age = 51.21 ; 78 % female ) with a waitlist control group ( N = 27 ; M age = 49.11 ; 82 % female ) . RESULTS Study 1 found significant pre/post gains in self-compassion , mindfulness , and various wellbeing outcomes . Study 2 found that compared with the control group , intervention participants reported significantly larger increases in self-compassion , mindfulness , and wellbeing . Gains were maintained at 6-month and 1-year follow-ups . CONCLUSIONS The MSC program appears to be effective at enhancing self-compassion , mindfulness , and wellbeing The mechanisms underlying the association between positive emotions and physical health remain a mystery . We hypothesize that an upward-spiral dynamic continually reinforces the tie between positive emotions and physical health and that this spiral is mediated by people ’s perceptions of their positive social connections . We tested this overarching hypothesis in a longitudinal field experiment in which participants were r and omly assigned to an intervention group that self-generated positive emotions via loving-kindness meditation or to a waiting-list control group .  Participants in the intervention group increased in positive emotions relative to those in the control group , an effect moderated by baseline vagal tone , a proxy index of physical health . Increased positive emotions , in turn , produced increases in vagal tone , an effect mediated by increased perceptions of social connections . This experimental evidence identifies one mechanism — perceptions of social connections — through which positive emotions build physical health , indexed as vagal tone . Results suggest that positive emotions , positive social connections , and physical health influence one another in a self-sustaining upward-spiral dynamic OBJECTIVE To present and determine the impact of the Mindfulness-Based Program for Infertility ( MBPI ) . DESIGN Controlled clinical trial . SETTING University research unit . PATIENT(S ) Fifty-five infertile women completed the MBPI , and 37 infertile women were assigned to a control group . INTERVENTION(S ) The MBPI includes 10 weekly sessions , in a group format , with a duration of about 2 hours each ( men attend three sessions ) . MAIN OUTCOME MEASURE(S ) St and ardized measures of depression , state anxiety , entrapment , defeat , internal and external shame , experiential avoidance , mindfulness , self-compassion , and infertility self-efficacy were endorsed pre- and post-MBPI . RESULT ( S ) The MBPI group and the control group were shown to be equivalent at baseline . By the end of the MBPI , women who attended the program revealed a significant decrease in depressive symptoms , internal and external shame , entrapment , and defeat . Inversely , they presented statistically significant improvement in mindfulness skills and self-efficacy to deal with infertility . Women in the control group did not present significant changes in any of the psychological measures , except for a decrease in self-judgment . CONCLUSION ( S ) Increasing mindfulness and acceptance skills , as well as cognitive decentering from thoughts and feelings , seem to help women to experience negative inner states in new ways , decreasing their entanglement with them and thus their psychological distress . Data suggest that the MBPI is an effective psychological intervention for women experiencing infertility OBJECTIVE To determine whether cognitive behavior therapy ( CBT ) , which we had shown in a previous study to restore ovarian function in women with functional hypothalamic amenorrhea ( FHA ) , could also ameliorate hypercortisolemia and improve other neuroendocrine and metabolic concomitants of in FHA . DESIGN R and omized controlled trial . SETTING Clinical research center at an academic medical university . PATIENT(S ) Seventeen women with FHA were r and omized either to CBT or observation . INTERVENTION(S ) CBT versus observation . MAIN OUTCOME MEASURE(S ) Circulatory concentrations of cortisol , leptin , thyroid-stimulating hormone ( TSH ) , total and free thyronine ( T(3 ) ) , and total and free thyroxine ( T(4 ) ) before and immediately after completion of CBT or observation . ( Each woman served as her own control . ) RESULT ( S ) Cognitive behavior therapy but not observation reduced cortisol levels in women with FHA . There were no changes in cortisol , leptin , TSH , T(3 ) , or T(4 ) levels in women r and omized to observation . Women treated with CBT showed increased levels of leptin and TSH , but their levels of T(3 ) and T(4 ) remained unchanged . CONCLUSION ( S ) In women with FHA , CBT ameliorated hypercortisolism and improved the neuroendocrine and metabolic concomitants of FHA while observation did not . We conclude that a cognitive , nonpharmacologic approach aim ed at alleviating problematic attitudes not only can restore ovarian activity but also improve neuroendocrine and metabolic function in women with FHA . CLINICAL TRIAL REGISTRATION NUMBER NCT01674426 BACKGROUND This study explores the differences in prenatal maternal expectations , coping re sources and maternal stress between first time mothers of IVF twins and first time mothers of spontaneously conceived twins . The role of prenatal maternal expectations in the prediction of maternal stress was examined , as well as the mediating and moderating effect of coping re sources on the association between pregnancy-type group and maternal stress . METHOD Mothers of twins from various regions in Israel were included in this prospect i ve and cross-sectional study in which 88 mothers of IVF-conceived twins and 98 mothers of spontaneously conceived twins were interviewed twice . First , at 33 - 36 weeks of their pregnancy they completed a socio-demographic question naire and the maternal expectations question naire ; then at 6 months after birth they completed a question naire regarding the delivery and medical condition of the infants , and their coping re sources and maternal stress . RESULTS Compared with mothers who conceived spontaneously , IVF mothers had more positive prenatal maternal expectations , but poorer coping re sources and higher levels of maternal stress 6 months after birth . Maternal expectations had no predictive power regarding maternal stress , although the mother 's coping re sources were significantly related to maternal stress and mediated the association between pregnancy type and maternal stress . CONCLUSIONS IVF-pregnant women bearing twins should be considered a high-risk group . Early identification of these mothers is essential for timely psychosocial interventions in order to enhance their re sources and decrease maternal stress . Further longitudinal studies are required to determine causality in more ethnically-diverse mothers of twins This study examined the correlation between various coping strategies and sexual functioning and the likelihood of conception from in vitro fertilization ( IVF ) . Self-reported question naires were distributed r and omly among the 102 women enrolled in an IVF program , 96 of whom were recruited . Of the studied parameters , positive reinterpretation , and growth , and active coping strategies were found to be positively associated with sexual functioning , while there was a significantly ( p < .05 ) adverse influence of planning and self-restraint . Being sexually active during the IVF-treatment period was found to be positively associated ( p < .05 ) with the likelihood of conception and with adaptive coping strategies Recent scientific work has established both a theoretical basis and strong empirical evidence for a causal impact of social relationships on health . Prospect i ve studies , which control for baseline health status , consistently show increased risk of death among persons with a low quantity , and sometimes low quality , of social relationships . Experimental and quasi-experimental studies of humans and animals also suggest that social isolation is a major risk factor for mortality from widely varying causes . The mechanisms through which social relationships affect health and the factors that promote or inhibit the development and maintenance of social relationships remain to be explored BACKGROUND IVF treatment involves a re assessment of issues concerning autonomy and relatedness . This study aims to extend prior studies on the psychological impact of IVF/ICSI by study ing the association between the personality dimensions of Self-Criticism and Dependency with the psychological well-being and quality of the couple relationship for women starting their first IVF treatment . METHODS This is a cross-sectional study of 68 women starting their first IVF treatment at the Leuven University Fertility Centre of the University of Leuven , Belgium . All women were administered vali date d self-report measures assessing Self-Criticism and Dependency , negative life events , psychological well-being , relationship satisfaction , and relationship and sexual concerns . Pearson 's correlation coefficients were calculated between all study variables , followed by four separate hierarchical multiple regression analyses for psychological well-being , relationship satisfaction , and relationship and sexual concerns . RESULTS High Self-Criticism was negatively associated with psychological well-being ( r = -0.63 , P < 0.001 ) and relationship satisfaction ( r = -0.29 , P < 0.05 ) , and positively associated with relationship ( r = 0.39 , P < 0.01 ) and sexual ( r = 0.37 , P < 0.01 ) concerns . High Dependency was negatively associated with psychological well-being ( r = -0.30 , P < 0.05 ) , not significantly associated with relationship satisfaction and relationship concerns , and positively related to sexual concerns ( r = 0.31 , P < 0.05 ) . CONCLUSIONS This cross-sectional study suggests that the personality dimensions of Self-Criticism and Dependency may enhance our underst and ing of the psychological well-being and quality of the couple relationship of women starting their first IVF treatment . However , further prospect i ve research on this topic is needed BACKGROUND The aim of this study was to gain more insight into long-term psychological adjustment to  IVF in women . METHODS In a prospect i ve cohort study , 298 women entering their first IVF treatment cycle ( including ICSI ) completed st and ardized psychological question naires before the start of the treatment , just after the last treatment cycle , and 6 months and 3 - 5 years after the last treatment cycle . The main outcome measures were state anxiety , depression and mode of adaptation to unsuccessful IVF . RESULTS Anxiety and depression were found at follow-up to return to baseline levels following treatment not result ing in a live birth , after an initial increase during treatment . On the contrary , treatment result ing in a live birth was found to lead to a more positive long-term emotional status . Women who focused on new life goals as a mode of adaptation 3 - 5 years after IVF without a live birth showed lower levels of anxiety and depression compared with those who persisted in their attempts to get pregnant . CONCLUSIONS Treatment that result ed in a live birth led to more positive emotional adjustment . In addition , most women who did not give birth to a child after treatment adjusted well psychologically . Positive adjustment was related to developing new life goals rather than persisting in attempts to get pregnant . Helping women to change life goals after ab and oning treatment might have beneficial effects on the adaptation process Objective : In an earlier study , positive emotional style ( PES ) was associated with resistance to the common cold and a bias to underreport ( relative to objective disease markers ) symptom severity . This work did not control for social and cognitive factors closely associated with PES . We replicate the original study using a different virus and controls for these alternative explanations . Methods : One hundred ninety-three healthy volunteers ages 21 to 55 years were assessed for a PES characterized by being happy , lively , and calm ; a negative emotional style ( NES ) characterized by being anxious , hostile , and depressed ; other cognitive and social dispositions ; and self-reported health . Subsequently , they were exposed by nasal drops to a rhinovirus or influenza virus and monitored in quarantine for objective signs of illness and self-reported symptoms . Results : For both viruses , increased PES was associated with lower risk of developing an upper respiratory illness as defined by objective criteria ( adjusted odds ratio comparing lowest with highest tertile = 2.9 ) and with reporting fewer symptoms than expected from concurrent objective markers of illness . These associations were independent of prechallenge virus-specific antibody , virus type , age , sex , education , race , body mass , season , and NES . They were also independent of optimism , extraversion , mastery , self-esteem , purpose , and self-reported health . Conclusions : We replicated the prospect i ve association of PES and colds and PES and biased symptom reporting , extended those results to infection with an influenza virus , and “ ruled out ” alternative hypotheses . These results indicate that PES may play a more important role in health than previously thought . BMI = body mass index ; CI = confidence interval ; NES = negative emotional style ; PES = positive emotional style ; RV = rhinovirus ; TCID = Tissue Culture Infectious Dose Research ers have documented the consequences of both expressing and suppressing emotion using between-subjects design s. It may be argued , however , that successful adaptation depends not so much on any one regulatory process , but on the ability to flexibly enhance or suppress emotional expression in accord with situational dem and s. We tested this hypothesis among New York City college students in the aftermath of the September 11th terrorist attacks . Subjects ' performance in a laboratory task in which they enhanced emotional expression , suppressed emotional expression , and behaved normally on different trials was examined as a prospect i ve predictor of their adjustment across the first two years of college . Results supported the flexibility hypothesis . A regression analysis controlling for initial distress and motivation and cognitive re sources found that subjects who were better 
    Output:
    
Neuroticism and the use of escapist coping strategies were positively associated with distress by multiple studies .
Social support was negatively associated with distress by several studies .
There is a paucity of research using positive emotional outcome measures ( e.g. well-being , positive affect , happiness or life satisfaction ) to quantify emotional adjustment .
Whilst some psychosocial variables appear to be consistently associated with distress for IVF patients , two-thirds of the variables tested to date do not appear to be associated with emotional adjustment .