***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 Clinical decision-making regarding the prevention of depression is complex for pregnant women with histories of depression and their health care providers . Pregnant women with histories of depression report preference for nonpharmacological care , but few evidence -based options exist . Mindfulness-based cognitive therapy has strong evidence in the prevention of depressive relapse/recurrence among general population s and indications of promise as adapted for perinatal depression ( MBCT-PD ) . With a pilot r and omized clinical trial , our aim was to evaluate treatment acceptability and efficacy of MBCT-PD relative to treatment as usual ( TAU ) . METHOD Pregnant adult women with depression histories were recruited from obstetric clinics at 2 sites and r and omized to MBCT-PD ( N = 43 ) or TAU ( N = 43 ) .  Treatment acceptability was measured by assessing completion of sessions , at-home practice , and satisfaction . Clinical outcomes were interview-based depression relapse/recurrence status and self-reported depressive symptoms through 6 months postpartum . RESULTS Consistent with predictions , MBCT-PD for at-risk pregnant women was acceptable based on rates of completion of sessions and at-home practice assignments , and satisfaction with services was significantly higher for MBCT-PD than TAU . Moreover , at-risk women r and omly assigned to MBCT-PD reported significantly improved depressive outcomes compared with participants receiving TAU , including significantly lower rates of depressive relapse/recurrence and lower depressive symptom severity during the course of the study . CONCLUSIONS MBCT-PD is an acceptable and clinical ly beneficial program for pregnant women with histories of depression ; teaching the skills and practice s of mindfulness meditation and cognitive-behavioral therapy during pregnancy may help to reduce the risk of depression during an important transition in many women 's lives Postnatal depression and anxiety have been shown to increase the risk of disturbances in mother – child interaction and child development . Research into mechanisms has focused on genetics and maternal behavior ; maternal cognitions have received little attention . Our aim was to experimentally determine if worry and rumination in mothers with generalized anxiety disorder ( GAD ) and major depressive disorder ( MDD ) , diagnosed in the postnatal 6 months , interfered with maternal responsiveness to their 10-month old infants . Mothers ( N = 253 : GAD n = 90 ; MDD n = 57 ; control n = 106 ) and their infants were r and omized to either a worry/rumination prime ( WRP ) or a neutral prime ( NP ) ; mother – infant interactions were assessed before and after priming . Type of priming was a significant predictor of maternal cognitions , with WRP result ing in more negative thoughts , higher thought recurrence and more self-focus relative to NP across the entire sample . Interaction effects between group and priming were significant for two parenting variables : Compared with controls , WRP had a more negative impact on maternal responsiveness to infant vocalization for GAD , and to a lesser extent for MDD ; WRP led to decreased maternal vocalization for GAD . Also , mothers with GAD used stronger control after the NP than WRP , as well as compared with other groups , and overall post-priming , their children exhibited lower emotional tone and more withdrawal . Across the entire sample , WRP was associated with increased child vocalization relative to NP . This study demonstrated that disturbances in maternal cognitions , in the context of postnatal anxiety and to a lesser degree depression , play a significant role in mother – child interaction This is the first study to examine attentional control capacities in generalized anxiety disorder ( GAD ) . GAD is characterized by uncontrollable worry . Individuals diagnosed with GAD and healthy participants ( HPs ) performed a r and om key-pressing task while thinking about a worrisome or a positive future event , to assess the extent to which attentional control re sources are used by worry . Attentional control was also assessed when participants were not instructed to think about a specific topic using the N-back task , which varies in task difficulty , and therefore is sensitive to subtle differences in ability to h and le increasing dem and s on attentional control within the same paradigm . GAD participants ( but not HPs ) were less r and om while worrying than thinking about a positive event during the key-pressing task , suggesting that worry consumed more attentional control re sources in this population . During the N-Back task , GAD participants performed worse than HPs during the high load conditions only , indicating greater difficulty in sustaining focus on conditions requiring a higher degree of attentional control , even without concurrent task activity . Poor attentional control might underpin the difficulty of GAD individuals to stop worrying and switch to thinking more benign information . Further research could investigate whether worry consumes attentional control re sources in other psychological disorders with high rates of worry ( e.g. , panic disorder , psychosis ) , as well as the extent to which attentional control is used by other forms of repetitive thinking , such as depressive rumination Background : Major depression is associated with cognitive deficits , particularly those requiring central executive functioning . Depressed patients also tend to focus on and think about their symptoms and problems ( “ ruminate ” ) more than non-depressed controls . Although an association has been found between rumination and impaired performance on a central executive processing task , the causal relation between impaired executive functioning and rumination has not been determined . This study sought to directly manipulate rumination and assess the impact on executive functioning in depression as measured by r and om number generation . Methods : Depressed patients ( n=14 ) and non-depressed controls ( n=14 ) were compared on a  r and om number generation task , performed after both a rumination induction and after a distraction induction , with order of inductions counter balanced within each group . Results : Compared with the distraction induction , the rumination induction produced a significant increase in both ruminations and the tendency towards stereotyped counting responses ( thought to reflect a failure of inhibitory executive control ) in depressed patients but not in controls . However , after distraction , no difference in r and om number generation or rumination was found between the two groups . Conclusions : The aspects of executive function involved in r and om number generation are not fundamentally impaired in depressed patients . In depressed patients , the rumination induction seems to trigger the continued generation of ruminative stimulus independent thoughts , which interferes with concurrent executive processing This individual differences study examined the separability of three often postulated executive functions-mental set shifting ( " Shifting " ) , information updating and monitoring ( " Updating " ) , and inhibition of prepotent responses ("Inhibition")- and their roles in complex " frontal lobe " or " executive " tasks . One hundred thirty-seven college students performed a set of relatively simple experimental tasks that are considered to predominantly tap each target executive function as well as a set of frequently used executive tasks : the Wisconsin Card Sorting Test ( WCST ) , Tower of Hanoi ( TOH ) , r and om number generation ( RNG ) , operation span , and dual tasking .  Confirmatory factor analysis indicated that the three target executive functions are moderately correlated with one another , but are clearly separable . Moreover , structural equation modeling suggested that the three functions contribute differentially to performance on complex executive tasks . Specifically , WCST performance was related most strongly to Shifting , TOH to Inhibition , RNG to Inhibition and Updating , and operation span to Updating . Dual task performance was not related to any of the three target functions . These results suggest that it is important to recognize both the unity and diversity of executive functions and that latent variable analysis is a useful approach to study ing the organization and roles of executive functions OBJECTIVE Maladaptive response styles to negative affect have been shown to be associated with prospect i ve ( postpartum ) depression . Whether maladaptive styles to positive affect are also critically involved is understudied , even though anhedonia ( a correlate of low positive affectivity ) is a cardinal symptom of depression . The present study is the first to investigate the predictive value of cognitive response styles to both negative ( depressive rumination ) and positive affect ( dampening ) for postpartum depressive symptoms . METHODS During the third trimester of pregnancy , 210 women completed self-report instruments assessing depression  ( symptom severity and current and /or past episodes ) and scales gauging the presence of depressive rumination and dampening .  Of these women , 187 were retained for postpartum follow-up , with depressive symptoms being reassessed at 12 ( n=171 ) and 24 ( n=176 ) weeks after delivery . RESULTS Regression analyses showed that higher levels of dampening of positive affect during pregnancy predicted higher levels of depressive symptoms at 12 and 24 weeks postpartum , irrespective of initial symptom severity , past history of depression and levels of rumination to negative affect . Prepartum trait levels of rumination , however , did not predict postpartum symptomatology when controlled for baseline symptoms and history of major depressive episode(s ) . CONCLUSIONS The results of this investigation suggest that the way women cognitively respond to positive affect contributes perhaps even more to the development of postpartum depression than maladaptive response styles to negative affect BACKGROUND Postnatal depression is associated with poorer parenting quality , but there are few studies examining maternal-specific cognitive processes that may impact on parenting quality . In this study , we examined the impact of rumination on parental problem-solving effectiveness in dysphoric and non-dysphoric postnatal mothers . METHODS Fifty-nine mothers with a infant aged 12 months and under , 20 of whom had a Beck Depression Score II ( BDI-II ) score ≥ 14 , and 39 who scored less than 14 on the BDI-II were r and omly assigned to either a rumination or distraction condition . Problem-solving effectiveness was assessed post-induction with the " Postnatal Parental Problem-Solving Task " ( PPST ) , which was adapted from the Means Ends Problem-solving task .  Parental problem-solving confidence was also assessed . RESULTS Dysphoric ruminating mothers exhibited poorer problem-solving effectiveness and poorer confidence regarding their problem-solving compared to dysphoric distracting , non-dysphoric distracting , and non-dysphoric ruminating mothers . LIMITATIONS A self-report measure of depressed mood was used . CONCLUSIONS Rumination may be a key mechanism associated with both depressive mood and maternal parenting quality during the postnatal period Impaired cognitive control may be an important vulnerability factor for depression . Moreover , impairments in cognitive control have been proposed as a crucial process underlying ruminative thinking . The present study investigates the influence of impaired cognitive control for emotional information on rumination and depressive symptoms in a prospect i ve design with a 1 year follow up in a clinical sample . Thirty remitted depressed adults completed the Internal Shift Task ( IST ) , a measure of cognitive control of emotional information , at baseline . Moreover , question naires measuring rumination  ( RRS ) and  depressive symptoms ( BDI-II ) were administered . One year later participants were contacted again and asked to complete the BDI-II and RRS . Mediation analyses showed a significant influence of impaired cognitive control for emotional information at baseline on depressive symptoms one year later , which was fully mediated by rumination . These findings underscore the importance of cognitive control abilities as a process underlying rumination and as a vulnerability factor for depression . They can stimulate translational research to improve the effectiveness of interventions that aim to decrease vulnerability by targeting cognitive control Ruminative responses to depression have predicted duration and severity of depressive symptoms . The authors examined how response styles change over the course of treatment for depression and as a function of type of treatment . They also examined the ability of response styles to predict treatment outcome and status at follow-up . Primary care patients ( n = 96 ) with dysthymia or minor depression were r and omly assigned to problem-solving therapy , paroxetine , or placebo . Patients ' depressive symptoms and rumination , but not distraction , decreased over time . Pretreatment rumination and distraction were associated with more depressive symptoms at the conclusion of treatment ; the latter finding was not consistent with the response style theory of depression . Results are discussed in terms of their implication s for this theory The current study examined whether maternal prenatal attachment is associated with the mother-infant relationship . One hundred pregnant women and their infants at 12 weeks participated in the study . The sample was part of the Umeâ Child and Family Development project and was r and omly recruited by midwives or health visitors . The expectant women completed a self-administered question naire , the PAI ( the Prenatal Attachment Inventory ) measuring prenatal attachment towards their unborn baby . At about 12 weeks postpartum , mothers and their infants were observed and videotaped during an en face interaction . The results revealed that maternal prenatal attachment towards the unborn baby is a good predictor of the early mother-infant relationship . Mothers who were high on the PAI-factor fantasy , for example , in general showed more involvement while interacting with their babies . Mothers rated highly on PAI-factors such as interaction and affection stimulated their infants by using more proximal stimulation , while those rated highly on differentiation of self with the unborn baby used more distal stimulation . Maternal responsive behaviour was only predicted by infant attentive behaviour . This study demonstrated that maternal prenatal attachment during the third trimester of pregnancy is associated with the postnatal maternal involvement , and can serve as an important diagnostic aid in identifying those women for whom the mother-child interaction is likely to be sub-optimal The authors report the first direct assessment of working memory capacity when people engage in worry . High and low worriers performed a r and om key-press task while thinking about a current worry or a positive personally relevant topic . High ( but not low ) worriers showed more evidence of restricted capacity during worry than when thinking about a positive topic . These findings suggest that high worriers have less residual working memory capacity when worrying than when thinking about other topics and , thus , have fewer attentional re sources available to redirect their thoughts away from worry 
    Output:
    
Our cognitive model emphasises the relationship between rumination , cognitive biases and cognitive control , and the impact of these variables on infant cue processing and subsequent parenting responses .