***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: This study examined associations of Prospect i ve IU and Inhibitory IU with symptom-levels of Prolonged Grief Disorder ( PGD ) , Posttraumatic Stress-Disorder ( PTSD ) , and depression in a sample of bereaved individuals . Specifically , 265 bereaved individuals completed measures of  IU  , PGD , PTSD , and depression in the first year after the death of a loved one ; 134 participants again completed symptom- measures six months later . Cross-sectional analyses showed that Inhibitory IU ( but not Prospect i ve IU ) was positively associated with symptom-levels of PTSD and depression ( but not PGD ) , even when controlling for neuroticism , worry , and rumination . Prospect i ve analyses showed that Prospect i ve IU ( but not Inhibitory IU ) at baseline , predicted PGD severity six months later ( but not PTSD or depression at follow-up ) while controlling for baseline symptom-levels . The findings support the notion that IU is a vulnerability factor for different emotional problems , including those developing after the death of a loved one . Clinical implication s of these findings are discussed Context Uncovering heterogeneities in the progression of early PTSD symptoms can improve our underst and ing of the disorder 's pathogenesis and prophylaxis . Objectives To describe discrete symptom trajectories and examine their relevance for preventive interventions . Design Latent Growth Mixture Modeling ( LGMM ) of data from a r and omized controlled study of early treatment . LGMM identifies latent longitudinal trajectories by exploring discrete mixture distributions underlying observable data . Setting Hadassah Hospital unselectively receives trauma survivors from Jerusalem and vicinity . Participants Adult survivors of potentially traumatic events consecutively admitted to the hospital 's emergency department ( ED ) were assessed ten days and one- , five- , nine- and fifteen months after ED admission . Participants with data at ten days and at least two additional assessment s ( n = 957 ) were included ; 125 received cognitive behavioral therapy ( CBT ) between one and nine months . Approach We used LGMM to identify latent parameters of symptom progression and tested the effect of CBT on these parameters . CBT consisted of 12 weekly sessions of either cognitive therapy ( n = 41 ) or prolonged exposure ( PE , n = 49 ) , starting 29.8±5.7 days after ED admission , or delayed PE ( n = 35 ) starting at 151.8±42.4 days . CBT effectively reduced PTSD symptoms in the entire sample . Main Outcome Measure Latent trajectories of PTSD symptoms ; effects of CBT on these trajectories . Results Three trajectories were identified : Rapid Remitting ( rapid decrease in symptoms from 1- to 5-months ; 56 % of the sample ) , Slow Remitting ( progressive decrease in symptoms over 15 months ; 27 % ) and Non-Remitting ( persistently elevated symptoms ; 17 % ) . CBT accelerated the recovery of the Slow Remitting class but did not affect the other classes . Conclusions The early course of PTSD symptoms is characterized by distinct and diverging response patterns that are central ly relevant to underst and ing the disorder and preventing its occurrence . Studies of the pathogenesis of PTSD may benefit from using clustered symptom trajectories as their dependent variables Rumination has been linked to posttraumatic stress disorder ( PTSD ) and depression following trauma . A cross-sectional ( N = 101 ) and a prospect i ve longitudinal study ( N = 147 ) of road traffic accident survivors assessed rumination , PTSD and depression with self-report measures and structured interviews . We tested the hypotheses that ( 1 ) rumination predicts the maintenance of PTSD and depression and ( 2 ) reduced concreteness of ruminative thinking may be a maintaining factor . Rumination significantly predicted PTSD and depression at 6 months over and above what could be predicted from initial symptom levels . In contrast to the second hypothesis , reduced concreteness in an iterative rumination task was not significantly correlated with self-reported rumination frequency , and did not consistently correlate with symptom severity measures . However , multiple regression analyses showed that the combination of reduced concreteness and self-reported frequency of rumination predicted subsequent PTSD better than rumination frequency alone . The results support the view that rumination is an important maintaining factor of trauma-related emotional disorders The aim of this study was to compare experimental avoidance , mindfulness and rumination in trauma-exposed individuals with and without PTSD in an Iranian sample . The method of the study was retrospective . The statistical population of the study composed of all people under the auspices of Committee on Relief or Martyr Foundation because of exposure to at least one traumatic event in Gilan-Gharb city ( Iran ) ( N=1708 ) . One hundred people , selected r and omly by stratified sampling method , responded to Mississippi PTSD scale and the question naires of experimental avoidance , mindfulness and rumination individually . Subjects were divided into two groups of with and without PTSD based on Mississippi PTSD scale and structured clinical interview . Multivariate analysis of variance ( MANOVA ) test was used for analyzing data . Results showed that although the mean scores of the group with PTSD were significantly higher than the group without PTSD in variables of experimental avoidance ( P<0/001 , F=63/8 ) and rumination ( P<0/001 , F=21/34 ) , the mean scores of the group with PTSD were significantly lower than the group without PTSD in the overall score of mindfulness ( P<0/05 , F=6/64 ) and variables of observing ( P<0/05 , F=8/27 ) and action description ( P<0/05 , F=9/19 ) . These results show that the  experimental avoidance and rumination  are as the risk factors and mindfulness as the protective factor PTSD in people faced with trauma Rumination has been identified as a core process in the development and maintenance of depression . Treatments targeting ruminative processes may , therefore , be particularly helpful for treating chronic and recurrent depression . The development of such treatments requires translational research that marries clinical trials , process– outcome research , and basic experimental research that investigates the mechanisms underpinning pathological rumination . For example , a program of experimental research has demonstrated that there are distinct processing modes during rumination that have distinct functional effects for the consequences of rumination on a range of clinical ly relevant cognitive and emotional processes : an adaptive style characterized by more concrete , specific processing and a maladaptive style characterized by abstract , overgeneral processing . Based on this experimental work , two new treatments for depression have been developed and evaluated : ( a ) rumination-focused cognitive therapy , an individual-based face-to-face therapy , which has encouraging results in the treatment of residual depression in an extended case series and a pilot r and omized controlled trial ; and ( b ) concreteness training , a facilitated self-help intervention intended to increase specificity of processing in patients with depression , which has beneficial findings in a proof-of-principle study in a dysphoric population . These findings indicate the potential value of process– outcome research ( a ) explicitly targeting identified vulnerability processes and ( b ) developing interventions informed by research into basic mechanisms Posttraumatic growth ( PTG ) is viewed as a positive psychological change result ing from a struggle with trauma . A number of trauma-related factors have been proven effective in predicting PTG ; however , the effects of pretrauma psychological factors on PTG have not been adequately evaluated ( e.g. , using a prospect i ve design ) . This prospect i ve study examined the effects of pretrauma psychological factors ( e.g. , coping styles , prior trauma ) on PTG . In total , 810 Taiwanese undergraduate students were recruited for a baseline survey  ( Time 1 ) , among whom 592 completed a  survey 2 months later  ( Time 2 ) . Data from 110 participants who had experienced trauma between Time1 and Time 2 were used for analysis . Among the pretrauma factors examined at baseline , only rumination and distractive style were positively correlated with PTG . The posttrauma factors based on Calhoun and Tedeschi 's model ( i.e. , core belief challenge , deliberate rumination , and social support ) were also positively correlated with PTG . A hierarchical regression analysis showed that pretrauma coping styles had an incremental effect on PTG beyond posttrauma predictors . Deliberate rumination signifciantly mediated the relationship between pretrauma rumination and PTG . These findings highlight the role of pretrauma psychological factors in PTG and present further support for Calhoun and Tedeschi 's model of PTG A prospect i ve longitudinal study assessed 967 consecutive patients who attended an emergency clinic shortly after a motor vehicle accident , again at 3 months , and at 1 year . The prevalence of posttraumatic stress disorder ( PTSD ) was 23.1 % at 3 months and 16.5 % at 1 year . Chronic PTSD was related to some objective measures of trauma severity , perceived threat , and dissociation during the accident , to female gender , to previous emotional problems , and to litigation . Maintaining psychological factors , that is , negative interpretation of intrusions , rumination , thought suppression , and anger cognitions , enhanced the accuracy of the prediction . Negative interpretation of intrusions , persistent medical problems , and rumination at 3 months were the most important predictors of PTSD symptoms at 1 year . Rumination , anger cognitions , injury severity , and prior emotional problems identified cases of delayed onset BACKGROUND Dissociative symptoms during trauma predict post-traumatic stress disorder ( PTSD ) , but they are often transient . It is controversial whether they predict chronic PTSD over and above what can be predicted from other post-trauma symptoms . AIMS To investigate prospect ively the relationship between dissociative symptoms before , during and after a trauma and other psychological predictors , and chronic PTSD . METHOD Two sample s of 27 and 176 road traffic accident survivors were recruited . Patients were assessed shortly after the accident and followed at intervals over the next 6 months . Assessment s included  measures of dissociation , memory fragmentation , data -driven processing , rumination and PTSD symptoms .  RESULTS All measures of dissociation , particularly persistent dissociation 4 weeks after the accident , predicted chronic PTSD severity at 6 months . Dissociative symptoms predicted subsequent PTSD over and above the other PTSD symptom clusters . Memory fragmentation and data -driven processing also predicted PTSD . Rumination about the accident was among the strongest predictors of subsequent PTSD symptoms . CONCLUSIONS Persistent dissociation and rumination 4 weeks after trauma are more useful in identifying those patients who are likely to develop  chronic PTSD  than initial reactions Background Some studies suggest that early psychological treatment is effective in preventing chronic post-traumatic stress disorder ( PTSD ) , but it is as yet unclear how best to identify trauma survivors who need such intervention . This prospect i ve longitudinal study investigated the prognostic validity of acute stress disorder ( ASD ) , of variables derived from a meta- analysis of risk factors for PTSD , and of c and i date cognitive and biological variables in predicting chronic PTSD following assault . Method Assault survivors who had been treated for their injuries at a metropolitan Accident and Emergency ( A&E ) Department were assessed with structured clinical interviews to establish diagnoses of ASD at 2 weeks ( n=222 ) and PTSD at 6 months ( n=205 ) after the assault . C and i date predictors were assessed at 2 weeks . Results Most predictors significantly predicted PTSD status at follow-up . Multivariate logistic regressions showed that a set of four theory-derived cognitive variables predicted PTSD best ( Nagelkerke R2=0·50 ) , followed by the variables from the meta- analysis ( Nagelkerke R2=0·37 ) and ASD ( Nagelkerke R2=0·25 ) . When all predictors were considered simultaneously , mental defeat , rumination and prior problems with anxiety or depression were chosen as the best combination of predictors ( Nagelkerke R2=0·47 ) . Conclusion Question naires measuring mental defeat , rumination and pre-trauma psychological problems may help to identify assault survivors at risk of chronic PTSD In this prospect i ve longitudinal study , the authors examined the relationship between reduced specificity in autobiographical memory retrieval and the development of depression , posttraumatic stress disorder ( PTSD ) , and specific phobia after injury in an assault . Assault survivors ( N = 203 ) completed the  Autobiographical Memory Test  ( J. M. G. Williams & K. Broadbent , 1986 ) at 2 weeks after the trauma as well as structured clinical interviews at 2 weeks and 6 months . Participants with acute stress disorder or major depression at 2 weeks , but not those with phobia , retrieved fewer specific autobiographical memories than those without the respective disorder . Reduced memory specificity at 2 weeks also predicted subsequent PTSD and major depression at 6 months over and above what could be predicted from initial diagnoses and symptom severity . Moderator analyses showed that low memory specificity predicted later depression in participants with prior episodes of major depression but not in those without prior depression . Mediation analyses suggested that rumination partly mediated and perceived permanent change fully mediated the effects of low memory specificity on posttrauma psychopathology at follow-up Objective : Cardiovascular recovery of prestress baseline blood pressure has been implicated as a possible additional determinant of sustained blood pressure elevation . We hypothesize that angry ruminations may slow the recovery process . Method : A within-subjects design was used in which resting baseline blood pressure and heart rate measurements were assessed on 60 subjects , who then took part in two anger-recall tasks .  After each task , subjects sat quietly and alone during a 12-minute recovery period r and omized to with or without distractions . During baseline , task , and recovery , blood pressure was continuously monitored ; during recovery , 
    Output:
    
This was not moderated by time since trauma , gender , prior trauma history , Criterion A congruence of events , type of rumination or PTS symptom measure , or sample setting .
However , trauma-focused rumination yielded smaller effect sizes than trait rumination .
Conclusions : Results confirm that rumination is associated with increased PTS symptoms .