***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: BACKGROUND The aim of this study is to examine the efficacy of mindfulness-based cognitive therapy ( MBCT ) in addition to treatment as usual ( TAU ) for recurrent depressive patients with and without a current depressive episode . METHOD A r and omized , controlled trial comparing  MBCT+TAU ( n=102 ) with  TAU alone ( n=103 ) . The study population consisted of patients with three or more previous depressive episodes . Primary outcome measure was post-treatment depressive symptoms according to the Hamilton Rating Scale for Depression . Secondary outcome measures included the Beck Depression Inventory , rumination , worry and mindfulness skills . Group comparisons were carried out with linear mixed modelling , controlling for intra-group correlations . Additional mediation analyses were performed . Comparisons were made between patients with and without a current depressive episode . RESULTS Patients in the MBCT+TAU group reported less depressive symptoms , worry and rumination and increased levels of mindfulness skills compared with patients receiving TAU alone . MBCT result ed in a comparable reduction of depressive symptoms for patients with and without a current depressive episode . Additional analyses suggest that the reduction of depressive symptoms was mediated by decreased levels of rumination and worry . CONCLUSIONS The study findings suggest that MBCT is as effective for patients with recurrent depression who are currently depressed as for patients who are in remission . Directions towards a better underst and ing of the mechanisms of action of MBCT are given , although future research is needed to support these hypotheses Background Approximately 20 - 40 % of out patients with diabetes experience elevated levels of emotional distress , varying from disease-specific distress to general symptoms of anxiety and depression . The patient 's emotional well-being is related to other unfavorable outcomes , like reduced quality of life , sub-optimal self-care , impaired glycemic control , higher risk of complications , and increased mortality rates . The purpose of this study is to test the effectiveness of a new diabetes-specific , mindfulness-based psychological intervention . First , with regard to reducing emotional distress ; second , with respect to improving quality of life , dispositional mindfulness , and self-esteem of patients with diabetes ; third , with regard to self-care and clinical outcomes ; finally , a potential effect modification by clinical and personality characteristics will be explored . Methods / Design The Diabetes and Mindfulness study ( DiaMind ) is a r and omized controlled trial . Patients with diabetes with low levels of emotional well-being will be recruited from outpatient diabetes clinics . Eligible patients will be r and omized to an intervention group or a wait-list control group . The intervention group will receive the mindfulness program immediately , while the control group will receive the program eight months later . The primary outcome is emotional distress ( anxiety , stress , depressive symptoms ) , for which data will be collected at baseline , four weeks , post intervention , and after six months follow-up . In addition , self-report data will be collected on quality of life , dispositional mindfulness , self-esteem , self-care , and personality , while complications and glycemic control will be assessed from medical files and blood pressure will be measured . Group differences will be analyzed with repeated measures analysis of covariance . The study is supported by grants from the Dutch Diabetes Research Foundation and Tilburg University and has been approved by a medical ethics committee . Discussion It is hypothesized that emotional well-being , quality of life , dispositional mindfulness , self-esteem , self-care , and blood pressure will improve significantly more in the mindfulness group compared to the control group . Results of this study can contribute to a better care for patients with diabetes with lowered levels of emotional well-being .  It is expected that the first results will become available in 2012.Trial registration Dutch Trial Register NTR2145 Background Although several studies have reported positive effects of mindfulness-based stress reduction ( MBSR ) intervention on psychological well-being , it is not known whether these effects are attributable to a change in mindfulness . Purpose The aim of this study is to compare the effects of MBSR to a waiting-list control condition in a r and omized controlled trial while examining potentially mediating effects of mindfulness . Methods Forty women and 20 men from the community with symptoms of distress ( mean age 43.6 years , SD = 10.1 ) were r and omized into a group receiving MBSR or a waiting-list control group . Before and after the intervention period , question naires were completed on psychological well-being , quality of life , and mindfulness . Results Repeated measures multiple analysis of variance ( MANCOVAs ) showed that , compared with the control group , the intervention result ed in significantly stronger reductions of perceived stress ( p = 0.016 ) and vital exhaustion ( p = 0.001 ) and stronger elevations of positive affect ( p = 0.006 ) , quality of life ( p = .009 ) , as well as mindfulness ( p = 0.001 ) . When mindfulness was included as a covariate in the MANCOVA , the group effects on perceived stress and quality of life were reduced to non significance . Conclusion Increased mindfulness may , at least partially , mediate the positive effects of mindfulness-based stress reduction intervention Background : Social anxiety disorder ( SAD ) is characterized by distorted self-views . The goal of this study was to examine whether mindfulness-based stress reduction ( MBSR ) alters behavioral and brain measures of negative and positive self-views . Methods : Fifty-six adult patients with generalized SAD were r and omly assigned to MBSR or a comparison aerobic exercise ( AE ) program . A self-referential encoding task was administered at baseline and post-intervention to examine changes in behavioral and neural responses in the self-referential brain network during functional magnetic resonance imaging . Patients were cued to decide whether positive and negative social trait adjectives were self-descriptive or in upper case font . Results : Behaviorally , compared to AE , MBSR produced greater decreases in negative self-views , and equivalent increases in positive self-views . Neurally , during negative self versus case , compared to AE , MBSR led to increased brain responses in the posterior cingulate cortex ( PCC ) . There were no differential changes for positive self versus case . Secondary analyses showed that changes in endorsement of negative and positive self-views were associated with decreased social anxiety symptom severity for MBSR , but not AE . Additionally , MBSR-related increases in dorsomedial prefrontal cortex ( DMPFC ) activity during negative self-view versus case were associated with decreased social anxiety related disability and increased mindfulness . Analysis of neural temporal dynamics revealed MBSR-related changes in the timing of neural responses in the DMPFC and PCC for negative self-view versus case . Conclusion : These findings suggest that MBSR attenuates maladaptive habitual self-views by facilitating automatic ( i.e. , uninstructed ) recruitment of cognitive and attention regulation neural networks . This highlights potentially important links between self-referential and cognitive-attention regulation systems and suggests that MBSR may enhance more adaptive social self-referential processes in patients with SAD Background There is increasing recognition of mindfulness and mindfulness training as a way to decrease stress and increase psychological functioning . Purpose The aims of this study were to examine the effects of mindfulness stress reduction training on perceived stress and psychological well-being and to examine if changes in mindfulness mediate intervention effects on these outcomes . Methods Seventy women and one man with a previous cancer diagnosis ( mean age 51.8 years , st and ard deviation = 9.86 ) were r and omized into an intervention group or a wait-list control group . The intervention consisted of an 8-week mindfulness training course . Results Compared to participants in the control group , participants in the mindfulness training group had significantly decreased perceived stress and posttraumatic avoidance symptoms and increased positive states of mind . Those who participated in the intervention reported a significant increase in scores on the five-facet mindfulness question naire ( FFMQ ) when compared to controls . The increase in FFMQ score mediated the effects of the intervention on perceived stress , posttraumatic avoidance symptoms , and positive states of mind . Conclusions This study indicates that the improvements in psychological well-being result ing from mindfulness stress reduction training can potentially be explained by increased levels of mindfulness as measured with the FFMQ . The importance of these findings for future research in the field of mindfulness is discussed OBJECTIVE To examine whether mindfulness-based cognitive therapy ( MBCT ) increases momentary positive emotions and the ability to make use of natural rewards in daily life . METHOD Adults with a life-time history of depression and current residual depressive symptoms ( mean age = 43.9 years , SD = 9.6 ; 75 % female ; all Caucasian ) were r and omized to MBCT ( n = 64 ) or waitlist control ( CONTROL ; n = 66 ) in a parallel , open-label , r and omized controlled trial . The Experience Sampling Method was used to measure momentary positive emotions as well as appraisal of pleasant activities in daily life during 6 days before and after the intervention . Residual depressive symptoms were measured using the 17-item Hamilton Depression Rating Scale ( Hamilton , 1960 ) . RESULTS MBCT compared to CONTROL was associated with significant increases in appraisal s of positive emotion ( b * = .39 ) and activity pleasantness ( b * = .22 ) as well as enhanced ability to boost momentary positive emotions by engaging in pleasant activities ( b * = .08 ; all ps < .005 ) . Associations remained significant when corrected for reductions in depressive symptoms or for reductions in negative emotion , rumination , and worry . In the MBCT condition , increases in positive emotion variables were associated with reduction of residual depressive symptoms ( all ps < .05 ) . CONCLUSIONS MBCT is associated with increased experience of momentary positive emotions as well as greater appreciation of , and enhanced responsiveness to , pleasant daily-life activities . These changes were unlikely to be pure epiphenomena of decreased depression and , given the role of positive emotions in resilience against depression , may contribute to the protective effects of MBCT against depressive relapse Cognitive Reactivity ( CR ) refers to the degree to which a mild dysphoric state reactivates negative thinking patterns , and it has been found to play a key causal role in depressive relapse . Although Mindfulness-Based Cognitive Therapy ( MBCT ) directly aims to address this mechanism of CR , the relationship between mindfulness and CR has not been tested to date . Using a cross-sectional design ( Study 1 ; n = 164 ) and a non-r and omized waiting list controlled design ( Study 2 ; MBCT [ n = 18 ] vs. waiting list [ n = 21 ] ) , the authors examined the relationship between naturally occurring levels of mindfulness ( Study 1 ) and MBCT ( Study 2 ) on the one h and , and CR on the other h and . In line with predictions , it was found that ( a ) trait mindfulness is significantly negatively correlated with CR , even when controlled for current depressive symptoms and prior history of depression ( Study 1 ) , and that ( b ) MBCT , compared to a matched control group , significantly reduces CR , and that this effect of MBCT on reduction of CR is mediated by a positive change in mindfulness skills ( Study 2 ) . Results provide first evidence for the cl aim that mindfulness practice s in MBCT are design ed to address the process of CR Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Research on mindfulness-based interventions ( MBIs ) for treating symptoms of a wide range of medical conditions has proliferated in recent decades . Mindfulness is the cultivation of nonjudgmental awareness in the present moment . It is both a practice and a way of being in the world . Mindfulness is purpose fully cultivated in a range of structured interventions , the most popular of which is mindfulness-based stress reduction ( MBSR ) , followed by mindfulness-based cognitive therapy ( MBCT ) . This paper begins with a discussion of the phenomenological experience of coping with a chronic and potentially life-threatening illness , followed by a theoretical discussion of the application of mindfulness in these situations . The literature evaluating MBIs within medical conditions is then comprehensively review ed , applying a levels of evidence rating framework within each major condition . The bulk of the research looked at diagnoses of cancer , pain conditions ( chronic pain , low back pain , fibromyalgia , and rheumatoid arthritis ) , cardiovascular disease , diabetes , human immunodeficiency virus (HIV)/acquired immune deficiency syndrome ( AIDS ) , and irritable bowel syndrome . Most outcomes assessed are psychological in nature and show substantial benefit , although some physical and disease-related parameters have also been evaluated . The field would benefit from more adequately powered r and omized controlled trials utilizing active comparison groups and assessing the moderating role of patient characteristics and program “ dose ” in determining outcomes OBJECTIVE This study compared changes in bodily pain , health-related quality of life ( HRQoL ) , and psychological symptoms during an 8-week mindfulness-based stress reduction ( MBSR ) program among groups of participants with different chronic pain conditions . METHODS From 1997 - 2003 , a longitudinal investigation of chronic pain patients ( n=133 ) was nested within a larger prospect i ve cohort study of heterogeneous patients participating in MBSR at a university-based Integrative Medicine center . Measures included the Short-Form 36 Health Survey and Symptom Checklist-90-Revised . Paired t tests were used to compare pre-post changes on outcome measures . Differences in treatment effect sizes were compared as a function of chronic pain condition . Correlations were examined between outcome parameters and home meditation practice . RESULTS Outcomes differed in significance and magnitude across common chronic pain conditions . Diagnostic subgroups of patients with arthritis , back/neck pain , or two or more comorb 
    Output:
    
Of these c and i date mechanisms , the most consistent finding was that greater self-reported change in mindfulness mediated superior clinical outcomes .
There was evidence that global changes in mindfulness are linked to better outcomes .
This evidence pertained more to interventions targeting psychological rather than physical health conditions .