***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 : We compared mindfulness-based cognitive therapy ( MBCT ) with both cognitive psychological education ( CPE ) and treatment as usual ( TAU ) in preventing relapse to major depressive disorder ( MDD ) in people currently in remission following at least 3 previous episodes . Method : A r and omized controlled trial in which 274 participants were allocated in the ratio 2:2:1 to MBCT plus TAU , CPE plus TAU , and TAU alone , and data were analyzed for the 255 ( 93 % ; MBCT = 99 , CPE = 103 , TAU = 53 ) retained to follow-up . MBCT was delivered in accordance with its published manual , modified to address suicidal cognitions ; CPE was modeled on MBCT , but without training in meditation . Both treatments were delivered through 8 weekly classes . Results : Allocated treatment had no significant effect on risk of relapse to MDD over 12 months follow-up , hazard ratio for MBCT vs. CPE = 0.88 , 95 % CI [ 0.58 , 1.35 ] ; for MBCT vs. TAU = 0.69 , 95 % CI [ 0.42 , 1.12 ] . However , severity of childhood trauma affected relapse , hazard ratio for increase of 1 st and ard deviation = 1.26 ( 95 % CI [ 1.05 , 1.50 ] ) , and significantly interacted with allocated treatment . Among participants above median severity , the hazard ratio was 0.61 , 95 % CI [ 0.34 , 1.09 ] , for MBCT vs. CPE , and 0.43 , 95 % CI [ 0.22 , 0.87 ] , for MBCT vs. TAU . For those below median severity , there were no such differences between treatment groups . Conclusion : MBCT provided significant protection against relapse for participants with increased vulnerability due to history of childhood trauma , but showed no significant advantage in comparison to an active control treatment and usual care over the whole group of patients with recurrent depression 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 IMPORTANCE Currently , fewer than 40 % of patients treated for major depressive disorder achieve remission with initial treatment . Identification of a biological marker that might improve these odds could have significant health and economic impact . OBJECTIVE To identify a c and i date neuroimaging " treatment-specific biomarker " that predicts differential outcome to either medication or psychotherapy . DESIGN Brain glucose metabolism was measured with positron emission tomography prior to treatment r and omization to either escitalopram oxalate or cognitive behavior therapy for 12 weeks . Patients who did not remit on completion of their phase 1 treatment were offered enrollment in phase 2 comprising an additional 12 weeks of treatment with combination escitalopram and cognitive behavior therapy . SETTING Mood and anxiety disorders research program at an academic medical center . PARTICIPANTS Men and women aged 18 to 60 years with currently untreated major depressive disorder . INTERVENTION R and omized assignment to 12 weeks of treatment with either escitalopram oxalate ( 10 - 20 mg/d ) or 16 sessions of manual-based cognitive behavior therapy . MAIN OUTCOME AND MEASURE Remission , defined as a 17-item Hamilton depression rating scale score of 7 or less at both weeks 10 and 12 , as assessed by raters blinded to treatment . RESULTS Positive and negative predictors of remission were identified with a 2-way analysis of variance treatment ( escitalopram or cognitive behavior therapy ) × outcome ( remission or nonresponse ) interaction . Of 65 protocol completers , 38 patients with clear outcomes and usable positron emission tomography scans were included in the primary analysis : 12 remitters to cognitive behavior therapy , 11 remitters to escitalopram , 9 nonresponders to cognitive behavior therapy , and 6 nonresponders to escitalopram . Six limbic and cortical regions were identified , with the right anterior insula showing the most robust discriminant properties across groups ( effect size = 1.43 ) . Insula hypometabolism ( relative to whole-brain mean ) was associated with remission to cognitive behavior therapy and poor response to escitalopram , while insula hypermetabolism was associated with remission to escitalopram and poor response to cognitive behavior therapy . CONCLUSIONS AND RELEVANCE If verified with prospect i ve testing , the insula metabolism-based treatment-specific biomarker defined in this study provides the first objective marker , to our knowledge , to guide initial treatment selection for depression . TRIAL REGISTRATION Registered at clinical trials.gov ( NCT00367341 ) OBJECTIVE Military deployment can have profound effects on physical and mental health . Few studies have examined whether interventions prior to deployment can improve mechanisms underlying resilience . Mindfulness-based techniques have been shown to aid recovery from stress and may affect brain-behavior relationships prior to deployment . The authors examined the effect of mindfulness training on resilience mechanisms in active-duty Marines preparing for deployment . METHOD Eight Marine infantry platoons ( N=281 ) were r and omly selected . Four platoons were assigned to receive mindfulness training ( N=147 ) and four were assigned to a training-as-usual control condition ( N=134 ) . Platoons were assessed at baseline , 8 weeks after baseline , and during and after a stressful combat training session approximately 9 weeks after baseline . The mindfulness training condition was delivered in the form of 8 weeks of Mindfulness-Based Mind Fitness Training ( MMFT ) , a program comprising 20 hours of classroom instruction plus daily homework exercises . MMFT emphasizes interoceptive awareness , attentional control , and tolerance of present-moment experiences . The main outcome measures were heart rate , breathing rate , plasma neuropeptide Y concentration , score on the Response to Stressful Experiences Scale , and brain activation as measured by functional MRI . RESULTS Marines who received MMFT showed greater reactivity ( heart rate [ d=0.43 ] ) and enhanced recovery ( heart rate [ d=0.67 ] , breathing rate [ d=0.93 ] ) after stressful training ; lower plasma neuropeptide Y concentration after stressful training ( d=0.38 ) ; and attenuated blood-oxygen-level-dependent signal in the right insula and anterior cingulate . CONCLUSIONS The results show that mechanisms related to stress recovery can be modified in healthy individuals prior to stress exposure , with important implication s for evidence -based mental health research and treatment 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 BACKGROUND Preliminary research findings have shown that mindfulness-based cognitive therapy improves anxiety and depressive symptoms in bipolar disorder . In this study , we further investigated the effects of MBCT in bipolar disorder , in a controlled fMRI study . METHOD Twenty three patients with bipolar disorder underwent neuropsychological testing and functional MRI .  Sixteen of these patients were tested before and after an eight-week MBCT intervention , and seven were wait listed for training and tested at the same intervals . The results were compared with 10 healthy controls . RESULTS Prior to MBCT , bipolar patients reported significantly higher levels of anxiety and symptoms of stress , scored significantly lower on a test of working memory , and showed significant BOLD signal decrease in the medial PFC during a mindfulness task , compared to healthy controls . Following MBCT , there were significant improvements in the bipolar treatment group , in measures of mindfulness , anxiety and emotion regulation , and in tests of working memory , spatial memory and verbal fluency compared to the bipolar wait list group . BOLD signal increases were noted in the medial PFC and posterior parietal lobe , in a repeat mindfulness task . A region of interest analysis revealed strong correlation between signal changes in medial PFC and increases in mindfulness . LIMITATIONS The small control group is a limitation in the study . CONCLUSION These data suggest that MBCT improves mindfulness and emotion regulation and reduces anxiety in bipolar disorder , corresponding to increased activations in the medial PFC , a region associated with cognitive flexibility and previously proposed as a key area of pathophysiology in the disorder The possibility of individualized treatment prediction has profound implication s for the development of personalized interventions for patients with anxiety disorders . Here we utilize r and om forest classification and pre-treatment functional magnetic resonance imaging ( fMRI ) data from individuals with generalized anxiety disorder ( GAD ) and panic disorder ( PD ) to generate individual subject treatment outcome predictions . Before cognitive behavioral therapy ( CBT ) , 48 adults ( 25 GAD and 23 PD ) reduced ( via cognitive re appraisal ) or maintained their emotional responses to negative images during fMRI scanning .  CBT responder status was predicted using activations from 70 anatomically defined regions . The final r and om forest model included 10 predictors contributing most to classification accuracy . A similar analysis was conducted using the clinical and demographic variables . Activations in the hippocampus during maintenance and anterior insula , superior temporal , supramarginal , and superior frontal gyri during re appraisal were among the best predictors , with greater activation in responders than non-responders . The final fMRI-based model yielded 79 % accuracy , with good sensitivity ( 0.86 ) , specificity ( 0.68 ) , and positive and negative likelihood ratios ( 2.73 , 0.20 ) . Clinical and demographic variables yielded poorer accuracy ( 69 % ) , sensitivity ( 0.79 ) , specificity ( 0.53 ) , and likelihood ratios ( 1.67 , 0.39 ) . This is the first use of r and om forest models to predict treatment outcome from pre-treatment neuroimaging data in psychiatry . Together , r and om forest models and fMRI can provide single-subject predictions with good test characteristics . Moreover , activation patterns are consistent with the notion that greater activation in cortico-limbic circuitry predicts better CBT response in GAD and PD 
    Output:
    
The most consistent longitudinal effect observed was increased insular cortex activity  following mindfulness‐based interventions .
In contrast to previous review s , we did not find robust evidence for increased activity in specific prefrontal cortex sub‐regions .
These findings suggest that mindfulness interventions are associated with changes in functioning of the insula , plausibly impacting awareness of internal reactions ‘ in‐the‐moment ’ .