***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 Objectives : converging research suggests that mindfulness training exerts its therapeutic effects on depression by reducing rumination . Theoretically , rumination is a multifaceted construct that aggregates multiple neurocognitive aspects of depression , including poor executive control , negative and overgeneral memory bias , and persistence or stickiness of negative mind states . Current measures of rumination , most-often self-reports , do not capture these different aspects of ruminative tendencies , and therefore are limited in providing detailed information about the mechanisms of mindfulness . Methods : we developed new insight into the potential mechanisms of rumination , based on three model-based metrics of free recall dynamics . These three measures reflect the patterns of memory retrieval of valenced information : the probability of first recall ( Pstart ) which represents initial affective bias , the probability of staying with the same valence category rather than switching , which indicates strength of positive or negative association networks ( Pstay ) , and probability of stopping ( Pstop ) or ending recall within a given valence , which indicates persistence or stickiness of a mind state . We investigated the effects of Mindfulness-Based Cognitive Therapy ( MBCT ; N = 29 ) vs. wait-list control  ( N = 23 ) on these recall dynamics in a r and omized controlled trial in individuals with recurrent depression . Participants completed a  st and ard laboratory stressor , the Trier Social Stress Test , to induce negative mood and activate ruminative tendencies . Following that , participants completed a free recall task consisting of three word lists . This assessment was conducted both before and after treatment or wait-list . Results : while MBCT participant ’s Pstart remained relatively stable , controls showed multiple indications of depression-related deterioration toward more negative and less positive bias . Following the intervention , MBCT participants decreased in their tendency to sustain trains of negative words and increased their tendency to sustain trains of positive words . Conversely , controls showed the opposite tendency : controls stayed in trains of negative words for longer , and stayed in trains of positive words for less time relative to pre-intervention scores . MBCT participants tended to stop recall less often with negative words , which indicates less persistence or stickiness of negatively valenced mental context . Conclusion :  MBCT participants showed a decrease in patterns that may perpetuate rumination on all three types of recall dynamics ( Pstart , Pstay , and Pstop ) , compared to controls . MBCT may weaken the strength of self-perpetuating negative associations networks that are responsible for the persistent and “ sticky ” negative mind states observed in depression , and increase the positive associations that are lacking in depression . This study also offers a novel , objective method of measuring several indices of ruminative tendencies indicative of the underlying mechanisms of rumination 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 Research suggests that suppressing unwanted thoughts is not possible , leads to a subsequent increase in frequency of the suppressed thoughts , and results in higher levels of distress . Because thought suppression may have negative effects , an alternative , acceptance-based approach has been proposed . The current paper reports the outcomes of two studies . Study I examined the relationships between two naturally occurring strategies of thought management ( thought suppression and acceptance ) , symptoms of psychopathology , and experiences with personally relevant intrusive thoughts . Results showed that those who naturally suppress personally relevant intrusive thoughts have more , are more distressed by , and have a greater " urge to do something " about the thoughts , while those who are naturally more accepting of their intrusive thoughts are less obsessional , have lower levels of depression , and are less anxious . Study II compared three groups ( thought suppression , acceptance , and monitor-only groups )  on the frequency and distress associated with experiencing personally relevant intrusive thoughts . Results revealed that those instructed to suppress their personal intrusive thoughts were unable to do so and experienced an increased level of distress after suppression , whereas those instructed to use an acceptance-based strategy experienced a decrease in discomfort level ( but not thought frequency ) after having used such a strategy . These data offer initial evidence that acceptance may be a useful alternative to the suppression of personally relevant intrusive thoughts Major Depressive Disorder ( MDD ) manifests in 20 - 30 % of college students , with increased incidence in recent decades . Very limited research has assessed the efficacy of evidence -based interventions for MDD in college students .  Mindfulness-Based Therapy ( MBT ) and Behavioral Activation ( BA ) are two interventions with significant potential to meet dem and s of college counseling clinics and effectively treat college students with MDD . This study utilized a r and omized controlled research design ( n = 50 ) to examine the efficacy of four-sessions of abbreviated MBT and BA relative to a wait-list control condition with depressed college students . Intent-to-treat data analyses on depression outcome measures suggested both treatments were superior to the control group . There were significant pre-post treatment improvements across measures of depression , rumination , stress , and mindfulness , gains largely maintained at 1-month follow-up . Neither active treatment effectively reduced somatic anxiety . Both treatments generally had moderate-strong effect sizes relative to the control group , and based on depression response and remission criteria , 56 - 79 % of patients exhibited clinical ly significant improvement . Based on reliable change indices , 75 - 85 % experienced clinical ly significant reductions in depression . There was strong therapist competence and adherence to treatment protocol s and high patient satisfaction with both interventions . Study limitations and implication s for the assessment and treatment of depressed college students are discussed OBJECTIVES The purpose of this study was to examine the efficacy of a 12-week mindfulness-based yoga intervention on depressive symptoms and rumination among depressed women . DESIGN Prospect i ve , r and omized , controlled 12 week intervention pilot study . Depressive symptoms were assessed at baseline , post-intervention ( 12 weeks ) , and one-month follow-up . SETTING Women with a history of diagnosed depression and currently depressed were r and omized to a mindfulness-based yoga condition or a walking control . INTERVENTIONS The mindfulness-based yoga intervention consisted of a home-based yoga asana , pranayama and meditation practice with mindfulness education sessions delivered over the telephone . The walking control condition consisted of home-based walking sessions and health education sessions delivered over the phone . MAIN OUTCOME MEASURES The Beck Depression Inventory ( BDI ) and Ruminative Responses Scale ( RRS ) . RESULTS Both groups reported decreases in depressive symptoms from baseline to post-intervention , f(1,33)=34.83 , p<0.001 , and from baseline to one-month follow-up , f(1,33)=37.01 , p<0.001 . After controlling for baseline , there were no significant between group differences on depression scores at post-intervention and the one-month follow-up assessment . The mindfulness-based yoga condition reported significantly lower levels of rumination than the control condition at post-intervention , after controlling for baseline levels of rumination , f(1,31)=6.23 , p<0.01 . CONCLUSIONS These findings suggest that mindfulness-based yoga may provide tools to manage ruminative thoughts among women with elevated depressive symptoms . Future studies , with larger sample s are needed to address the effect of yoga on depression and further explore the impact on rumination OBJECTIVES Mindfulness-based cognitive therapy ( MBCT ) is a new group-based intervention for prevention of relapse in recurrent depression which has not been scientifically evaluated regarding its clinical effectiveness for ameliorating residual depressive symptoms following a depressive episode . The aim of this study was to assess the efficacy of MBCT in reducing residual depressive symptoms in psychiatric out patients with recurrent depression , and to particularly explore the effects of mindfulness techniques on rumination . DESIGN The design of this study was a mixed model complex design . Design 1 consisted of a consecutive series of patients . They were assigned to either MBCT or TAU . The independent variables were time and group allocation , and dependent variables were Beck Depression Inventory ( BDI ) and Rumination Scale . In Design 2 , the TAU group proceeded to complete an MBCT group , and the BDI and Rumination Scale results of the two groups were collapsed . METHOD Nineteen patients with residual depressive symptoms following a depressive episode , and who were attending outpatient clinic , were assigned to either MBCT or treatment as usual ( TAU ) , with the TAU group then proceeding to complete an MBCT group . Depressive and ruminative symptoms were assessed before , during , and after treatment , and at one-month follow-up . RESULTS A significant reduction in depressive symptoms was found at the end of MBCT , with a further reduction at one-month follow-up . A trend towards a reduction in rumination scores was also observed . CONCLUSIONS Group MBCT has a marked effect on residual depressive symptoms , which may be mediated through the mindfulness-based cognitive approach towards excessive negative ruminations in patients with residual depressive symptoms following a depressive episode OBJECTIVE To examine whether metacognitive psychological skills , acquired in mindfulness-based cognitive therapy ( MBCT ) , are also present in patients receiving medication treatments for prevention of depressive relapse and whether these skills mediate MBCT 's effectiveness . METHOD This study , embedded within a r and omized efficacy trial of MBCT , was the first to examine changes in mindfulness and decentering during 6 - 8 months of antidepressant treatment and then during an 18-month maintenance phase in which patients discontinued medication and received MBCT , continued on antidepressants , or were switched to a placebo . In total , 84 patients ( mean age = 44 years , 58 % female ) were r and omized to 1 of these 3 prevention conditions . In addition to symptom variables , changes in mindfulness , rumination , and decentering were assessed during the phases of the study . RESULTS Pharmacological treatment of acute depression was associated with reductions in scores for rumination and increased wider experiences . During the maintenance phase , only patients receiving MBCT showed significant increases in the ability to monitor and observe thoughts and feelings as measured by the Wider Experiences ( p < .01 ) and Decentering ( p < .01 ) subscales of the Experiences Question naire and by the Toronto Mindfulness Scale . In addition , changes in Wider Experiences ( p < .05 ) and Curiosity ( p < .01 ) predicted lower Hamilton Rating Scale for Depression scores at 6-month follow-up . CONCLUSIONS An increased capacity for decentering and curiosity may be fostered during MBCT and may underlie its effectiveness . With practice , patients can learn to counter habitual avoidance tendencies and to regulate dysphoric affect in ways that support recovery 
    Output:
    
Furthermore , findings suggest that mindfulness/acceptance processes might mediate changes in rumination , and that they in turn mediate in the clinical effects of interventions .
Conclusions : Mindfulness-based cognitive therapy compared to usual care , produces a significant and moderate reduction in rumination .