The relationship between mindfulness, psychological flexibility, and symptom severity in persons with schizophrenia-spectrum-disorders: a cross-sectional study

Abstract

Abstract The effectiveness of mindfulness-based interventions (MBIs) in enhancing mental well-being and reducing positive, negative, and depressive symptoms in schizophrenia spectrum disorders (SSD) has been increasingly supported by evidence. However, the underlying mechanisms of MBIs require further examination. Psychological flexibility (PF), typically assessed through cognitive fusion, has been associated with clinical change in MBIs. This study employed a cross-sectional design to explore the interplay between mindfulness, PF, and symptom severity in SSD. A total of N = 94 persons with SSD were included in the analysis. Correlation and mediation analyses were performed using PROCESS analysis, with positive, negative, and depressive symptom severity as outcome variables, measured by the Positive and Negative Syndrome Scale (PANSS) and the Depression Anxiety Stress Scale (DASS-21), respectively. The findings indicated that mindfulness was significantly negatively correlated with positive and depressive symptoms and significantly positively correlated with PF. A significant mediating effect of PF was identified in the relationship between mindfulness and both negative and depressive symptoms. This study supports previous research suggesting PF as a possible mechanism of action in MBIs. However, future research utilizing longitudinal designs, more nuanced analyses, and mixed method approaches in assessment tools is warranted.