Mindfulness as a Protective Factor Against Depression, Anxiety and Psychological Distress During the COVID-19 Pandemic: Emotion Regulation and Insomnia Symptoms as Mediators

Mindfulness is linked to better mental health, and this study examined why. Surveying 493 adults during the COVID-19 pandemic, the authors found that mindfulness was associated with lower depression, anxiety, and psychological distress, both directly and through indirect pathways. Specifically, mindfulness was negatively associated with rumination and insomnia, which in turn were linked to fewer mental health problems. Rumination also increased insomnia, creating a chain of effects. For depression only, mindfulness was positively associated with cognitive reappraisal and negatively with suppression, which were respectively linked to fewer and more depressive symptoms. The authors suggest that targeting emotion regulation and sleep in mindfulness interventions could improve mental health.

Study at a glance

Abstract

Objectives Research has linked mindfulness to improved mental health, yet the mechanisms underlying this relationship are not well understood. This study explored the mediating role of emotion regulation strategies and sleep in the relationship between mindfulness and symptoms of depression, anxiety and psychological distress during the COVID-19 pandemic. Methods As detailed in this study’s pre-registration (osf.io/k9qtw), a cross-sectional research design was used to investigate the impact of mindfulness on mental health and the mediating role of emotion regulation strategies (i.e., cognitive reappraisal, rumination and suppression) and insomnia. A total of 493 participants from the general population answered an online survey and were included in the final analysis. The online survey consisted of the short form of the Five-Facets Mindfulness Questionnaire (FFMQ-SF), the Impact of Event Scale-revised (IES-R), the Generalised Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire (PHQ-8), the Emotion Regulation Questionnaire (ERQ), the short form of the Rumination Response Scale (RSS-SF), and the Insomnia Severity Index (ISI). Results Structural equation modelling revealed that mindfulness was related to lower symptoms of depression, anxiety and psychological distress, both directly and indirectly. Mindfulness was negatively associated with rumination and insomnia. As hypothesised, models revealed that the associations between mindfulness and depression, anxiety and psychological distress were significantly mediated by its negative associations with rumination and insomnia. Our findings also demonstrated that rumination was related to increased insomnia symptoms, which in turn was associated with increased mental health problems, indicating a mediated mediation. Mindfulness was also positively associated with cognitive reappraisal and negatively associated with suppression, which were, respectively, negatively and positively associated with depressive symptoms, and thus functioned as specific mediators of the association between mindfulness and depression. Conclusion Our findings suggest that rumination and insomnia operate transdiagnostically as interrelated mediators of the effects of mindfulness on mental health, whereas cognitive reappraisal and suppression function as specific mediators for depression. These insights emphasise the importance of targeting emotion regulation and sleep in mindfulness interventions for improving mental health. Limitations and implications for practice are discussed.