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Mindfulness, Emotion Regulation, and Psychological Distress: A Cluster Randomized Controlled Trial with High-Achieving University Students in China

Rong Tian, Chien-Chung Huang, Jiou-Fang Peng, Hao Qiu

Mindfulness July 1, 2026 DOI: 10.1007/s12671-026-02893-9 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Cluster randomized controlled trial Preregistered Peer reviewed
Sample size 218
Population First-year students from a Double First-Class university in China
Intervention Mindfulness-based program
Duration Eight-session program
Topics Meditation
Key findings The mindfulness intervention significantly increased mindfulness and reduced psychological distress. Posttest mindfulness was positively associated with cognitive reappraisal (β = 0.39) and negatively with expressive suppression (β = -0.26). Cognitive reappraisal predicted lower distress (β = -0.22), while suppression predicted higher distress (β = 0.17). Mindfulness had a direct negative effect on distress (β = -0.22), and indirect effects through emotion regulation were significant (β = -0.13), accounting for 36.86% of the total effect.

Abstract

Abstract Objectives First-year college students navigating the transition into emerging adulthood face heightened psychological vulnerability, particularly within competitive academic environments. This study examined whether a mindfulness-based intervention can enhance mindfulness and reduce psychological distress, and whether these effects operate through emotion regulation strategies, including cognitive reappraisal and expressive suppression.

Method: A cluster randomized controlled trial (cRCT) was conducted with 218 first-year students from a Double First-Class university in China. Participants in the intervention group completed an eight-session mindfulness-based program. Pretest and posttest data were analyzed using structural equation modeling within a residualized change framework, controlling for baseline measures and demographic covariates.

Results: The intervention significantly increased mindfulness over time relative to the control group. Posttest mindfulness was positively associated with cognitive reappraisal ( β = 0.39, p < 0.001) and negatively associated with expressive suppression ( β = − 0.26, p < 0.001). Cognitive reappraisal predicted lower psychological distress ( β = − 0.22, p < 0.001), whereas suppression predicted higher distress ( β = 0.17, p = 0.012). Mindfulness also had a direct negative effect on distress ( β = − 0.22, p < 0.001). Indirect effects through emotion regulation were significant ( β = − 0.13, p < 0.001), accounting for 36.86% of the total effect.

Conclusions: Mindfulness reduces psychological distress through both direct and emotion regulation pathways. By focusing on first-year students in a hypercompetitive academic setting, this study demonstrates that early, mechanism-based mindfulness interventions can support adaptation and resilience during the transition into emerging adulthood. Preregistration This study is not preregistered.