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.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cites 5
- The effects of mindfulness-based techniques on self-rumination, cognitive reappraisal and expressive suppression among patients with major depression: a nursing perspective. Journal of Research in Nursing August 1, 2024
- Defining Mindfulness: A Review of Existing Definitions and Suggested Refinements Mindfulness 2025
- Mindfulness as a Protective Factor Against Depression, Anxiety and Psychological Distress During the COVID-19 Pandemic: Emotion Regulation and Insomnia Symptoms as Mediators Frontiers in Psychology April 1, 2022
- Effectiveness of Online Mindfulness-Based Interventions on Psychological Distress and the Mediating Role of Emotion Regulation Frontiers in Psychology October 31, 2018
- Mindfulness and Emotion Regulation: Insights from Neurobiological, Psychological, and Clinical Studies Frontiers in Psychology March 6, 2017