Effect of cognitive flexibility in mindfulness intervention for emotional distress: Two randomized controlled trials.
Zhenzhen Wang, Mo Chen, Amy Hu, Shixing Feng, Stefan G Hofmann, Xinghua Liu
Journal of Counseling Psychology July 14, 2025 DOI: 10.1037/cou0000812 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 696 |
| Population | Adults experiencing high emotional distress |
| Intervention | Mindfulness intervention for emotional distress (MIED) |
| Duration | 8-week intervention |
| Topics | Meditation |
| Keywords | Mindfulness programs Mindfulness interventions Cognitive flexibility Mentally shift gears Mental agility Attention Emotional well-being Emotional distress Trials |
| Citations | 2 |
| Key findings | The mindfulness intervention alleviated emotional distress by enhancing cognitive flexibility, which mediated later reductions in distress. |
Abstract
To examine the mechanistic role of cognitive flexibility in mindfulness intervention for emotional distress (MIED), we conducted two randomized controlled trials. In Study 1, 607 participants experiencing high emotional distress were randomly assigned to either an MIED program group (N = 304) or a waitlist control group (N = 303). Levels of cognitive flexibility, anxiety, depression, and general emotional distress were assessed at baseline (T0), Week 3 (T3), Week 5 (T5), and Week 7 (postintervention, T7). Study 2 included 89 participants with high emotional distress, randomly assigned to either an MIED group (N = 45) or a control group (N = 44). The same measures were assessed weekly, and cognitive flexibility was measured by a behavioral task at T0, T3, T5, and T7. All measures showed significant improvement in the MIED group. The effects of the MIED program on the change in emotional distress at a later time were significantly mediated by the change in cognitive flexibility during the intervention. Hierarchical regression analysis showed that more efficient shifting of attention away from affective toward nonaffective aspects of positive stimuli at T5, and less efficient shifting of attention away from affective aspects of negative stimuli to positive stimuli at T3, predicted greater reductions in emotional distress at T7. The MIED program alleviated emotional distress by enhancing cognitive flexibility, suggesting that cognitive flexibility is a key mechanism underlying the intervention. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
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 |