The Relationship between Mindfulness, Psychological Flexibility, and Symptom Severity in Persons with Schizophrenia-Spectrum-Disorders – a Cross-Sectional Study

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 demonstrated by a growing body of evidence. However, the underlying mechanisms of MBIs still need further examination. Psychological flexibility (PF), generally assessed by cognitive fusion, has been shown to be associated with clinical change in MBIs. This study used a cross-sectional design to investigate the interplay of mindfulness, PF, and symptom severity in SSD. In total, N = 94 individuals with SSD were included. 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. Findings indicated that mindfulness was significantly negatively correlated with positive and depressive symptoms, as well as significantly positively related to PF. A significant mediating effect of PF was found for the relationship between mindfulness and negative as well as depressive symptoms. The current study supports previous research about PF as a possible mechanism of action in MBIs. Still, future research using longitudinal designs, more fine-grained analyses, and mixed-method approaches regarding assessment tools are warranted.