The role of mindfulness and dysexecutive functioning in the association between depression and COVID-19-related stress: cross-sectional and longitudinal analyses

ABSTRACT Background: Since the COVID-19 outbreak, the severity of college student's mental health has increased, with depression being the most prominent. This study's primary purpose was to explore (1) whether the perceived stress of COVID-19 was associated with depression through sequential mediation of mindfulness and dysexecutive function and also (2) the temporal association among mindfulness, dysexecutive function and depression. Methods: We performed two studies to evaluate dysexecutive function as a mechanism through which mindfulness impacts depression under the stress of the COVID-19 pandemic. Study 1 used a sequential mediation model to test the mediating role of mindfulness and dysexecutive function between the perceived stress of COVID-19 and depression based on 1,665 emerging adults. Study 2 used a random-effect, cross-lagged panel model (RE-CLPM) to test the directionality among mindfulness, dysexecutive function, and depression based on 370 emerging adults. Results: The cross-sectional study showed that perceived stress of COVID-19 was positively associated with depression through the sequential mediation of mindfulness and dysexecutive function (effect: 0.08, 95%CI = [0.07, 0.10]), also through the mediation of mindfulness (effect: 0.05, 95%CI = [0.03, 0.06]) and dysexecutive function (effect: 0.08, 95%CI = [0.06, 0.10]) separately. The RE-CLPM study indicated that dysexecutive function mediates the reciprocal relation between mindfulness and depression at the within-person level. Conclusion: These results suggest that dysexecutive function is an intermediate psychological mechanism that exacerbates depression under pandemic-related stress. Mindfulness can predict dysexecutive function and subsequently improve depression. As depression under pandemic-related stress can weaken the mindful state, long-term mindfulness practices are needed to maintain mental health during COVID-19.

[1]  Suhua Chang,et al.  The effect of perceived stress on cognition is mediated by personality and the underlying neural mechanism , 2022, Translational Psychiatry.

[2]  S. Shorey,et al.  Global prevalence of depression and elevated depressive symptoms among adolescents: A systematic review and meta-analysis. , 2021, The British journal of clinical psychology.

[3]  Hong Luo,et al.  Anxiety, depression, and stress prevalence among college students during the COVID-19 pandemic: A systematic review and meta-analysis. , 2021, Journal of American college health : J of ACH.

[4]  A. Campo‐Arias,et al.  Review of the COVID-19 Pandemic-related Perceived Stress Scale (PSS–10–C) , 2021, Revista Colombiana de Psiquiatría (English ed.).

[5]  Zhenhong Wang,et al.  Perceived stress of the COVID-19 pandemic and adolescents' depression symptoms: The moderating role of character strengths , 2021, Personality and Individual Differences.

[6]  T. Dalgleish,et al.  Decentering as a core component in the psychological treatment and prevention of youth anxiety and depression: a narrative review and insight report , 2021, Translational Psychiatry.

[7]  J. Karbach,et al.  Effects of a Single Physical or Mindfulness Intervention on Mood, Attention, and Executive Functions: Results from two Randomized Controlled Studies in University Classes , 2021, Mindfulness.

[8]  C. Loo,et al.  An investigation of working memory deficits in depression using the n-back task: A systematic review and meta-analysis. , 2021, Journal of affective disorders.

[9]  G. Caplovitz,et al.  Does mindfulness-based intervention improve cognitive function?: A meta-analysis of controlled studies. , 2021, Clinical psychology review.

[10]  M. Qorbani,et al.  Prevalence and severity of depression, anxiety, stress and perceived stress in hospitalized patients with COVID-19 , 2020, Journal of Diabetes & Metabolic Disorders.

[11]  P. Zelazo Executive Function and Psychopathology: A Neurodevelopmental Perspective. , 2020, Annual review of clinical psychology.

[12]  Andrew F. Hayes,et al.  Conditional Process Analysis: Concepts, Computation, and Advances in the Modeling of the Contingencies of Mechanisms , 2020, American Behavioral Scientist.

[13]  Li-Jun Jiang,et al.  The Reliability and Validity of the Center for Epidemiologic Studies Depression Scale (CES-D) for Chinese University Students , 2019, Front. Psychiatry.

[14]  A. Arnsten,et al.  Loss of Prefrontal Cortical Higher Cognition with Uncontrollable Stress: Molecular Mechanisms, Changes with Age, and Relevance to Treatment , 2019, Brain sciences.

[15]  I. Gotlib,et al.  Depression: A cognitive perspective. , 2019, Clinical psychology review.

[16]  Ian A. Carroll,et al.  A single-level random-effects cross-lagged panel model for longitudinal mediation analysis , 2018, Behavior research methods.

[17]  Claudia M. Roebers,et al.  Executive function and metacognition: Towards a unifying framework of cognitive self-regulation , 2017 .

[18]  J. Creswell,et al.  Mechanisms of mindfulness training: Monitor and Acceptance Theory (MAT). , 2017, Clinical psychology review.

[19]  E. J. Pedrero-Pérez,et al.  Dysexecutive Questionnaire (DEX): Unrestricted structural analysis in large clinical and non-clinical samples , 2015, Neuropsychological rehabilitation.

[20]  Britta K. Hölzel,et al.  The neuroscience of mindfulness meditation , 2015, Nature Reviews Neuroscience.

[21]  L. Selemon A role for synaptic plasticity in the adolescent development of executive function , 2013, Translational Psychiatry.

[22]  R. Ryan,et al.  Psychometric Properties of the Chinese Translation of the Mindful Attention Awareness Scale (MAAS) , 2012 .

[23]  C. Beevers,et al.  Neural mechanisms of the cognitive model of depression , 2011, Nature Reviews Neuroscience.

[24]  B. Fredrickson,et al.  Upward spirals of positive emotions counter downward spirals of negativity: insights from the broaden-and-build theory and affective neuroscience on the treatment of emotion dysfunctions and deficits in psychopathology. , 2010, Clinical psychology review.

[25]  Sylvia D. Kreibig,et al.  Autonomic nervous system activity in emotion: A review , 2010, Biological Psychology.

[26]  J. Joormann Cognitive Inhibition and Emotion Regulation in Depression , 2010 .

[27]  Klaus P. Ebmeier,et al.  A meta-analysis of depression severity and cognitive function. , 2009, Journal of affective disorders.

[28]  C. Liston,et al.  Psychosocial stress reversibly disrupts prefrontal processing and attentional control , 2009, Proceedings of the National Academy of Sciences.

[29]  Giovanni B. Moneta,et al.  Metacognition, perceived stress, and negative emotion , 2008 .

[30]  F. Chen Sensitivity of Goodness of Fit Indexes to Lack of Measurement Invariance , 2007 .

[31]  C. Beevers Cognitive vulnerability to depression: a dual process model. , 2005, Clinical psychology review.

[32]  Masato Fukuda,et al.  Executive and prefrontal dysfunction in unipolar depression: a review of neuropsychological and imaging evidence , 2004, Neuroscience Research.

[33]  Scott B. MacKenzie,et al.  Common method biases in behavioral research: a critical review of the literature and recommended remedies. , 2003, The Journal of applied psychology.

[34]  J. Hill Childhood trauma and depression , 2003 .

[35]  B. Fredrickson,et al.  Positive Emotions Trigger Upward Spirals Toward Emotional Well-Being , 2002, Psychological science.

[36]  L. Radloff The CES-D Scale , 1977 .

[37]  A. Diamond Executive functions. , 2014, Handbook of clinical neurology.

[38]  R. Ryan,et al.  The benefits of being present: mindfulness and its role in psychological well-being. , 2003, Journal of personality and social psychology.