Beyond distress: a sequential quantitative investigation of MBSR through a dual-factor model of mental health in college students.

Mindfulness-Based Stress Reduction (MBSR) among college students improved positive mental health with a large, sustained effect (d = 0.71) at post-intervention and 6-month follow-up, but did not significantly reduce psychological distress compared to a waitlist control. Cross-sectional analyses showed mindfulness was positively linked to well-being and negatively linked to distress, with sleep quality acting as a potential mediator, especially for positive mental health. The study used a sequential design: a cross-sectional survey of 406 students and a randomized controlled trial of 120 students assigned to an 8-week MBSR program or waitlist.

Study at a glance

Abstract

This study applies the Dual-Factor Model of Mental Health to examine the effects of Mindfulness-Based Stress Reduction (MBSR) among college students, addressing a critical gap in understanding how mindfulness interventions simultaneously promote positive mental health and reduce psychological distress. Sleep quality was investigated as a potential mediating mechanism, and the scalability of MBSR as a campus-wide intervention was explored in the post-pandemic context, where student mental health concerns have risen sharply. A sequential quantitative design was employed, combining cross-sectional analysis (N = 406) and a randomized controlled trial (N = 120). In the cross-sectional phase, mindfulness (MAAS), sleep quality (Athens Insomnia Scale), psychological distress (DASS-21), and positive mental health (MHC-SF) were assessed. Path analysis and bootstrap-based mediation testing (5,000 resamples) were used to examine structural relationships and estimate indirect effects, particularly the mediating role of sleep quality. In the experimental phase, participants were randomly assigned to an 8-week MBSR program or a waitlist control group, with assessments at baseline, post-intervention, and 6-month follow-up to evaluate sustained outcomes. We employed sequential quantitative design combining cross-sectional analysis (N = 406) and a randomized controlled trial (N = 120). The cross-sectional phase used the Mindful Attention Awareness Scale (MAAS), Athens Insomnia Scale (AIS), Depression Anxiety Stress Scale-21 (DASS-21), and Mental Health Continuum-Short Form (MHC-SF) to establish structural relationships through path analysis and bootstrap-based mediation testing (5,000 resamples). The intervention phase randomly assigned participants to an 8-week MBSR program or waitlist control, with assessments at baseline, post-intervention, and 6-month follow-up to capture sustainability. Cross-sectional analyses revealed that mindfulness was positively associated with positive mental health (β = 0.38, p < 0.01) and negatively associated with psychological distress (β = -0.31, p < 0.01). Sleep quality emerged as a potential mediator, particularly in relation to positive mental health outcomes. The intervention group demonstrated robust and sustained improvements in positive mental health (d = 0.71, 95% CI [0.52, 0.90]). Psychological distress showed more variable patterns, with no significant between-group differences observed.