Developing a Structural Model of University Students’ Psychological Well-Being Based on Mindfulness and Ambiguity Tolerance, with the Mediating Roles of Cognitive Flexibility and Emotion Regulation

BackgroundOne factor influencing mental health is cognitive flexibility and emotion regulation. Employing adaptive strategies positively impacts the development of appropriate responses to emotional situations. Nursing students, particularly during initial patient and family interactions, may experience high stress and anxiety, often accompanied by reduced cognitive flexibility and emotion regulation. Therefore, incorporating strategies to enhance these skills, such as transactional analysis (TA) training, into nursing curricula is essential. TA is one of the theories that has provided practical solutions in the field of interpersonal relationships, increasing self-concept, and adapting to existing conditions in the field of interpersonal issues. This study aimed to evaluate the effect of TA training on cognitive flexibility and emotion regulation in nursing students.MethodsThis experimental study was conducted with a pre-test and post-test design with intervention and control groups among employed 80 sixth-semester nursing students from Razi School of Nursing and Midwifery affiliated with Kerman University of Medical Sciencesin southeastern Iran. The participants were included in the study via a census method and were randomly assigned to either an intervention group (n = 40) or a control group (n = 40). The intervention group received four weeks of TA training, consisting of two 90-minute sessions per week. The control group received no intervention during this period. Both groups completed the Cognitive Flexibility Inventory and the Affective Style Questionnaire before and one month after the intervention.ResultsResults indicated no significant difference in pre-test cognitive flexibility scores between the intervention (100.4 ± 17.38) and control groups (102.07 ± 15.53; p = 0.065). However, post-test scores revealed a significant increase in cognitive flexibility in the intervention group (113.72 ± 10.73) compared to the control group (61 ± 16.85/101; p = 0.001). Additionally, the intervention group exhibited a significant increase in post-test emotion regulation score (67.85 ± 7.42) compared to pre-test scores (64.58 ± 10.55; p = 0.003). However, no significant difference in post-test emotion regulation scores was observed between the intervention and control groups (65.6 ± 10.64; p = 0.27).ConclusionThe results of this study demonstrated the efficacy of TA programs in enhancing cognitive flexibility and emotion regulation among nursing students. It is recommended that this intervention be implemented in medical education, particularly for nursing students who frequently interact with patients and may experience increased stress, anxiety, and reduced cognitive flexibility and emotion regulation during initial patient encounters. TA as an educational method, can enhance self-awareness, interpersonal relationship, and emotional regulation among nursing and nursing students in clinical setting. It can also It can be used to improve the quality of professional interactions and clinical practice of nursing students, finally enhancing the quality of nursing care.

Given the importance of mental health in self-care of patients with type 2 diabetes and the relationship between cognitive flexibility and emotion regulation with mindfulness, the present study aimed to investigate the mediating role of cognitive flexibility in the relationship between cognitive emotion regulation strategies and mindfulness in patients with type 2 diabetes. The present study was conducted using correlation method and structural equation modeling. The statistical population of the study consisted of all men and women with type 2 diabetes referred to Imam Khomeini Hospital in Tehran. 253 participants were selected using convenience sampling. Participants completed the Garnefski & Kraaij (2006) Cognitive Emotion Regulation Questionnaire, the Kentucky Inventory of Mindfulness Skills (Baer, Smith & Allen, 2004), and the Cognitive Flexibility Inventory (Dennis & Vander Wal, 2010). The results showed a positive overall path coefficient between adaptive cognitive emotion regulation strategies and mindfulness (P = 0.005, β = 0.243) and a negative overall path coefficient between maladaptive cognitive emotion regulation strategies and mindfulness (P = 0.001, β = -0.453). The path coefficient between cognitive flexibility and mindfulness was positive and significant (P = 0.009, β = 0.273). The indirect path coefficient between adaptive cognitive emotion regulation strategies and mindfulness was positive (P = 0.007, β = 0.094) and the indirect path coefficient between maladaptive cognitive emotion regulation strategies and mindfulness was negative and significant (P = 0.009, β = -0.117). With an increase in emotion regulation skills, cognitive flexibility and mindfulness also increase in patients with type 2 diabetes.

Background & Aims: Nurses serve as a critical bridge between vulnerable communities and healthcare services, playing a vital role in medical care.Therefore, maintaining their mental health is essential.This study aimed to test a hypothesized model examining the structural relationships between mindfulness and self-efficacy with the mediation of emotion regulation and cognitive flexibility in nurses.Materials & Methods: This study employed a descriptive, structural equation modeling design.The target population included 894 nurses from hospitals in Sari, Iran.Using proportional stratified random sampling by gender, 255 participants were selected based on Klein's model.Data were collected using the General Self-Efficacy Scale (GSE-17) by Sherer et al., the Emotion Regulation Questionnaire (ERQ) by Gross and John, the Five Facet Mindfulness Questionnaire (FFMQ) by Baer et al., and the Cognitive Flexibility Inventory (CFI) by Dennis and Vander Wal.Data were analyzed using SPSS version 27 and AMOS version 24.Results: Structural equation modeling indicated significant relationships between mindfulness and self-efficacy among nurses, mediated by emotion regulation and cognitive flexibility.The conceptual model demonstrated good fit with the data (P < 0.05, /df = 2.843, RMSEA = 0.076, CFI = 0.907, t -1.96-1.96).Positive, significant relationships were observed between mindfulness and self-efficacy (P < 0.05, t = 3.751), mindfulness and emotion regulation (P < 0.05, t = 2.672), mindfulness and cognitive flexibility (P < 0.05, t = 8.699), emotion regulation and self-efficacy (P < 0.05,t = 5.414), and cognitive flexibility and self-efficacy (P < 0.05, t = 2.246).Furthermore, both emotion regulation and cognitive flexibility fully mediated the relationship between mindfulness and self-efficacy (P < 0.05).Conclusion: Mindfulness and self-efficacy, mediated by emotion regulation and cognitive flexibility, play a significant role in enhancing nurses' personal and professional well-being as well as their interpersonal relationships.These factors should be utilized to enhance mental health of nurses.

Purpose: This study aimed to compare the effectiveness of emotional cognitive regulation strategies and self-regulated learning strategies on improving academic self-concept and cognitive flexibility in elementary school students diagnosed with specific learning disabilities in reading. Methods and Materials: A quasi-experimental pre-test, post-test, and follow-up design was used, involving 60 students with specific reading disabilities from elementary schools in Sari, Iran. Participants were randomly assigned to one of three groups: emotional cognitive regulation training, self-regulated learning training, or a control group. Each experimental group consisted of 20 students who underwent 8 sessions of their respective intervention. Data were collected using two standardized questionnaires: the Academic Self-Concept Questionnaire (Chen, 2004) and the Cognitive Flexibility Inventory (Dennis &amp; Vander Wal, 2010). Statistical analysis was performed using multivariate analysis of covariance (MANCOVA) and Bonferroni post-hoc tests. Findings: Both emotional cognitive regulation and self-regulated learning strategies significantly improved academic self-concept and cognitive flexibility compared to the control group (p &lt; .001). No significant differences were found between the two experimental groups in terms of academic self-concept (p = .102) or cognitive flexibility (p = .241). The Bonferroni post-hoc test confirmed that both interventions were equally effective in enhancing the targeted outcomes. Conclusion: The findings indicate that emotional cognitive regulation and self-regulated learning strategies are equally effective in improving academic self-concept and cognitive flexibility in students with specific learning disabilities in reading. Both interventions offer valuable tools for educators to support these students' academic and emotional development.

پرستش افراد مشهور مسئله‌ای پیچیده و چندبعدی است که در این بین انعطاف‌پذیری شناختی و تنظیم هیجانی ازجمله عوامل بسیار مهمی هستند که می‌توانند در پرستش افراد مشهور مؤثر واقع شوند. این پژوهش با هدف بررسی نقش انعطاف‌پذیری شناختی و مشکلات تنظیم هیجانی در پیش‌بینی پرستش افراد مشهور دانشجویان صورت گرفته است. جامعة آماری پژوهش شامل دانشجویان دانشکده معماری و هنر دانشگاه گیلان در سال 1397 بود که از این بین 280 دانشجوی خانم و آقا با روش نمونه‌گیری در دسترس انتخاب گردیدند. مقیاس نگرش نسبت به افراد مشهور (مک‌کاتچئون و همکاران، 2002)، پرسشنامه انعطاف‌پذیری شناختی (دنیس و واندوال، 2010) و مقیاس دشواری در نظم‌بخشی هیجانی (گراتزوروئمر، 2004) به شرکت‌کنندگان ارائه شد. در انتها تجزیه‌وتحلیل داده‌های توسط نرم‌افزار SPSS24 و با استفاده از روش رگرسیون چندگانه همزمان انجام گردید. بر طبق نتایج، انعطاف‌پذیری شناختی و دشواری در تنظیم هیجانی به‌صورت معناداری پرستش افراد مشهور را پیش‌بینی می‌کنند (01/0>p). طبق یافته‌های حاصل از پژوهش، با اعمال برنامه‌ها و مداخلاتی برای افزایش انعطاف‌پذیری شناختی و توانایی تنظیم هیجانی می‌توان از پرستش افراد مشهور که با بسیاری از اختلالات جسمانی و روان‌شناختی و پیامدهای منفی اجتماعی و فرهنگی مرتبط هستند، کاست.

To assess emotion regulation strategies in a clear and direct manner, Emotion Regulation Questionnaire (ERQ) was developed based on the process model of emotion regulation. ERQ primarily assesses an individual's propensity for reappraisal (a cognitive change in the individual's psychological state in specific situations) and expressive suppression (a regulatory response where an individual alters their emotional response after the onset of an emotional reaction). Recent studies have suggested that the abbreviated 8-item version of the ERQ exhibits comparable model fit to the original version. The present study aimed to explore the psychometric properties and assess cross-gender invariance of the ERQ-8 in Chinese university students. University students from Jiangsu Province participated in this study. Participants completed self-report surveys assessing emotion regulation strategies. It was conducted from May 2022 to July 2022. The study employed confirmatory factor analysis (CFA) to assess the two-factor model of ERQ-8 and measurement invariance across male and female samples. The mean age of 1534 participants was 19.83 years (SD = 1.54), and the majority were female (70.4%). The initial ERQ-10 model with ten items demonstrated good fit for all indicators, CFI (Comparative Fit index) = 0.967, TLI (Tucker-Lewis Index) = 0.957, RMSEA (Root Mean Square Error of Approximation) = 0.043, SRMR (Standardised Root Mean Square Residual) = 0.029. However, to assess the fit of the previously proposed ERQ-8 model, two items (Q1 and Q3) were excluded. The fit of the ERQ-8 model was further improved (CFI = 0.989, TLI = 0.984, RMSEA = 0.029, SRMR = 0.021). All item loadings exceeded or were equal to 0.573. Internal consistency analysis based on the ERQ-8 model revealed Cronbach's alpha values of 0.840 for reappraisal and 0.745 for suppression, and corresponding composite reliability (CR) values of 0.846 and 0.747, respectively. Test-retest reliability, assessed using the intraclass correlation coefficient (ICC) (95% CI) within a one-week interval, ranged from 0.537 to 0.679. The correlation coefficient between the two factors was 0.084, significantly below 0.85, which suggested a low correlation between the two factors. The results of the invariance analysis across gender demonstrated that the values of ΔCFI and ΔTLI were both below 0.01. It was supported the gender invariance of the ERQ-8 among university students. The eight-item ERQ demonstrated validity and reliability in evaluating emotion regulation strategies, and measurement invariance was observed across gender among university students. The ERQ-8 may prove to be a practical and cost-effective tool, particularly in time-constrained situations.

Being flexible to the environment is of great significance to the individual’s successful social life, the improvement of subjective well-being and the maintenance of physical and mental health. Cognitive flexibility deficits and mood disorders are generally considered to be typical characteristics of depression, anxiety and other mental disorders. Although cognitive flexibility as an important component of executive function has been shown to play an important role in the process of emotional regulation, it is not yet clear that how cognitive flexibility contributes to different aspects of emotional regulation and the mechanisms of its influence. Based on existing theories and empirical studies, we systematically elaborated the promoting effect of cognitive flexibility on emotional regulation and analyzed its influencing mechanism from four aspects of emotional regulation tendency, effectiveness, flexibility and adaptiveness. The emotional cognitive control model and the cognitive control framework emotional regulation flexibility provide the theoretical basis of cognitive flexibility promoting emotional regulation. The former emphasizes that cognitive flexibility play a role in the use of emotional regulation strategies, while the latter emphasizes that cognitive flexibility also have an impact on the change of emotional regulation strategies. On the one hand, cognitive flexibility plays an important role by promoting individuals tend to use protective regulation strategies and effectively alleviate emotional responses during using emotional regulation strategies. On the other hand, cognitive flexibility also plays a promoting role by helping individuals to respond rapidly to situational changes and reducing cognitive load in multi-objective tradeoffs during goal pursuit behaviors. Specifically, (1) emotional regulation strategies that play a protective role in physical and mental health may benefit from cognitive flexibility, which promotes individuals’ tendency to use cognitive reappraisal; (2) cognitive flexibility may promote the effectiveness of emotional regulation either indirectly (enhancing the effect of emotion regulation strategies) or directly (decreasing the intensity of emotional responses); (3) in the process of adjusting emotion regulation strategies according to the situation, cognitive flexibility can promote individuals to make a rapid response to the changing situation that may be a necessary condition for emotional regulation flexibility; (4) cognitive flexibility can reduce cognitive load in multiple goal pursuit behaviors by flexibly balancing multiple personal goals, which promote emotion regulation adaptiveness. Additionally, we speculated that cognitive flexibility is most closely related to emotion regulation adaptiveness because the three aspects of emotion regulation: tendency, effectiveness, and flexibility are important prerequisites for adaptiveness. In summary, cognitive flexibility plays a promoting role in the use and change of emotional regulation strategies. Both cognitive flexibility and emotional regulation play an important role in individual mental health. Clarifying the promoting effect of cognitive flexibility on different aspects of emotional regulation can help us further understand the internal mechanism of cognitive deficits in mood disorders and provide important reference for the combination and improvement of cognitive flexibility with cognitive therapy related to depression, anxiety and other mental disorders.

Discrimination is associated with mental health problems. While prior research has demonstrated the significance of emotion regulation in explaining the onset and development of discrimination-related anxiety, few studies investigated this dynamic with cognitive flexibility among sexual and/or racial minority individuals. The current study incorporated cognitive flexibility to investigate its potential buffering effects on discrimination-related anxiety. 221 individuals, 37.6% of whom (n = 83) identified as sexual and/or racial minorities, responded to an online questionnaire about their levels of cognitive flexibility and emotion regulation, perceived discrimination, and anxiety. Moderated mediation analyses were conducted with these variables. Our findings indicated that emotion regulation difficulty (ERD) mediated the relationship between discrimination and anxiety, while cognitive flexibility had a strong moderating effect on the relationship between ERD and anxiety. These results suggested new research directions and implied the therapeutic potential of advancing cognitive flexibility skills with emotion regulation training in depression and anxiety intervention and treatments. Future research is needed to investigate cognitive flexibility as a transdiagnostic mechanism underlying the onset and development of anxiety, to potentially lead to novel prevention or intervention for marginalized people facing additional stressors like discrimination.

Cognitive flexibility is the ability to adapt between different cognitive strategies in response to changing demands. Psychological well-being refers to an individual's level of self-acceptance in terms of finding meaning in one's life, living according to one's beliefs, and making use of one's potential and limitations. The concept of cognitive emotion regulation refers to the deliberate cognitive methods people use to manage their emotional encounters. This study investigates the mediating role of cognitive emotion regulation in the relationship between cognitive flexibility and psychological well-being. The research was conducted using a relational scanning model with 312 students from various universities. 216 of the participants are women and 96 are men, aged between 18 and 55. Among them, 53 were in their first, 34 in their second, 87 in their third, and 138 in their fourth year of study. The research instruments included the Psychological Well-Being Scale, Cognitive Flexibility Inventory, Cognitive Emotion Regulation Scale. Regression-based bootstrapping was used to analyse the data, and positive, statistically significant relationships were found between cognitive flexibility, psychological well-being, and adaptive sub-dimensions of cognitive emotion regulation. Furthermore, the indirect effect of cognitive emotion regulation on the cognitive flexibility-psychological well-being link was found to be significant. Specifically, refocus on planning, positive refocusing and positive reappraisal sub-dimensions exhibited a partial mediating role in this relationship, whereas the mediating role of the putting into perspective sub-dimension was not supported. In conclusion, as levels of cognitive flexibility increase, concurrent rises in cognitive emotion regulation are observed, thereby contributing to enhanced psychological well-being.

The current quantitative research was an attempt to investigate the predictive role of cognitive flexibility and emotional regulation on psychological resilience among Pakistani university students. A self-administered Likert-scale questionnaire was used to collect data on 150 students in both the public and the private universities. A random sampling was used to have a representative sample of the population. Research based on statistical analyses using regression, multiple regression, and correlation methods was done to ascertain the relationship between variables. The results have shown that there is a positive significant connection between cognitive flexibility and psychological resilience (r = 0.742, p &lt; 0.01), and the higher students are flexible in their thinking pattern, the higher their level of resilience. Moreover, emotional regulation was identified to play a major role in resilience indicating that highly emotionally regulated students are psychologically more stable and have a better coping capacity. The joint predictive effect of cognitive flexibility and emotional regulation proved that both concepts have a combined beneficial impact on the academic stress management capabilities in students and well-being. The paper underscores the need to foster emotional intelligence and adaptive cognitive skills within the educational environment to help university students in Pakistan gain resilience and mental health.

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Research has found that difficulties in emotion regulation negatively impact mental health, whereas cognitive flexibility may promote stress resilience and positive mental health. Little is known about cognitive flexibility and emotion regulation in people with comorbid eating disorder (ED) and anxiety and stress disorders. A transdiagnostic ED population (N = 227) at an outpatient ED treatment facility completed several self-report instruments that measured cognitive flexibility, emotion regulation difficulties, posttraumatic stress disorder (PTSD) symptoms, and generalized anxiety disorder (GAD) symptoms upon admission. We investigated cognitive flexibility and emotion regulation differences for those with an ED without comorbidity and those with various combinations of comorbidity. In a one-way between-groups ANOVA, we investigated differences in cognitive flexibility for those with GAD, PTSD, neither, and both comorbidities. We found a statistically significant difference between these groups, with mean cognitive flexibility inventory scores being the lowest in the group with both comorbidities. However, when controlling for emotion regulation, a one-way between-groups ANCOVA indicated no significant differences in cognitive flexibility between comorbidity groups F(3, 222) = 1.20, p = .31 Partial η 2 = .02. Though self-reported cognitive flexibility levels differ among ED patients with and without comorbidities, it appears that these differences are better explained by emotion regulation. Therefore, addressing emotion regulation early in treatment for all individuals with EDs, regardless of comorbidity, is recommended as a future research focus to enhance treatment outcomes. Further research is needed to understand the impact of treating emotion regulation on ED treatment engagement, dropout, and effectiveness.

Research has found that difficulties in emotion regulation negatively impact mental health, whereas cognitive flexibility may promote stress resilience and positive mental health. Little is known about cognitive flexibility and emotion regulation in people with comorbid eating disorder (ED) and anxiety and stress disorders. A transdiagnostic ED population () at an outpatient ED treatment facility completed several self-report instruments that measured cognitive flexibility, emotion regulation difficulties, posttraumatic stress disorder (PTSD) symptoms, and generalized anxiety disorder (GAD) symptoms upon admission. We investigated cognitive flexibility and emotion regulation differences for those with an ED without comorbidity and those with various combinations of comorbidity. In a one-way between-groups ANOVA, we investigated differences in cognitive flexibility for those with GAD, PTSD, neither, and both comorbidities. We found a statistically significant difference between these groups, with mean cognitive flexibility inventory scores being the lowest in the group with both comorbidities. However, when controlling for emotion regulation, a one-way between-groups ANCOVA indicated no significant differences in cognitive flexibility between comorbidity groups Partial. Though self-reported cognitive flexibility levels differ among ED patients with and without comorbidities, it appears that these differences are better explained by emotion regulation. Therefore, addressing emotion regulation early in treatment for all individuals with EDs, regardless of comorbidity. Further research is needed to understand the impact of treating emotion regulation on ED treatment engagement, dropout, and effectiveness.

Background and Aim: The purpose of present study was to examine the causal relationship between Cognitive Emotion Regulation and psychological well-being, considering the mediating role of mindfulness in middle school students in Tehran. Methods: This descriptive correlational study was conducted on a sample of 352 people using a multi-stage cluster sampling method among all the second grade high school students of the district 2, Tehran province, during the academic year, in 2020-21. data were collected using Gratz &amp; Roemer’s difficulties in emotion regulation scale (DERS) (2004), Ryff’s Psychological well-being inventory (2002) and Freiburg Mindfulness Inventory (2006). The data were analyzed by descriptive statistics, Pearson correlation and structural equation modeling, with AMOS and SPSS software version 24 at a significance level of P&lt;0.01. Results: The structural model of predicting psychological well-being based on the Cognitive Emotion Regulation with the mediating role of mindfulness in students had a good fit with the collected data (P&lt;0.01). Therefore, the cognitive emotion regulation through the mediation of mindfulness significantly explain the psychological well-being of middle school students. Conclusion: Considering the positive significant relationship between psychological well-being and cognitive emotion regulation and confirming the mediating role of mindfulness, school admins can provide life skills workshops at educational environments, so by increasing the students’ level of mindfulness, enhance the possibility of using the positive skills of cognitive emotions regulation

BackgroundThis study examines the innovative roles of emotion regulation (ER) and cognitive flexibility (CF) as mediators in the association between cooperative learning (CL) and social skills among university students. Although prior research has investigated CL or social skills in isolation, limited studies have analyzed the concurrent mediation of this connection by ER and CF.MethodsA cross-sectional survey was executed with 502 university students in Shandong, China, chosen by stratified random sampling. Participants administered the Social Skills Inventory, Cooperative Learning Application Scale, Emotion Regulation Questionnaire, and Cognitive Flexibility Inventory. Data were examined utilizing Partial Least Squares Structural Equation Modeling (PLS-SEM) to investigate direct and indirect effects.ResultsCooperative learning markedly improved students’ social competencies. Both emotional regulation and cognitive flexibility partially mediated this association, with cognitive load cooperative learning enhancing emotional sensitivity and emotion regulation, while cognitive flexibility affected social sensitivity and expressiveness.ConclusionsThe integration of emotional regulation and cognitive flexibility in educational curricula promotes the efficacy of cooperative learning, fostering emotional and social abilities. These findings offer practical insights for educators and policymakers to create organized interventions that promote whole student development.