Introduction
Psychological symptoms such as depression, anxiety, and posttraumatic stress (PTS) are among the most commonly reported emotional problems in different samples, including emerging adults (Ahmed et al., 2023; Cusack et al., 2019; Ibrahim et al., 2013). Given these psychological symptoms’ associations with social well-being, occupational well-being, physical issues, and mental health problems (Brooks et al., 2016; Goodwin, 2006), enhancing our understanding of factors that affect these psychological symptoms is of major importance. Dispositional mindfulness has been proposed as an important symptom-buffering factor (Brown et al., 2012; Brown & Ryan, 2003).
Dispositional mindfulness refers to an individual’s inherent ability to engage with present-moment experiences in a nonjudgmental way (Brown & Ryan, 2003). Unlike state mindfulness, dispositional mindfulness is relatively stable over time and considered a personality trait. The mindfulness stress-buffering hypothesis posits that dispositional mindfulness is an important coping resource that buffers the effects of stress on psychological symptoms (Creswell & Lindsay, 2014). Empirical evidence confirms significant associations between higher levels of dispositional mindfulness and lower levels of psychological symptoms (Tomlinson et al., 2018).
With growing attention for the impact of dispositional mindfulness on psychological symptoms, research has increasingly examined mechanisms mediating this impact (Cheung & Ng, 2019; Desrosiers et al., 2013; Freudenthaler et al., 2017). Emotion regulation (ER) has been proposed as one such mediating mechanism (Cheung & Ng, 2019; Huang, 2022; Jimenez et al., 2010). ER refers to cognitive and behavioural strategies used to modify emotional circumstances, responses, and expressions, including those connected to negative affect (NA) and positive affect (PA) (Gross & Jazaieri, 2014). Adaptive ER involves ER strategies, such as cognitive reappraisal, that are applied to manage NA and maintain or increase PA effectively. Maladaptive ER includes ER strategies, such as excessive rumination, that increase NA and decrease or dampen PA (Nelis et al., 2011). More adaptive regulation of NA and PA has been found to be linked to reduced psychological symptoms, while increased maladaptive regulation of NA and PA is associated with elevated psychological symptoms (Aldao & Dixon-Gordon, 2014; Nelis et al., 2011).
Teper et al. (2013) proposed that dispositional mindfulness strengthens effective ER, which results in better mental health. Empirical studies confirmed this conceptual model (Desrosiers et al., 2013; Freudenthaler et al., 2017; Ma & Fang, 2019). For instance, in a study conducted among adults diagnosed with mood and anxiety disorders, lower dispositional mindfulness was associated with more rumination, which was, in turn, related to elevated depressive symptoms (Desrosiers et al., 2013). Also relevant is the Mindfulness-to-Meaning Theory put forth by Garland et al. (2015). This theory suggests that dispositional mindfulness encourages positive reappraisal of life events, contributing to a greater sense of meaning, which is associated with better mental health (Garland et al., 2015). Supporting this theory, studies demonstrated that higher dispositional mindfulness was associated with better well-being via the increased ability to savour positive experiences (Cheung & Lau, 2021; Garland et al., 2017).
Taken together, some research has been done to examine the role of ER in mediating the linkage between dispositional mindfulness and psychological symptoms. While previous studies mainly focused on distinct ER strategies, no study has yet explored the mediating role of ER profiles. ER profiles refer to patterns of ER strategies that individuals use to regulate their emotions. Such ER profiles are typically identified by applying latent class or latent profile analysis (LPA) to indicators of various ER strategies (Chesney et al., 2019; Dixon-Gordon et al., 2015; Heuvel et al., 2020). Studies have varied in the number of identified ER profiles, yet the most commonly identified are the so-called Adaptive profile and Maladaptive profile (Pugach & Wisco, 2021). Individuals with an Adaptive profile are characterised by a high utilisation of adaptive ER strategies and a low use of maladaptive strategies. Those with a Maladaptive profile are marked by high employment of maladaptive ER strategies and low use of adaptive ones (De France & Hollenstein, 2017; Dixon-Gordon et al., 2015). Notably, these previous studies focused on ER profiles concerning the regulation of NA, leaving a gap in understanding whether distinct profiles can also be identified for ER strategies to regulate PA.
The Current Study
The overarching aim of our study was to examine whether the association between dispositional mindfulness and psychological symptoms would be mediated by different ER profiles. Data were gathered from a large sample of university students. We focused on symptoms of depression, anxiety, and PTS, considering that these are among the most common symptoms in the community, including university students. To identify ER profiles, indicators of ER strategies were subjected to LPA. Four ER indicators were considered: Adaptive regulation of NA, adaptive regulation of PA, maladaptive regulation of NA, and maladaptive regulation of PA. Our first hypothesis (H1) was that at least two ER profiles would emerge in the LPA, including an Adaptive profile, characterised by high endorsement of adaptive ER strategies and low endorsement of maladaptive strategies and a Maladaptive profile, characterised by high endorsement of maladaptive ER strategies and low use of adaptive ones. Our second hypothesis (H2) was that increased levels of dispositional mindfulness would be associated with lower levels of psychological symptoms. Our third hypothesis (H3) was that ER profiles would mediate these associations. Specifically, we expected, that the association of increased dispositional mindfulness with decreased symptom severity would be mediated by increased likelihood of Adaptive profile membership. We had no a priori expectations about other ER profiles that might emerge.
Method
Participants and Procedure
The study used data obtained from an internet-based survey focusing on cognitive-behavioural and ER variables across various psychological symptoms among students at (University’s Name). Notably, the original survey did not impose specific eligibility criteria beyond being a Dutch-proficient student at (University’s Name). To align with our research objectives, we established eligibility criteria mandating participants to be aged between 18 and 30 and to have encountered at least one negative life event within the past year, which ensured we captured PTS symptoms connected with relatively recent life events. The final sample consisted of 759 students, with a mean age of 21.45 (SD = 1.85) years, of whom 655 (86%) were female. Participants experienced various negative events, including the death of a loved one, and the mental or physical illness of a loved one. See Supplemental Table 1 for the full list of events and descriptive statistics.
Upon indicating their interest in participating, students were directed to a secure online platform where they received comprehensive study details, gave written informed consent, and completed all designated questionnaires. Participants received compensation in the form of course credits. The study was approved by the Ethics Committee of the Faculty of Social and Behavioural Sciences at (University’s Name) (file number 20–211).
Measures
Negative Events
Life Events Scale
The Life Events Scale, adapted from Garnefski et al. (2001), assessed a range of adverse events. Because we aimed to examine psychological symptoms associated with relatively recent events, participants were instructed to identify the most distressing events from the past year as the anchor event for their PTS.
Psychological Symptoms
Beck Depression Inventory-II (BDI-II)
The BDI-II is a 21-item self-report questionnaire measuring depressive symptoms over the past two weeks(Beck et al., 1996). For each item, participants select one of four statements that best represents their experience. For example, participants report the frequency of their sadness using a scale with the following options: 0 (‘I do not feel sad’), 1 (‘I feel sad much of the time’), 2 (‘I am sad all of the time’), and 3 (‘I am so sad or unhappy that I can’t stand it’). Both English (Beck et al., 1996) and Dutch versions (Van der Does, 2002) of the BDI-II have evidenced satisfactory psychometric properties. Cronbach’s α in the current study was 0.89.
Beck Anxiety Inventory (BAI)
The BAI is a 21-item self-report questionnaire evaluating anxiety symptoms over the past week on a 4-point Likert scale (0 = ‘not at all’ to 3 = ‘severely’) (Beck et al., 1988). English (Beck et al., 1988) and Dutch versions (Muntingh et al., 2011) of the BAI showed adequate psychometric properties. Cronbach’s α in the current study was 0.85.
Posttraumatic Symptom Scale Self-Report Version (PSS-SR)
The PSS-SR is a 17-item questionnaire assessing PTS symptoms over the past month on a 4-point Likert scale (0 = ‘not at all’ to 3 = ‘five or more times per week/almost always’) (Foa et al., 1993). English (Foa et al., 1993) and Dutch versions (Engelhard et al., 2007) of the PSS-SR exhibited satisfactory psychometric properties. Cronbach’s α in the current study was 0.87.
Dispositional Mindfulness
Mindful Attention Awareness Scale (MAAS)
The MAAS is a 15-item self-report measure evaluating dispositional mindfulness on a 6-point Likert scale (1 = ‘almost always’ to 6 = ‘almost never’) (Brown & Ryan, 2003). Both English (Brown & Ryan, 2003) and Dutch versions (Schroevers et al., 2008) of the MAAS have demonstrated good psychometric properties. Cronbach’s α in the current study was.90.
Emotion Regulation (Four ER indicators)
Emotion Regulation Profile Revised (ERP-R)
The ERP-R was used to measure the four general ER indicators: adaptive regulation of NA, adaptive regulation of PA, maladaptive regulation of NA, and maladaptive regulation of PA. ERP-R is a vignette-based measure (Nelis et al., 2011). It involves 15 scenarios, nine of which refer to NA (e.g., anger, sadness) and six referring to PA (e.g., joy, pride). For NA scenarios, participants chose from four adaptive (e.g., positive reappraisal) and four maladaptive (e.g., rumination) ER strategies. For PA scenarios, they selected from four adaptive (e.g., savouring the moment) and four maladaptive (e.g., inattention) strategies.
Each time a particular strategy was selected for each scenario, this was scored as 1 point for one of the four general ER indicators. For example, the ER indicator of adaptive regulation of NA was calculated as the total number of times each of the four adaptive ER strategies was chosen across the nine negative scenarios. Cronbach’s α for the endorsement of items representing adaptive ER strategies for NA, adaptive ER strategies for PA, maladaptive ER strategies for NA, and maladaptive ER strategies for PA, respectively, were 0.71, 0.81, 0.73, and 0.76. See Supplemental Figs. 1 for a visual representation of all ER strategies and illustrations of calculation for four ER indicators.
Statistical Analyses
Data analyses were conducted using Rstudio (version 2023.06.1 + 524) and Mplus (version 8.9). Missing values were imputed with the missForest package in R, which is suitable for complex data with minimal distributional assumptions (Stekhoven & Bühlmann, 2012). Descriptive statistics and Pearson correlations of study variables were computed for study variables (See Supplemental Table 2).
We used LPA to identify the optimal number of ER profiles using standardised scores of four ER indicators (adaptive regulation of NA, adaptive regulation of PA, maladaptive regulation of NA, and maladaptive regulation of PA). Model fits were evaluated via the Akaike information criterion (AIC), Bayesian information criterion (BIC), sample size-adjusted BIC (SSA-BIC), entropy, the Lo-Mendell-Rubin adjusted likelihood ratio test (LMR-LRT) and profiles’ size (Nylund-Gibson & Choi, 2018). Lower AIC, BIC, or SSA-BIC values indicate a better fit, with entropy closer to 1 suggesting a more accurate classification. A significant LMR-LRT p-value indicates that adding a profile improves model fit. Rare profiles (< 5%) were excluded to avoid instability (Nylund-Gibson & Choi, 2018).
To investigate H2 and H3, analyses were conducted separately for each pair of emerging ER profiles, resulting in multiple comparisons for each psychological symptom cluster: depression, anxiety, and PTS. Given that the mediator (ER profiles) was a categorical variable, the path from dispositional mindfulness to ER profiles was modelled using logistic regression (path a), while the path from ER profiles to psychological symptoms was based on a linear regression coefficient (path b) (For a visual representation, please refer to Fig. 1). Iacobucci (2012) proposed a feasible method to calculate ZMediation by the following formulas:
$$\:{{Y}_{psychological\:symptoms}}_{\:\:}={i}_{1}+c{X}_{dispositional\:mindfulness}+\:{{\upepsilon\:}}_{1}$$
(1)
$$\:{M}_{ER\:profiles}={i}_{2}+a{X}_{dispositional\:mindfulness}+{{\upepsilon\:}}_{2}$$
(2)
$$\begin{aligned}&\:{\:{Y}_{psychological\:symptoms}}_{\:}\cr&\quad={i}_{3}+{c}^{{\prime\:}}{X}_{dispositional\:mindfulness}+b{M}_{ER\:profiles}+{{\upepsilon\:}}_{3}\end{aligned}$$
(3)
$$\:{Z}_{Mediation}\:=\:\frac{\frac{a}{{s}_{a}}\text{*}\frac{b}{{s}_{b}}}{\sqrt{{z}_{a}^{2}+{z}_{b}^{2}+1}}$$
(4)
To test H2, the parameter estimate c from the formula (1) was used to assess the total effect of dispositional mindfulness on psychological symptoms, controlling for gender and age. Linear regression assumptions were tested, with data transformations applied using the bestNormalize package if necessary.
Fig. 1
Mediation analysis diagram. Note. ER = emotion regulation. The upper panel represents the total effect (path c) of dispositional mindfulness (X) on psychological symptoms (Y). The lower panel illustrates the mediation model, where ER profiles (M) serve as the mediator. Path a = direct effect of dispositional mindfulness on ER profiles, path b = direct effect of ER profiles on psychological symptoms, and path c’ = direct effect of dispositional mindfulness on psychological symptoms. Error terms are represented by ε₁, ε₂, and ε₃
To test H3, mediation effects were evaluated by calculating estimate a and its standard error sa using logistic regression as specified in formula (2). Estimate b and its standard error sb were calculated through linear regression, as outlined in formula (3). The ZMediation was computed using formula (4) and then compared to the standard normal distribution. It was considered statistically significant at α = 0.05 level when the absolute value exceeded 1.96. Additionally, the significance of Za × Zb was tested using the distribution of the product approach (MacKinnon & Cox, 2012), and asymmetric confidence intervals were obtained with the RMediation package. The indirect effect was deemed significant if the confidence interval did not include zero (Tofighi & MacKinnon, 2011).
Results
The Best Fitting Latent Profile Solution and its Characteristics
Table 1 displays fit indices for the one-profile through six-profile solutions of the LPA. According to the criteria of AIC, BIC, and SSA-BIC, the six-profile solution was the best solution. However, considering the criteria for the significant p values of LMR-LRT, and the smallest profile should not include less than 5%, a four-profile solution was considered to be the most appropriate model for characterising the latent ER profiles in the dataset.
Table 1
Latent profile analysis model fit indices
AIC (Δ) | BIC (Δ) | SSA-BIC (Δ) | Entropy | LMR-LRT | Smallest class size | |
|---|---|---|---|---|---|---|
One-profile solution | 8627.79 | 8664.85 | 8639.45 | - | - | 759 (100%) |
Two-profile solution | 8141.75 | 8201.96 | 8160.68 | 0.869 | 0.0001 | 136 (18%) |
Three-profile solution | 7909.60 | 7992.98 | 7935.82 | 0.782 | 0.1736 | 72 (10%) |
Four-profile solution | 7750.31 | 7856.85 | 7783.82 | 0.823 | 0.0068 | 36 (5%) |
Five-profile solution | 7683.74 | 7813.43 | 7724.53 | 0.819 | 0.0844 | 21 (3%) |
Six-profile solution | 7616.57 | 7769.43 | 7664.64 | 0.781 | 0.3084 | 22 (3%) |
Fig. 2
Characteristics of the four-profile solution. Note. ER = Emotion Regulation, NA = Negative Affect, PA = Positive Affect. ER indicators are standardised with a mean of 0 and a standard deviation of 1
The Associations Between Dispositional Mindfulness and Psychological Symptoms
The normality assumptions were initially violated but became acceptable after transforming the positively skewed dependent variables, while other linear regression assumptions were approximately satisfied. Supporting H2, higher levels of dispositional mindfulness were significantly associated with lower levels of depression (β = − 0.47, p <.001), anxiety (β = − 0.42, p <.001), and PTS (β = − 0.34, p <.001).
Mediation Effect of ER Profiles
Regarding H3, the results for the mediating effect are presented in Tables 2, 3, and 4 for depression, anxiety and PTS, respectively. Since the ER profiles were categorical variables, six pairwise comparisons were made among the four ER profiles: (1) Adaptive vs. Low Adaptive, (2) Adaptive vs. High Maladaptive, (3) Adaptive vs. Severe Maladaptive, (4) Low Adaptive vs. Severe Maladaptive, (5) High Maladaptive vs. Severe Maladaptive, and (6) Low Adaptive vs. High Maladaptive.
Mediation Effects for Depression
Partly supporting H3, the mediation analysis for depression across six ER profile comparisons indicated significant indirect effects (ZMediation > 1.96). Specifically, higher dispositional mindfulness was associated with an increased likelihood of being in the Adaptive profile when compared to the Low Adaptive, High Maladaptive, or Severe Maladaptive profiles, which, in turn, was associated with lower levels of depression. Conversely, lower levels of dispositional mindfulness were associated with higher chances of being classified in the Severe Maladaptive profile, when compared to the Low Adaptive or High Maladaptive profiles, which, in turn, were associated with elevated levels of depression. Additionally, higher dispositional mindfulness levels increased the likelihood of classification into the Low Adaptive profile over the High Maladaptive profile, which, in turn, was associated with lower depression levels. Through the R package, RMediation, the Za × Zb asymmetric confidence intervals were obtained. In the mediation analyses of the six pairwise comparisons, the confidence intervals did not cross zero, indicating that the indirect effects were statistically significant.
Mediation Effects for Anxiety and PTS
For anxiety and PTS, four of the six ER profile comparisons showed significant mediation effects, similar to the findings for depression: Adaptive versus High Maladaptive and Severe Maladaptive, as well as Low Adaptive versus High Maladaptive and Severe Maladaptive profiles. These results indicate that individuals with higher dispositional mindfulness were more likely to be classified into the Adaptive (compared to High Maladaptive or Severe Maladaptive) or Low Adaptive (compared to High Maladaptive or Severe Maladaptive) profiles, which, in turn, was related to lower levels of anxiety and PTS. No mediation effects were found in the comparisons between the Adaptive and Low Adaptive profiles or between the High Maladaptive and Severe Maladaptive profiles in the relationship between dispositional mindfulness and anxiety/PTS.
Table 2
Mediation test results for depression
ER profiles compared | Adaptive vs. Low (ref.) | Adaptive vs. High (ref.) | Adaptive vs. Severe (ref.) | Severe vs. Low (ref.) | Severe vs. High (ref.) | Low vs. High (ref.) | |
|---|---|---|---|---|---|---|---|
N = 629 | N = 535 | N = 477 | N = 224 | N = 130 | N = 282 | ||
Mindfulness\(\:\to\:\)Depression | c | -0.35 | -0.39 | -0.47 | -0.49 | -0.32 | -0.36 |
sc | 0.04 | 0.04 | 0.04 | 0.06 | 0.07 | 0.05 | |
zc | -9.93*** | -10.38*** | -11.95*** | -8.96*** | -4.43*** | -6.94*** | |
Mindfulness\(\:\to\:\)ER profiles | a | 0.24 | 0.94 | 1.48 | -1.02 | -0.52 | 0.62 |
sa | 0.09 | 0.14 | 0.22 | 0.21 | 0.22 | 0.14 | |
za | 2.50* | 6.66*** | 6.59*** | -4.91*** | -2.36* | 4.35*** | |
Mindfulness\(\:\to\:\)ER profiles\(\:\to\:\)Depression | c’ | -0.33 | -0.29 | -0.32 | -0.37 | -0.25 | -0.30 |
sc’ | 0.03 | 0.04 | 0.04 | 0.05 | 0.07 | 0.05 | |
zc’ | -9.55*** | -7.90*** | -8.61*** | -6.79*** | -3.68*** | -5.83*** | |
b | -0.38 | -0.78 | -1.48 | 1.01 | 0.71 | -0.42 | |
sb | 0.07 | 0.09 | 0.14 | 0.16 | 0.15 | 0.11 | |
zb | -5.48*** | -8.52*** | -10.83*** | 6.21*** | 4.82*** | -3.71*** | |
ZMediation | -2.24* | -5.23*** | -5.61*** | -3.82*** | -2.08* | -2.78** | |
Confidence interval (CI) | [-0.18, -0.02] | [-1.02, -0.47] | [-3.00, -1.47] | [-1.60, -0.55] | [-0.76, -0.06] | [-0.46, -0.10] |
Table 3
Mediation test results for anxiety
ER profiles compared | Adaptive vs. Low (ref.) | Adaptive vs. High (ref.) | Adaptive vs. Severe (ref.) | Severe vs. Low (ref.) | Severe vs. High (ref.) | Low vs. High (ref.) | |
|---|---|---|---|---|---|---|---|
N = 629 | N = 535 | N = 477 | N = 224 | N = 130 | N = 282 | ||
Mindfulness\(\:\to\:\)Anxiety | c | -0.37 | -0.40 | -0.41 | -0.45 | -0.30 | -0.42 |
sc | 0.04 | 0.04 | 0.04 | 0.06 | 0.08 | 0.05 | |
zc | -10.10*** | -10.19*** | -10.18*** | -8.14*** | -3.82*** | -7.95*** | |
Mindfulness\(\:\to\:\)ER profiles | a | 0.24 | 0.94 | 1.48 | -1.02 | -0.52 | 0.62 |
sa | 0.09 | 0.14 | 0.22 | 0.21 | 0.22 | 0.14 | |
za | 2.50* | 6.66*** | 6.59*** | -4.91*** | -2.36* | 4.35*** | |
Mindfulness\(\:\to\:\)ER profiles\(\:\to\:\)Anxiety | c’ | -0.36 | -0.32 | -0.32 | -0.37 | -0.27 | -0.37 |
sc’ | 0.04 | 0.04 | 0.04 | 0.06 | 0.08 | 0.05 | |
zc’ | -9.81*** | -8.03*** | -7.62*** | -6.44*** | -3.37** | -6.81*** | |
b | -0.22 | -0.66 | -0.98 | 0.65 | 0.33 | -0.44 | |
sb | 0.07 | 0.10 | 0.15 | 0.17 | 0.17 | 0.12 | |
zb | -3.00** | -6.72*** | -6.40*** | 3.81*** | 1.93 | -3.80** | |
ZMediation | -1.86 | -4.70*** | -4.56*** | -2.97** | -1.42 | -2.82* | |
Confidence interval (CI) | [-0.12, -0.007] | [-0.90, -0.38] | [-2.11, -0.87] | [-1.15, -0.28] | [-0.46, -0.01] | [-0.48, -0.11] |
Table 4
Mediation test results for PTS
ER profiles compared | Adaptive vs. Low (ref.) | Adaptive vs. High (ref.) | Adaptive vs. Severe (ref.) | Severe vs. Low (ref.) | Severe vs. High (ref.) | Low vs. High (ref.) | |
|---|---|---|---|---|---|---|---|
N = 629 | N = 535 | N = 477 | N = 224 | N = 130 | N = 282 | ||
Mindfulness\(\:\to\:\)PTS | c | -0.26 | -0.26 | -0.29 | -0.41 | -0.26 | -0.36 |
sc | 0.04 | 0.04 | 0.05 | 0.06 | 0.08 | 0.05 | |
zc | -6.45*** | -6.10*** | -6.28*** | -7.24*** | -3.40*** | -6.74*** | |
Mindfulness\(\:\to\:\)ER profiles | a | 0.24 | 0.94 | 1.48 | -1.02 | -0.52 | 0.62 |
sa | 0.09 | 0.14 | 0.22 | 0.21 | 0.22 | 0.14 | |
za | 2.50* | 6.66*** | 6.59*** | -4.91*** | -2.36* | 4.35*** | |
Mindfulness\(\:\to\:\)ER profiles\(\:\to\:\)PTS | c’ | -0.25 | -0.18 | -0.18 | -0.33 | -0.22 | -0.31 |
sc’ | 0.04 | 0.04 | 0.05 | 0.06 | 0.08 | 0.05 | |
zc’ | -6.16*** | -4.11*** | -3.85*** | -5.63*** | -2.88** | -5.73*** | |
b | -0.24 | -0.68 | -1.08 | 0.62 | 0.39 | -0.37 | |
sb | 0.08 | 0.11 | 0.17 | 0.17 | 0.17 | 0.12 | |
zb | -3.02** | -6.20*** | -6.34*** | 3.56*** | 2.37* | -3.23*** | |
ZMediation | -1.86 | -4.51*** | -4.54*** | -2.84** | -1.60 | -2.55** | |
Confidence interval (CI) | [-0.13,-0.008] | [-0.93, -0.38] | [-2.34, -0.97] | [-1.11, -0.25] | [-0.50, -0.009] | [-0.43, -0.08] |
Discussion
The main aim of our study was to investigate the mediating role of emerging ER profiles in the association between dispositional mindfulness and various psychological symptoms (depression, anxiety, and PTS). To achieve this, the first step was to determine the optimal number of ER profiles. A four-profile solution was considered the most suitable for characterising the latent ER profiles in the present sample: Adaptive (58%), Low Adaptive (25%), High Maladaptive (12%), and Severe Maladaptive (5%). This supports our H1 that at least one Adaptive profile and one Maladaptive profile would emerge and is in line with previous studies, in which these two profiles were repeatedly found in various populations (Chesney et al., 2019; Pugach & Wisco, 2021). Individuals evidencing an Adaptive profile were characterised by using relatively more adaptive ER strategies and less maladaptive ER strategies. Conversely, individuals in the Severe Maladaptive profile were characterised by fewer adaptive ER and more maladaptive ER strategies. Interestingly, we also identified two additional profiles: Low Adaptive and High Maladaptive profiles. Individuals in these profiles showed distinct patterns of ER, predominantly using fewer adaptive strategies (but not less maladaptive ER strategies) in the Low Adaptive profile and more maladaptive strategies (but not less Adaptive ER strategies) in the High Maladaptive profile. Individuals in these two profiles exhibited moderate levels of dispositional mindfulness and psychological symptoms, relative to participants in the Adaptive profile, who showed the lowest levels of psychological symptoms, and those in the Severe Maladaptive profile, who showed the highest.
The presence of two maladaptive profile types (High Maladaptive and Severe Maladaptive profiles) highlights the heterogeneity of maladaptive ER. This may help explain inconsistent findings on the relationship between ER strategies and psychological symptoms in previous studies (Dryman & Heimberg, 2018). For example, evidence on the role of expressive suppression in depression was mixed, with some studies finding a significant positive association, while others did not. This inconsistency may stem from past studies focusing on ER strategies in isolation, without considering the combined use of both adaptive and maladaptive strategies. Individuals in the High Maladaptive profile use maladaptive strategies (e.g., expressive suppression) alongside certain adaptive strategies, which could result in moderate levels of psychological symptoms. On the other hand, those in the Severe Maladaptive profile depend almost exclusively on maladaptive strategies, leading to more intense psychological symptoms. Regarding the Low Adaptive profile, while previous studies have identified ER profiles characterised by low levels of both adaptive and maladaptive strategies (Dixon-Gordon et al., 2015; Heuvel et al., 2020), our study is, to our knowledge, the first to identify a distinct Low Adaptive profile. This may be because our study included a broader range of ER strategies compared to previous research, particularly by examining both the regulation of NA and PA. Taken together, this differentiation underscores the value of person-centered methods like LPA, which have been used in other studies but here reveal a more nuanced understanding of ER patterns.
In accord with H2, higher levels of dispositional mindfulness were associated with decreased levels of all psychological symptoms (depression, anxiety, and PTS). This finding aligns with the mindfulness stress-buffering hypothesis (Creswell & Lindsay, 2014), which postulates that mindfulness can mitigate psychological symptoms by promoting greater awareness, and acceptance of present experiences. Our findings also accord with evidence showing these associations across diverse psychological symptoms in the general population and students (Tomlinson et al., 2018).
Regarding the mediation role of the ER profiles in H3, our findings indicate that for all three mediation models (depression, anxiety, and PTS), individuals with high levels of dispositional mindfulness were more likely to be classified in the Adaptive profile, as compared to the High Maladaptive and Severe Maladaptive profiles. Evidencing an Adaptive ER profile was, in turn, related to lower psychological symptoms. Conversely, participants with lower levels of dispositional mindfulness had increased chances of being classified in the Severe Maladaptive profile, compared to the Low Adaptive profile. This, in turn, was associated with higher levels of psychological symptoms. In general, our findings on mediating effects were consistent with Teper’s conceptual model and the Mindfulness-to-Meaning Theory, which emphasise the role of dispositional mindfulness in promoting adaptive ER, and reducing maladaptive ER, which helps individuals cope with negative events, and finding meaning in life (Garland et al., 2015; Teper et al., 2013). Therefore, individuals with higher dispositional mindfulness are less vulnerable to psychological symptoms.
An intriguing mediating effect emerged when comparing the Low Adaptive and High Maladaptive profiles. Individuals with high levels of dispositional mindfulness were more likely to be classified in the Low Adaptive profile, as compared to the High Maladaptive profile. Being classified as the Low Adaptive profile, in turn, was related to lower psychological symptoms. This mediating effect could be driven by the low frequency of adaptive strategies (characteristic of the Low Adaptive profile) or the high frequency of maladaptive strategies (characteristic of the High Maladaptive profile), or potentially by a combination of both. However, previous research suggests that maladaptive ER strategies are generally more strongly associated with psychological symptoms than adaptive strategies (Aldao et al., 2010; Kraft et al., 2023). Thus, the higher levels of maladaptive strategies in the High Maladaptive profile may play a key role in how lower dispositional mindfulness indirectly increases psychological symptoms.
Interestingly, the mediation effects somewhat differed between depression on the one hand and anxiety and PTS on the other hand. Two comparisons showed significant mediation effects for depressive symptoms but not for anxiety and PTS: Adaptive vs. Low Adaptive, and High Maladaptive vs. Severe Maladaptive profiles. Higher dispositional mindfulness increased the likelihood of being in the Adaptive (compared to the Low Adaptive profile) or High Maladaptive (compared to the Severe Maladaptive profile), both of which were linked to reduced depressive symptoms. We noted that the distinction between these two comparisons of ER profiles primarily reflects the differences in adaptive ER strategies. This suggests that depression may be particularly sensitive to the impact of dispositional mindfulness mediated by adaptive regulation in ER profiles. In addition, the non-significant mediation effects of these two comparisons for anxiety and PTS indicate that the pathway through which dispositional mindfulness influences these symptoms may not be fully captured by adaptive but rather by maladaptive ERs.
Limitations and Future Research
Several limitations should be mentioned. First, the study relied on self-report measures, which are susceptible to biases like social desirability and recall biases. Future studies should consider employing multiple methods, such as behavioural observations or physiological measures, to complement self-report data and enhance the reliability and validity of findings. Second, our cross-sectional design limits the ability to establish causality or determine the temporal sequence of relationships. Longitudinal or experimental designs would provide stronger evidence for the mediating effects of ER profiles on the relationship between dispositional mindfulness and psychological symptoms. Third, our sample consisted of university-aged students in the Netherlands with an over-representation of females. While this convenience sampling approach limits the generalisability of our findings, the focus on this population may be justifiable. Prior research has shown that females tend to report higher levels of psychological symptoms, including depression, anxiety, and PTS (Afifi, 2007), and that university students may be vulnerable due to role transitions and multiple challenges (Arnett, 2000). Even so, we acknowledge that a more representative sample would be preferable, and future studies should include more diverse samples to enhance the generalisability of the findings. Finally, we used a single-factor measure of mindfulness (i.e., MAAS), which limits our ability to assess specific facets of dispositional mindfulness like observing, describing, acting with awareness, non-judging, and non-reactivity (Baer et al., 2006). Future research could employ multi-dimensional measures of dispositional mindfulness to capture its diverse association with ER profiles and psychological symptoms comprehensively.
Implications
Our findings hold several potential practical implications. First, the significant mediation effects of ER profiles in the relationship between dispositional mindfulness and psychological symptoms suggest that mindfulness training could be a valuable tool for treating psychological symptoms. Mindfulness interventions can foster greater awareness of present experiences and encourage a non-judgmental attitude toward emotions and thoughts, which can enhance adaptive ER and reduce reliance on maladaptive strategies. Second, interventions should be tailored to specific ER profiles. For example, individuals evidencing a Low Adaptive ER profile could benefit from savouring techniques to strengthen adaptive strategies. People with a High Maladaptive profile could learn from emotional expression skills, which can help reduce maladaptive strategies such as emotional suppression. Cognitive behavioural interventions might be useful for people with a Severe Maladaptive profile who might benefit from identifying and challenging negative thought patterns, enhancing adaptive strategies (e.g., cognitive reappraisal), and reducing maladaptive ones (e.g., rumination). Third, the differences in mediation effects observed between the symptom types suggest that specific treatment strategies may be needed for different psychological syndromes. For example, individuals with depression may benefit more from increasing adaptive ER strategies compared to those with anxiety and PTS.
Conclusion
Although previous studies have investigated the mediating role of ER, our study offers two key contributions to understanding how ER mediates the relationship between dispositional mindfulness and psychological symptoms. First, by using a person-centered approach, we identified distinct ER profiles and tested their mediating roles. When the ER profiles were clearly adaptive and maladaptive (Adaptive and Severe Maladaptive profiles, respectively), the mediating effects were evident. However, we also observed two more complex profiles, with little adaptive ER but not clearly above average maladaptive ER (Low Adaptive profile), and much maladaptive ER but not clearly below average adaptive ER (High Maladaptive profile). This study shows the value of looking at patterns of ER strategies rather than scores on indices for adaptive and maladaptive strategies. A second key contribution consists of investigating mediation across different clusters of psychological symptoms, we observed symptom-specific differences in the mediation effects of ER profiles on depression, anxiety, and PTSD. Future research should further explore these ER profiles’ differences and mechanisms, and develop more precise and personalised interventions to improve psychological health.
Declarations
Ethical approval
This study was performed in line with the principles of the Declaration of Helsinki. The Ethics Review Committee of the Faculty of Social and Behavioural Sciences at UtrechtUniversity approved our study (approval file: 20-211)
Consent to Participate
Informed consent was obtained from all individual participants included in the study.Participation was entirely voluntary, and participants could withdraw at any time withoutconsequence.
Conflict of Interest
The author(s) declared no potential conflicts of interest with respect to the research,authorship, and/or publication of this article.
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