The Relationship Between Intolerance Of Uncertainty And Mental Health During The COVID-19:The Mediating Role Of Mindfulness And Its Interventions

The spread of novel coronaviruses poses a significant challenge to global public health and the physical and mental health status of the population.Existing research suggests that populations struggle to cope with increasing levels of uncertainty due to uncertainty factors such as medical risks,prevention and control policies,and economic pressures,leading to an increase in mental health symptoms.Mindfulness has received extensive attention from researchers as an important protective factor.Because of its emphasis on awareness and acceptance,mindfulness can enhance an individual’s ability to tolerate uncertainty,thereby reducing the dysfunctional responses it may trigger.Therefore,this study aims to explore the effects of intolerance of uncertainty on mental health status from the perspective of mindfulness through two sub-studies and to investigate the role of mindfulness levels and online mindfulness-based interventions in this context.Study 1 cross-sectionally examined the relationship between intolerance of uncertainty,mindfulness,and mental health in the Shanghai population and whether the mediating role of mindfulness between intolerance of uncertainty and mental health was valid.The Five Facet Mindfulness Questionnaire,the Intolerance of Uncertainty Scale,the Perceived Stress Scale,the Generalized Anxiety Scale,and the Patient Health Questionnaire were used.Through convenience sampling and snowball sampling methods,Shanghai residents were selected as the study population,and 819 study questionnaires were distributed online from April 19 to 29,2022,with 469 valid questionnaires returned.The results showed that the prevalence of mental health symptoms among Shanghai people during the epidemic were 75.480% for perceived stress,65.030%for anxiety,and 67.800% for depression;in the correlation analysis,intolerance of uncertainty was positively correlated with perceived stress,anxiety,and depression,and positive thoughts were negatively correlated with perceived stress,anxiety,and depression,and mindfulness partially mediated the relationship between intolerance of uncertainty and mental health symptoms.The bias-corrected percentile Bootstrap(repeated sampling 5000 times)mediation effect analysis found that mindfulness partially mediated the relationship between intolerance of uncertainty and mental health.Study 2 examined the effectiveness of a 4-week online mindfulnessbased intervention in enhancing mindfulness and alleviating intolerance of uncertainty and psychological conditions in the Shanghai population,and whether the effects were maintained 1 month after the end of the intervention.The scales were the same as in Study 1,except that the Five Facet Mindfulness Questionnaire replaced with a short version of 20 items.Study 2 used convenience sampling and snowball sampling methods to recruit 78 people from Shanghai online and randomly assigned 1:1 to the intervention and control groups,with the final 55 participants completing three measures in the intervention(n = 29)and control groups(n = 26).The results showed that in the 2(group: intervention,control)× 3(measurement time: pre-test,post-test,follow-up)repeated measures ANOVA,the group and time interactions differed significantly between the intervention and control groups on the positive thoughts,intolerance uncertainty,perceived stress,anxiety,and depression variables;in the simple effects analysis,at the between-group simple effects level,between the intervention and control groups on the pre and post-test scores of anxiety In the between-group simple effects analysis,the difference between the intervention group and the control group was not significant for anxiety pre and post-test scores,and the difference was not significant for depression on all three measures,while the rest were significant.In summary,this study concluded that(1)the prevalence of mental health symptoms was higher in Shanghai people during the epidemic;(2)intolerance of uncertainty was positively related to mental health symptoms,and mindfulness were negatively related to mental health symptoms,and mindfulness partially mediated the relationship between intolerance of uncertainty and mental health symptoms;(3)the 4-week online mindfulness-based intervention was effective in enhancing the level of mindfulness and improving intolerance of uncertainty and mental health symptoms in epidemic population,and the overall effect was maintained in 1 month after the end of the intervention.