Mindfulness and mood symptomatology in schizophrenia: The mediating roles of rumination

Introduction: Previous studies showed that rumination plays a significant mediating role between mindfulness and symptoms of depression and anxiety in the general and clinical population. However, no studies have examined this pathway in people with schizophrenia. 
Method: A cross-sectional study was conducted to examine the relations among mindfulness, rumination, mood and psychotic symptoms in people with schizophrenia (n=52) using Five Facet Mindfulness Questionnaire– Short form (FFMQ-SF), Short Ruminative Response Scale (SRRS), Depression Anxiety Stress Scale (DASS-21) and the Psychotic Symptom Rating Scales (PSYRATS). Regression analyses and mediation analysis were performed to examine the relationships and the role of rumination as a mediator.

Results: Mindfulness was negatively associated with mood symptoms (β = − 0.524, P = 0.002) while rumination was positively associated with mood (β = 1.672, P < 0.001). Awareness facet affected mood symptoms both directly (β = −0.924, 95% CI: − 1.4360 to −0.4123, p < 0.001), and indirectly mediated by rumination (β = -0.438, 95% CI: -0.765 to -0.172, p <0.003). Nonjudgement facet affected mood symptoms indirectly (β = -0.882, 95% CI: -1.375 to -0.443, p < 0.001), but the direct effect was not significantly detected. Besides, mood symptoms and rumination were positively correlated to hallucination (β = 0.371, P = 0.010; and β = 0.826, P = 0.035), but the mediation effect was not detected.

Conclusion: Rumination plays a significant mediating role between mindfulness and mood symptoms in schizophrenia. Interventions focusing on mindfulness and rumination may be useful in reducing mood disturbance and psychotic symptoms.