A dyadic approach to mindfulness and psychological flexibility on depressive symptoms in couples facing gynecological cancers: A cross-sectional study

Gynecologic cancer couples have reported high depressive symptom levels. Mindfulness and psychological flexibility are negatively associated with depressive symptoms, but their beneficial effects have rarely been studied beyond the individual level. Few studies address their associations with depression in patient–spouse dyads facing gynecological cancer. Explore dyadic associations among couples regarding mindfulness, its five facets, and psychological flexibility with depressive symptoms. A cross-sectional study. One hundred dyads with one person diagnosed with gynecological (cervix uteri, corpus uteri, or ovary) cancer and their spouses responded to surveys examining depressive symptoms, mindfulness (observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience), and psychological flexibility. The Actor–Partner Interdependence Model was used to explore dyadic associations. Patients’ and spouses’ acting with awareness (actor effect: β = −0.440, P < 0.001; β = −0.207, P = 0.045) and Acceptance and Action Questionnaire-II (AAQ-II) scores (actor effect: β = 0.604, P < 0.001; β = 0.370, P < 0.001) were associated with depressive symptoms. Patients’ acting with awareness and AAQ-II scores were associated with spouses’ depressive symptoms (partner effect: β = −0.252, P = 0.015; β = 0.227, P = 0.016). Couple similarity scores in describing and non-judging scores played a significant role in patients’ and spouses’ depressive symptoms (describing: β = 0.197, P = 0.045; β = 0.313, P < 0.001; non-judging : β = 0.336, P < 0.001; β = 0.212, P = 0.033). Mindfulness and psychological flexibility can affect couples’ psychological distress. Future research should examine whether couples facing gynecological cancers benefit from programs that foster an awareness of attending to the present moment and psychological flexibility.