Beyond distress: a sequential quantitative investigation of MBSR through a dual-factor model of mental health in college students

Cross-sectional analyses revealed that mindfulness was positively associated with positive mental health (<i>β</i> = 0.38, <i>p</i> < 0.01) and negatively associated with psychological distress (<i>β</i> = -0.31, <i>p</i> < 0.01). Sleep quality emerged as a potential mediator, particularly in relation to positive mental health outcomes. The intervention group demonstrated robust and sustained improvements in positive mental health (<i>d</i> = 0.71, 95% CI [0.52, 0.90]). Psychological distress showed more variable patterns, with no significant between-group differences observed.