Correlation Study between behavioral inhibition/activation system, negative emotions and mindfulness in patients after hip fracture surgery

This study aims to test the theoretical model proposed based on the Reinforcement Sensitivity Theory (RST), which states that the individual's Behavioral Inhibition System (BIS) and Behavioral Activation System (BAS) not only directly affect their negative emotions, but also may have indirect effects through the internal psychological process of mindfulness. A total of 200 elderly patients who received hip fracture surgery were included in this study. Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), Behavioral Inhibition/Activation System Scale (BIS/BAS), and five facets mindfulness questionnaire (FFMQ) were used to conduct a cross-sectional investigation. The study mainly employed Pearson correlation analysis to explore the pairwise correlations among four consecutive variables: the behavioral inhibition system, the behavioral activation system, negative emotions, and mindfulness. The behavioral inhibition system of elderly patients negatively correlated with description, observation, and action with mindfulness and nonjudgmental. However, it positively correlated with nonreactivity and negative emotions. The behavioral activation system of elderly patients positively correlated with description, observation, action with mindfulness, and nonjudgmental and negatively correlated with nonreactivity and negative emotions. The results of the multiple linear regression showed that behavioral inhibition/activation system, mindfulness, gender, presence or absence of children, and presence or absence of complications constituted the primary influencing factors for postoperative negative emotions in patients. Bootstrap mediation analysis showed that mindfulness partially mediated the relationship between the behavioral activation system and negative emotions, with a total effect of - 0.051 (95% CI: -0.062 to - 0.040) and a mediation effect accounting for 27.0% of the total effect. Mindfulness also partially mediated the relationship between the behavioral inhibition system and negative emotions, with a total effect of 0.022 (95% CI: 0.016 to 0.027) and a mediation effect accounting for 24.3%. The results of this study generally support the research hypotheses proposed based on the theory of sensitivity to reinforcement. The behavioral inhibition and activation systems are indeed associated with the negative emotions of elderly patients after hip fracture surgery, and mindfulness plays an important mediating role in this relationship. This finding has clear clinical significance: it suggests that for postoperative patients with high BIS and low BAS traits, in addition to direct emotional intervention, enhancing their mindfulness skills training may be a particularly effective breakthrough. By intervening through this mediating path, it is possible to more precisely alleviate their emotional distress and promote psychological rehabilitation.