The mediating role of psychological flexibility in the relationship between mental alertness and mental health among patients with irritable bowel syndrome

Mental health issues are prevalent among individuals with Irritable Bowel Syndrome (IBS), yet the cognitive and psychological mechanisms underlying these challenges remain underexplored. This study examined the relationships among mental alertness, psychological flexibility, and mental health, focusing on the mediating role of psychological flexibility. A sample of 300 Libyan IBS patients completed the Cognitive Failures Questionnaire (CFQ), Acceptance and Action Questionnaire II (AAQ-II), and Depression, Anxiety, and Stress Scale-21 (DASS-21). Correlational and mediation analyses were conducted to assess direct and indirect associations. Mental alertness was negatively correlated with psychological distress (r = –0.48, p < .001), indicating that higher alertness was linked to better mental health. Psychological flexibility showed a positive correlation with mental health (r = 0.52, p < .001), suggesting that greater flexibility was associated with improved outcomes. Mediation analysis revealed that psychological flexibility significantly mediated the relationship between mental alertness and mental health (β = 0.36, SE = 0.05, p < .001, 95% CI [0.25, 0.47]). Psychological flexibility plays a crucial mediating role between cognitive functioning and mental health in IBS patients. Enhancing flexibility may improve psychological outcomes, with interventions like Acceptance and Commitment Therapy (ACT) and Mindfulness-Based Cognitive Therapy (MBCT) offering promising strategies. Future research should employ longitudinal and intervention-based designs to further explore these mechanisms.