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. 2025 Jul 21;25(1):2518.
doi: 10.1186/s12889-025-23673-5.

The mediating role of psychological inflexibility in the association between physical activity and depressive symptoms among college students

Xiumin Dou  1 , Erkang Cai  2 , Yiting Liu  3 , Tianle Chen  3 , Teck Cheng Tan  4 , Qian Gu  5 , Tao Huang  3
Affiliations

The mediating role of psychological inflexibility in the association between physical activity and depressive symptoms among college students

Xiumin Dou et al. BMC Public Health. .

Abstract

Background: Depressive symptoms are prevalent mental health issues among college students. Physical activity has been recognized as a potential protective factor. However, the mechanisms through which physical activity alleviates depressive symptoms remain unclear.

Purpose: This study aimed to investigate the associations between physical activity, psychological flexibility, psychological inflexibility, and depressive symptoms among Chinese college students. The mediating roles of psychological flexibility and psychological inflexibility on these associations were also examined.

Methods: A cross-sectional study was conducted with 1205 college students from four universities in Shanghai, China. The International Physical Activity Questionnaire-Short Form (IPAQ-SF) and the Center for Epidemiological Studies Depression Scale (CESD-10) were used to assess physical activity and depressive symptoms, respectively. Psychological flexibility and psychological inflexibility were measured using the Multidimensional Psychological Flexibility Inventory Short Form (MPFI-24). PROCESS macro models were used to analyze the mediating effects of psychological flexibility and psychological inflexibility on the relationship between physical activity and depressive symptoms.

Results: The results showed a significant negative correlation between physical activity and depressive symptoms (r = -0.15, p < 0.01). Psychological inflexibility played a partial mediation role in the association between physical activity and depressive symptoms (indirect effect: -0.24, 95% CI: -0.48 ~ -0.01). However, psychological flexibility did not mediate the association between physical activity and depressive symptoms.

Conclusions: The study suggested that psychological inflexibility partially mediated the association between physical activity and depressive symptoms among college students. Interventions targeting physical activity and psychological inflexibility may be effective strategies for lowering depressive symptoms in this population.

Keywords: College students; Depressive symptoms; Mental health; Physical activity; Psychological flexibility.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study adhered to the ethical standards of the Declaration of Helsinki and received approval from the Institutional Review Board for Human Research Protections of Shanghai Jiao Tong University (approval number: H2022225I). All participants provided informed consent after being informed of the purpose and procedures of the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Theoretical model
Fig. 2
Fig. 2
Mediation Model Illustrating the Indirect Effects of Psychological Flexibility on the Relationship between MVPA and Depressive Symptoms. Notes: MVPA, moderate-to-vigorous intensity physical activity; ***P<0. 001
Fig. 3
Fig. 3
Mediation Model Illustrating the Indirect Effects of Psychological Inflexibility on the Relationship between MVPA and Depressive Symptoms. Notes: MVPA, moderate-vigorous intensity physical activity; **P<0. 01, ***P<0. 001
Fig. 4
Fig. 4
Mediation Model Illustrating the Indirect Effects of Total Psychological Flexibility on the Relationship between MVPA and Depressive Symptoms. Notes: MVPA, moderate-vigorous intensity physical activity; **P<0. 01, ***P<0. 001
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