Distress tolerance and decreased cognitive fusion tendencies explain the connection between mindfulness, posttraumatic growth and health-related quality of life among HIV patients

Dispositional mindfulness is one psychological resource that consistently promotes posttraumatic growth (PTG) and health-related quality of life (HRQoL). However, the precise mechanisms through which mindfulness performs this function are not clear. The current study aimed to examine the mediating role of distress tolerance and cognitive fusion in the relationship between mindfulness, PTG and HRQoL among HIV patients. Using a cross-sectional design, 491 HIV patients (M age = 31.41; SD = 10.37; gender = 211 (47%) males; and 280 (53%)) females were randomly selected from a tertiary healthcare institution. Participants completed relevant measures. The results showed that mindfulness was positively associated with PTG (B = 0.57, p < .001), and HRQoL (β = 0.79, p < .001). Additionally, mindfulness indirectly promoted PTG (95%CI = 0.08, 0.20), and HRQoL (95%CI = 0.05, 0.13) through the mechanism of increased distress tolerance abilities. Furthermore, mindfulness indirectly improved PTG (95%CI = 0.02, 0.07); and HRQoL (95%CI = 0.02, 0.08) through the pathway of reduced cognitive fusion tendencies. These findings highlight the potential benefit of mindfulness in enhancing quality of life and growth in people living with HIV (PLWH) by improving distress tolerance abilities and reducing cognitive fusion tendency. Therefore, psychological interventions aimed at improving positive psychological outcomes in HIV patients may focus on enhancing mindfulness.