Correction: The role of healthy personality, psychological flexibility, and coping mechanisms in university students' mental health in China
Year: 2026
Type: erratum
Abstract: In the aftermath of the COVID-19 pandemic, the mental health of Chinese university students has exhibited a marked decline (Ibrahim & Alexcius, 2023;Chang et al., 2020;Blake et al., 2009). Incidences of anxiety, depression, and even suicide have become increasingly prevalent on university campuses (Chen et al., 2024;Hu et al., 2023;Guo et al., 2023). According to data from the Chinese Centre for Disease Control, between 16% and 25.4% of students are affected by mental health disorders. Broader studies report that 30% to 50% of Chinese university students experience mental health difficulties (Han et al., 2020;Guo et al., 2021). At Huangshan University, for instance, 37.8% of students were reported to have psychological issues in the 2022 school-wide Mental Health Test Report (Yang et al., 2022). Other surveys have revealed that 34.6% of university students show symptoms of depression, and 41.1% experience anxiety (Huang et al., 2022;Fu et al., 2021).Among the emerging approaches to address these problems, Acceptance and Commitment Therapy (ACT)-a third-wave cognitive behavioral therapy-has gained prominence for its core focus on psychological flexibility and its demonstrated efficacy in promoting mental health during the pandemic (Hu et al., 2020;Hayward et al.2013). It is a central concept that enhances psychological flexibility and can improve Chinese university students' mood and quality of life (Hussey et al., 2012;Jin, 2013). Moreover, it has proven effective in addressing behavioral and psychological issues (Landi et al., 2022), including anxiety and depression among adolescents (Chen et al., 2017). However, while ACT has been validated in various settings, the mechanisms through which psychological flexibility interacts with other psychological constructs-such as personality traits and coping styles-remain insufficiently understood in the context of Chinese university students (Tanhan et al., 2020). A deeper theoretical understanding of these relationships is essential for the effective application of ACT in this population (Li et al., 2015).According to the Chinese Dictionary of Psychology, mental health is characterized not only by the absence of psychological disorders but also by a well-functioning state of self-awareness, adaptability to one's environment, and continuous psychological growth (Lin et al., 2003;Lin et al., 2018). Mental health, therefore, involves proactive engagement with life challenges and internal regulation (Li, 2003;Melé ndez et al., 2020). A healthy personality serves as the foundation for mental resilience, shaping how individuals perceive themselves and respond to stress (Yıldırım et al., 2023;Yıldırım & Özaslan 2022;Mir et al., 2023). Research has shown that specific personality traits are closely associated with mental health conditions such as depression (Fournier et al., 2017;Li et al., 2019), and these associations are further influenced by coping styles (Tee et al., 2022). While positive coping strategies generally foster well-being (Pan et al., 2021), negative coping strategies often have complex and potentially harmful effects (Yuan et al., 2023).The construct of psychological flexibility, introduced by Hayes et al. (1999), addresses fundamental cognitive and behavioral patterns underlying many mental health issues (Shi et al., 2018). It refers to the ability to remain aware, open, and engaged in the present moment while adapting behavior in alignment with one's values-even in the presence of negative thoughts or emotions (Hayes, 2019). Two core components of this construct-cognitive fusion and experiential avoidancehave been shown to strongly correlate with mental health symptoms (Twohig et al., 2018), including anxiety and depression, particularly among university students (Yang et al., 2019;Cookson et al., 2020;Lei et al., 2019;Wei, 2014).Despite a growing body of literature, most studies in China have examined university students' mental health from an interventionist or symptom-focused perspective. This often overlooks the psychological processes and structural factors-such as personality traits, coping mechanisms, and psychological flexibility-that contribute to the development and persistence of mental health issues.While the relationships between some of these variables have been individually examined, few studies have proposed integrated models or predictive frameworks.This study proposes an integrated theoretical model in which personality traits influence both coping mechanisms and psychological flexibility (Figure 1), and these two factors in turn directly impact mental health. Furthermore, it is hypothesized that psychological flexibility mediates the relationship between personality and mental health, while coping mechanisms may moderate this effect. This conceptual framework allows for the identification of both direct and indirect pathways to psychological well-being, emphasizing process-oriented variables rather than symptom-based outcomes.Our survey included five categories of variables: sociodemographic characteristics, healthy personality, psychological flexibility, coping mechanisms, and mental health outcomes. Sociodemographic variables included gender (male or female), age (18-25 years), grade (2021, 2022, 2023, or 2024), academic discipline (literature, science, engineering, art, or physical education), and first degree (undergraduate or university level). Healthy personality was measured using the Chinese version of the Minnesota Multiphasic Personality Inventory (MMPI), which consists of 399 items that assess personality-related psychopathology across four validity scales and ten clinical scales. A healthy personality was operationalized as the relative absence of elevated clinical scores, with scores below 60 on each clinical scale indicating non-clinical functioning (Zhou et al., 2020). The clinical scales included Hs (Hypochondriasis), D (Depression), Hy (Hysteria), Pd (Psychopathic Deviate), Mf (Masculinity/Femininity), Pa (Paranoia), Pt (Psychasthenia), Sc (Schizophrenia), Ma (Hypomania), and Si (Social Introversion). The validity scales were Q (Question Scale), L (Lie Scale), F (Infrequency Scale), and K (Correction Scale). Psychological flexibility was assessed using the Acceptance and Action Questionnaire (AAQ) and the Cognitive Fusion Questionnaire (CFQ). Both instruments are widely used in Chinese populations to measure experiential avoidance and cognitive fusion, respectively, with higher scores indicating lower psychological flexibility (Yıldız, 2020). Coping mechanisms were evaluated using the Simplified Coping Style Questionnaire (SCSQ), which includes two subscales measuring positive coping (PC) and negative coping (NC) styles. The SCSQ (Simplified Coping Style Questionnaire) has demonstrated high reliability and cultural validity in Chinese samples. Mental health outcomes were measured using the Symptom Checklist (SCL), a widely used instrument that assesses psychological symptoms across ten dimensions, including SOM (Somatization), O-C (Obsessive-Compulsive), INT (Interpersonal Sensitivity), DEP (Depression), ANX (Anxiety), HOS (Hostility), PHOB (Phobic Anxiety), PAR (Paranoid Ideation), PSY (Psychoticism), and the Global Severity Index (GSI). Additional indicators include the total score (T), the average score (AT), and the number of positive items (NP) (Jin, 1984). All instruments were adapted and validated for use in Chinese university populations to ensure cultural appropriateness and psychometric reliability. By emphasizing psychological processes rather than merely symptomatic expression, this study aims to provide a deeper understanding of how psychological flexibility and adaptive coping strategiessupported by stable personality traits-serve as protective factors for the mental health of Chinese university students.The selection of these variables is grounded in well-established psychological models, including the cognitive-behavioral framework of psychological flexibility (Hayes et al., 2019;Wu et al., 2019;Xu et al., 2018), and the understanding of coping mechanisms as dynamic factors that shape mental health outcomes (Wang et al., 2015;Xu, 2022). By examining these variables in combination, the study offers a comprehensive framework for understanding the role of psychological flexibility and coping styles in mental health. This integrated perspective not only fills a critical gap in regional research but also contributes to broader global discussions on student mental health in higher education settings.This study is a cross-sectional investigation based on a large sample of observations. The research participants were university students from Huangshan University in Anhui Province, China. Through a school-wide mental health assessment, we examined the relationships between healthy personality, psychological flexibility, coping mechanisms, and mental health. The study was approved by the ethics committees of Universiti Teknologi MARA and Huangshan University and was conducted with the support of the Student Affairs Office and the University Student Mental Health Education Center of Huangshan University.Up to 35% of students at Huangshan University are currently experiencing mental health problems as a result of the COVID-19 pandemic. Unfortunately, incidents of student suicide have occurred, drawing serious concern from relevant administrative departments and highlighting the urgent need to improve mental health support for students. A self-administered demographic questionnaire and a survey consisting of psychological assessments-covering psychological flexibility, mental health, healthy personality, and coping mechanisms-will be distributed to research participants. By analyzing the differences in students' responses, we aim to identify significant variations across key psychological constructs.To ensure scientific rigor and representativeness, a systematic random sampling strategy was employed. Participants were selected from the full-time undergraduate student population at Huangshan University using a structured sampling interval, ensuring proportional representation across the institution's various academic departments and academic year levels. This method allowed each individual in the population to have an equal and independent chance of selection, thereby reducing sampling bias and enhancing the generalizability of the findings.Huangshan University, located in Anhui Province, recruits students from a broad range of regions across mainland China. These include eastern coastal provinces such as Jiangsu and Zhejiang, central provinces like Hubei and Henan, as well as southwestern and northern areas. Consequently, the sample indirectly captures a wide range of geographic, cultural, and educational backgrounds, contributing to regional diversity within the student cohort.Efforts were made to maintain balance across key sociodemographic variables, including gender, academic year, academic discipline, and first-degree status. Although detailed socioeconomic information was not directly collected, the student body generally reflects middle-and lower-middleincome populations in China, as inferred from institutional enrollment profiles and tuition structures. This diversity ensures that the study's findings are demographically and contextually relevant to the broader population of Chinese university students.This study utilized several validated instruments to assess personality health, psychological flexibility, coping mechanisms, and mental health outcomes, all of which have been culturally adapted and psychometrically verified for use within the Chinese context. A detailed description of each tool and its adaptation process is provided below:(1) Minnesota Multiphasic Personality Inventory (MMPI, Chinese Version)The MMPI, developed by Professor Song Weizhen's team at the Institute of Psychology, Chinese Academy of Sciences, is a widely adopted instrument in China for assessing personality health. The scale consists of 399 items and includes four validity scales (Q, L, F, K) and ten clinical scales (Hs, D, Hy, Pd, Mf, Pa, Pt, Sc, Ma, Si). It is an adaptation of the original American MMPI, with modifications to enhance cultural relevance and linguistic appropriateness. The Chinese version has demonstrated strong psychometric properties, including test-retest reliability coefficients ranging from 0.70 to 0.90, and is extensively used in both clinical and occupational settings in China.(2) Acceptance and Action Questionnaire (AAQ)The AAQ measures psychological flexibility by assessing individuals' tendencies toward experiential avoidance and cognitive fusion. Higher scores on the AAQ indicate lower levels of psychological flexibility. This instrument has been adapted for Chinese university students and exhibits strong internal consistency (Cronbach's α = 0.800) and acceptable test-retest reliability (α = 0.883) in Chinese samples.(3) Cognitive Fusion Questionnaire (CFQ)The CFQ is designed to assess cognitive fusion, one of the core components of psychological inflexibility. The Chinese version has been validated for non-clinical populations and demonstrates high internal consistency (α = 0.86) and test-retest reliability (r = 0.82) (Zhang et al., 2014).(4) Simplified Coping Style Questionnaire (SCSQ)Developed by experts at the Shanghai Mental Health Centre, the SCSQ is specifically designed for the Chinese population. It consists of two subscales: Positive Coping (PC) and Negative Coping (NC). The scale captures culturally relevant coping behaviors and has been widely employed in Chinese psychological research. The SCSQ has demonstrated excellent internal consistency, with an overall Cronbach's α of 0.90.(5) Symptom Checklist (SCL)The SCL is a comprehensive self-report inventory used to evaluate a broad range of psychological symptoms, including anxiety, depression, and somatization. The Chinese version was translated and validated by a team at the Shanghai Mental Health Centre and has shown robust reliability across multiple studies. Internal consistency coefficients for its subscales range from 0.75 to 0.97, making it one of the most commonly used instruments for mental health assessment in China (Jin, 1984).Participants and ProcedureThe study sample consisted of 2,528 students from Huangshan University, selected from a total student population of approximately 20,000. Participants ranged in age from 18 to 24 years, with a mean age of 20.5 years (SD = 1.5). Gender distribution in the sample included 1,345 male students (53.26%) and 1,183 female students (46.74%). The sample was evenly distributed across four academic cohorts: 25.4% from the 2020 cohort, 26.3% from 2021, 24.8% from 2022, and 23.5% from 2023. Regarding academic disciplines, 18.4% of participants were enrolled in literature and history, 22.1% in science, 27.8% in engineering, 13.2% in physical education, and 18.5% in art. In terms of degree status, 91.8% were pursuing undergraduate degrees, while 8.2% had completed university-level education.The sample was obtained using a systematic random sampling method. In April 2024, a schoolwide mental health assessment was administered to all enrolled students via the university's official online mental health management system. The assessment was completed voluntarily, and the system automatically calculated and stored standardized scores for each scale in Excel format. After excluding 212 incomplete or invalid submissions, a total of 20,641 valid responses were retained.A comprehensive list was created linking student ID numbers to their psychological assessment results. Systematic sampling was then applied by selecting every 8th student from the list, based on the formula k=N/n, where N=20,641 and n=2,528. A random number generator was used to determine the initial selection point. Additionally, the MMPI includes built-in validity checks, and 52 responses were excluded for failing to meet these criteria. The final analytic sample consisted of 2,528 valid participants.Before participation, all students received detailed information about the study's purpose and procedures via pop-up windows within the online system and were required to provide informed consent prior to beginning the psychological assessments. All procedures to and the and of were were conducted using the of for version were conducted to the central and of the and the were used to assess the of continuous variables, while were applied to identify and and were reported for variables, and and were reported for continuous variables were further by gender, academic and first were conducted to significant differences in continuous variables based on gender and first to the the of the relevant continuous variables was and was used to assess the of and were for each of was used to continuous variables by and academic was applied to assess the of were reported using and The of of was verified through was conducted to the and of the relationships between of continuous to the of the variables was variables with significant as gender, and academic included to for Personality health was measured using the MMPI from each psychological flexibility using the AAQ and CFQ total scores, coping styles using SCSQ positive and negative scores, and mental health using the SCL and total multiple were conducted on variables with mental health by the total score of the A was used to evaluate the predictive of each included only personality psychological included coping and all This strategy allowed to assess how the of each the of the while for gender, and academic terms were introduced by key independent variables to effects psychological flexibility the effects of personality traits or coping styles on mental health. The was used to assess with a indicating and were verified by of and ensuring the of was of the were to assess the of the all were coefficients associated and levels were the and of the examined in this personality health, psychological flexibility, coping mechanisms, and mental health was both and to and The of the and that while personality health is associated with mental health outcomes, its predictive is psychological flexibility and coping mechanisms are This the that psychological flexibility may the relationship between personality and mental that individuals with personality traits may psychological flexibility, thereby their mental Furthermore, to individual differences in these psychological flexibility may also as a that or the effects of personality traits and coping styles on psychological obtained 2,528 valid psychological between April and April 2024, through the mental health management system for university students at Huangshan Chinese university students are required to in mental health the had Participants were between 18 and years and four academic to and five academic literature and history, science, engineering, physical education, and art. The gender distribution was 1,345 male students (53.26%) and 1,183 female students the sociodemographic of the study The is approximately participants were pursuing their first degree while a had completed a education university The also differences in personality health by psychological flexibility by AAQ and coping mechanisms by Positive Coping and Negative Coping and mental health by the across gender and first-degree status. were used to these Gender significant effects on several variables, indicating it be as a in not show significant significant differences were between and in terms of or coping the of used to assess the effects of grade and academic on the research Both grade and influenced several variables and were included as had a broader impact than academic grade influenced the of coping However, psychological flexibility across but not across academic significant effects were for age or the of Personality health was to be with mental health, the of this relationship was (r = to Psychological flexibility exhibited a moderate and significant with mental health (r = to Coping mechanisms were also with mental health, but the was than that of psychological flexibility (r = to psychological flexibility and coping mechanisms were with most personality health for Psychological flexibility was not associated with and while coping mechanisms were not with The relationship between personality and negative coping strategies further a the The reflects the of the with indicating The is four The lower and direct between personality health and mental health, the are the presence of or The which among personality health complex and In the lower among mental health and indicating that mental health variables a Additionally, psychological flexibility and coping mechanisms show strong associations with both personality health and mental health variables, with psychological flexibility the of multiple models mental health outcomes. A was included only personality health variables, a psychological flexibility, the predictive included coping mechanisms, and all The of psychological flexibility and coping mechanisms the of the a moderate of predictive These findings that while personality health is to mental health, its effects are indirect and are through variables such as psychological flexibility and coping This study examined the relationships between personality health, psychological flexibility, coping mechanisms, and mental health in Chinese university students. The revealed significant with psychological flexibility the These findings that psychological symptoms not only from stable personality traits but also from dynamic processes such as flexibility and coping personality traits, psychological flexibility and coping mechanisms can be findings with prior research (Yang et al., et al., a decline in university student mental health students reported psychological flexibility and mental health than with studies Additionally, psychological flexibility and mental health were influenced by gender and academic grade but not by highlighting the need for study also the need for mental health education, as personality health issues were The high that to the MMPI scale are for cultural relevance in China. Coping mechanisms not indicating that both positive and negative strategies are used based on individual study the significant role of psychological flexibility and coping mechanisms in mental health, particularly anxiety and depression, which are strongly associated with these factors (Chen et al., 2022). psychological flexibility a while addressing coping strategies can mental health The positive between psychological flexibility and mental health like Acceptance and Commitment Therapy which has been effective in mental health et al., et al., et al., cultural ACT with Chinese such as and to University be to and address the by culturally and measures may and research measures or data to provide a comprehensive The of effects further of how personality traits, coping and psychological flexibility to influence mental health. studies use to deeper relationships between these this study the of psychological flexibility and coping mechanisms in mental health and that can improve student research relationships and the of through studies and comprehensive measures of psychological flexibility.
Source: Frontiers in Psychology
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7126041543
Cites:
Cited by:
Related to: