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| Home > Publications database > Psychological (in)flexibility as a mediator between resilience and psychological outcomes in patients with cancer |
| Journal Article | DKFZ-2026-02629 |
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2026
Springer Nature
[London]
Abstract: Resilience and psychological flexibility are protective factors for mental health and well-being inthe general population as well as in patients with cancer. Additionally, psychological inflexibility is arisk factor for poor wellbeing and psychopathology. Research suggests that psychological flexibilityconstitutes a resilience factor and mediates the association between resilience and psychologicaloutcomes across various contexts. However, there is only sparse evidence regarding the mediatingrole of psychological inflexibility and flexibility processes in the relationship between resilienceand psychological outcomes in patients with a chronic health condition. This study examinedpsychological inflexibility and flexibility processes as mediators of the relationship between resilienceand psychological outcomes in patients with cancer. A total of N=222 patients completed an onlinesurvey assessing resilience (Resilience Scale-11), psychological inflexibility (Acceptance and ActionQuestionnaire-2), distress (National Cancer Center Network distress thermometer), depression(Patient Health Questionnaire-8), anxiety (General Anxiety Disorder-7), and mental health-relatedquality of life (Short Form Health Survey-12). Across all bootstrapped mediation models, psychologicalinflexibility mediated the relationship between resilience and all psychological outcomes. Secondaryanalyses of acceptance of versus struggle with illness and value-based living versus obstructionshowed partial mediation, with distinct patterns of association for each process. Our findings highlightpsychological (in)flexibility as a key mediator between resilience and psychological outcomes in cancerpatients. Obstruction showed the strongest association, suggesting that ACT-based interventionstargeting psychological barriers may be particularly effective in enhancing resilience and mentalhealth.
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