Differential effects of mindfulness and grit on positive mental health outcomes in major depressive and bipolar disorders: A moderation analysis using an ecological momentary assessment approach.

Abstract

BACKGROUND\nMETHODS\nRESULTS\nLIMITATIONS\nCONCLUSION\nHolistic management of persons living with Major Depressive Disorder (MDD) and Bipolar Disorder (BD) invites the need for evaluation of positive mental health (PMH; pleasure attainment and meaning-in-life), alongside conventional measures of psychopathology. The aforementioned dimensions of PMH involve aspects of mindfulness and grit. Herein, we evaluate these aspects using ecological momentary assessment (EMA) approach.\nThis study investigated how positive psychological traits interact with negative affect (NA) to affect PMH in persons with MDD (n = 29), BD (n = 29), and healthy controls (HCs) (n = 30). Self-reported NA, pleasure attainment, and meaning-in-life were captured five times a day during a two-week observation period. Mindfulness and grit were assessed using the Five-Facet Mindfulness Questionnaire and Grit-Scale-Short, respectively. Moderation and simple-slope-analyses were conducted.\nA total of 4632 EMA observations were made. Moderated-moderation-analyses indicated significant differences between groups. Lower NA levels significantly potentiated the mindfulness-life meaning relationship in the MDD group (b = -0.315, p = .037), but not in BD and HC. Meanwhile, higher grit levels significantly attenuated NA's negative impact on pleasure attainment in the BD (b = 0.247, p = .034), but not in the MDD/HC group.\nThe use of trait measurements limited direct state comparisons.\nLower NA levels augmented the positive effects of measures of mindfulness on life-meaning in MDD. Higher grit levels mitigated against reduction in pleasure attainment due to NA in BD. Our results underscore the complex interactions between measures of positive psychological traits and PMH in MDD and BD.