The Effectiveness of Mindfulness-Based Cognitive Therapy on Cognitive Fusion and Interpersonal Needs in Students with Suicidal Ideation

Authors
Mohammad Mahdi Zeidabadinejad
Noshin Noori
Leila Fatehi Khoshknabk
Sara malakmohammadi
Ziba Poursadegا Gavgani
Abstract
The present study aimed to investigate the effectiveness of mindfulness-based cognitive therapy (MBCT) in reducing cognitive fusion and interpersonal needs among students experiencing suicidal ideation. Employing a quasi-experimental design with pre-test, post-test, and follow-up assessments, participants were selected based on predefined criteria and randomly assigned to intervention and control groups. The intervention group received MBCT sessions, and data were analyzed using covariance analysis (ANCOVA). Results demonstrated that MBCT significantly decreased overall cognitive fusion, particularly the fusion component, and significantly reduced total scores of interpersonal needs, including perceived burdensomeness and thwarted belongingness. Additionally, a significant reduction in the severity of suicidal thoughts was observed in the intervention group compared to controls, whereas changes in cognitive defusion were not statistically significant. Follow-up data indicated that the positive effects of the intervention were maintained to a satisfactory degree over time. These findings support the clinical utility of MBCT as an effective intervention to improve maladaptive cognitive and interpersonal processes associated with psychological vulnerability in at-risk students. The study underscores the potential of MBCT in suicide prevention and mental health promotion, and recommends further research with larger samples and integrative interventions to explore underlying mechanisms and long-term efficacy.
Keywords
Mindfulness-based cognitive therapy
cognitive fusion
Interpersonal Needs
Suicidal Thoughts
Abdelrasheed, N. S. G., & Saeed, M. A. (2024). The Impact of Mindfulness-based Cognitive Therapy in enhancing Psychological Resilience among basic education teachers in Oman: Longitudinal Study. International Journal of Linguistics, Literature and Translation, 7(4), 163-176.
Sharei, A., Ebrahimi, M., Ahmadi Ochtapeh, P., Mahdavirad, H., & Jamshiddoust Miyanroudi, F. (2023). The Effectiveness of Strength-Based Therapy in Improving Self-Esteem and Reducing Suicidal Thoughts of Women Affected by Domestic Violence in Ardebil. Preventive Counseling, 4(1), 31-44.
Acikgoz, F., & Karaca, A. (2025). The effect of a mindfulness based cognitive therapy program on depression, anxiety, stress, and cognitive flexibility in nursing students: A randomized clinical trial. Journal of Professional Nursing, 56, 94-103.
AL‐Hammouri, M. M., Rababah, J., & Dormans, J. (2025). The impact of cognitive fusion on stress among nurses: Exploring gender as a moderator controlling for depressive symptoms. International Nursing Review, 72(2), e13027.
Anderberg, J. L., Baker, L. D., Kalantar, E. A., & Berghoff, C. R. (2024). Cognitive fusion accounts for the relation of anxiety sensitivity cognitive concerns and rumination. Current Psychology, 43(5), 4475-4481.
Beach, V. L., Brown, S. L., & Cukrowicz, K. C. (2021). Examining the relations between hopelessness, thwarted interpersonal needs, and passive suicide ideation among older adults: does meaning in life matter?. Aging & mental health, 25(9), 1759-1767.
Bommersbach, T. J., Olfson, M., & Rhee, T. G. (2025). National trends in suicidal thoughts and suicide attempts among high school students in the United States. American Journal of Psychiatry, appi-ajp.
Boolaghi, Y., & Kianimoghadam, A. (2017). Validity and Reliability of Cognitive Fusion Scale in Students. Clinical Psychology Achievements, 2(4), 97-108.
Bryan, C. J., Clemans, T. A., & Hernandez, A. M. (2012). Perceived burdensomeness, fearlessness of death, and suicidality among deployed military personnel. Personality and Individual Differences, 52(3), 374-379.
Chen, J., Guo, L., Chen, T. Z., Chen, Y., Xu, C., Zheng, H., & Lu, J. X. (2025). Prediction and explanation of the increase in suicide risk of emerging adults: A comprehensive approach combining logistic regression, glasso network analysis, and Bayesian networks. Journal of Affective Disorders, 383, 469-479.
Chiarella, S. G., De Pastina, R., Raffone, A., & Simione, L. (2024). Mindfulness affects the boundaries of bodily self-representation: the effect of focused-attention meditation in fading the boundary of Peripersonal space. Behavioral Sciences, 14(4), 306.
Dai, J., Sun, D., Li, B., Zhang, Y., Wen, M., Wang, H., & Bi, H. (2024). Mixed-Mode Mindfulness-based cognitive therapy for psychological resilience, Self Esteem and Stigma of patients with schizophrenia: a randomized controlled trial. BMC psychiatry, 24(1), 179.
Djajadisastra, F. W., Ma, J. S., Musabiq, S., & Geshica, L. (2025). Relationship Between Self-Compassion, Thwarted Interpersonal Needs, and Suicidal Thoughts Among Indonesian Young Adults. Mindfulness, 1-13.
Esfahani, M., Hashemi, Y., & Alavi, K. (2015). Psychometric assessment of beck scale for suicidal ideation (BSSI) in general population in Tehran. Medical journal of the Islamic Republic of Iran, 29, 268.
Feng, Q., Huang, Z., Wang, Y., & Wang, B. (2024). The Effects of Mindfulness-Based Interventions on Symptoms of Mild Traumatic Brain Injury: A Systematic Review. International Journal of Mental Health Promotion, 26(6).
Ghaffari, E. (2024). A systematic review of suicide among Iranians physicians, etiology and solutions. International Journal of Science and Research Archive, 12(2), 1582-93.
Ghorbanpour, A., Salehi, A., Doostfatemeh, M., & Mowla, A. (2024). Suicidal ideation amongst medical students in Shiraz, South of Iran: a cross-sectional study. International Review of Psychiatry, 36(4-5), 402-412.
Gkintoni, E., Vassilopoulos, S. P., & Nikolaou, G. (2025). Mindfulness-based cognitive therapy in clinical practice: A systematic review of neurocognitive outcomes and applications for mental health and well-being. Journal of Clinical Medicine, 14(5), 1703.
Gruber, N., & Henriksen, D. (2024). Bridging the distance: Relational mindfulness practices for connection and compassion in online education. Journal of Technology and Teacher Education, 32(1), 59-97.
Gruber, N., & Henriksen, D. (2024). Bridging the distance: Relational mindfulness practices for connection and compassion in online education. Journal of Technology and Teacher Education, 32(1), 59-97.
Heidari, M. E., Irvani, S. S. N., Pourhoseingholi, M. A., Takhtegahi, M. M., Beyranvand, R., Mardanparvar, H., ... & Hatami, H. (2024). Prevalence of depressive symptoms and suicidal behaviors among Iranian high school students: A systematic review and meta-analysis. Journal of affective disorders, 346, 9-20.
Huang, T. L., & Chung, H. F. (2025). Achieving close psychological distance and experiential value in the MarTech servicescape: a mindfulness-oriented service perspective. Journal of Research in Interactive Marketing, 19(3), 358-386.
Kaiser, V., Diaz, G. B., Schaab, B. L., Calvetti, P. Ü., & Reppold, C. T. (2025). The effectiveness of mindfulness-based cognitive therapy intervention for depression in adults: a systematic review of randomized controlled trials. Current Psychology, 1-14.
Kelley, M. L., Chae, J. W., Bravo, A. J., Milam, A. L., Agha, E., Gaylord, S. A., ... & Currier, J. M. (2021). Own soul's warning: Moral injury, suicidal ideation, and meaning in life. Psychological trauma: theory, research, practice, and policy, 13(7), 740.
Maji, S., Jordan, G., Bansod, S., Upadhyay, A., Deevela, D., & Biswas, S. (2025). Student Suicide in India: An Analysis of Newspaper Articles (2019–2023). Early Intervention in Psychiatry, 19(1), e13616.
Mandracchia, J. T., Sunderland, M. N., & To, Y. M. (2021). Evaluating the role of interpersonal hopelessness in the interpersonal theory of suicide. Death studies, 45(9), 746-750.
Moshfegh, N. (2014). The multidimensional wellbeing assessment: Preliminary validation in an Iranian sample. Pepperdine University.
Park, Y. H., Jeong, Y. W., Kang, Y. H., Kim, S. W., Park, S. Y., Kim, K. J., ... & Choi, D. B. (2022). Mediating the effects of depression in the relationship between university students' attitude toward suicide, frustrated interpersonal needs, and non-suicidal self-injury during the COVID-19 pandemic. Archives of psychiatric nursing, 37, 25-32.
Shadnezhad, P., Babazadeh, M., Rostami, A., & Abdizadeh, N. (2024). Suicidal Ideation Among Medical Students in Urmia. Iranian biomedical journal, 28, 227.
Sönmez, İ. (2024). How does sexual identity-attraction discordance influence suicide risk? A study on male and female adults in the US. Archives of suicide research, 28(2), 686-700.
Subbarao, B., Hayani, Z., & Clemmens, Z. (2024). Complementary and integrative medicine in treating headaches, cognitive dysfunction, mental fatigue, insomnia, and mood disorders following traumatic brain injury: a comprehensive review. Physical Medicine and Rehabilitation Clinics, 35(3), 651-664.
Troister, T., D'Agata, M. T., & Holden, R. R. (2015). Suicide risk screening: comparing the beck depression inventory-II, beck hopelessness scale, and psychache scale in undergraduates. Psychological assessment, 27(4), 1500
van Son, J., Nyklíček, I., Pop, V. J., & Pouwer, F. (2011). Testing the effectiveness of a mindfulness-based intervention to reduce emotional distress in outpatients with diabetes (DiaMind): design of a randomized controlled trial. BMC Public Health, 11(1), 131.
Wang, C., Guo, J., Shen, Y., & You, J. (2024). Suicide is my only way: The longitudinal reciprocal relations of experiential avoidance, cognitive fusion, and suicidal ideation among adolescents. Journal of Contextual Behavioral Science, 33, 100803.
Yaghubi, H., Soleimani, L., Abedi Yarandi, M. S., Mollaei, A., & Mahdavinoor, S. M. M. (2024). Prevalence and associated factors of suicide-related behaviors in Iranian students: a large sample cross-sectional study. Middle East Current Psychiatry, 31(1), 88.
Yan, H., Huang, X., Qian, C., & Chen, B. (2024). When lonely employees are productive: an intervention study on workplace mindfulness and job autonomy. Current Psychology, 43(27), 23036-23052.
Zhao, Q., Wan, H., Pan, H., & Xu, Y. (2024). Postoperative cognitive dysfunction—current research progress. Frontiers in behavioral neuroscience, 18, 1328790.