Mindfulness-based Writing Expression Training Among Military Personnel

The Effectiveness of Mindfulness-based Writing Expression Training on Stress and Cognitive Flexibility Among Military Personnel

The goal of this clinical trial is to learn if mindfulness-based writing expression training works to improve stress and cognitive flexibility among military personnel. The main questions it aims to answer are:

• Does the mindfulness-based writing expression training lower the scores of the perceived stress scale and of the cognitive flexibility inventory?
• Researchers will compare the mindfulness-based writing expression training to the regular mental health education to see if the mindfulness-based writing expression training works to relieve stress and enhance cognitive flexibility among military personnel.

Participants will:

The intervention group received five sessions of mindfulness-based expressive writing training.

The control group carried out activities according to the daily mental health education training without any additional intervention.

All participants completed assessments of cognitive flexibility and perceived stress using the Cognitive Flexibility Questionnaire and the Perceived Stress Scale, administered both prior to and following the randomized controlled trial.

Study Overview

• Status: Completed
• Conditions: Military Personnel With High Pressure
• Intervention / Treatment: Other: mindfulness-based writing expression intervention; Other: Regular Mental Health Education Group

• Study Type: Interventional
• Enrollment (Actual): 72
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Chongqing, China
    • Army Medical University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Active-duty military personnel who are experiencing psychological stress can participate in the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Mindfulness-based writing expression training group; The intervention group received five sessions of mindfulness-based expressive writing training. Each session lasts for 40 to 60 minutes, including 10 minutes of mindfulness meditation, 20 to 30 minutes of writing expression, and 10 to 20 minutes of discussion and sharing. This is done once a day for 5 consecutive days.	Other: mindfulness-based writing expression intervention; Each intervention session followed a standardized protocol comprising: (1) a 5-minute guided mindfulness breathing exercise; (2) 20-30 minutes of expressive writing; (3) 10-20 minutes of facilitated group sharing and discussion; and (4) a concluding 5-minute guided mindfulness breathing exercise.
Active Comparator: control group; The control group carried out regular mental health education activities during the same period, each session lasting 40 to 60 minutes, once a day for 5 consecutive days.	Other: Regular Mental Health Education Group; Regular mental health education covers: common psychological problems among active-duty military personnel, methods for stress relief, and techniques for identifying and handling abnormal psychological conditions. 40 to 60 minutes each day, for a total of 5 days.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
perceived stress	The Perceived Stress Scale (PSS) is used to measure the participants' perceived stress levels over the previous month. This scale contains 14 items, including 7 measuring loss of control and 7 measuring perceived tension, with responses ranging from 0 (never) to 4 (always). Notably, items 4, 5, 6, 7, 9, 10, and 13 are scored in reverse order. The total scores ranged between 0 and 56, with higher scores indicating increased levels of stress.	Baseline: The perceived stress level of military personnel is evaluated one day before the intervention. After 5 sessions intervention, the same scale is used again to assess the perceived stress of the military personnel immediately afterwards.
cognitive flexibility	The Cognitive Flexibility Inventory (CFI) is used to measure participants' cognitive flexibility levels. It contains 20 items, which include 10 for control ability and 10 for alternatives, with responses ranging from 1 (strongly disagree) to 7 (completely agree). Importantly, items 2, 4, 7, 9, 11 and 17 are scored in reverse order. The total scores ranged between 20 and 140, with higher scores indicating higher cognitive flexibility levels.	The cognitive flexibility level of military personnel is evaluated one day before the intervention. After 5 sessions intervention, the same scale is used again to assess the cognitive flexibility of the military personnel immediately afterwards.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
anxiety	The anxiety levels of active-duty military personnel The participants' anxiety is measured by the Generalized Anxiety Disorder Scale (GAD-7). It is a measure used to assess the severity of symptoms of generalized anxiety disorder. This scale contains 7 items, the scores for each item, on the GAD range from 0 (not at all) to 3 (nearly every day), and the total score ranges from 0 to 21. A higher total score indicates a higher level of anxiety. GAD-7 score > 14 has been shown to indicate severe anxiety .	The anxiety level of military personnel was evaluated one day before the intervention. After 5 sessions intervention, the same scale was used again to assess the anxiety of the military personnel immediately afterwards.
depression	The Patient Health Questionnaire (PHQ-9) is used to assess depression severity among military personnel. The scale contains 9 items. The response options for each item, of the PHQ-9 range from 0 (not at all) to 3 (nearly every day). The total PHQ-9 score ranges from 0 to 27. A higher total score indicates a higher level of depression.	The depression level of military personnel is evaluated one day before the intervention. After 5 sessions intervention, the same scale is used again to assess the depression level of the military personnel immediately afterwards.
posttraumatic growth	The Posttraumatic Growth Inventory (PTGI) is used to determine the positive changes that occur as a result of the traumatic events experienced by military personnel. Participants are asked to rate the degree to which they have experienced the change described by each item. The scale consists of 21 items in total and uses a 6-point Likert-type response scale ranging from 0 (almost never) to 5 (almost always). The total score ranges from 0 to 105, and the higher the score is, the greater the level of posttraumatic growth.	The posttraumatic growth level of military personnel is evaluated one day before the intervention. After 5 sessions intervention, the same scale is used again to assess the posttraumatic growth of the military personnel immediately afterwards.

Collaborators and Investigators

• Sponsor: Xiaofan Yan

Study record dates

Study Major Dates

• Study Start (Actual): August 10, 2025
• Primary Completion (Actual): August 30, 2025
• Study Completion (Actual): August 30, 2025

Study Registration Dates

• First Submitted: February 10, 2026
• First Submitted That Met QC Criteria: February 15, 2026
• First Posted (Actual): February 23, 2026

Study Record Updates

• Last Update Posted (Actual): February 23, 2026
• Last Update Submitted That Met QC Criteria: February 15, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: mindfulness; expressive writing; perceived stress; cognitive flexibility; active-duty military personnel
• Other Study ID Numbers: ArmyMedUniversity

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No