The Role of Cognitive Flexibility and Mindfulness in Predicting Resiliency in Celiac patients

Abstract

Chronic diseases such as celiac are the ones that cause much psychological damage in addition to physical damage. Resilience is one of the features that can make the patient tolerate these conditions. In this regard, the present study investigated the role of cognitive flexibility and mindfulness in predicting resilience in celiac patients. The statistical population of this correlational study included the patients with celiac disease in Gorgan, Iran. A number of 114 individuals were recruited by convenience sampling filled out the Cognitive Flexibility Scale, the Mindfulness Questionnaire (Bauer et al., 2006), and the Resilience scale. Then, the data were analyzed using Pearson correlation coefficient and step-by-step regression test. The results showed that cognitive flexibility and mindfulness could significantly predict resilience in celiac patients. In the first step, mindfulness was able to predict about 9% of the changes related to resilience, while cognitive flexibility and mindfulness in the second step were able to predict 17% of the variance. Consequently, cognitive flexibility and mindfulness can predict the resilience of celiac patients.IntroductionIn celiac disease, regardless of biological background and physical risk factors, various types of stress, stressful life events, and low levels of resilience are effective in aggravating it (Lee et al., 2019). Resilience is a protective factor against future risk factors that researchers are interested in (Mirmoradzehi Sibi & Sanagoi Moharrar, 2018). One of the most important promoters of this indicator is mindfulness (Mitchell, 2021; Rahimpour et al., 2021), paying attention to the present moment and accepting any thoughts and feelings without judgment (Clarkson et al, 2019). In the meantime, the role of cognitive flexibility is prominent, which refers to the ability to adapt efficiently, the ability to change thoughts and actions in response to the demands of situations and problems (Darby et al., 2018). The necessity of knowing the psychological factors involved in this disease is an important step in controlling and reducing the ill effects of this disease. Therefore, the present study was conducted with the aim of determining the role of mindfulness and cognitive flexibility in predicting the resilience of celiac patients. MethodThe sample of this descriptive-correlation study was 185 patients, according to Morgan's table, from all the patients of Celiac Society of Gorgan, Iran. They were selected using convenience sampling. The entry criteria in this study were being at least 18 years old and having a minimum education. In the end, 114 people volunteered to participate in this research and the data of these 114 people were analyzed. The tools used were Dennis and Vanderwaal's Cognitive Flexibility Scale (2010), Baer et al. (2006) Mindfulness Questionnaire, and Conner and Davidson's Resilience Scale (2003). Then, Pearson's correlation coefficient test and step-by-step regression were used to analyze research hypotheses in SPSS-16 statistical software. It should be noted that the present research was carried out in compliance with all ethical principles and confidentiality. ResultAccording to the correlation coefficient value (r=0.2) with a probability level of 95%, there was a significant relationship between cognitive flexibility and resilience in celiac patients (p≥0.02, 0.21 =r). In addition, there was a significant relationship between mindfulness and resilience of celiac patients (p ≥0.001, r=0.31). Next, in order to check the prediction of resilience based on mindfulness and cognitive flexibility in patients with celiac disease, a stepwise regression test was used. According to the amount of variance analysis, it was significant at the level of 0.001 to predict resilience in patients with celiac disease by the components of cognitive flexibility and mindfulness. Mindfulness was the first variable that entered the regression model and was able to explain about 9% of the changes related to the resilience variable in patients with celiac disease. The cognitive flexibility variable was also entered into the regression equation in the second step and along with the mindfulness variable was able to explain about 17% of the variance of resilience variable. In addition, in order to determine the difference between the real values ​​and the values ​​predicted by the regression model, Durbin-Watson's statistic was used. It was equal to 2.12, which indicates that the errors are independent in the range between 1 and 3. ConclusionThe results of this study confirm that cognitive flexibility and mindfulness can predict the resilience of celiac patients. The results are in line with the research results of Clarkson et al. (2019), Meyer et al. (2019), Rezaei (2019). In general, it can be mentioned that in patients with celiac disease, due to long-term involvement with the disease, have weak strength and ability to control impulses and communicate effectively with peers, especially in conflict situations, mindfulness helps people overcome difficult conditions and achieve a higher level of resilience (Sunbul & Guneri, 2019). In addition, people who have flexible thinking, use alternative justifications, positively reconstruct their thinking framework and accept challenging situations or stressful events (Baradaran & Ranjbar Noushari, 2021).The limitations of this study include time limit, the researcher's facilities, the existing deficiencies and obstacles, and the sample group only including patients with celiac disease who were members of the Celiac Society of Gorgan. Also, not paying attention to some psychological and demographic variables was considered as another limitation of the current research, which can threat the internal validity. Therefore, it is suggested to investigate the role of some moderating variables in future studies. In conclusion, it is recommended to prevent the transformation of non-adaptive strategies into fixed and resistant styles by training mindfulness and cognitive flexibility, and as a result, increase the growth of resilience. Ethical considerationsThe present research was carried out in compliance with all ethical principles and *. Corresponding author

Keywords

• cognitive flexibility
• mindfulness
• resilience
• celiac disease