Mind-Body Exercise, Cognitive Reappraisal, Brooding, and Psychological Distress Among Middle-Aged Women.

Mind-body exercise may support psychological well-being, but the cognitive-emotional processes associated with psychological distress among middle-aged women remain unclear. This cross-sectional study examined cognitive reappraisal and brooding as potential indirect pathways linking mind-body exercise participation with psychological distress. In May 2026, 423 women aged 40-55 years who had regularly participated in mind-body exercise at least once per week during the previous three months completed a paper-based questionnaire. Confirmatory factor analysis and structural equation modelling were conducted, and specific indirect effects were estimated using bootstrap procedures. Greater mind-body exercise participation was associated with more frequent cognitive reappraisal (β = 0.430, p < 0.001) and lower brooding (β = -0.274, p < 0.001). Cognitive reappraisal was negatively associated with brooding (β = -0.309, p < 0.001) and psychological distress (β = -0.322, p < 0.001), whereas brooding was positively associated with psychological distress (β = 0.353, p < 0.001). Significant negative indirect associations were observed through cognitive reappraisal (effect = -0.0032), through brooding (effect = -0.0024), and through the serial sequence of cognitive reappraisal and brooding (effect = -0.0010), with all bootstrap confidence intervals excluding zero. These findings highlight cognitive reappraisal and brooding as potentially important cognitive-emotional processes associated with the relationship between mind-body exercise participation and psychological distress among middle-aged women, providing a basis for future longitudinal and intervention research.