The Effects of Cognitive Fusion on Depression in Primary School Principals During the COVID-19 Pandemic: The Mediating Role of Psychological Vulnerability and the Moderating Role of Self-Esteem

Introduction

With the deepening of educational reform in China, the public has higher expectations for principals in China and also puts forward higher requirements for them at the same time. Especially, as leaders and administrators of schools in rural primary and secondary schools, principals are more able to promote the development of teaching practices and methods effectively, thus promoting students’ progress.¹ Therefore, we need to pay attention to the important role of primary school principals in the development of rural primary education. Principals in rural primary schools have been under a state of high pressure for a long time. Overloaded work, study and stressful educational environment would not only negatively impact the mental health of primary school principals, but also have a negative impact on the teaching work of the schools they manage.² Since covid-19 spread globally in 2020, the epidemic situation is an important risk factor for teachers’ depression and the prevalence of depression among teachers was high during the epidemic period.³ The higher the level of depressive symptoms of teachers, the worse the psychological pressure and the well-being of students.⁴

According to acceptance and commitment therapy, most mental health problems stem from psychological inflexibility.⁵ Cognitive fusion is one of the main processes of psychological inflexibility, which refers to the excessive control of individual behavior by the concept of some language rules. When the environment changes, individuals with high cognitive fusion cannot guide their behavior with current experience and form a benign interaction with the environment.⁶ Depression is a mental disease with persistent emotional stepping down, lack of pleasure and one or more physical disorders.⁷ The crucial point about improving the degree of symptoms in depressed individuals is to reduce the integration with cognition.⁸ Cognitive fusion is positively correlated with depression, and is likely to aggravate the severity of depression.⁹ Cognitive fusion and empiric avoidance are positively associated with depression, and individuals with depression have a higher degree of cognitive confusion and empiric avoidance than normal.¹⁰ Therefore, Individuals with high cognitive fusion may be more susceptible to depression. In the early years of the COVID-19 pandemic, the shift from online to in-person education, the constant closure and reopening of schools, and the requirement for schools to enforce social distancing rules brought enormous challenges and pressures to principals’ jobs.^11,12 In addition, principals need to be dynamic and flexible in allocating resources and funding, adhering to infection prevention guidelines, and motivating teachers and students to ensure learning and teaching activities.¹³ Therefore, these unprecedented workloads can cause great stress to the principal, which can lead to depression.¹¹

Psychological Vulnerability as a Mediator

The vast majority of ordinary people have psychological symptoms such as depression, anxiety and interpersonal sensitivity during the novel coronavirus pneumonia outbreak, showing high psychological vulnerability.¹⁴ However, little research has been done on the psychological vulnerability of principals during the epidemic. Principals in some elementary schools in rural China are not only burdened with a large amount of administrative work but also with teaching tasks.^15,16 Therefore, principals are not only under pressure from leading and coordinating teaching tasks, but also feel pressure from teachers who have been performing distance learning tasks. Psychological vulnerability was defined as a pattern of cognitive beliefs reflecting a dependence on achievement or external sources of affirmation for one’s sense of self-worth.¹⁷

The relationship between cognitive fusion and psychological vulnerability has rarely been discussed in previous studies. Research has found that psychological inflexibility predicts psychological vulnerability in a positive way.¹⁸ As mentioned earlier, cognitive fusion serves as one of the main processes of psychological inflexibility. Individuals with high cognitive fusion may be more inclined to psychological inflexibility.¹⁸ Individuals with high psychological inflexibility may be more inclined to psychological vulnerability, including more pain, negativity and failure.⁵ Individuals with high psychological vulnerability feel worthless if they fail and are not recognized by others.¹⁷

When an individual with high psychological vulnerability fails, he or she will have a lower sense of self-worth, which can easily lead to depression. Depression can decrease an individual’s interest or pleasure, energy, and capacity to deal with daily tasks, and even increase the risk of suicide.¹⁹ Psychological vulnerability is a maladaptive cognitive pattern associated with dependency and perfectionism.^17,20 Maladaptive perfectionism includes negative reactions to mistakes, fear of failure, critical self-evaluation, and concerns about the evaluation of others.²¹ Maladaptive perfectionism is thought to be one of the factors that increase the risk of depression in teachers, which gives rise to serious health consequences for those who are frequently exposed to stressful situations.^21,22 Evidence suggests that maladaptive perfectionism is associated with higher levels of depression in primary educators.²¹ Studies had shown that psychological vulnerability is an influencing factor of depression.²³ Therefore, we speculate that psychological vulnerability plays a mediating role in the relationship between cognitive fusion and depression.

Self-Esteem as a Moderator

While cognitive fusion may affect the level of depression in elementary school principals through psychological vulnerability, the degree of cognitive fusion of elementary school principals may vary depending on the level of self-esteem. Self-esteem is a positive or negative evaluation of oneself, and individuals with high self-esteem are more positive about self-evaluation, while individuals with low self-esteem are more negative about self-evaluation.²⁴ In the midst of a severe epidemic, principals had to quickly cope with school closures and fundamental shifts in education, such as a shift in teaching methods from offline to online. These changes created a high level of psychological uncertainty for school principals, which resulted in depression.²⁵ Low self-esteem, on the other hand, can cause individuals to develop information processing biases, which in turn can exacerbate negative emotions such as depression and anxiety.²⁶ Teachers with high self-esteem, on the contrary, had more psychological buffer resources and tended to choose positive coping strategies, which can reduce depression and anxiety.^26,27 The vulnerability model believes that the individual’s negative evaluation of self (ie, low self-esteem) is one of the risk factors leading to depression.²⁸ Low self-esteem as a cognitive vulnerability factor to depression causes individuals to develop negative thinking and negative cognition, in addition, individuals with high cognitive fusion are easily controlled by this negative cognition, which results in higher levels of depression.^29–31 The buffering role of self-esteem hypothesis believes that individuals with high self-esteem have a positive cognition of themselves and possess a stronger processing ability for negative information or pressures from external life, which can alleviate the negative impact of adverse events on individuals to a certain extent. Primary educators with high self-esteem levels have a more flexible mindset and are able to cope effectively with their negative emotions.³² Protective factors, such as high self-esteem, can prevent the outcome of depressive symptoms by reducing the negative impact of depressive thoughts on the emotional, cognitive, behavioral, and physiological symptoms of depression.³³ Thus positive and self-affirming attitudes in individuals with high levels of self-esteem may reduce the effects of cognitive fusion on individual depression. Furthermore, the risk buffering model believes that protective factors can buffer or weaken the adverse effects of risk factors, commonly known as “sending charcoal in the snow” (雪中送炭).^34,35 According to the model, self-esteem (a protective factor) can weaken or buffer the effects of cognitive fusion (risk factors) on depression. The degree of cognitive fusion in primary school principals may have different effects on depression at different levels of self-esteem. Primary school principals with low levels of self-esteem will have higher levels of depression when they have higher levels of cognitive fusion. The relationship between cognitive fusion and depression was weaker for primary school principals with high levels of self-esteem. The relationship between self-esteem and psychological vulnerability has received little research attention. Individuals’ self-esteem levels can be affected by others’ evaluation, which is perceived by individuals in social activities.³⁶ Individuals whose sense of self-worth is more susceptible to external evaluations by others and those who are overly dependent on others have higher levels of psychological vulnerability.¹⁷ Individuals with low self-esteem attach too much importance to others’ evaluations, which are likely to aggravate psychological vulnerability. Individuals with higher levels of self-esteem and low levels of cognitive fusion are easier to free themselves from dependence on other people’s evaluations, and are not easily confused with the reality; thus enabling them to reduce psychological vulnerability. In mental health studies, self-esteem is often used as a protective factor.^37,38 Self-esteem is a stable self-emotion performing the social adaptation function that affects an individual’s cognitive and behavioral patterns.³⁹ Self-esteem may play a moderating role between cognitive fusion and psychological vulnerability. According to the “drop-in-The-bucket”(杯水车薪) model,⁴⁰ positive traits are not enough to buffer the adverse effects of risk factors. Even in cases where protective factors are identified, once the risk factor reaches a certain level, they may lose the ability to resist the risk.⁴¹ So individuals exposed to severe adversity may have difficulty in showing positive results.⁴² According to this model, self-esteem is protective only in low-risk situations. Primary school principals with low self-esteem and also low levels of cognitive fusion would have higher levels of psychological vulnerability than those primary school principals with high self-esteem. Primary school principals with low self-esteem would keep the same high level of psychological vulnerability as those with high self-esteem when they all have higher levels of cognitive fusion.

The Present Study

The purposes of this research were threefold: (a) To test whether psychological vulnerability mediates the relationship between cognitive fusion and depression; (b) To test whether self-esteem moderates the relationship between cognitive fusion and depression; (c) To test whether self-esteem moderates the relationship between cognitive fusion and psychological vulnerability. The proposed model is illustrated in Figure 1. Based on the review of literature, we posit the following hypotheses:

Hypothesis 1 Psychological vulnerability mediates the relationship between cognitive fusion and depression.

Figure 1 The proposed moderated mediation model.

Methods

Participants

In this study, 279 participants (Female=41.9%, Mage=37.87, SD=8.24) were investigated in the form of offline questionnaires. They are all primary school principals from rural areas. The participant characteristics are shown in Table 1. All participants consented to participate, and no identifiable information was collected. Participation in this study was entirely voluntary, and no compensation was given.

Table 1 Participant Characteristics

Measures

Cognitive Fusion Questionnaire

Cognitive fusion was measured using the Chinese version of the Cognitive Fusion Questionnaire (CFQ),⁴³ adapted from Gillanders.⁴⁴ The scale contains 9 items (eg, “Some thoughts make me feel annoyed and painful”). Participants rated each item on a seven-point scale ranging from 1 (Completely inconsistent) to 7 (Completely consistent) with higher scores showing higher levels of cognitive fusion. The scale has good reliability, validity and applicability in the study of the Chinese population.⁴³ The confirmatory factor analysis showed that the scale had good construct validity (CFI = 0.99, TLI =0.99, RMSEA = 0.046 (90% CI = 0.00, 0.08), and SRMR = 0.02). In this study, the Cronbach alpha coefficient for this scale was 0.93.

Center for Epidemiological Studies Scale (CES-D)

Depression was measured using the Chinese version of the Center for Epidemiological Studies Depression Scale (CES-D), compiled by Radloff in 1977.^45,46 The scale consists of 20 items and includes four dimensions: somatic symptoms, depressed affect, positive affect, and interpersonal problems (eg, “I was bothered by things that usually don’t bother me”). Participants rated each item on a four-point scale ranging from 1 (very few or never) to 4 (most of the time) with higher scores showing higher levels of depression. The scale has good reliability and validity in both Chinese adolescents and adults.^45,47 The confirmatory factor analysis showed that the scale had good construct validity (CFI =0.93, TLI =0.92, RMSEA = 0.07 (90% CI = 0.06, 0.08), and SRMR = 0.05).In this study, the Cronbach alpha coefficient for this scale was 0.94.

Psychological Vulnerability Scale

The psychological vulnerability was measured by the Psychological Vulnerability Scale that contains 6 items (eg, “If I don’t achieve my goals, I feel like a failure as a person”).¹⁷ Participants rated each item on a five-point scale ranging from 1 (Does not describe me at all) to 5 (Describes me very well) with higher scores showing higher levels of psychological vulnerability. This study used a forward and backward translation technique to translate the Psychological Vulnerability Scale into Chinese.⁴⁸ The confirmatory factor analysis showed that the scale had good construct validity (CFI = 0.98, TLI =0.95, RMSEA = 0.06 (90% CI =0.00, 0.11), and SRMR = 0.03). In this study, the Cronbach alpha coefficient for this scale was 0.75.

Self-Esteem Scale

Self-esteem was measured by using the Chinese version of Self-Esteem Scale (SES), compiled by Rosenberg in 1965.^24,49 The scale consists of 10 items (eg, “I feel that I have a number of good qualities”). Participants rated each item on a four-point scale ranging from 1 (strongly disagree) to 4 (strongly agree), with higher scores showing higher levels of self-esteem. The scale has good reliability and validity in both Chinese adolescents and adults.^49,50 The confirmatory factor analysis showed that the scale had good construct validity (CFI = 0.98, TLI =0.94, RMSEA = 0.08 (90% CI =0.05, 0.11), and SRMR =0.04). In this study, the Cronbach alpha coefficient for this scale was 0.93.

Procedure

This study was approved by the Research Ethics Committee of the first author’s unit. We distributed questionnaires to the primary school principals as participants through an officially organized training program for primary school principals. We used the structured questionnaire that included a set of measurement tools with validated psychometric properties, and was appropriately validated among Chinese participants. Before data collection, we obtained consent from all the primary school principals involved. All participants were informed of the importance of the authenticity and completeness of their answers, as well as the anonymity of the study. Participants were given questionnaires, and they provided demographic information and completed the measurements listed above. All participants completed the survey in their presence, and the researchers collected the questionnaires immediately after the participants completed the survey. All measures were administered by well-trained postgraduate students majored in psychology.

Data Analysis

First, data filtering showed that there were no outliers in our data, and answers to missing data (such as not reporting gender) were excluded from data processing. Then descriptive statistics and Pearson correlation calculation were calculated among research variables. Then we analyze the mediation model (as shown in Figure 1) and the steps are as follows. The PROCESS macro for SPSS (Model 4) was applied to examine the mediating effect of psychological vulnerability.⁵¹ The PROCESS macro (Model 8) was applied to examine the moderating effect of self-esteem on the indirect links between access to cognitive fusion and depression and between cognitive fusion and psychological vulnerability. The bootstrap confidence intervals (CIs) determine whether the effects in Model 4 and Model 58 are significantly based on 5000 random samples.⁵¹ Significant effects were supported by the absence of zero within the confidence intervals.

Result

Preliminary Analyses

The means and Pearson-correlations among the study variables are presented in Table 2. Both cognitive fusion and depression were positively associated with psychological vulnerability (r=0.54, p<0.01; r=0.48, p<0.01). Cognitive fusion was positively correlated with depression (r=0.52, p<0.01). Both cognitive fusion and depression were negatively associated with self-esteem (r=−0.41, p<0.01; r=0.68, p<0.01). Self-esteem was negatively correlated with psychological vulnerability (r=−0.33, p<0.01).

Table 2 Descriptive Statistics and Correlations Among Variables

Testing for Mediation Effect

Hypothesis 1 assumed that psychological vulnerability mediates the relationship between cognitive fusion and depression. To test this hypothesis, we used Model 4 of the SPSS macro-PROCESS complied by Hayes. The results are shown in Table 3. Cognitive fusion was significantly positively correlated with psychological vulnerability (β=0.54, t=10.67, p<0.001). Psychological vulnerability was significantly positively correlated with depression (β=0.27, t=4.57, p<0.001). Cognitive fusion was significantly positively correlated with depression (β=0.37, t=6.32, p<0.001). So hypothesis 2 was supported, and psychological vulnerability played a mediating role between cognitive fusion and depression (indirect effect=0.15, SE=0.36, 95% CI= [0.08, 0.22]). The effect size of the mediating effect was 28%. The indirect effects of cognitive integration and depression are shown in Table 4.

Table 3 Testing the Mediation Effect of Psychological Vulnerability on Depression

Table 4 The Indirect Effect of the Link Between Cognition Fusion and Depression

Moderated Mediation Effect Analysis

Hypothesis 2 assumed that self-esteem moderates the relationship between cognitive fusion and depression. To test the moderated mediation model, we used Model 8 of the SPSS macro-PROCESS compiled by Hayes.⁵¹ The results of the self-esteem moderation test were shown in Table 5. The interaction of self-esteem and cognitive fusion had a significant association with depression (β=−0.12, t=−0.32, p<0.001). In order to make a clear demonstration of the moderating role of self-esteem, this study plotted the explored cognitive fusion against depression, separately for low and high levels of self-esteem (one SD below and one SD above the mean, respectively; Figures 2). Simple slope tests revealed that cognitive fusion and depression are significantly associated at low levels of self-esteem (b_simple=0.30, p<0.001) and not significantly associated at high levels of self-esteem (b_simple =0.07, p=0.31). Hypothesis 2 was supported.

Table 5 Testing the Moderated Mediation Effect

Figure 2 Interaction between cognitive fusion and self-esteem on depression.

Hypothesis 3 assumed that self-esteem plays a moderation role between cognitive fusion and psychological vulnerability. Table 5 showed that the interaction of cognitive fusion and self-esteem had a significant association with psychological vulnerability (β=0.10, t=2.20, p<0.05). Moreover, this study plotted explored cognitive fusion against psychological vulnerability, separately for low and high levels of self-esteem (one SD below and one SD above the mean, respectively; Figure 3). Simple slope tests revealed that cognitive fusion was positively associated with psychological vulnerability in primary school principals with both low (b_simple=0.39, p<0.001) and high levels of self-esteem (b_simple=0.59, p<0.001), but the correlation was notably stronger in the latter. Hypothesis 3 was supported.

Figure 3 Interaction between cognitive fusion and self-esteem on psychological vulnerability.

Discussion

It is found that school principals tend to suffer more psychological problems than their colleagues. However, during the COVID-19 pandemic, few researchers focused on the mental health of primary school principals who faced high levels of stress. Mental health problems among principals may induce additional adverse effects, such as burnout, sleep problems, and low productivity. Due to the lack of educational resources in rural areas, rural primary school principals may face additional difficulties and stress in order to provide online curriculums in rural primary schools during the epidemic. Promoting the mental health of rural primary school principals has a positive effect on the design of school activities and the maintenance of teachers’ and students’ mental health.

Affected by the epidemic, the work pressure and work tasks of principals have increased. Principals also need to address the difficulties brought about by rural students taking online courses via the Internet because of the economic backwardness of rural areas and the lack of computers and reliable Internet access.^52–54 School administrators must deal with both changes in regulations and operating procedures and changes in teachers’ daily lives and work schedules, as well as the health effects of a pandemic on teachers, students, and their own families.⁵⁵ The higher demands of the principal’s supervisor during the pandemic and other additional tasks and pressures have placed greater professional and personal responsibility on principals.^56,57 All of these jobs increase the stress and difficulty of the principal’s work. Occupational stress can reduce a principal’s overall physical and mental health, leading to depression.^11,58 In China, rural primary school principals have contributed significantly to rural primary schools’ educational development under challenging conditions. And rural primary school principals need to keep a healthy psychological state in order to provide better services for rural students.⁵⁹ Therefore, we need to pay more attention to the mental health problems of rural primary school principals.

The Relationship Between Cognitive Fusion and Depression

This study found that cognitive fusion of rural primary school principals was positively correlated with depression, which is consistent with the results of previous studies.^10,60 Individuals with high cognitive fusion confuse distorted negative cognitions with facts and immerse themselves in negative thoughts, leading to the generation and aggravation of emotions such as anxiety and depression.⁶¹ Individuals with higher levels of cognitive fusion are likely to have higher levels of depression. As a special profession, primary school principals need to make interactions with various social relationships and parents, contact with diverse social groups, and require greater psychological flexibility (ie, lower levels of cognitive fusion). The lower the level of cognitive fusion of primary school principals, the lower their depression levels. During the pandemic, restricted lifestyles have brought inconvenience to all aspects of life, and the work of primary school principals certainly faces great difficulties and challenges.⁶² Primary school principals with a high degree of cognitive fusion are more susceptible to negative events and fall into these effects, leading to depression.

The Mediating Role of Psychological Vulnerability

Existing research found the effect of cognitive fusion on individual depression, but few studies have explored the mechanisms of psychological vulnerability in this relationship. Our study provides the first evidence that psychological vulnerability mediated the relationship between cognitive fusion and depression. Cognitive fusion was positively correlated with psychological vulnerability, and the higher the degree of cognitive fusion, the higher the degree of psychological vulnerability. Less research has focused on the relationship between cognitive fusion and psychological vulnerability and Uğur’s research found that psychological flexibility was positively associated with psychological vulnerability.¹⁸ Psychological flexibility is the inverse variable of psychological inflexibility, and cognitive fusion is one of the main processes of psychological inflexibility.⁶ Individuals with psychological vulnerability are more likely to make negative attributions and negative evaluations of themselves,⁶³ and therefore may develop cognitive fusion. In order to avoid feelings of guilt, self-blame, anxiety and other feelings brought about by negative failure experiences, individuals with psychological vulnerability may deliberately avoid challenges, and detach themselves from the current real situation. They would gradually form and attach themselves to a conceptual self, being dominated by the conceptualized past and future, and thus they would get trapped in place and unable to take any effective actions that can bring about change, that is to say, they are involved in empirical avoidance and cognitive fusion. All of the responsibilities and challenges which principals faced during the COVID-19 pandemic have been amplified. And principals have been meeting new and urgent challenges related to public health, resource inequities, rapid instructional shifts, and mental health issues for students and staff.⁶⁴ These stressful events cause the principals with cognitive fusion to confuse reality with inappropriate self-concept and negative thinking content, and thus become more vulnerable to the impact of stressful events, resulting in depression.^20,65 So, cognitive fusion had positive correlation with psychological vulnerability, and the results of this study provide a basis for such correlation. Second, psychological vulnerability was significantly positively correlated with depression, which has been proved by studies.²³ Individuals with higher psychological vulnerability are more likely to have high levels of depression. Overall, psychological vulnerability mediates the relationship between cognitive fusion and depression. Therefore, according to the perspective of acceptance commitment therapy, we should guide primary school principals to recognize the present, accept the present, improve their psychological flexibility and reduce their level of cognitive fusion, thereby decreasing their psychological vulnerability, as well as reducing the occurrence of depression.

The Moderating Role of Self-Esteem

In investigating the process of how psychological vulnerability mediates the relationship between cognitive fusion and depression, we also examined the moderating effect of self-esteem on the first half of the path of cognitive fusion on psychological vulnerability and the direct path of cognitive fusion and depression. And we found that self-esteem, as a variable, played an important role in moderating the relationship between cognitive fusion and depression, and the relationship between cognitive fusion and psychological vulnerability as well. It provided evidence for appropriate strategies to improve the mental health of principals during the pandemic. Individuals with low cognitive fusion had lower levels of self-esteem and lower levels of depression. According to the vulnerability model of depression, low self-esteem is a risk factor for depression, and negative perceptions of self by individuals with low self-esteem are a key trigger for depression.⁶⁶ Individuals who are cognitive confusion confuse negative cognition with negative information and facts, thus immersing themselves in the negative cognitive style, leading to depression. The results of this study also validated a buffer model of self-esteem, suggesting that individuals with high self-esteem have a protective effect on depression.³³ The positive affirmation of self-esteem of individuals is more likely to increase individual psychological flexibility, reduce the occurrence of cognitive fusion, and thus reduce levels of depression. Therefore, we should improve primary school principals’ levels of self-esteem, increase their affirmation of themselves, enhance the psychological flexibility of primary school principals, and then reduce the level of depression among them and hence improve their mental health.

We also found that self-esteem moderates the path of cognitive fusion and psychological vulnerability. The moderation of self-esteem on the relationship between cognitive fusion and psychological vulnerability has not drawn much attention in the past, and this relationship has been found in this study. At the low level of cognitive fusion, individuals with low self-esteem have higher psychological vulnerability than those with high self-esteem. The self-worth of individuals with high psychological vulnerability depends on the affirmation of others and events that seriously interfere with their ability to achieve their goals in life.¹⁷ Individuals with low self-esteem tend to seek self-protection and are used to avoiding positive evaluation, so that low self-esteem can be maintained (in fact, low self-esteem produces cognitive fusion), and then the individual experience of cognitive confusion produced high psychological vulnerability.^67–69 Conversely, individuals with high self-esteem seek self-verification and accept even negative feedback.⁷⁰ In short, the lower the level of self-esteem and the higher the degree of cognitive confusion of primary school principals, the more likely they are to have higher psychological vulnerability. According to the inspiration of “a drop in the bucket” (杯水车薪) model, when the power of risk factors exceeds the power of protective factors, it is not enough to merely rely on protective factors, we also need to protect the development of individuals by intervening in risk factors.³⁴ Therefore, while promoting the positive evaluation of primary school principals to improve their self-esteem, we should reduce their cognitive fusion by adopting methods such as Acceptance Commitment Therapy for group treatment, thereby reducing their psychological vulnerability.

Based on this model, we found that there is a need to increase attention to the level of mental health in primary schools’ principals. We can do this by promoting the psychological flexibility of primary school principals as well as reducing their cognitive confusion. We can also improve the self-esteem of elementary school principals by reinforcing a sense of professional identity, etc. During the epidemic, the government should provide more policy incentives for rural primary schools to reduce the pressure of primary school principals, which will help improve the mental health of primary school principals.

Limitations

Several limitations need to be considered when interpreting the implications of the findings. First of all, this study used a cross-sectional survey study, we could not make causal inferences about the results or investigate the dynamic process. Therefore, in the future, longitudinal research should be conducted to continue to test our mediated moderation model. Secondly, this study adopts a self-report method, which may have been subject to the social-desirability bias. Future studies should use multiple measurements and collect data from multiple informants. Finally, this study only collects data about primary school principals in rural China, and due to the differences between Chinese and Western cultures, the results need to be cautious when applied and generalized to other countries.

Conclusion

Although further replication and extensions were needed, this study was an important step in unpacking how cognitive fusion was related to depression in rural primary school principals. The findings suggested a significant positive correlation between cognitive fusion and depression among primary school principals, which was mediated by psychological vulnerability. In addition, self-esteem not only moderated the effect of cognitive fusion on depression, but also played a moderating role in the relationship between cognitive fusion and psychological vulnerability. We should focus on improving primary school principals’ self-esteem and buffering cognitive fusion’s impact on psychological vulnerability and depression.