As university students transition from adolescence to adulthood and leave their homes to attend universities, they face a range of challenges. According to a WHO investigation, more than 30% of university students in eight countries experience psychological difficulties (Auerbach et al., 2018). Similarly, research conducted in China indicates that the rate of university students with mental health challenges (e.g., depression, anxiety, and stress) ranged from 10 to 30% (Huang et al., 2011; Wei & Sang, 2017). These findings underscore the importance of addressing the mental health needs of university students in order to support their academic success and overall well-being. Empirical studies suggested that a range of stressful events, including academic pressure, financial difficulties, harassment and discrimination, and traumatic experiences, can significantly impact the mental health of university students (Campbell et al., 2022). However, while numerous studies have explored the relationship between stressful events and mental health outcomes among university students, less attention has been given to how students’ perceptions of these events may contribute to their psychological well-being.

As a cornerstone of Buddhist philosophy, impermanence has the potential to alleviate the strains of life by fostering an interpretation of challenging circumstances. This concept posits that all phenomena are ephemeral and constantly changing. Fernández-Campos et al. (2021) suggested that impermanence can be further elucidated by dividing it into two core components: awareness and acceptance. The first facet—awareness—refers to an individual’s ability to recognize and acknowledge the ephemeral and dynamic nature of all phenomena. The second facet—acceptance—involves a cognitive stance of embracing the transient nature of all phenomena. The relationship between impermanence and mental health outcomes is complex and not entirely clear. Some studies suggested that awareness of impermanence without acceptance may actually increase anxiety (Lindsay & Creswell, 2019; Sahdra et al., 2016), while others found that both awareness and acceptance of impermanence were positively associated with psychological well-being (Fernández-Campos et al., 2021). These mixed findings suggest that two components of impermanence should be considered when examining the relationship between impermanence and mental health outcomes. To fully understand the effect of impermanence on psychological well-being, this study takes a more nuanced approach that examines how both components of impermanence interact to influence mental health outcomes, including depression, anxiety, posttraumatic stress disorder (PTSD), everyday stress, and life satisfaction.

The heightened awareness of impermanence does not necessarily lead to acceptance of impermanence. In fact, awareness of impermanence may evoke feelings of insecurity or loss of control over a world that is constantly changing. For some individuals, this may make it difficult to accept the impermanence of things. Evidence suggests that awareness and acceptance of impermanence may not necessarily be correlated (Fernández-Campos et al., 2021). However, it is important to note that awareness is a necessary precursor of acceptance of impermanence. In other words, individuals cannot accept impermanence unless they are aware of it in the first place. With this in mind, this study speculated that there may be three distinct groups of university students: those with high levels of both impermanence awareness and acceptance, those with low levels of both impermanence awareness and acceptance, and those with high awareness but low acceptance of impermanence.

To the best of our knowledge, studies rarely examined whether there are subgroups of impermanence awareness and acceptance. Thus, it calls for the person-centered approach (also known as latent profile/class analysis) since it can identify the dynamics of emergent sub-populations based on a set of chosen variables (Howard & Hoffman, 2018). In addition, Fernández-Campos et al. (2021) developed the Impermanence Awareness and Acceptance Scale (IMAAS) to measure two components of impermanence. These provide foundations for conducting latent profile analysis and exploring whether the hypothesized three subgroups of impermanence awareness and acceptance would emerge among university students.

The period of adolescence and young adulthood represents a crucial transitional phase in the typical development of emotional reactivity and the acquisition of emotional regulation skills (Romeo, 2010). During this phase, adolescents and young adults experience a noteworthy increase in emotional reactivity and heightened sensitivity to stressors (Casey et al., 2010; Somerville et al., 2010). As such, this period may serve as a pivotal time where the utilization of effective coping strategies becomes particularly necessary (Compas et al., 2001). This study intended to illuminate the coping strategies employed by late adolescents and young adults to perceive and respond to stressors, with the goal of identifying strategies that promote their psychological well-being.

By cultivating impermanence awareness and acceptance, individuals can find solace in the understanding that challenging experiences are temporary and will eventually pass (Coleman & Thupten, 2006; Shonin et al., 2014). This mindset can help alleviate negative emotions and provide a sense of hope and resilience (Bruehlman-Senecal & Ayduk, 2015). In addition to helping individuals gain emotional relief, impermanence can also facilitate the development of gratitude and appreciation for life by acknowledging the temporary nature of every moment, person, and relationship. However, when examining the relationship between the awareness and acceptance components of impermanence and mental health outcomes, previous research has yielded inconsistent findings (Fernández-Campos et al., 2021; Lindsay & Creswell, 2019; Sahdra et al., 2016). To further clarify the relationship between both awareness and acceptance components of impermanence and psychological health, it may be useful to examine how many distinct groups of university students exist based on their experiences of impermanence awareness and acceptance. By identifying these distinct groups, researchers may be better able to understand the complex relationship between impermanence and mental health outcomes.

Mindfulness, a related construct to impermanence, consists of two components: awareness, which involves being highly aware of one’s internal and external experiences, and acceptance, which involves accepting and nonjudgmental attitudes towards those experiences (Cardaciotto et al., 2008). Mindfulness enables individuals to observe and embrace changes without judgment, ultimately leading to a heightened sense of awareness and acceptance of impermanence (Fernández-Campos et al., 2021). By cultivating this awareness and acceptance of impermanence, individuals may feel more motivated to focus their attention on the present moment (Fernández-Campos et al., 2021). Despite their shared focus on awareness and acceptance, mindfulness and impermanence diverge in terms of their temporal scope. Mindfulness predominantly emphasizes cultivating an awareness and acceptance of the present moment; conversely, impermanence calls for individuals not to only be mindful of the current situation but also to recognize and embrace the inevitable change, both in the past and the future (Fernández-Campos et al., 2021).

The burgeoning field of mindfulness research offers valuable insights that can inform the study of impermanence. Monitor and Acceptance Theory suggests that awareness of mindfulness alone would enhance emotional responses, but when combined with acceptance of mindfulness, it would improve psychological health (Lindsay & Creswell, 2017). The empirical research on mindfulness has consistently demonstrated that the acceptance component plays a more critical role in promoting positive mental health outcomes than the awareness component (Lindsay & Creswell, 2019; Simione et al., 2021). While the acceptance component of mindfulness can be beneficial for managing moment-to-moment experiences and tempering affective reactivity (Cardaciotto et al., 2008; Lindsay & Creswell, 2019; Simione et al., 2021), increased awareness of one’s experiences was not always adaptive or healthy. For instance, focusing on positive aspects of the self has been associated with more intense and frequent positive experiences (Lindsay & Creswell, 2017; Mor & Winquist, 2002). However, focusing too much on negative aspects of the self without an attitude of acceptance and non-judgment may increase the intensity of distress (Bravo et al., 2018; Lam et al., 2017; Wang et al., 2019). In the same vein, being aware of the transient and changing nature of joyful moments or experiences may lead to negative affect, such as disappointment and anger (Gethin, 1998); realizing that painful events or experiences will eventually come to an end may increase positive affect, such as hopefulness (Ahmed et al., 2018). As such, acceptance component of impermanence might be a more critical factor in affecting psychological health than awareness component.

Furthermore, examining the research on mindfulness profiles may contribute to our understanding of impermanence profiles. The Five Facet Mindfulness Questionnaire (FFMQ; Baer et al., 2006) was frequently used to measure mindfulness. It includes five facets of mindfulness: observing (i.e., noticing or attending to internal or external experiences), describing (i.e., labeling internal experiences with words), acting with awareness (i.e., being fully engaged in one’s present activities rather than acting mechanically when the focus of attention is elsewhere), non-judging of inner experience (i.e., adopting a nonjudgmental position towards thoughts and emotions), and non-reacting to inner experience (i.e., the tendency to let thoughts and feelings naturally arise and pass, without getting caught up or carried away by them) (Baer et al., 2006). The initial three facets align with different modes of engaging the awareness component of mindfulness, while the latter two facets are ways of operating acceptance component of mindfulness (Baer et al., 2006, 2008; Cardaciotto et al., 2008). Previous researchers utilized the FFMQ to identify mindfulness profiles, including high or low mindfulness profile, judgmentally observing profile, and non-judgmentally aware profile (Lecuona et al., 2022). A high mindfulness profile was found to be related to higher psychological well-being, happiness, life effectiveness, satisfaction than a low mindfulness profile (Stanmyre et al., 2022); the judgmentally observing profile showed the highest levels of psychological distress and discomfort, and the lowest satisfaction with life, and vice versa for the non-judgmentally aware profile (Bronchain et al., 2021; Calvete et al., 2019; Gómez-Odriozola & Calvete, 2021). These mindfulness research findings suggest that the profile characterized by a combination of high acceptance and high awareness of impermanence may have the lowest levels of psychological distress and the highest levels of positive mental health. Conversely, the profile characterized by high awareness but low acceptance of impermanence may exhibit the opposite pattern.

Based on previous research and theory, we hypothesized that there would be three profiles of impermanence awareness and acceptance: (1) the first profile would be characterized as low awareness and low acceptance, (2) the second profile would be characterized as high awareness and high acceptance, and (3) the third profile would be characterized as high awareness and low acceptance.

The dual-continua model of mental health suggests that positive and negative mental health represent separate dimensions (Keyes, 2005), suggesting that individuals with high levels of psychological distress may not necessarily have low levels of mental well-being. Because the global rise in mental disorders such as depression, anxiety, PTSD, and stress among young adults and university students is raising concerns at an alarming rate (Boals et al., 2020; Griggs, 2017), they were included as representatives of psychological distress. Life satisfaction, as the cognitive aspect of subjective well-being, can be described as a comprehensive measure of the extent to which individual aspirations align with achievements (Cummins, 2013). Its significance as an overall well-being indicator for the general population is underscored by its utilization in the World Health Organization (WHO; Lindert et al., 2015). Regarding the associations of the profiles of impermanence awareness and acceptance with negative and positive mental health, we made the following hypotheses: (1) University students in the second profile would have the lowest levels of depression, anxiety, PTSD, everyday stress, and highest levels of life satisfaction; (2) university students in the third profile would have the highest levels of depression, anxiety, PTSD, everyday stress, and lowest levels of life satisfaction.

Method

Participants

The researchers invited university students from the first and second authors’ institute to participate in this study. The recruitment advertisement was posted at these two universities. If students had interest, they could scan the QR code to enter the online survey in Wenjuanxing platform (https://www.wjx.cn). On the first page of the survey, participants were provided with the consent form that introduced the purpose and procedure of the present study, and emphasized anonymity, confidentiality and voluntary participation. After participants submitted their informed consent, they were allowed to complete the measures. The participants had an opportunity to take part in the sweepstake upon completion.

A total of 549 individuals completed the online survey, but 77 of them were excluded because the participants answered the questionnaires within a short period (i.e., 2 s per item or in total less than 300 s; Huang et al., 2012). In addition, 39 participants were excluded because (1) 20 participants did not correctly answer one validity item (i.e., please select the last option for this item), (2) 10 participants acknowledged that they did not provide authentic data and suggested not to analyze their data at the end of the survey. Because PTSD was included as an outcome variable, nine participants who did not report any traumatic experience were also excluded. Finally, 433 (73.2% female; age M = 19.73 years, SD = 1.90) participants were included in the subsequent analyses. The participants’ demographic information is shown in Table 1.

Table 1 Demographic information of the participants (n = 433)
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Measures

Impermanence

The IMAAS (Fernández-Campos et al., 2021) was used to measure the degree to which individuals understand that all phenomena are transient and have accepting attitudes towards the transient nature of all phenomena. This 13-item scale consists of two subscales (i.e., Impermanence Awareness and Impermanence Acceptance). All items are rated using a 7-point Likert-type scale (1 = strongly disagree, 4 = neutral, 7 = strongly agree). Given that this scale has never been used in Mainland China, it was translated into Chinese by the first author and then back-translated to English independently by the third author. The two translators reached consensus on the Chinese version of the IMASS after the discrepancy in translation was discussed. Sample items for the Impermanence Awareness and Impermanence Acceptance subscales were “I am aware of the brevity of life” and “Imagining my body going through old age scares me”, respectively. In the present sample, the internal reliabilities of both the Impermanence Awareness and Impermanence Acceptance subscales were 0.81. The average score of the 6 items in the Impermanence Awareness subscale was computed to obtain impermanence awareness score, while the average score of the 7 items in the Impermanence Acceptance subscale was computed to obtain impermanence acceptance score after these items were reversely scored. Higher scores reflected higher levels of impermanence awareness and acceptance. Based on the present sample, confirmatory factor analysis was conducted to test the two-factor structure of the IMAAS. The results indicated that the 2-factor structure was fit (CFI = 0.936; TLI = 0.92; RMSEA = 0.067, 90% CI [0.055, 0.078]), with factor loadings of all items ranging from 0.40 to 0.85.

Depression

The 2-item Patient Health Questionnaire (PHQ-2; Kroenke et al., 2003) was used to assess depressive symptoms. Respondents were required to answer items rated by a 4-point Likert-type scale (0 = not at all to 3 = nearly every day). This scale had good reliability and validity among the population in China and the U.S. For example, the internal reliability of this scale was 0.76 among Chinese patients (Liu et al., 2016); the PHQ-2 had a sensitivity of 87% and a specificity of 78% for major depressive disorder (Löwe et al., 2005). A sample item was “Little interest or pleasure in doing things”. In the present sample, the internal reliability of this scale was 0.70. The depression score was obtained by averaging all item scores and used in the subsequent analysis, with a higher score indicating a higher level of depressive symptoms.

Anxiety

The 2-item Generalized Anxiety Disorder Scale (GAD-2; Löwe et al., 2010; Luo et al., 2019) was adopted to measure the frequency with which participants experienced anxiety symptoms in the past 2 weeks. All items are rated on a 4-point Likert-type scale ranging from 0 = not at all to 3 = nearly every day. A sample item was “Not being able to stop or control worrying”. This scale had satisfactory reliability and validity among the Chinese and U.S. population (Luo et al., 2019; Plummer et al., 2016). Based on the present sample, the Cronbach’s α value of this scale was 0.84. The anxiety score was used in subsequent analyses and a higher score indicates a higher level of anxiety.

PTSD

The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5; Weathers et al., 2013) was adopted to measure the occurrence and frequency of PTSD symptoms when university students experienced the most distressing trauma event in the past. The first part of the PCL-5 is a list of difficult or stressful events that could happen to university students; two questions were used to evaluate which event was the most distressing and when the most distressing event happened. The second part of the PCL-5 is a 20-item questionnaire that was utilized to assess the occurrence and severity of four PTSD symptom clusters in response to the most distressing event reported by the participants. According to the DSM-5, these symptom clusters are intrusion (5 items), avoidance (2 items), negative alterations in cognitions and mood (7 items), and alterations in arousal and reactivity (6 items). All 20 items are rated by a 5-point Likert-type scale (0 = not at all, 4 = six or seven times a week/always). If item score was 2 or above, this item was considered to be symptomatic. The PCL-5 has been widely used in Chinese research and showed a good reliability and validity among the Chinese population (Wang et al., 2020, 2023; Yang et al., 2017). In the present sample, the internal reliability of the scale was 0.95. The four symptom scores were obtained by summing the scores of their corresponding items, with higher scores indicating greater severity of PTSD symptoms.

Everyday Stress

The 4-item Perceived Stress Scale (PSS-4; Cohen et al., 1983; Vallejo et al., 2018) was used to assess university students’ perceptions of the extent to which their lives were characterized by unpredictability, lack of control, and excessive demands in the past month. Each item is rated by a 4-point Likert-type scale ranging from 1 = never to 4 = very often. This scale has been widely used across the world and showed satisfactory construct validity, internal reliability and concurrent validity in the Chinese population (Leung et al., 2010). In the present sample, the internal reliability coefficient was 0.73. The scale score was obtained by averaging all item scores and used in the subsequent analysis, with a higher score indicating a higher level of everyday stress.

Life Satisfaction

The 5-item Satisfaction With Life Scale (SWLS; Diener et al., 1985) was employed to measure participants’ life satisfaction. All items are rated on a 7-point Likert-type scale (1 = strongly disagree, 7 = strongly agree). The SWLS has been evidenced to be a reliable and valid tool for life satisfaction (Michaels et al., 2019; Wu & Yao, 2006). For instance, the internal and test–retest reliabilities for this scale were 0.87 and 0.82, respectively (Diener et al., 1985; Wu & Yao, 2006). In the present sample, the internal reliability of this scale was 0.89. The scale score was obtained by averaging all item scores, with a higher score indicating a higher level of life satisfaction.

Data Analyses

LPA was conducted with the maximum likelihood estimator in Mplus 7.4 to identify distinct profiles of impermanence awareness and acceptance using the item scores of impermanence awareness and item scores of impermanence acceptance. First, a one-profile latent profile analysis (LPA) model was evaluated as a comparative baseline for subsequent models containing two to eight profiles. These models were estimated with 200 random sets of starting points along with 50 final stage optimizations (Wang & Bi, 2018) to avoid Local Likelihood Maxima. The optimal model was evaluated jointly by the following fit indices: the Akaike Information Criterion (AIC), Bayesian Information Criterion (BIC), the Sample-Size Adjusted Bayesian Information Criterion (SSA-BIC), Lo-Mendell-Rubins likelihood ratio test (LMR-LRT), bootstrap likelihood ratio test (BLRT), entropy, and the prevalence and interpretability of each profile (Nylund et al., 2007; Tein et al., 2013). Lower values of the AIC, BIC, SSA-BIC indicate a better model fit. The entropy value reflects the accuracy of classification, with entropy value of 0.80 or higher indicating a good classification of individuals into profiles. The LMR-LRT and BLRT were used to compare profile models, with a significant p value suggesting that k profile model is better than k-1 profile model. Mean posterior assignment probabilities for profiles were examined, considering a threshold of 0.70 or higher as being adequate (Nagin, 2014). Furthermore, given that low prevalence of profile is difficult to replicate, the model with profile less than 5% of participants was excluded to avoid unstable results (Nylund-Gibson & Choi, 2018). Finally, the theoretical sense of the emerging patterns was checked.

When the optimal profile model was determined, the Bolck–Croon–Hagenaars (BCH; Bolck et al., 2004) approach was used to analyze profile differences in distal outcomes (anxiety, depression, everyday stress, PTSD, and life satisfaction). The BCH approach was performed to compare the profiles on distal outcomes while considering unequal variances among outcome variables and classification error probabilities of latent variable. Statistical significance was set at p < 0.05.

Results

The fit indices for the LPA models between one and eight profiles in the present sample are illustrated in Table 2. The values of AIC, BIC, and SSA-BIC continued to decrease with the addition of profiles. The BLRT was significant for all profile solutions, so it was not helpful to determine the optimal model. The LMR-LRT supported the 3-profile solution, suggesting that the 3-profile solution was better than the 2-profile solution. Moreover, the 3-profile solution had a greater entropy than the 2-, 4-, and 5-profile solutions, indicating a more accurate classification of profile membership. Although the 6-, 7-, and 8-profile solutions had a greater entropy than the 3-profile solution, these profiles had at least 1 profile lower than 5% and they were excluded. Therefore, we chose the 3-profile solution as the optimal model.

Table 2 Model fit indices for the latent profile models
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Figure 1 shows the graphical description of the three-profile model in this sample. Profile 1 (32.8%) was characterized by moderate scores on items of impermanence awareness and items of impermanence acceptance, and was therefore identified as Neutral Stance of Impermanence (NSI); Profile 2 (16.9%) was characterized by high scores on items of impermanence awareness and items of impermanence acceptance, and was thus labeled as High Awareness and Acceptance (HAA); Profile 3 (50.3%) was characterized by high scores on items of impermanence awareness and low scores on items of impermanence acceptance and was thus labeled as High Awareness Without Acceptance (HAWA).

Fig. 1
figure 1

Profiles of impermanence awareness and acceptance. Note. Profile 1 = Neutral Stance of Impermanence; Profile 2 = High Awareness and Acceptance; Profile 3 = High Awareness Without Acceptance

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The profile differences in anxiety, depression, PTSD, everyday stress, and life satisfaction are shown in Table 3. The HAWA profile had the highest levels of depression, anxiety, everyday stress, intrusion, negative alterations in cognitions and mood, and total PTSD score, followed by the NSI profile and HAA profile. The HAWA profile had higher levels of avoidance than the NSI profile and HAA profile, but there was no significant difference in this outcome between the NSI profile and HAA profile. In addition, the HAWA and NSI profile had higher levels of alterations in arousal and reactivity than HAA but there was no significant difference in this outcome between the HAWA profile and the NSI profile. Finally, the HAWA had lower levels of life satisfaction than the HAA profile. However, both the HAWA and HAA did not have significant difference in life satisfaction when comparing to the NSI profile.

Table 3 Latent profiles of impermanence awareness and acceptance associated with distal outcomes among university students
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Discussion

This is the first study to examine the profiles of impermanence awareness and acceptance, and investigate their associations with a range of mental health outcomes. This study found 3 profiles: NSI, HAA, and HAWA. In addition, HAWA had the highest risks of depression, anxiety, everyday stress, and PTSD, and lowest levels of life satisfaction, followed by NSI and HAA. The implications of these findings are discussed.

Consistent with our second and third hypotheses, the expected second (HAA) and third (HAWA) profiles emerged in the present study. In addition, the HAA and HAWA profiles had the lowest and highest rate of university students, respectively. This finding indicates that more than 60% of university students have intellectual understanding that everything changes, but one quarter of them are able to accept it. This echoes the previous finding that impermanence awareness had a weak correlation with impermanence acceptance (Fernández-Campos et al., 2021). In addition, this finding suggests that acceptance of impermanence is much more difficult than awareness of impermanence among university students. Recognizing the ubiquitous nature of impermanence may lead to anxiety about life’s uncertain and uncontrollable nature, which may prevent individuals from embracing it. Unexpectedly, we discovered another profile that exhibited a moderate level of impermanence awareness and acceptance, instead of the expected low level. This finding goes against our first hypothesis. One possible explanation for this phenomenon is that late adolescents and young adults have encountered various life events, such as changes in physical appearance and interpersonal relationships, which have heightened their awareness of impermanence to at least a moderate degree.

Considering the limited scope of previous impermanence research and the novelty of this study in examining the impermanence profile, it becomes challenging to discuss the profile findings in relation to previous research on impermanence. However, we conducted a comparison between the current impermanence profiles and previous mindfulness research. In a meta-analysis, profiles of mindfulness can be categorized into homogenous and heterogenous profiles (Lecuona et al., 2022). Homogeneous profiles refers to similar levels in five facets of mindfulness, such as high, moderate, and low mindfulness profiles (Calvete et al., 2019; Marques et al., 2020; Pearson et al., 2015; Stanmyre et al., 2022); while heterogenous profiles are identified as high and low levels of facets of mindfulness, such as non-judgmentally aware and judgmentally observing profiles (Bronchain et al., 2021; Calvete et al., 2019; Gómez-Odriozola & Calvete, 2021). Similar to the classification of mindfulness profiles, the impermanence profiles in this study also comprised homogeneous profiles (HAA and NSI) as well as a heterogeneous profile (HAWA). Nevertheless, additional work is required to investigate whether these three impermanence profiles could be replicated in multiple populations.

The HAWA profile was found to have the highest levels of psychological distress and lower levels of life satisfaction, supporting our hypothesis. These findings resonate with previous research on mindfulness, which has shown that individuals within the judgmentally observing profile tend to exhibit highest levels of depression and perceived stress than another two profiles (i.e., the moderate mindfulness and non-judgmentally aware profiles; Calvete et al., 2019) and higher levels of rumination and sleep problems than the non-judgmentally aware profile (Gómez-Odriozola & Calvete, 2021). This suggests that a conflict between awareness and acceptance, whether in the context of mindfulness or impermanence, might have an adverse impact on psychological well-being. In the HAWA profile, even though they are aware of the transient nature of phenomenon, low acceptance of impermanence suggests that they may still expect temporary circumstances to remain permanent, which may intensify their pain and suffering of loss, grief, rejection, and disappointment when change does arise.

In addition, the inconsistency between awareness and acceptance for the changing nature of things may trigger cognitive dissonance, which may further increase the risks of psychological health (Cooper, 2019). Cognitive dissonance is experienced when two pieces of information contradict each other or when one’s behavior conflicts with the truth of a situation. To alleviate this mental conflict, individuals often respond by either modifying their behavior or disregarding information that challenges their desires and goals (Festinger, 1962). For instance, when individuals experience the loss of their beloved ones, they may intellectually comprehend that their loved ones have passed away, but they may struggle to accept this reality. As a result, they might continue to clean and arrange their loved ones’ room as if their loved ones were still present. This may lead to prolonged bereavement and cause them to become trapped in a cycle of suffering and internal conflicts, making it challenging for them to move forward (Freud, 1957). In the context of the HAWA profile, individuals often encounter situations where they acknowledge the inevitability of change, but struggle to accept it. Consequently, they may employ various defense mechanisms, including denial, pathological rumination, and engaging in addictive behaviors, as a means to evade and exert control over the ever-changing nature of the world (Cramer, 2015). However, the ways to avoid facts to cover for a lie may worsen their psychological health (Piazza et al., 2014).

In contrast, the HAA profile had the lowest levels of depression, anxiety, everyday stress, and PTSD, and higher levels of life satisfaction. This finding suggests that university students in this profile have the lowest risk of mental health problems. The recognition and acknowledgement of impermanence can aid individuals in interpreting life’s vicissitudes, particularly the inevitable tragedies, losses, disappointments, and rejections that they may encounter at various points in time, in a less personal manner (Bruehlman-Senecal & Ayduk, 2015; Shonin et al., 2014). In addition, the different associations of HAA and HAWA with mental health outcomes suggests that impermanence acceptance would be a more significant and proximal factor affecting mental health outcomes than impermanence awareness. The experience of pain is an inevitable part of human existence, but it is possible to reduce suffering by cultivating an acceptance of impermanence and avoiding resistance to the present moment (Phillips et al., 2012; Sahdra et al., 2016). Rather than engaging in avoidance strategies to maintain a desired state, individuals can benefit from developing an acceptance of the transient nature of life. By embracing this perspective, individuals may find greater peace and satisfaction with their current circumstances, leading to a more positive overall wellbeing.

Regarding the NSI profile, the present study found that this profile had higher and lower levels of depression, anxiety, PTSD, and everyday stress than HAWA and HAA respectively. Despite a high level of impermanence awareness, the HAWA profile had worse mental health than the NSI profile. This is a noteworthy finding, as it implies that a congruent alignment between the awareness and acceptance of impermanence may be more advantageous for mental health outcomes than a discordant alignment between the two.

Moreover, the variations in mental health outcomes among three impermanence profiles may be primarily attributed to the levels of acceptance of impermanence. Acceptance and Commitment Therapy (ACT) utilizes a combination of acceptance and mindfulness techniques, along with commitment and behavior-change strategies, to enhance individuals’ psychological flexibility. The effectiveness of ACT in addressing a wide range of mental health outcomes has consistently and strongly been supported by empirical evidence (Gloster et al., 2020; Thompson et al., 2021). The current and previous findings suggest that an increase in understanding and acceptance of impermanence has the potential to alleviate psychological distress and foster psychological well-being.

This study has implications. The three identified profiles in the present study contributes to our understanding about the group types and rates of Chinese university students who hold the perspective of impermanence. This provides a foundation for future researchers to further examine the possible correlates and outcomes of impermanence profiles across various populations. In addition, the present findings may inform mental health professionals of the ways to work with university clients. The HAWA and HAA profile were found to have the highest and lowest risk of mental health problems, respectively. This reminds mental health professionals to assess the level of impermanence awareness and acceptance in their clients, as it may provide valuable insights into the underlying causes of their psychological distress.

Limitations and Future Research

Although this study enriches our understanding about patterns of impermanence awareness and acceptance and their associations with mental health outcomes among Chinese university students, it still has several limitations. First, the participants were recruited from two universities, and most of them were females and undergraduate students. In addition, it is imperative to note that the study has not taken into account the middle-aged and elderly population. Therefore, it remains uncertain whether the profiles identified in this study can be generalized to other university students and individuals of varying age demographics. Second, this study did not measure participants’ religious beliefs, which limits us to examine whether religious beliefs would influence the impermanence profiles. Third, this study is a cross-sectional design, so it is not possible to make causal inferences about the directionality of the relationships between impermanence profiles and mental health outcomes. Moreover, this research design prevents us from examining the potential changes and developments in the impermanence profiles of individuals as they age. In order to address these limitations, future researchers should consider recruiting a sample that is more representative, thoroughly assess participants’ religious beliefs, and employ a longitudinal design.