Sertraline and Escitalopram But Not Other Antidepressants Increase Acetylcholinesterase Activity Ex Vivo in the Rat Frontal Cortex.

Anxiety is one of the most prevalent mental health disorders worldwide, with the global prevalence increasing by 23.2–28.0% after the COVID-19 pandemic (), and accumulating evidence suggests that elevated anxiety levels have persisted into the post-pandemic period (; ). Anxiety exerts an enormous burden on individuals and society, closely associated with multiple diseases and adverse health outcomes (; ; ). However, individuals exhibit heterogeneous emotional response patterns when confronted with anxiety triggers (; ). Emotional stability, a key component of the Big Five personality traits, denotes the intensity and variability of an individual’s emotional reactions in response to stress, obstacles, and negative emotions (). High emotional stability is associated with stronger emotional resilience and is vital in mitigating the intensification of anxiety (; ). Understanding how emotional stability is developed and maintained requires a theoretical framework of emotion regulation. According to the process model of emotion regulation (), the most effective regulation occurs during the early “cognitive change” stage, when individuals can alter their appraisal of emotion-eliciting situations before a full emotional response unfolds. This framework suggests that examining the regulatory processes that precede emotional stability—and the anxiety outcomes that follow its disruption—may yield critical insights for intervention. Within this framework, mindfulness has been increasingly recognized as a key cognitive change strategy. Mindfulness, defined as a conscious and nonjudgmental awareness of the present moment, facilitates profound cognitive reappraisal by enabling individuals to detach from automatic ideas and embrace a more expansive, accepting viewpoint on interior experiences, rather than repressing emotions (; ). In accordance with James J. Gross’s Process Model of Emotion Regulation, we assert that an individual’s state of mindfulness, by fostering acceptance-based cognitive transformation, can enhance emotional stability and ultimately reduce anxiety. In fact, numerous empirical investigations have evidenced bidirectional relationships among anxiety, emotional stability, and mindfulness, as well as the emotional regulation function of mindfulness at the individual level. Studies demonstrate that mindfulness significantly improves emotional stability and effectively reduces anxiety symptoms (; ). Investigation on heart rate variability (HRV) indicates that enhanced mindfulness boosts emotional stability by regulating autonomic nervous system function (S. ). Simultaneously, mindfulness acceptance training (MAT) significantly diminishes individual anxiety symptoms and improves emotional self-regulation effectiveness (). Regarding emotional stability and anxiety, research shows that individuals with lower emotional stability exhibit more significant anxiety symptoms (). Neurobiological evidence indicates that emotion regulation and cognitive functions engage overlapping brain networks, with the prefrontal cortex being pivotal for emotional stability and anxiety (). Current research, however, lacks longitudinal designs and mostly analyzes the interrelationships among these variables using aggregate scores, neglecting the complex associations at the item level.