. 2021 Apr 14;18(8):4143.

doi: 10.3390/ijerph18084143.

Patterns of Psychological Responses among the Public during the Early Phase of COVID-19: A Cross-Regional Analysis

Yuen Yu Chong¹, Wai Tong Chien¹, Ho Yu Cheng¹, Demetris Lamnisos², Jeļena Ļubenko³, Giovambattista Presti⁴, Valeria Squatrito⁴, Marios Constantinou⁵, Christiana Nicolaou⁶, Savvas Papacostas⁷, Gökçen Aydin⁸, Francisco J Ruiz⁹, Maria B Garcia-Martin¹⁰, Diana P Obando-Posada¹⁰, Miguel A Segura-Vargas⁹, Vasilis S Vasiliou¹¹, Louise McHugh¹², Stefan Höfer¹³, Adriana Baban¹⁴, David Dias Neto¹⁵, Ana Nunes da Silva¹⁶, Jean-Louis Monestès¹⁷, Javier Alvarez-Galvez¹⁸, Marisa Paez Blarrina¹⁹, Francisco Montesinos²⁰, Sonsoles Valdivia Salas²¹, Dorottya Őri²², Bartosz Kleszcz²³, Raimo Lappalainen²⁴, Iva Ivanović²⁵, David Gosar²⁶, Frederick Dionne²⁷, Rhonda M Merwin²⁸, Andrew T Gloster²⁹, Maria Karekla³⁰, Angelos P Kassianos^{30

31}

Affiliations

¹ The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
² Department of Health Sciences, European University Cyprus, 1516 Nicosia, Cyprus.
³ Psychological Laboratory, Faculty of Public Health and Social Welfare, Riga Stradiņš University, LV-1007 Riga, Latvia.
⁴ Kore University Behavioral Lab (KUBeLab), Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy.
⁵ Department of Social Sciences, School of Humanities and Social Sciences, University of Nicosia, 2417 Nicosia, Cyprus.
⁶ Department of Nursing, Cyprus University of Technology, 3036 Limassol, Cyprus.
⁷ Cyprus Institute of Neurology and Genetics, 1683 Nicosia, Cyprus.
⁸ Department of Psychological Counseling and Guidance, Faculty of Education, Hasan Kalyoncu University, Gaziantep 27010, Turkey.
⁹ Department of Psychology, Fundación Universitaria Konrad Lorenz, Bogotà 110231, Colombia.
¹⁰ Faculty of Psychology, University of La Sabana, Chía 53753, Colombia.
¹¹ School of Applied Psychology, University College Cork, T12 YN60 Cork, Ireland.
¹² School of Psychology, University College Dublin, D04 V1W8 Dublin, Ireland.
¹³ Department of Medical Psychology, Innsbruck Medical University, 6020 Innsbruck, Austria.
¹⁴ Department of Psychology, Babeş-Bolyai University (UBB), 400095 Cluj-Napoca, Romania.
¹⁵ ISPA-Instituto Universitário, APPsyCI-Applied Psychology Research Center Capabilities & Inclusion, 1149-041 Lisbon, Portugal.
¹⁶ Faculdade de Psicologia, Alameda da Universidade, Universidade de Lisboa, 1649-013 Lisbon, Portugal.
¹⁷ LIP/PC2S Lab, Univ. Grenoble Alpes, 38040 Grenoble, France.
¹⁸ Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, 11003 Cadiz, Spain.
¹⁹ Instituto ACT, 28036 Madrid, Spain.
²⁰ Department of Psychology, European University of Madrid, 28670 Madrid, Spain.
²¹ Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain.
²² Heim Pal National Pediatric Institute, Department of Mental Health, 1089 Budapest, Hungary.
²³ Bartosz Kleszcz Psychotherapy and Training, ul. Aleja Zwycięstwa 31/8, 41-200 Sosnowiec, Poland.
²⁴ Department of Psychology, University of Jyväskylä, FI-40014 Jyväskylä, Finland.
²⁵ Clinic for Psychiatry, Clinical Center of Montenegro, 81110 Podgorica, Montenegro.
²⁶ Department of Child, Adolescent and Developmental Neurology, University Children's Hospital, University Medical Center, 1000 Ljubljana, Slovenia.
²⁷ Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC G9A 5H7, Canada.
²⁸ Department of Psychiatry and Behavioral Science, Duke University, Durham, NC 27708, USA.
²⁹ Division of Clinical Psychology and Intervention Science, University of Basel, 4001 Basel, Switzerland.
³⁰ Department of Psychology, University of Cyprus, 1678 Nicosia, Cyprus.
³¹ Department of Applied Health Research, University College London, London WC1E 6BT, UK.

PMID: 33919888
PMCID: PMC8070933
DOI: 10.3390/ijerph18084143

Patterns of Psychological Responses among the Public during the Early Phase of COVID-19: A Cross-Regional Analysis

Yuen Yu Chong et al. Int J Environ Res Public Health. 2021.

. 2021 Apr 14;18(8):4143.

doi: 10.3390/ijerph18084143.

Authors

Affiliations

¹ The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
² Department of Health Sciences, European University Cyprus, 1516 Nicosia, Cyprus.
³ Psychological Laboratory, Faculty of Public Health and Social Welfare, Riga Stradiņš University, LV-1007 Riga, Latvia.
⁴ Kore University Behavioral Lab (KUBeLab), Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy.
⁵ Department of Social Sciences, School of Humanities and Social Sciences, University of Nicosia, 2417 Nicosia, Cyprus.
⁶ Department of Nursing, Cyprus University of Technology, 3036 Limassol, Cyprus.
⁷ Cyprus Institute of Neurology and Genetics, 1683 Nicosia, Cyprus.
⁸ Department of Psychological Counseling and Guidance, Faculty of Education, Hasan Kalyoncu University, Gaziantep 27010, Turkey.
⁹ Department of Psychology, Fundación Universitaria Konrad Lorenz, Bogotà 110231, Colombia.
¹⁰ Faculty of Psychology, University of La Sabana, Chía 53753, Colombia.
¹¹ School of Applied Psychology, University College Cork, T12 YN60 Cork, Ireland.
¹² School of Psychology, University College Dublin, D04 V1W8 Dublin, Ireland.
¹³ Department of Medical Psychology, Innsbruck Medical University, 6020 Innsbruck, Austria.
¹⁴ Department of Psychology, Babeş-Bolyai University (UBB), 400095 Cluj-Napoca, Romania.
¹⁵ ISPA-Instituto Universitário, APPsyCI-Applied Psychology Research Center Capabilities & Inclusion, 1149-041 Lisbon, Portugal.
¹⁶ Faculdade de Psicologia, Alameda da Universidade, Universidade de Lisboa, 1649-013 Lisbon, Portugal.
¹⁷ LIP/PC2S Lab, Univ. Grenoble Alpes, 38040 Grenoble, France.
¹⁸ Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, 11003 Cadiz, Spain.
¹⁹ Instituto ACT, 28036 Madrid, Spain.
²⁰ Department of Psychology, European University of Madrid, 28670 Madrid, Spain.
²¹ Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain.
²² Heim Pal National Pediatric Institute, Department of Mental Health, 1089 Budapest, Hungary.
²³ Bartosz Kleszcz Psychotherapy and Training, ul. Aleja Zwycięstwa 31/8, 41-200 Sosnowiec, Poland.
²⁴ Department of Psychology, University of Jyväskylä, FI-40014 Jyväskylä, Finland.
²⁵ Clinic for Psychiatry, Clinical Center of Montenegro, 81110 Podgorica, Montenegro.
²⁶ Department of Child, Adolescent and Developmental Neurology, University Children's Hospital, University Medical Center, 1000 Ljubljana, Slovenia.
²⁷ Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC G9A 5H7, Canada.
²⁸ Department of Psychiatry and Behavioral Science, Duke University, Durham, NC 27708, USA.
²⁹ Division of Clinical Psychology and Intervention Science, University of Basel, 4001 Basel, Switzerland.
³⁰ Department of Psychology, University of Cyprus, 1678 Nicosia, Cyprus.
³¹ Department of Applied Health Research, University College London, London WC1E 6BT, UK.

PMID: 33919888
PMCID: PMC8070933
DOI: 10.3390/ijerph18084143

Abstract

This study aimed to compare the mediation of psychological flexibility, prosociality and coping in the impacts of illness perceptions toward COVID-19 on mental health among seven regions. Convenience sampled online survey was conducted between April and June 2020 from 9130 citizens in 21 countries. Illness perceptions toward COVID-19, psychological flexibility, prosociality, coping and mental health, socio-demographics, lockdown-related variables and COVID-19 status were assessed. Results showed that psychological flexibility was the only significant mediator in the relationship between illness perceptions toward COVID-19 and mental health across all regions (all ps = 0.001-0.021). Seeking social support was the significant mediator across subgroups (all ps range = <0.001-0.005) except from the Hong Kong sample (p = 0.06) and the North and South American sample (p = 0.53). No mediation was found for problem-solving (except from the Northern European sample, p = 0.009). Prosociality was the significant mediator in the Hong Kong sample (p = 0.016) and the Eastern European sample (p = 0.008). These findings indicate that fostering psychological flexibility may help to mitigate the adverse mental impacts of COVID-19 across regions. Roles of seeking social support, problem-solving and prosociality vary across regions.

Keywords: COVID-19; mental health; prosociality; psychological flexibility; survey.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Hypothetical model of the study.

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Patterns of Psychological Responses among the Public during the Early Phase of COVID-19: A Cross-Regional Analysis

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Patterns of Psychological Responses among the Public during the Early Phase of COVID-19: A Cross-Regional Analysis

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