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. 2020 Jul:17:109-118.
doi: 10.1016/j.jcbs.2020.07.003. Epub 2020 Jul 20.

The moderating roles of psychological flexibility and inflexibility on the mental health impacts of COVID-19 pandemic and lockdown in Italy

Kenneth I Pakenham  1 , Giulia Landi  2   3 , Giada Boccolini  3 , Annalisa Furlani  3 , Silvana Grandi  2   3 , Eliana Tossani  2   3
Affiliations

The moderating roles of psychological flexibility and inflexibility on the mental health impacts of COVID-19 pandemic and lockdown in Italy

Kenneth I Pakenham et al. J Contextual Behav Sci. 2020 Jul.

Abstract

The Moderating Roles of Psychological Flexibility and Inflexibility on the Mental Health Impacts of COVID-19 Pandemic and Lockdown in Italy. Preliminary data suggest the COVID-19 pandemic has adverse effects on mental health in approximately a quarter of the general population. Few prior studies have identified contextual risk factors and no published study has explored factors that might moderate their adverse effects on mental health. Psychological flexibility is the cornerstone of psychological health and resiliency. This study investigated the roles of psychological flexibility and inflexibility in moderating the effects of COVID-19 risk factors on three mental health outcomes: COVID-19 peritraumatic distress, anxiety, depression. We hypothesized that psychological flexibility would mitigate and psychological inflexibility would exacerbate the adverse effects of COVID-19 risk factors on mental health. During the Italian national lockdown (M = 39.29 days, SD = 11.26), 1035 adults (79% female, M = 37.5 years, SD = 12.3) completed an online survey. Twelve COVID-19 risk factors were identified (e.g. lockdown duration, family infected by COVID-19, increase in domestic violence and in unhealthy lifestyle behaviours) and constituted a COVID-19 Lockdown Index. As predicted, results showed that after controlling for sociodemographic variables, global psychological flexibility and four of its sub-processes (self-as context, defusion, values, committed action), mitigated the detrimental impacts of COVID-19 risk factors on mental health. In contrast and as expected, global psychological inflexibility and four of its sub-processes (lack of contact with present moment, fusion, self-as-content, lack of contact with personal values) exacerbated the detrimental impacts of COVID-19 risk factors on mental health. Findings converge with those from the broader psychological flexibility literature providing robust support for the use of ACT-based interventions to promote psychological flexibility and mental health during the COVID-19 pandemic.

Keywords: Anxiety; COVID-19 pandemic; Depression; Lockdown; Peritraumatic distress; Psychological flexibility; Psychological inflexibility.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1A–B
Fig. 1A–B
Johnson-Neyman plots representing the relationships between The COVID-19 Lockdown Index and COVID-19 peritraumatic distress, anxiety and depression as moderated through global psychological flexibility and inflexibility.
See this image and copyright information in PMC

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