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