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

This study aimed to compare the mediation of psychological flexibility, prosociality andcoping 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 citizensin 21 countries. Illness perceptions toward COVID-19, psychological flexibility, prosociality, copingand mental health, socio-demographics, lockdown-related variables and COVID-19 status wereassessed. Results showed that psychological flexibility was the only significant mediator in therelationship between illness perceptions toward COVID-19 and mental health across all regions (allps = 0.001–0.021). Seeking social support was the significant mediator across subgroups (allps range= <0.001–0.005) except from the Hong Kong sample (p= 0.06) and the North and South Americansample (p= 0.53). No mediation was found for problem-solving (except from the Northern Europeansample,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 psychologicalflexibility may help to mitigate the adverse mental impacts of COVID-19 across regions. Roles ofseeking social support, problem-solving and prosociality vary across regions.