Chong, Yuen YuCHIEN, Wai TongCheng, Ho YuLamnisos, DemetrisLubenko, JelenaPresti, GiovambattistaSquatrito, ValeriaConstantinou, MariosNicolaou, ChristianaPapacostas, SavvasAydın, GökçenRuiz, Francisco J.Garcia-Martin, Maria B.Obando-Posada, Diana P.Segura-Vargas, Miguel A.Vasiliou, Vasilis S.McHugh, Louise AnitaHöfer, StefanBaban, AdrianaKassianos, Angelos P.2025-04-242025-04-242021-04-14Chong, Y. Y., Chien, W. T., Cheng, H. Y., Lamnisos, D., Ļubenko, J., Presti, G., Squatrito, V., Constantinou, M., Nicolaou, C., Papacostas, S., Aydin, G., Ruiz, F. J., Garcia-Martin, M. B., Obando-Posada, D. P., Segura-Vargas, M. A., Vasiliou, V. S., McHugh, L., Höfer, S., Baban, A., ... Kassianos, A. P. (2021). Patterns of psychological responses among the public during the early phase of covid-19: A cross-regional analysis. International Journal of Environmental Research and Public Health, 18(8), 4143. https://doi.org/10.3390/ijerph180841431660-4601http://hdl.handle.net/10400.5/100342This 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.engCOVID-19Psychological flexibilityMental healthSurveyjournal article2024-03-14cv-prod-266659410.3390/ijerph180841432-s2.0-85104038712