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COVID-19: Psychological flexibility, coping, mental health, and wellbeing in the UK during the pandemic
Open accessAbstract
The COVID-19 pandemic has profoundly altered the daily lives of many people across the globe, both through the direct interpersonal cost of the disease, and the governmental restrictions imposed to mitigate its spread and impact. The UK has been particularly affected and has one of the highest mortality rates in Europe. In this paper, we examine the impact of COVID-19 on psychological health and well-being in the UK during a period of 'lockdown' (15th-21st May 2020) and the specific role of Psychological Flexibility as a potential mitigating process. We observed clinically high levels of distress in our sample (N = 555). However, psychological flexibility was significantly and positively associated with greater wellbeing, and inversely related to anxiety, depression, and COVID-19-related distress. Avoidant coping behaviour was positively associated with all indices of distress and negatively associated with wellbeing, while engagement in approach coping only demonstrated weaker associations with outcomes of interest. No relationship between adherence to government guidelines and psychological flexibility was found. In planned regression models, psychological flexibility demonstrated incremental predictive validity for all distress and wellbeing outcomes (over and above both demographic characteristics and COVID-19-specific coping responses). Furthermore, psychological flexibility and COVID-19 outcomes were only part-mediated by coping responses to COVID-19, supporting the position that psychological flexibility can be understood as an overarching response style that is distinct from established conceptualisations of coping. We conclude that psychological flexibility represents a promising candidate process for understanding and predicting how an individual may be affected by, and cope with, both the acute and longer-term challenges of the pandemic.
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“Several studies demonstrated that ACT-based interventions led to significant reductions in depression and stress symptoms in pandemic-exposed populations, with long-term effects persisting months after initial treatment [179].”
From Impact of Media-Induced Uncertainty on Mental Health: Narrative-Based Perspective. (2025) · cites this paper as [179]
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“Acceptance-based coping is another pathway to coping with the psychological repercussions of the COVID-19 pandemic (Dawson & Golijani-Moghaddam, 2020;Gurvich et al., 2021).”
From RESILIENCE, COPING, AND THE COVID-19 PANDEMIC ACROSS THE GLOBE – AN UPDATE: WHAT HAVE WE LEARNED? (2023) · cites this paper as Dawson & Golijani-Moghaddam, 2020
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Supporting this, PF was found to predict wellbeing, stress, depression and affect during the pandemic (Dawson & Golijani-Moghaddam, 2020; Gloster, Lamnisos et al., 2020).”
From Behind the masks: A cross-sectional study on intolerance of uncertainty, perceived vulnerability to disease and psychological flexibility in relation to state anxiety and wellbeing during the COVID-19 pandemic (2021) · cites this paper as Dawson & Golijani-Moghaddam, 2020
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“A growth of literature has identified psychological flexibility as an underlying process surrounding the dramatic increases in mental health difficulties related to the COVID-19 pandemic (Dawson & Golijani-Moghaddam, 2020; Kroska et al., 2020; Pakenham et al., 2020).”
From ACTing towards better living during COVID-19: The effects of Acceptance and Commitment therapy for individuals affected by COVID-19 (2022) · cites this paper as Dawson & Golijani-Moghaddam, 2020
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“ACTbased interventions might provide people with abuffer against detrimental impacts of the pandemic and everyday anxiety and fear-inducing challenges (Kashdan et al . 2020; Dawson and Golijani-Moghaddam 2020; McCracken et al . 2021).”
From Recent findings in the pathogenesis and treatment of fear and anxiety (2022) · cites this paper as Dawson and Golijani-Moghaddam 2020
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“mindfulness, psychological flexibility, and psychological mindedness (PM) have been determined as factors that can directly affect the levels of psychological distress”
From Fear of COVID‐19 and COVID‐19 stress and association with sociodemographic and psychological process factors in cases under surveillance in a frontline worker population in borneo (2021) · cites this paper as [27]
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“Results from additional research have consistently demonstrated that psychological inflexibility exacerbates the detrimental impacts of COVID-19 on mental health (Dawson and Golijani-Moghaddam, 2020; Kroska et al., 2020; Pakenham et al., 2020).”
From Dealing With the Pandemic of COVID-19 in Portugal: On the Important Role of Positivity, Experiential Avoidance, and Coping Strategies (2021) · cites this paper as Dawson and Golijani-Moghaddam, 2020
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Such interventions, which focus on emotional regulation, cognitive flexibility, and acceptance, are particularly effective for older individuals who may struggle with rumination and excessive worry when faced with distressing news [178,179].”
From Impact of Media-Induced Uncertainty on Mental Health: Narrative-Based Perspective. (2025) · cites this paper as [179]
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“This finding is also consistent with COVID-19 related findings that PF has direct effects on wellbeing (Dawson & Golijani-Moghaddam, 2020; Gloster, Lamnisos et al., 2020; McCracken et al., 2021) and a moderating role between the psychological impacts of COVID-19 and mental health outcomes and wellbeing (Chong et al., 2021; Crasta et al., 2020; Daks et al., 2020; Pakenham et al., 2020; Smith et al.”
From Behind the masks: A cross-sectional study on intolerance of uncertainty, perceived vulnerability to disease and psychological flexibility in relation to state anxiety and wellbeing during the COVID-19 pandemic (2021) · cites this paper as Dawson & Golijani-Moghaddam, 2020
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“Some of these identify psychological flexibility, or the ability to act with openness, awareness, and engagement (Hayes et al., 2006) as an important target in the treatment and recovery of those adversely affected”
From Health, well-being, and persisting symptoms in the pandemic: What is the role of psychological flexibility? (2022) · cites this paper as Dawson & Golijani-Moghaddam, 2020
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In the citing paper
“literature from across multiple populations demonstrates that psychological flexibility predicts ability to cope with COVID-related distress over and above previously identified coping-factors (Dawson & Golijani-Moghaddam, 2020; Gloster, Lamnisos, et al., 2020; Pakenham et al., 2020).”
From ACTing towards better living during COVID-19: The effects of Acceptance and Commitment therapy for individuals affected by COVID-19 (2022) · cites this paper as Dawson & Golijani-Moghaddam, 2020
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Metadata
- Authors
- Dawson, D. L., & Golijani-Moghaddam, N.
- Affiliations
- University of Lincoln (GB)
- Venue
- Journal of Contextual Behavioral Science
- Publisher
- Elsevier BV
- Published
- 2020-07
- Volume
- 17
- Pages
- 126-134
- ISSN
- 2212-1447 (ISSN-L)
- PMC
- PMC7392106
- OpenAlex
- W3046001566
- Cited by
- 445
- References
- 72
- Citations by year
- 2026: 21 · 2025: 41 · 2024: 55 · 2023: 83 · 2022: 109 · 2021: 122 · 2020: 13
- FWCI
- 32.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Contextual Behavioral Science (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Lincoln Repository (University of Lincoln) (acceptedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Keywords
- COVID-19 pandemic, psychological flexibility, coping, mental health, well-being, lockdown, anxiety, depression, avoidance coping, approach coping, United Kingdom
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