Psychological flexibility in the context of COVID-19 adversity: Associations with distress
Open accessAbstract
The COVID-19 pandemic has led to hardship for individuals across the globe, and research to-date has indicated a significant impact of the pandemic on mental health functioning. In order to promote psychological resilience during this time, it is important to understand modifiable targets for clinical intervention. The current study examined demographic characteristics, pandemic-related adversity, and psychological flexibility in relation to general and peritraumatic distress in a sample of United States survey respondents during May of 2020. Participants were recruited from Amazon Mechanical Turk (MTurk), N = 485. Participants completed measures of pandemic-related adversity, psychological flexibility components (openness to experience, behavioral awareness, and valued action), peritraumatic distress, and general distress. Hierarchical regression analyses examined whether demographic characteristics, pandemic-related adversity, and components of psychological flexibility were associated with general and peritraumatic distress. Results indicated that higher pandemic-related adversity, lower openness to experience, and lower behavioral awareness were significantly associated with higher general distress. Greater pandemic-related adversity, lower openness to experience, lower behavioral awareness, and higher valued action were significantly associated with higher peritraumatic distress. Adding the components of psychological flexibility to the model increased the amount of variance accounted for in both measures of distress. The results indicated that psychological flexibility components may be particularly important targets for prevention and intervention efforts in the midst of the COVID-19 pandemic. Transdiagnostic interventions, such as Acceptance and Commitment Therapy, that target psychological flexibility may be useful as the impact of the pandemic continues to unfold.
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A growth of literature has identified psychological flexibility as an underlying process surrounding increases in mental health difficulties related to the COVID-19 pandemic.
“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 Kroska et al., 2020
The Discussion identifies psychological flexibility as a potential modifiable process that may reduce distress during COVID-19 adversity. The paper reports associations with distress, however, rather than establishing that psychological flexibility underlies the claimed dramatic increases in mental health difficulties. (LLM, conf=0.82)
Experimental — accuracy not yet measuredPsychological flexibility is a significant protective factor against the adverse effects of general and peritraumatic distress.
“prior studies suggest that psychological flexibility is a significant protective factor against the adverse effects of general and peritraumatic distress [63].”
From Examining the associations between psychological flexibility, mindfulness, psychosomatic functioning, and anxiety during the covid-19 pandemic: A path analysis (2020) · cites this paper as [63]
The Discussion reports that higher openness and behavioral awareness were associated with lower general and peritraumatic distress, supporting an association for two components of psychological flexibility. But it also reports that valued action was positively associated with peritraumatic distress and explicitly says the single-timepoint study cannot establish causation. Calling psychological flexibility a protective factor therefore overstates the findings. (LLM, conf=0.87)
Experimental — accuracy not yet measuredPsychological inflexibility exacerbates the detrimental impacts of COVID-19 on mental health.
“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 Kroska et al., 2020
The Abstract reports that lower openness to experience and behavioral awareness were associated with greater distress during the pandemic. But the Discussion says the single-timepoint study cannot establish causation; it does not show that psychological inflexibility exacerbates COVID-19’s impact on mental health. (LLM, conf=0.88)
Experimental — accuracy not yet measuredACT may be well suited to pandemic distress because it builds psychological flexibility when stressors are unpredictable and uncontrollable.
“Acceptance and Commitment Therapy (ACT) is a promising intervention for pandemic-related distress because it promotes psychological flexibility in the face of unpredictable, uncontrollable stressors (e.g., Kroska et al., 2020).”
From Examining the effects of prior Acceptance and Commitment Therapy (ACT) treatment among anxious cancer survivors during the COVID-19 pandemic: Evidence from a randomized controlled trial (2022) · cites this paper as Kroska et al., 2020
Recent literature points to ACT as a possible intervention for COVID-related distress.
“recent literature is pointing towards ACT as a possible intervention to address COVID-related distress (Gloster, Lamnisos, et al., 2020; Kroska 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 Kroska et al., 2020
Psychological flexibility is malleable and trainable to support coping with distressing events, and interventions targeting it may help mitigate mental health effects of the COVID-19 pandemic.
“Psychological flexibility has been found to be malleable and trainable to support individuals to cope with distressing events, and interventions which target psychological flexibility may be particularly helpful in mitigating the mental health effects of the COVID-19 pandemic (Gloster et al., 2017, 2020a; Kroska 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 Kroska et al., 2020
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“These recent studies support ACT as a promising therapeutic approach to improving psychological wellbeing during the COVID-19 pandemic (Kroska et al., 2020).”
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- Authors
- Kroska, E. B., Roche, A. I., Adamowicz, J. L., & Stegall, M. S.
- Affiliations
- University of Iowa (US)
- Corresponding author
- Kroska, Emily B.
- Venue
- Journal of Contextual Behavioral Science
- Publisher
- Elsevier BV
- Published
- 2020-10
- Volume
- 18
- Pages
- 28-33
- ISSN
- 2212-1447 (ISSN-L)
- PMC
- PMC7406424
- OpenAlex
- W3047559965
- Semantic Scholar
- ffeca27b0759cbd5c2f60f857b9869bc619b8ebf
- Cited by
- 108
- References
- 33
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 18 · 2023: 24 · 2022: 21 · 2021: 25 · 2020: 4
- FWCI
- 7.40
- Type
- journal article
- Language
- en
- Update notices
- erratum (2021-07-01)
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Contextual Behavioral Science (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- 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
- psychological flexibility, COVID-19 pandemic, peritraumatic distress, general distress, openness to experience, behavioral awareness, valued action, psychological resilience, acceptance and commitment therapy, transdiagnostic treatment, mental health
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