Is psychological flexibility a mediator between perceived stress and general anxiety or depression among suspected patients of the 2019 coronavirus disease (COVID-19)?
Open accessAbstract
This study is aimed to investigate the status of general anxiety and depression among suspected patients of COVID-19 and explore whether psychological flexibility can serve as a mediator between perceived stress and general anxiety or depression. Total of 180 participants completed the online questionnaire which comprised demographic information, the Perceived Stress Scale (PSS), the 7-item Generalized Anxiety Disorder scale (GAD-7), the 9-item Patients Health Questionnaire (PHQ-9), the Acceptance and Action Questionnaire-II (AAQ-II) and the Cognitive Fusion Questionnaire (CFQ). Statistical methods including correlation analysis, multiple linear regression analysis and structural equation model were used in this study. The scores of 23.9% (43/180) and 34.4% (62/180) of participants were higher than the cut points of GAD-7 and PHQ-9 respectively. Psychological flexibility was significantly correlated with perceived stress, general anxiety and depression. Multiple regression analyses showed the possible mediation effect of psychological flexibility between perceived stress and general anxiety or depression. The structural equation model confirmed that psychological flexibility partially mediated between perceived stress and general anxiety or depression. Our findings suggested the potential benefit of Acceptance and Commitment Therapy (ACT) as a psychological support approach in suspected patients of COVID-19 because ACT targets psychological flexibility. © 2021 Elsevier Ltd
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Claims the paper makes
4 of 10 cited sources checked · 2 supported · 0 flagged · accuracy not yet measured
- Premisecitation
Online ACT interventions and ACT self-help books have been shown to improve psychological flexibility in other populations.
“online ACT interventions or ACT self-help books could be used in suspected patients of COVID-19, which were proven to improve psychological flexibility in other populations (Pots et al., 2016; Wersebe et al., 2018).”
Quote in the paperSubstantial claim2 of 2 sources checked- cites Pots et al., 2016 source
The Outcomes section reports significantly greater improvement across measured outcomes, including psychological flexibility, for the web-based ACT group than for the waiting-list and expressive-writing groups. The Acceptance and commitment therapy section also reports earlier evidence for a guided ACT self-help intervention, but this paper does not show that ACT self-help books improve psychological flexibility. Page numbers are unavailable in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measured - cites Wersebe et al., 2018 source
- Findingown data
The indirect effect of perceived stress on depression through psychological flexibility represented 65.5% of the total effect.
“The indirect effect of perceived stress on depression through psychological flexibility accounted for 65.5% (0.372/0.568) of the total effect.”
Quote in the paperSubstantial claim- Rests on an assumption: The mediation analysis assumes that the observed associations are not due to unmeasured confounding and that the temporal ordering is as modeled, so that perceived stress causally affects anxiety and depression through psychological flexibility.
- Findingown data
Individuals who reported greater perceived stress also reported lower psychological flexibility.
“The results indicated that individuals who had experienced higher perceived stress reported lower levels of psychological flexibility.”
Quote in the paperSubstantial claim - Findingown data
Among people suspected of having COVID-19, 23.9% (43 of 180) had GAD-7 scores at or above the screening cut point.
“The scores of 23.9% (43/180) and 34.4% (62/180) of participants were higher than the cut points of GAD-7 and PHQ-9 respectively.”
- Also stated in: § Preliminary analyses · plain
“Of the total, 23.9% (43/180) fell at or above the cut points of GAD-7 and 34.4% (62/180) fell at or above the cut points of PHQ-9.”
Quote in the paperNot a substantial claim - Also stated in: § Preliminary analyses · plain
- Findingown data
The rates of general anxiety and depression among suspected COVID-19 patients were much higher than the normative rates of 7.8% and 13.4% reported for general residents in China.
“The positive rates of screening general anxiety and depression among suspected patients of COVID-19 were 23.9% and 34.4%, which were much higher than the normative data from general residents in China (7.8% and 13.4%) (Qi, 2014).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Qi, 2014
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Findingown data
Lower psychological flexibility was associated with more severe general anxiety.
“We also found that lower psychological flexibility was associated with higher levels of general anxiety and depression”
Quote in the paperSubstantial claim - Findingown data
The structural equation model indicated that psychological flexibility partially mediated the relationship between perceived stress and depression.
“The structural equation model confirmed that psychological flexibility partially mediated between perceived stress and general anxiety or depression.”
- Also stated in: § Mediation analyses · boosted
“The standardized structural equation model analysis confirmed the direct, indirect, and total effects of mediation.”
- Also stated in: § Discussion · plain
“The structural equation model verified that psychological flexibility was a mediator (as a partial mediator) between perceived stress and general anxiety or depression.”
Quote in the paperSubstantial claim- Rests on an assumption: The mediation analysis assumes that the observed associations are not due to unmeasured confounding and that the temporal ordering is as modeled, so that perceived stress causally affects anxiety and depression through psychological flexibility.
- Also stated in: § Mediation analyses · boosted
- Findingown data
Lower psychological flexibility was associated with more severe depression.
“We also found that lower psychological flexibility was associated with higher levels of general anxiety and depression”
Quote in the paperSubstantial claim - Findingown data
Perceived stress showed a positive association with the severity of general anxiety in the suspected COVID-19 patient sample.
“Our results suggested that perceived stress was positively and significantly associated with the severity of general anxiety and depression.”
Quote in the paperSubstantial claim - Findingown data
The structural equation model indicated that psychological flexibility partially mediated the relationship between perceived stress and general anxiety.
“The structural equation model confirmed that psychological flexibility partially mediated between perceived stress and general anxiety or depression.”
- Also stated in: § Mediation analyses · boosted
“The standardized structural equation model analysis confirmed the direct, indirect, and total effects of mediation.”
- Also stated in: § Discussion · plain
“The structural equation model verified that psychological flexibility was a mediator (as a partial mediator) between perceived stress and general anxiety or depression.”
Quote in the paperSubstantial claim- Rests on an assumption: The mediation analysis assumes that the observed associations are not due to unmeasured confounding and that the temporal ordering is as modeled, so that perceived stress causally affects anxiety and depression through psychological flexibility.
- Also stated in: § Mediation analyses · boosted
- Findingown data
In the regression model for depression, adding psychological flexibility reduced the standardized coefficient for perceived stress from 0.561 to 0.268, a 29.3% decrease.
“Taking depression as the dependent variable, when psychological flexibility was added in Model 3, age was no longer significant predictor; the influence of perceived stress on depression decreased from 0.561 to 0.268 (decreased by 29.3%)”
Quote in the paperSubstantial claim - Findingown data
Among people suspected of having COVID-19, 34.4% (62 of 180) had PHQ-9 scores at or above the screening cut point.
“The scores of 23.9% (43/180) and 34.4% (62/180) of participants were higher than the cut points of GAD-7 and PHQ-9 respectively.”
- Also stated in: § Preliminary analyses · plain
“Of the total, 23.9% (43/180) fell at or above the cut points of GAD-7 and 34.4% (62/180) fell at or above the cut points of PHQ-9.”
Quote in the paperNot a substantial claim - Also stated in: § Preliminary analyses · plain
- Findingown data
In the regression model for general anxiety, adding psychological flexibility reduced the standardized coefficient for perceived stress from 0.614 to 0.271, a 34.3% decrease.
“Taking general anxiety as the dependent variable, when psychological flexibility was added in Model 3, the influence of perceived stress on general anxiety decreased from 0.614 to 0.271 (decreased by 34.3%)”
Quote in the paperSubstantial claim - Findingown data
The indirect effect of perceived stress on general anxiety through psychological flexibility represented 66.8% of the total effect.
“The indirect effect of perceived stress on general anxiety through psychological flexibility accounted for 66.8% (0.410/0.614) of the total effect.”
Quote in the paperSubstantial claim- Rests on an assumption: The mediation analysis assumes that the observed associations are not due to unmeasured confounding and that the temporal ordering is as modeled, so that perceived stress causally affects anxiety and depression through psychological flexibility.
- Findingown data
Perceived stress showed a positive association with the severity of depression in the suspected COVID-19 patient sample.
“Our results suggested that perceived stress was positively and significantly associated with the severity of general anxiety and depression.”
Quote in the paperSubstantial claim - Findingown data
All standardized path coefficients among variables in the two mediation models were statistically significant at P<0.01.
“The standardized path coefficients among variables of the two models were all significant (P < 0.01), shown in Fig. 1 .”
Quote in the paperSubstantial claim - Interpretationown data
The study's results have limited generalizability because the sample was drawn from two hospitals in China.
“Firstly, our sample was from two hospitals in China, the generalizability of its results is limited.”
Quote in the paperNot a substantial claim - Premisecitation
Acceptance and Commitment Therapy targets psychological flexibility.
“because ACT targets psychological flexibility.”
- Also stated in: § Introduction · plain
“Acceptance and Commitment Therapy (ACT) to promote psychological flexibility for suspected patients of COVID-19 in the current pandemic (Hayes & Strosahl, 2004).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Hayes & Strosahl, 2004
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Also stated in: § Introduction · plain
- May combine two claims. 9
- Classified as probably not a substantial claim. 11
May combine two claims.
PremisecitationThe Chinese version of the PSS-14 has satisfactory content validity and reliability.
“A Chinese version of PSS-14 with satisfactory content validity and reliability (Leung, Lam, & Chan, 2010) was adopted.”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Leung, Lam, & Chan, 2010 source
The Results (Reliability analysis) report satisfactory internal consistency for the Chinese PSS-14. The Discussion and Conclusion support its construct and concurrent validity, but our copy does not establish the distinct claim of content validity; the study examined Chinese cardiac patients who smoke. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationA power calculation using G*Power determined that 107 participants were needed to achieve 95% power to detect a medium effect size (f2=0.15) in multiple linear regression with two predictors at an alpha of 0.05.
“Sample size calculations (using G*Power version 3.1 (Faul, Erdfelder, Buchner, & Lang, 2009) determined that 107 participants were needed to provide sufficient power (1-β = 0.95) to detect medium effect size (f 2 = 0.15) associations using multiple linear regression analyses with two presumed predictors (perceived stress and psychological flexibility), and an alpha level of 0.05.”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Faul, Erdfelder, Buchner, & Lang, 2009 source
May combine two claims.
Findingown dataThe regression model for general anxiety explained 59.9% of the variance, with 22.6% of that variance explained after psychological flexibility was added.
“the multiple linear regression accounted for 59.9% variance of general anxiety, a total of 22.6% of which was explained after psychological flexibility was added”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe regression model for depression explained 50.7% of the variance, with 16.0% of that variance explained after psychological flexibility was added.
“the multiple linear regression accounted for 50.7% variance of depression, a total of 16.0% of which was explained after psychological flexibility was added”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataHigher psychological flexibility acts as a protective factor that reduces the psychological impact of stress and serves as a protective mediator between perceived stress and general anxiety or depression.
“These results suggest that higher psychological flexibility plays a protective role in reducing the psychological impact of stress on individuals and it is a protective mediator between perceived stress and general anxiety or depression.”
Quote in the paperSubstantial claim- Rests on an assumption: The mediation analysis assumes that the observed associations are not due to unmeasured confounding and that the temporal ordering is as modeled, so that perceived stress causally affects anxiety and depression through psychological flexibility.
Classified as probably not a substantial claim. May combine two claims.
PremisecitationThe Chinese version of the PHQ-9 has satisfactory content validity and reliability.
“A Chinese version of PHQ-9 with satisfactory content validity and reliability (Wang et al., 2014) was adopted.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Wang et al., 2014 source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe Cronbach's alpha for the CFQ-F in this study was 0.950.
“Cronbach's alpha of AAQ-II and CFQ-F in this study was 0.930 and 0.950 respectively.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningThe psychological assessments captured only a single time point of how suspected COVID-19 patients felt during the early outbreak.
“Lastly, the psychological assessments provide a single snapshot of how suspected patients of COVID-19 were feeling during the early outbreak”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationThe Chinese version of the CFQ-F is a reliable and valid measure of cognitive fusion.
“However, CFQ-F is a reliable and valid assessment of cognitive fusion (Zhang, Ji et al., 2014).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Zhang, Ji et al., 2014 source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningAfter adding 15% for non-response, the required sample size was 126.
“The addition of 15% of non-response rate resulted in the required sample size of 126.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningThe time at which participants submitted their questionnaires could not be standardized because data were collected online during the pandemic.
“Secondly, because questionnaires could only be collected through the internet during the pandemic, the time for participants to submit questionnaires cannot be unified.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe Cronbach's alpha for the PHQ-9 in this study was 0.899.
“Cronbach's alpha in this study was 0.899.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductown dataThe two structural equation models showed good fit, with CFI=1.000 and SRMR values of 0.002 and 0.001.
“The standardized indices of two models presented good model fits: χ 2 = 0.047(P = 0.828), χ 2/df = 0.047, CFI = 1.000, SRMR = 0.002; χ 2 = 0.014(P = 0.907), χ 2/df = 0.014, CFI = 1.000, SRMR = 0.001.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe Cronbach's alpha for the AAQ-II in this study was 0.930.
“Cronbach's alpha of AAQ-II and CFQ-F in this study was 0.930 and 0.950 respectively.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe Cronbach's alpha for the GAD-7 in this study was 0.939.
“Cronbach's alpha in this study was 0.939.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe Cronbach's alpha for the Perceived Stress Scale in this study was 0.796.
“Cronbach's alpha in this study was 0.796.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningThe study collected data exclusively through self-report questionnaires.
“Thirdly, this study exclusively used self-report questionnaires for data collection.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationThe Chinese version of the AAQ-II has satisfactory content validity and reliability.
“A Chinese version of AAQ-II with satisfactory content validity and reliability (Zhang, Chung, Si, & Liu, 2014) was adopted.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Zhang, Chung, Si, & Liu, 2014 source
May combine two claims.
PremisecitationThe Chinese version of the GAD-7 has satisfactory content validity and reliability.
“A Chinese version of GAD-7 with satisfactory content validity and reliability (Tong, An, McGonigal, Park, & Zhou, 2016) was adopted.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Tong, An, McGonigal, Park, & Zhou, 2016 source
The paper relies on this without support.
It had not been reported whether perceived stress, anxiety, depression, and psychological flexibility are related in people suspected of COVID-19, nor whether psychological flexibility mediates the link between perceived stress and anxiety or depression.
“However, the relationship between perceived stress, anxiety, depression and psychological flexibility among suspected patients of COVID-19 is unreported, and whether psychological flexibility acts as a mediating variable between perceived stress and anxiety or depression has not been confirmed.”
The paper relies on this without support.
The mediation analysis assumes that the observed associations are not due to unmeasured confounding and that the temporal ordering is as modeled, so that perceived stress causally affects anxiety and depression through psychological flexibility.
“perceived stress indirectly affects anxiety and depression through psychological flexibility from regression analysis results.”
Claims other papers make about this one
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The findings support earlier research that lower psychological flexibility is linked with greater psychological distress among nursing students.
“Our findings support earlier research by indicating that lower levels of flexibility are linked with greater psychological distress among nursing students”
From Associations of psychological flexibility, mindfulness, and valued living with psychological distress among nursing students (2025) · cites this paper as [45]
The Discussion reports that lower psychological flexibility was associated with higher general anxiety and depression, supporting the claimed link with distress. However, this study examined suspected COVID-19 patients, not nursing students; it does not establish that association in the population named in the claim. (LLM, conf=0.86)
Experimental — accuracy not yet measuredLimited psychological flexibility may heighten vulnerability to emotional challenges in high-pressure academic and clinical environments.
“This suggests that limited flexibility may heighten vulnerability to emotional challenges in high-pressure academic and clinical environments.”
From Associations of psychological flexibility, mindfulness, and valued living with psychological distress among nursing students (2025) · cites this paper as [45]
The Discussion reports that lower psychological flexibility was associated with higher anxiety and depression among suspected COVID-19 patients, supporting the suggested link to emotional challenges. The paper does not study high-pressure academic or clinical environments, so that setting is an extrapolation. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Cites
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910 · see citing works
Statistical power analyses using G∗Power 3.1: tests for correlation and regression analyses
Faul, F., Erdfelder, E., Buchner, A., & Lang, A.-G. (2009) · Behavior Research Methods · doi:10.3758/brm.41.4.1149 · Cited by 37,615 · cited 1× · see citing works
“1 (Faul et al., 2009)) determined that 107 participants were needed to provide sufficient power (1-β=0.”
A Global Measure of Perceived Stress
Cohen, S., Kamarck, T., & Mermelstein, R. (1983) · Journal of Health and Social Behavior · doi:10.2307/2136404 · Cited by 32,807 · see citing works
A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765 · see citing works
A novel coronavirus from patients with pneumonia in China, 2019
Zhu, N., Zhang, D., Wang, W., Li, X., Yang, B., Song, J., Zhao, X., Huang, B., Shi, W., Lu, R., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2001017 · Cited by 28,244 · cited 1× · see citing works
“Since December 2019, a novel coronavirus initially called SARS-CoV2 and later coronavirus disease (COVID-19) by the World Health Organization, has emerged and caused respiratory illness in Wuhan, China (World Health Organization, 2020a; Zhu et al., 2020).”
A novel coronavirus outbreak of global health concern
Wang, C., Horby, P. W., Hayden, F. G., & Gao, G. F. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30185-9 · Cited by 7,700 · cited 1× · see citing works
“With such fast transmissibility and large affected scope, the COVID-19 pandemic now is a global health threat (Wang et al., 2020), and is by far the largest outbreak of atypical pneumonia since the severe acute respiratory syndrome (SARS) outbreak in 2003.”
Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., Waltz, T., & Zettle, R. D. (2011) · Behavior Therapy · doi:10.1016/j.beth.2011.03.007 · Cited by 3,950 · cited 2× · see citing works
“…have echoed in previous studies in other populations suggesting lower psychological flexibility is associated with greater depressive symptoms, more anxietyrelated symptoms, and greater overall psychological ill-health (Bond et al., 2011; Dalrymple & Herbert, 2007; Karekla & Panayiotou, 2011).”
Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed
Xiang, Y.-T., Yang, Y., Li, W., Zhang, L., Zhang, Q., Cheung, T., & Ng, C. H. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30046-8 · Cited by 3,598 · cited 2× · see citing works
“…treatment, concerns about the development of the illness, physical discomfort, loneliness from quarantine, social bias and stigma (Mental Health Center of Gansu Province, 2020; Xiang et al., 2020; Xiao, 2020), suspected patients usually suffer from tremendous perceived pressure in such epidemics.”
Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.64.6.1152 · Cited by 3,595 · see citing works
Psychological flexibility as a fundamental aspect of health
Kashdan, T. B., & Rottenberg, J. (2010) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.03.001 · Cited by 3,054 · cited 3× · see citing works
“Psychological flexibility is a fundamental aspect of psychological health (Kashdan & Rottenberg, 2010).”
InfluentialStructural equations modeling: Fit Indices, sample size, and advanced topics
Iacobucci, D. (2010) · Journal of Consumer Psychology · doi:10.1016/j.jcps.2009.09.003 · Cited by 2,263 · cited 2× · see citing works
“Four indices were employed to assess the goodness of fit of the model (Iacobucci, 2010): Chi-square statistic (χ 2 ) and its p-value>0.”
InfluentialWang, W., Bian, Q., Zhao, Y., Li, X., Wang, W., Du, J., Zhang, G., Zhou, Q., & Zhao, M. (2014) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2014.05.021 · Cited by 1,480 · cited 1× · see citing works
“A Chinese version of PHQ-9 with satisfactory content validity and reliability (Wang et al., 2014) was adopted.”
A Practical Guide to Acceptance and Commitment Therapy
(2004) · doi:10.1007/978-0-387-23369-7 · Cited by 875 · cited 2× · see citing works
“Thus, it is meaningful to explore the above problems and provide timely guidance to apply effective psychological interventions such as Acceptance and Commitment Therapy (ACT) to promote psychological flexibility for suspected patients of COVID-19 in the current pandemic (Hayes & Strosahl, 2004).”
Hayes, S. C., Villatte, M., Levin, M., & Hildebrandt, M. (2011) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-032210-104449 · Cited by 800 · see citing works
Klein, E. M., Brähler, E., Dreier, M., Reinecke, L., Müller, K. W., Schmutzer, G., Wölfling, K., & Beutel, M. E. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0875-9 · Cited by 716 · cited 1× · see citing works
“As we know, people who sustained lasting perceived stress are also more vulnerable to psychological problems such as anxiety and depression (Daudelin-Peltier, Forget, Blais, Deschenes, & Fiset, 2017; Hill, Hellemans, Verma, Gorzalka, & Weinberg, 2012; Klein et al., 2016).”
Xiao, C. (2020) · Psychiatry Investigation · doi:10.30773/pi.2020.0047 · Cited by 699 · cited 1× · see citing works
“…treatment, concerns about the development of the illness, physical discomfort, loneliness from quarantine, social bias and stigma (Mental Health Center of Gansu Province, 2020; Xiang et al., 2020; Xiao, 2020), suspected patients usually suffer from tremendous perceived pressure in such epidemics.”
Leung, D. Y., Lam, T.-H., & Chan, S. S. (2010) · BMC Public Health · doi:10.1186/1471-2458-10-513 · Cited by 562 · cited 1× · see citing works
“A Chinese version of PSS-14 with satisfactory content validity and reliability (Leung et al., 2010) was adopted.”
China coronavirus: WHO declares international emergency as death toll exceeds 200
Mahase, E. (2020) · British medical journal · doi:10.1136/bmj.m408 · Cited by 539 · cited 1× · see citing works
“On 30 January 2020, the World Health Organization declared the outbreak a public health emergency of international concern (Mahase, 2020).”
Validation of the Generalized Anxiety Disorder-7 (GAD-7) among Chinese people with epilepsy
Tong, X., An, D., McGonigal, A., Park, S.-P., & Zhou, D. (2016) · Epilepsy Research · doi:10.1016/j.eplepsyres.2015.11.019 · Cited by 525 · cited 1× · see citing works
“A Chinese version of GAD-7 with satisfactory content validity and reliability (Tong et al., 2016) was adopted.”
Neurobiology of chronic mild stress: parallels to major depression
Hill, M. N., Hellemans, K. G. C., Verma, P., Gorzalka, B. B., & Weinberg, J. (2012) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2012.07.001 · Cited by 420 · see citing works
Annual Review of Clinical Psychology
(2017) · Annual Review of Clinical Psychology · doi:10.1146/clinpsy.724 · Cited by 317 · see citing works
Acceptance and Commitment Therapy for Generalized Social Anxiety Disorder: A Pilot Study
Dalrymple, K. L., & Herbert, J. D. (2007) · Behavior Modification · doi:10.1177/0145445507302037 · Cited by 312 · see citing works
RUSLI, B. N., Abdin, E., & Naing, L. (2008) · BMC Public Health · doi:10.1186/1471-2458-8-48 · Cited by 270 · see citing works
Bergdahl, J., & Bergdahl, M. (2002) · Stress and Health · doi:10.1002/smi.946 · Cited by 258 · cited 1× · see citing works
“This is consistent with an abundance of prior research that linked perceived stress with anxiety and depression (Bergdahl & Bergdahl, 2002; de Rooij, Schene, Phillips, & Roseboom, 2010; Rusli, Edimansyah, & Naing, 2008).”
Wersebe, H., Lieb, R., Meyer, A. H., Hofer, P., & Gloster, A. T. (2018) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2017.09.002 · Cited by 250 · cited 3× · see citing works
“of COVID-19, which were proven to improve psychological flexibility in other populations (Pots et al., 2016; Wersebe et al., 2018).”
Assessing Psychological Flexibility: What Does It Add Above and Beyond Existing Constructs?
Gloster, A. T., Klotsche, J., Chaker, S., Hummel, K. V., & Hoyer, J. (2011) · Psychological Assessment · doi:10.1037/a0024135 · Cited by 206 · see citing works
Coping and experiential avoidance: Unique or overlapping constructs?
Karekla, M., & Panayiotou, G. (2011) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2010.10.002 · Cited by 196 · cited 1× · see citing works
“…have echoed in previous studies in other populations suggesting lower psychological flexibility is associated with greater depressive symptoms, more anxietyrelated symptoms, and greater overall psychological ill-health (Bond et al., 2011; Dalrymple & Herbert, 2007; Karekla & Panayiotou, 2011).”
Further evaluation of the psychometric properties of the acceptance and action questionnaire-II
Fledderus, M., Oude Voshaar, M. A. H., ten Klooster, P. M., & Bohlmeijer, E. T. (2012) · Psychological Assessment · doi:10.1037/a0028200 · Cited by 195 · see citing works
de Rooij, S. R., Schene, A. H., Phillips, D. I., & Roseboom, T. J. (2010) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2009.11.011 · Cited by 164 · see citing works
Psychological Flexibility as a Resilience Factor in Individuals with Chronic Pain
Gentili, C., Rickardsson, J., Zetterqvist, V., Simons, L. E., Lekander, M., & Wicksell, R. K. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.02016 · Cited by 148 · cited 4× · see citing works
“Although other studies have reported a significant mediation of psychological flexibility on anxiety or depression among chronic-pain individuals, trauma-exposed individuals and individuals with workplace-related stress (Gentili et al., 2019; Kurz et al., 2014; Richardson & Jost, 2019).”
InfluentialPots, W. T. M., Fledderus, M., Meulenbeek, P. A. M., ten Klooster, P. M., Schreurs, K. M. G., & Bohlmeijer, E. T. (2016) · British Journal of Psychiatry · doi:10.1192/bjp.bp.114.146068 · Cited by 133 · cited 2× · see citing works
“of COVID-19, which were proven to improve psychological flexibility in other populations (Pots et al., 2016; Wersebe et al., 2018).”
Zhang, C.-Q., Chung, P.-K., Si, G., & Liu, J. D. (2014) · Measurement and Evaluation in Counseling and Development · doi:10.1177/0748175614538064 · Cited by 96 · see citing works
Hussey, I., & Barnes‐Holmes, Y. (2012) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2012.03.002 · Cited by 72 · cited 1× · see citing works
“Furthermore, Hussey and Barnes-Holmes (2012) have indicated the mediating role of psychological flexibility of anxiety and depression, which assessed on the Implicit Relational Assessment Procedure (IRAP) at baseline and again after an experimentally induced sad mood state.”
Estimating uncertainty in respondent-driven sampling using a tree bootstrap method
Baraff, A. J., McCormick, T. H., & Raftery, A. E. (2016) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1617258113 · Cited by 58 · cited 1× · see citing works
“Corporation, Armonk, NY, USA)) with 5,000 bootstrap samples for further mediation effect confirmation and path coefficient estimation (Baraff et al., 2016).”
Richardson, C. M. E., & Jost, S. A. (2018) · Personality and Individual Differences · doi:10.1016/j.paid.2018.12.029 · Cited by 57 · cited 2× · see citing works
“Although other studies have reported a significant mediation of psychological flexibility on anxiety or depression among chronic-pain individuals, trauma-exposed individuals and individuals with workplace-related stress (Gentili et al., 2019; Kurz et al., 2014; Richardson & Jost, 2019).”
The effect of acute social stress on the recognition of facial expression of emotions
Daudelin-Peltier, C., Forget, H., Blais, C., Deschênes, A., & Fiset, D. (2017) · Scientific Reports · doi:10.1038/s41598-017-01053-3 · Cited by 55 · cited 1× · see citing works
“more vulnerable to psychological problems such as anxiety and depression (Daudelin-Peltier et al., 2017; Hill et al., 2012; Klein et al., 2016).”
Reliability and validity of the Chinese version of the Cognitive Fusion Questionnaire
Zhang, W. (2014) · Zhongguo xinli weisheng zazhi · Cited by 31 · see citing works
Kurz, A. S., Bethay, J. S., & Ladner-Graham, J. M. (2014) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2014.06.003 · Cited by 21 · cited 1× · see citing works
“Although other studies have reported a significant mediation of psychological flexibility on anxiety or depression among chronic-pain individuals, trauma-exposed individuals and individuals with workplace-related stress (Gentili et al., 2019; Kurz et al., 2014; Richardson & Jost, 2019).”
Reliability and validity of the Chinese version of the Cognitive Fusion Questionnaire
Wei-Chen, Z., Yang, J. W., Li, X., Hui-Na, G., & Zhu, Z. (2014) · Zhongguo xinli weisheng zazhi · Cited by 10 · see citing works
Zhao, Y., Jin, M., Cao, J.-Y., Bai, X.-Y., Wang, F.-F., Long, H., & Zhu, Z.-H. (2018) · doi:10.3760/cma.j.issn.1674-6554.2018.02.003 · Cited by 6
Flagged first, then by citations
5 of the 45 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
- Mental Health Center of Gansu Province. (2020). Guidance manual on psychological protection against new coronavirus infections. Chen X.(Ed.) (pp. 164).
- Zhao, 2003, Psychological characteristics and psychological care of SARS and suspected SARS patients, Journal of General Hospital of Air Force, pla, 03, 48
Cited by
Sorted by citations
Landi, G., Pakenham, K. I., Crocetti, E., Tossani, E., & Grandi, S. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.03.067 · Cited by 74 · see citing works
Tracking perceived stress, anxiety, and depression in daily life: a double-downward spiral process
Feng, G. Y., Xu, X., & Lei, J. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1114332 · Cited by 68 · see citing works
“In the process of coping with stressful events, individuals are prone to produce a series of negative emotions such as anxiety, depression, anger, and pain (PereiraMorales et al., 2019; Huang et al., 2021; Clayborne et al., 2022).”
Chong, Y. Y., Frey, E., Chien, W. T., Cheng, H. Y., & Gloster, A. T. (2023) · Journal of Nursing Scholarship · doi:10.1111/jnu.12874 · Cited by 42 · see citing works
Yao, X., Xu, X., Chan, K. L., Chen, S., Assink, M., & Gao, S. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.09.116 · Cited by 43 · see citing works
Jo, D., Pyo, S., Hwang, Y., Seung, Y., & Yang, E. (2024) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2024.100798 · Cited by 34 · see citing works
Browne, A., Stafford, O., Berry, A., Murphy, E., Taylor, L. K., Shevlin, M., McHugh, L., Carr, A., & Burke, T. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11020377 · Cited by 26 · see citing works
Bruno, F., Vozzo, F., Arcuri, D., Maressa, R., La Cava, E., Malvaso, A., Lau, C., & Chiesi, F. (2024) · Current Psychology · doi:10.1007/s12144-022-03502-3 · Cited by 28 · see citing works
“…the relationship between different constructs such as COVID-19 stress and psychological distress (i.e., depression, anxiety, and somatization) (Arslan et al., 2021), perceived stress, anxiety, and depression (Huang et al., 2021), intolerance of uncertainty, and PTSD symptoms (Kennedy et al., 2021).”
Zhang, J., & Wang, E. (2022) · Behavioral Sciences · doi:10.3390/bs12120485 · Cited by 25 · see citing works
“This finding accords with previous studies [44,81].”
Бондарчук, О. І., Balakhtar, V., Pinchuk, N. I., Пустовалов, І. В., & Pavlenok, K. S. (2023) · Journal of Law and Sustainable Development · doi:10.55908/sdgs.v11i10.1852 · Cited by 24 · see citing works
“In the process of coping with stressful events, people are prone to several negative emotions, such as anxiety, depression, anger, and pain (Huang et al., 2021).”
Bırni, G., Erus, S. M., Satıcı, S. A., & Deniz, M. E. (2024) · Personality and Individual Differences · doi:10.1016/j.paid.2024.112861 · Cited by 20 · see citing works
Behavioral Patterns of Depression Patients and Control Population
Carreira-Míguez, M., Navarro-Jiménez, E., & Clemente‐Suárez, V. J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19159506 · Cited by 15 · see citing works
Chen, X., Yang, Q., Yıldırım, M., Ye, B., & Wang, R. (2023) · Journal of Health Psychology · doi:10.1177/13591053231189419 · Cited by 15 · see citing works
“…role of psychological inflexibility between stress (a trigger for burn-out) and emotional symptoms (depression and anxiety; Arslan et al., 2020; Huang et al., 2021), no study, to our knowledge, has explored the mediating mechanisms between prevention burnout, psychological inflexibility, and…”
Davoudi, M., Lundgren, T., Jansson-Fröjmark, M., Saeedipour, Z., & Badinlou, F. (2022) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2022.108672 · Cited by 12 · see citing works
Yao, Y.-J., Yan, Z., Xu, D., & Xuan, Y. (2024) · Current Psychology · doi:10.1007/s12144-024-06818-4 · Cited by 11 · see citing works
“As a protective function, emotion regulation flexibility can encourage individuals to choose more active and adaptive emotion regulation strategies, thus reducing their anxiety level (Huang et al., 2021; Yan et al., 2022).”
From Anxiety to Hardiness: The Role of Self-Efficacy in Spanish CCU Nurses in the COVID-19 Pandemic
Gil‐Almagro, F., García-Hedrera, F. J., Monge, F. J. C., & Peñacoba, C. (2024) · Medicina · doi:10.3390/medicina60020215 · Cited by 13 · see citing works
“…the percentage of variance is significant, it would be of interest to include other variables such as social support, self-esteem, cognitive fusion, emotional regulation and gratitude, which have also been found to be relevant variables in adaptive coping during the COVID-19 pandemic [60–63].”
Emotions, coping and psychological flexibility in earthquake survivors: a cross-sectional study
Turan, N., Hülya, K. E., & Acar Gül, G. B. (2025) · Psychology, Health & Medicine · doi:10.1080/13548506.2024.2433540 · Cited by 9 · see citing works
“In other words, individuals with higher PF may experience less depression, anxiety, insomnia, and perceived stress during stressful life events (Huang et al., 2021; McCracken et al., 2021).”
Niazi, A., Alekozay, M., & Najm, A. F. (2022) · Global Health Journal · doi:10.1016/j.glohj.2022.02.001 · Cited by 9 · see citing works
Li, X., Peng, H., Hu, S., Xie, J., & Qin, C. (2022) · Journal of Clinical Nursing · doi:10.1111/jocn.16372 · Cited by 9 · see citing works
Self-citationThe relationship between test anxiety, rumination, and psychological flexibility
Doğan, U. (2023) · Current Psychology · doi:10.1007/s12144-023-04411-9 · Cited by 12 · see citing works
“…that psychological inflex - ibility and anxiety have a favorable relationship (Berryhill et al., 2018 ; Davis et al., 2020; Gallego et al., 2020; Huang et al., 2021; Landi et al., 2020; Masuda et al., 2014; Masuda & Tully, 2012 ; Simon & Verboon, 2016; Tavakoli et al., 2019; Tirch et al., 2012…”
Liu, C., Chen, H., Xu, W., Dai, S., & Lin, S. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1422845 · Cited by 8 · see citing works
Shi, C., Chen, W., Huang, J., & Ren, Z. (2023) · The Journal of Early Adolescence · doi:10.1177/02724316231186111 · Cited by 8 · see citing works
“…fusion mediated the association of cyber vic-timization with depression accords with previous research that has revealed the mediating role of cognitive fusion in the relation between negative experience and depressive symptoms (Carvalho et al., 2019; Huang et al., 2021; Trindade et al., 2018).”
Sebastião, R., & Neto, D. D. (2024) · Applied Psychology Health and Well-Being · doi:10.1111/aphw.12614 · Cited by 8 · see citing works
Deng, Y., Huang, P., Yang, Q., & Ye, B. (2023) · Psychology Research and Behavior Management · doi:10.2147/prbm.s409395 · Cited by 7 · see citing works
Yao, X., Chan, K. L., Chen, S., & Gao, S. (2024) · Current Psychology · doi:10.1007/s12144-024-05628-y · Cited by 7 · see citing works
“…the specific context of the COVID-19 pandemic, evidence-based interventions using (online) ACT or ACT self-help books to foster PF could be used to alleviate psychological distress and improve resilience against prolonged stressors (Huang et al., 2021; Levin et al., 2020; Probst et al., 2019).”
la Puente, G. D., da Silva, A. R. F., & Felix, R. (2024) · IEEE International Conference on Electronics, Electrical Engineering and Computing (INTERCON) · doi:10.1109/intercon63140.2024.10833503 · Cited by 7 · see citing works
Shao, S., Zhang, Y., Yang, M., Li, C., Zhao, R., Liu, Z., Wu, M., Liu, Y., Zhu, Z., & Cui, L. (2024) · Journal of School Psychology · doi:10.1016/j.jsp.2024.101357 · Cited by 5 · see citing works
Machulska, A., & Klucken, T. (2025) · Scientific Reports · doi:10.1038/s41598-025-26492-1 · Cited by 7 · see citing works
A cross-sectional network analysis of successful aging in a resilience-based framework
Brinkhof, L. P., Ridderinkhof, K. R., de Wit, S., Krugers, H. J., & Murre, J. M. J. (2025) · PLoS ONE · doi:10.1371/journal.pone.0315445 · Cited by 7 · see citing works
Adeleke, O. T., Olatubi, I. V., Ademuyiwa, G. O., Samson, T. K., Awotunde, T. A., Adeleke, O. V., Awolola, A., & Olatubi, M. I. (2025) · PLOS mental health. · doi:10.1371/journal.pmen.0000235 · Cited by 4 · see citing works
Giani, L., Amico, C., Crepaldi, C., Caputi, M., Scaini, S., Michelini, G., & Forresi, B. (2025) · Pediatric Reports · doi:10.3390/pediatric17020033 · Cited by 6 · see citing works
Ardi, Z., Putra, A. H., Murni, A. W., Eseadi, C., Otu, M. S., Yetiş, H., & Barabanova, E. (2024) · Islamic Guidance and Counseling Journal · doi:10.25217/0020247431600 · Cited by 3 · see citing works
Özden, E., & Ermiş, E. N. (2024) · Pamukkale University Journal of Social Sciences Institute · doi:10.30794/pausbed.1476833 · Cited by 2 · see citing works
Saar‐Ashkenazy, R. (2025) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70158 · Cited by 2 · see citing works
Zhang, Q., Qin, C., Xie, J., Li, X., Zeng, L., Wang, Y., Wang, Y., & Peng, H. (2023) · PubMed Central · doi:10.11817/j.issn.1672-7347.2023.220327 · Cited by 2 · see citing works
Self-citationChen, X., Hou, X., Chen, C., Wang, D., Zhai, L., & Wang, J. (2022) · Research Square · doi:10.21203/rs.3.rs-1466973/v1 · Cited by 2 · see citing works
Self-citationŞık, T., Günüşen, N., & Serçe Yüksel, Ö. (2025) · BMC Psychology · doi:10.1186/s40359-025-03455-9 · Cited by 1 · see citing works
Die Validierung der deutschsprachigen Version des CompACT-8 zur Messung psychischer Flexibilität
Unruh, I., Moghaddam, N. G., Dawson, D. L., Hargarter, L., & Euteneuer, F. (2023) · Verhaltenstherapie · doi:10.1159/000533533 · Cited by 1 · see citing works
“Außerdem steht sie im Zusammenhang mit einer Symptomverbesserung z.B. bei Depressi-onen und chronischen Schmerzen [Goldbart et al., 2021; Huang et al., 2021 Zusammengefasst ist der CompACT-8 ein robustes, reliables und valides Messinstrument, welches zudem aufgrund des geringen Zeitaufwandes…”
Indhumathi, Thirumoorthi, & Bhuvaneswari (2025) · Multidisciplinary Science Journal · doi:10.31893/multiscience.2025570 · Cited by 1 · see citing works
Baquero-Sierra, A., Torres-Cuellar, L., Salamanca, S. L. C., Grau-Gonzalez, I. A., & Ortega, L. A. (2026) · Journal of Behavioral and Cognitive Therapy · doi:10.1016/j.jbct.2026.100608 · Cited by 1 · see citing works
Gil‐Almagro, F., Monge, F. J. C., García-Hedrera, F. J., & Peñacoba, C. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13133767 · Cited by 1 · see citing works
“Furthermore, there is evidence that it also plays a mediating role between work-related stressors and mental health problems [52].”
Lee, J., & Hong, M.-H. (2023) · Asia-pacific Journal of Convergent Research Interchange · doi:10.47116/apjcri.2023.08.19
(2023) · AD ALTA Journal of Interdisciplinary Research · doi:10.33543/130236
Flexibilidad psicológica y afrontamiento al estrés en estudiantes universitarios
Amaya, M. F. G., & Ramos, D. C. G. (2024) · Revista Científica Arbitrada Multidisciplinaria PENTACIENCIAS · doi:10.59169/pentaciencias.v6i4.1161
Raio, C. M., Szuhany, K. L., Secmen, A., Mellis, A. M., Chen, A., Adhikari, S., Malgaroli, M., Miron, C. D., Jennings, E. L. M., Simon, N. M., et al. (2024) · Stress and Health · doi:10.1002/smi.3473 · Cited by 2 · see citing works
Polat, E., Çiriş, Ş., Çelikbaş, Z., & Chaudhry, A. (2025) · Medicina · doi:10.3390/medicina61071139
“Psychological flexibility describes the ability to navigate through challenges and is theorized to be the mediator between perceived stress and depression or anxiety [24].”
Turan, N., & Gül, G. B. A. (2025) · Journal of Health Psychology · doi:10.1177/13591053251347146
“Thus, individuals with greater PF may experience fewer psychological symptoms (e.g. depression, anxiety, insomnia, and perceived stress; Huang et al., 2021; McCracken et al., 2021) and be more adaptable, allowing them to cope with adversity more effectively.”
Addai, P., Asiedu, E., Obuobisa‐Darko, T., & Okyere, I. (2025) · SN Business & Economics · doi:10.1007/s43546-025-00965-x
“According to Huang et al. ( 2021 ), individuals with higher psychological flexibil - ity demonstrate greater resilience, a willingness to embrace change, and an ability to stay focused on their values and goals even in uncertain situations.”
The role of psychological inflexibility on post-traumatic stress symptoms among COVID-19 survivorsPreprint
KARAKUŞ, K., Kuru, T., Kömürcü, S., et al. (2026) · Research Square · doi:10.21203/rs.3.rs-8969637/v1
Turan, M. E., & Cengiz, S. (2026) · Journal of Health Psychology · doi:10.1177/13591053261423641
Kim, N. (2026) · Child Indicators Research · doi:10.1007/s12187-026-10355-w
“However, some research (e.g., Farrell & Vaillancourt, 2021; Huang et al., 2021 ) has also reported asymmetric competency patterns, such as groups with relatively high emotional empathy or social awareness but low self-regulation, or vice versa.”
Zhang, X., Tang, W., Yu, W., et al. (2026) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.70123
Huynh, T. (2026) · Journal of American College Health · doi:10.1080/07448481.2026.2668612
“Given psychological inflex-ibility’s close association with depression and anxiety, 29–32 psychological inflexibility may be understood as a distress-related regulatory process, with its role potentially varying across contexts as either a regulatory mechanism or an indicator of general…”
Zhou, J., Cao, Y.-H., Deng, X., & Luo, P.-C. (2026) · Journal des adolescens · doi:10.1002/jad.70180
Huang, Z., Diao, P., Tian, T., Yang, L., & Li, X. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1581857
Yue, H., Bai, Y., Gao, S., Bao, H., Liu, M., & Huang, Y. (2026) · Current Psychology · doi:10.1007/s12144-026-09583-8
“Besides, some scholars found that PF can relieve mental distress such as depression and anxiety and decrease negative beliefs concerning oneself and the world (Huang et al., 2021).”
Qi, H., Shi, H., Li, J., Li, M., Chen, X., & Luo, Y. (2026) · Stress and Health · doi:10.1002/smi.70189
Akbulut, Ö. F., Pamuk, K., & Yavuz, B. (2026) · International Journal of Applied Positive Psychology · doi:10.1007/s41042-026-00306-9
“Psychological flexibility is regarded as an essential component of well-being (Huang et al., 2021 ).”
Sauer, C., Sajjad, T., Zinndorf, L., & Weißflog, G. (2026) · Scientific Reports · doi:10.21203/rs.3.rs-9994953/v1
Eweida, R. S. (2026) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2026.152203
Zhang, Y., Yan, Y., Yang, S., Wang, C., & Ma, Y. (2026) · Journal of Nephrology · doi:10.1093/joneph/aajag123
Bachir, M., Ayoub, M., van Hout, H. V., Agopian, V., & Bosqui, T. J. (2026) · Current Psychology · doi:10.1007/s12144-026-09995-6
“Similarly, Huang et al. (2021) found a negative relation between psychological flexibility and anxiety among suspected COVID-19 patients in China.”
ÇAKIR, G. (2026) · Behavioral Sciences · doi:10.3390/bs16091703
“Earlier findings are consistent with this, linking cognitive flexibility to educational attitudes (de-la-Peña et al., 2021), to mental health more broadly (Huang et al., 2021), and to meaning and resilience (Malo et al., 2024; Modzelewska, 2025).”
- Authors
- Huang, C., Xie, J., Owusua, T., Chen, Z., Wang, J., Qin, C., & He, Q.
- Affiliations
- Central South University (CN)
- Corresponding author
- Qin, Chunxiang
- He, Qingnan
- Venue
- Personality and Individual Differences
- Publisher
- Elsevier BV
- Published
- 2021-12
- Volume
- 183
- Pages
- 111132
- ISSN
- 0191-8869 (ISSN-L)
- PMC
- PMC8279940
- OpenAlex
- W3178918041
- Cited by
- 64
- References
- 45
- Citations by year
- 2026: 17 · 2025: 10 · 2024: 16 · 2023: 11 · 2022: 10
- FWCI
- 6.31
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Personality and Individual Differences (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- psychological flexibility, perceived stress, general anxiety, depression, mediating effect, acceptance and commitment therapy, cognitive fusion, psychological support
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