Examining the Associations between Psychological Flexibility, Mindfulness, Psychosomatic Functioning, and Anxiety during the COVID-19 Pandemic: A Path Analysis

The Effect of Psychological Flexibility on Well-Being during the COVID-19 Pandemic: The Multiple Mediation Role of Mindfulness and Coping

The COVID-19 pandemic involved a complex set of stressors affecting the health and well-being of the population. The understanding of the psychological processes that influence well-being in response to the pandemic and their interrelation is vital. A promising process in understanding the emotional impacts of these stressors is psychological flexibility. This study investigated the effect of psychological flexibility on well-being, both directly and indirectly, via mindfulness and coping strategies. A total of 334 Portuguese adults participated in this cross-sectional study. Participants were asked to complete an online questionnaire, including measures of psychological flexibility, well-being, mindfulness, and coping strategies. A multiple mediation model studied whether there are conditional indirect effects of mindfulness and coping strategies on well-being. The results showed statistically significant correlations between psychological flexibility, well-being, mindfulness, and coping strategies. Furthermore, we found that mindfulness and coping strategies partly mediate the relationship between psychological flexibility and well-being. Understanding the processes through which psychological flexibility influences well-being in a stressful context is important in comprehending the processes involved in an emotional reaction to a pandemic-like societal event. Mindfulness and coping are shown to be important processes to consider in understanding this phenomenon and designing future responses.

Reducing the stress of mothers in the postpartum period: psychological inflexibility or mother-infant bonding

BACKGROUND

Parental stress is a critical problem because it affects both the mental health of the mother and children's development. In addition to many factors related to birth and marriage, mother - infant bonding and psychological inflexibility are essential factors that can affect stress. In this study, we examined the effects of the psychological processes of mothers and factors related to pregnancy, mother, environment on parental stress, and their relationships.

METHODS

A sociodemographic variables scale, Acceptance and Action Questionnaire-II, Postpartum Bonding Questionnaire, and Parental Stress Scale were completed by 115 mothers in their first postpartum year. The model created with the correlation and regression results was subjected to path analysis.

RESULTS

Breastfeeding, psychological inflexibility, and mother - infant bonding are related to parental stress. The bonding problem is the mediator of the relationship between psychological inflexibility and parental stress. The entire effect of sleep quality on parental stress occurred through psychological inflexibility.

CONCLUSION

Efforts should be directed towards improving the bond between the mother and infant and enhancing the mother's psychological flexibility to lessen the negative impacts of stress. Breastfeeding should not be treated categorically, and its potential adverse effects should not be ignored.

Dysfunctional parenting and emotional problems and substance misuse: Enhancing psychological flexibility in college students

This cross-sectional study aimed to investigate the mediating role of psychological flexibility in the relationship between dysfunctional parenting (i.e., dysfunctional parent modes) and emotional problems and substance misuse among Turkish college students. Participants were 466 undergraduate students (69% female) aged between 18 and 45 years (M = 21.46, SD = 3.31) from a public university in Turkey. The majority of participants in the study reported never or infrequent use of tobacco, alcohol, and prescription drugs, with daily or almost daily use reported by less than a quarter of the sample for each substance. Results showed that higher levels of dysfunctional parent modes were associated with increased emotional problems and substance misuse. Moreover, psychological flexibility mediated the relationship between dysfunctional parent modes and emotional problems, as well as both mediated and moderated the relationship between dysfunctional parent modes and substance misuse. Results from the study also showed that people in the at-risk group for substance misuse reported higher levels of dysfunctional parent modes and emotional problems, as well as lower levels of psychological flexibility than the typical group. These results suggest that psychological flexibility may play a significant role in the link between dysfunctional parent modes and emotional problems and substance misuse among Turkish college students. Future research should investigate whether interventions targeting psychological flexibility could be effective in reducing emotional problems and substance misuse among students with dysfunctional parent modes.

Effectiveness of Daily Mindfulness Meditation App Usage to Reduce Anxiety and Improve Well-Being During the COVID-19 Pandemic: A Randomized Controlled Trial

Introduction This study examined the effect of 10-minute daily meditation app usage for 30 days on adult anxiety and mental well-being during the first year of the COVID-19 pandemic. Methods Participants were randomized into intervention (10 minutes of daily usage of the Insight Timer app) or control groups. Participants completed surveys to assess anxiety and well-being pre- and post-study. Data were analyzed using t-tests, analysis of variance (ANOVA), or nonparametric equivalents. Results Pre-study results were comparable between groups. The pre- vs. post-study General Anxiety Disorder-7 (GAD-7) scores for anxiety decreased in the intervention group (n=18, median 5.5 vs. 3.0 (pre vs. post), p=0.0233, d=0.50), but not in the control group (n=28). The intervention group had a lower median GAD-7 score than the control group post-study (3.0 vs. 8.0, p=0.0223, d=0.35). Pre- vs. post-study mean 5-item World Health Organization Well-Being Index (WHO-5) scores were improved in both the control (11.6 vs. 12.9 (pre vs. post), p=0.0408, d=0.36) and intervention groups (12.0 vs. 16.3 (pre vs. post), p=0.0001, d=0.77), although it was higher in the intervention group (16.3 vs. 12.9, p=0.0056, d=0.88). Conclusion Ten minutes of daily meditation app usage for 30 days may reduce anxiety and improve well-being in adults during the COVID-19 pandemic.

Beyond illness perception: the effects of psychological flexibility when coping with a chronic medical condition

Several factors have been suggested to affect well-being among patients with a Chronic Medical Condition (CMC). Using self-report questionnaires, the effects of Illness Cognitions (IC) and Psychological Flexibility (PF) on well-being (Subjective Happiness) was explored in two groups of patients at a large medical center in Tel Aviv, Israel. This included 79 patients with psoriasis and 71 patients with End-Stage Renal Disease (ESRD), the former representing moderate, and the latter severe, chronic medical conditions. Significant correlations between IC and PF, and well-being, were observed. In regression analyses, helplessness (an IC factor) and perceiving oneself as flexible (a PF factor) significantly contributed to well-being. Perceiving oneself as open and innovative (another PF factor) was associated with higher levels of well-being only among those with ESRD. This suggests that well-being is associated with both a specific cognitive inference regarding one's medical condition (IC) and a general attitude about change (PF). Additionally, it appears that the association between PF and well-being changes across different CMCs, possibly depending on the CMC severity. Theoretical and clinical implications are discussed.

Mindfulness and COVID-19-Related Stress: Staying Present During Uncertain Times

Objectives

The SARS-CoV-2 (COVID-19) pandemic is recognized as a mass traumatic event in which COVID-19-related stress (CS) can indicate other trauma- and/or stressor-related disorder. The facets of mindfulness (observing, describing, acting with awareness, nonjudging, and nonreacting) have been linked to reductions in stress-related symptoms and thus may protect against CS. We extended previous research by evaluating mindfulness facets as resilience skills negatively related to CS.

Method

Undergraduate students (n = 495) completed an online battery of questionnaires. A subsample of students endorsing clinically elevated CS (n = 165) was also evaluated. We utilized hierarchical regression to account statistically for the mindfulness facets in addition to indicators of psychological distress (e.g., negative affect, neuroticism, dissociation) and social desirability. We performed analyses twice, once in the overall sample, and once in the high CS subsample.

Results

Less observing and greater nonjudging related to reduced CS while other study variables were controlled for in the overall sample. In contrast, acting with awareness and nonjudging negatively related to CS in the subsample, but were not related to CS when we accounted for psychological-distress variables that positively related to CS in the analysis.

Conclusions

Although variables indicative of psychological distress robustly contribute to CS, observing, acting with awareness, and nonjudging may be mindfulness skills that can be targeted to buffer clinically significant CS.

Preregistration

This study was not pre-registered.

The Utility of Meditation and Mindfulness-Based Interventions in the Time of COVID-19: A Theoretical Proposition and Systematic Review of the Relevant Prison, Quarantine and Lockdown Literature

As of July 20, 2021, Covid-19 has killed 4,086,000 people, infected at least 190,169,833 others, and devastated the world's economy. To slow the spread of the virus, numerous governments instituted "lockdown" policies and quarantines, limiting social interactions to the immediate household. The experience of isolation and uncertainty have contributed to increased fear, anxiety, and loneliness; with limited options of research-supported interventions. Although different in nature, the experiences of quarantine and lockdown have been likened to incarceration. Past research has found meditation and mindfulness-based interventions (MBIs) to be effective psychological treatments for prisoners and may therefore translate well into effective methods for the maintenance of psychological well-being for individuals quarantined during the pandemic. More recently, research investigating the effects of meditation and MBIs during the pandemic have demonstrated preliminary evidence for beneficial psychological improvements. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), the current narrative review paper: 1) examines the parallels and differences between the experience of quarantine and imprisonment, 2) investigates the mechanisms through which meditation and mindfulness enact their effects, and 3) systematically reviews literature on the benefits of various types of meditation and MBIs for inmates and individuals in lockdown or quarantine. With this knowledge, the public can garner applicable insight into the potential use of meditation and MBIs for individuals forced to cope with pandemic lockdowns and quarantines. Two hundred and twenty one (221) articles were identified through Pubmed and Google Scholar, and 24 articles were ultimately included in the manuscript.

Somatic symptoms associated with mental distress during the COVID-19 pandemic: a systematic review

OBJECTIVE

The primary objective of this article was to systematically review the prevalence of somatic symptoms in patients, healthcare workers and general population during the COVID-19 pandemic. The secondary objectives were to record the association between somatic symptoms and indices of mental distress and to record the qualitative characteristics of such somatic complaints.

METHODS

Following the PRISMA methodology we systematically searched PubMed, Scopus and Google Scholar for primary research reporting on somatic symptoms in association with mental distress. We specifically sought papers reporting on bodily distress disorder, somatic symptoms disorder or medically unexplained symptoms.

RESULTS

1569 papers were retrieved, which yielded 36 relevant studies after screening. 15 studies referred to healthcare workers, 13 to general population, 5 to COVID-19 patients, 2 compared medical with non-medical professionals and 1 was studying COVID-19 patients some of which were also healthcare workers. The reported prevalence of somatic symptoms ranged from 7.4% to 67.8%. Commonly seen symptoms were shortness of breath, dyspnea, palpitations and pain in arms, legs and joints.

CONCLUSIONS

Our systematic review suggests that somatic symptoms are very frequent during the pandemic and are often linked to mental distress. All three population groups are affected.

The relationship between mindfulness, anxiety and depression during the COVID-19 pandemic: A meta-analysis of correlational studies

Background

The emergence of the COVID-19 pandemic has created an environment in which numerous determinants of poor mental health are intensified. Lockdown, re-lockdown, and media coverage of the spread of the virus, have the potential to contribute to increased levels of anxiety and depression. Mindfulness may act as a buffer against COVID-19-related depressive and anxiety disorders.

Methods

We conducted a systematic review and meta-analysis by searching PubMed, PsycINFO, Web of Science, and Google Scholar for any study published between January 2020 and March 2022. In this study, Comprehensive Meta-Analysis Version 3.3 software was applied to evaluate the effect size by random effect model. In addition, the heterogeneity analysis was evaluated using indicators Q and I² indicators. Three methods were used to test for publication bias: funnel plot, Classic Fail-safe N, and Egger's linear regression. According to the features of the included articles, subgroup analysis was utilized for the moderator analysis of this study.

Results

The analysis finally included 12 articles (16 samples, N = 10,940) and obtained 26 independent effect sizes. In accordance with the meta-analysis, in the random effect model, the correlation between mindfulness and anxiety was -0.330 (p < 0.001), and the correlation between mindfulness and depression was -0.353 (p < 0.001), which supported the effect of mindfulness on anxiety and depression. In the meta-analysis of the correlation between mindfulness and anxiety, study region had an essential moderating effect (p < 0.001). The Sample type did not produce a significant moderating effect (p = 0.190). The mode of action of mindfulness was a significant moderator (p = 0.038). In the meta-analysis of the linkage between mindfulness and depression, regional differences had a significant moderating effect (p < 0.001). The sample type had no discernible moderating impact (p = 0.213). The mode of action of mindfulness was a significant moderator (p = 0.003).

Conclusion

Our meta-analysis indicated that there was an essential correlation between public mindfulness and mental health. Our systematic review added evidence supporting the beneficial nature of mindfulness. A cascading development of beneficial traits that improve mental health may start with mindfulness.

The trajectories of anxiety and depression during the COVID-19 pandemic and the protective role of psychological flexibility: A four-wave longitudinal study

BACKGROUND

Published reports on the adverse mental health impacts of the initial phase of the COVID-19 pandemic suggest an emerging global mental health crisis. However, the trajectories of these mental health impacts over multiple COVID-19 peaks and corresponding lockdowns are unknown. This study explored the trajectories of anxiety and depression over two consecutive lockdowns during the first nine months of the pandemic in Europe (April 2020-January 2021) and examined whether they varied as a function of different psychological flexibility and inflexibility profiles.

METHODS

A total of 569 Italians completed online surveys at four assessment points. Trajectories of anxiety and depression were examined with latent growth modeling and according to different psychological flexibility and inflexibility profiles.

RESULTS

Anxiety increased linearly throughout the study period, whereas depression displayed a quadratic trajectory evidencing a decrease with the easing of the first lockdown followed by an increase during the second lockdown. Furthermore, two profiles were identified that displayed different anxiety and depression trajectories. Compared to the psychologically flexible profile, the psychologically inflexible profile reported significantly higher anxiety and depression which remained higher across the study period.

LIMITATIONS

A reliance on self-report measures and convenience sampling constitute key study limitations.

CONCLUSIONS

Results suggest that high psychological inflexibility is a risk factor for prolonged elevated anxiety and depression during the COVID-19 pandemic, whereas high psychological flexibility is a protective factor. Psychological flexibility and inflexibility should be targeted by preventive public health interventions that harness evidence-based strategies shown to effectively target these factors.

The psychological impact of quarantine due to COVID-19: A systematic review of risk, protective factors and interventions using socio-ecological model framework

Background

Though quarantine is a pertinent control measure for the spread of COVID-19, it is equally important to consider its negative impacts, as it causes severe psychological, emotional, and financial problems not only for those who are quarantined but also for many others who are directly or indirectly connected to those who are quarantined. There appears to be a need to synthesise the available literature evidence on the psychological impact of quarantine experience, especially the multilevel risk factors that make individuals vulnerable to psychological impact and the protective factors to deal with the negative effects of quarantine.

Objective

This systematic review attempted to identify the various psychological impacts associated with the experience of quarantine, the risk and protective factors and list out various psycho-social interventions that can minimise the risks and facilitate the protective factors associated with the experience of quarantine.

Methods

A systematic search adhering to the PRISMA guidelines was performed in four databases PubMed, Scopus, PsycNet, Web of Science and 10518 articles related to COVID-19 and quarantine were obtained. After screening processes and quality assessment using standard checklist 74 articles that fulfilled the eligibility criteria were chosen for the final review.

Findings

Individuals subjected to quarantine had anxiety, depression, post-traumatic stress symptoms, sleep problems, and somatic difficulties. Some of the key risk factors during quarantine are young age, female gender, low money, fear of infection, poor sleep quality, reduced physical activity, increased sedentary behaviours, and a lack of social support. Financial difficulties and stigma remained risk factors even after the quarantine period had ended. Key protective factors were coping skills, home based exercise, leisure, recreational activities, maintaining relationships using social media and availability of mental health services. The findings also highlight the necessity for tele mental health interventions to address the psychological effects of quarantine.

Conclusion

Multilevel interventions are required to minimise the impact of risk factors and enhance protective factors.

Social support, psychological flexibility and coping mediate the association between COVID-19 related stress exposure and psychological distress

The COVID-19 pandemic has contributed to an increase in psychological distress. However, protective factors such as social support, psychological flexibility, and coping mechanisms can help individuals cope with the effects of psychological distress. This study aimed to test a recent hypothesis suggesting that psychological flexibility is not necessarily a coping strategy but a mechanism that can influence the coping strategies an individual employs during stressful events. We tested a mediation model that COVID-19 concerns would contribute to higher levels of perceived social support, which would directly increase psychological flexibility, and finally test if the effect of psychological flexibility on distress was mediated by approach and avoidant coping strategies. The results show that social support facilitates higher levels of psychological flexibility. Further, that psychological flexibility indirectly reduces psychological distress by reducing avoidant coping and increasing approach coping strategies. Within the context of COVID-19, we have shown the importance of social support and psychological flexibility for reducing distress. We have provided further evidence that psychological flexibility might not be a coping mechanism but a strategy that leads individuals to engage in more approach coping strategies and fewer avoidant coping strategies.

The Relationship of Breathing and COVID-19 Anxiety When Using Smart Watches for Guided Respiration Practice: A Cross-Sectional Study

COVID-19 mortality rates are increasing worldwide, which has led to many highly restrictive precautionary measures and a strong sense of anxiety about the outbreak for many people around the world. There is thus an increasing concern about COVID-19 anxiety, resulting in recommending approaches for effective self-care. From a positive psychology perspective, it is also important for people to have positive affect when dealing with this pandemic. According to previous literature, respiration is considered to be an effective way to enhance people’s mental health. Among all the wearable devices, Apple Watch has the largest market share, so this study recruited Chinese users that use respiration exercise function on Apple Watch; a total of 316 valid data were retrieved. Meanwhile, to understand one approach related to using Apple Watch to practice respiration to reduce COVID-19 anxiety about being infected during the COVID-19 outbreak, this study used a web-based cross-sectional survey to examine anxiety about being infected by COVID-19 among Chinese people who had been using the Apple Watch to practice respiration during the period of the COVID-19 outbreak. The study was based on the Health Theoretical Model, and the model was developed with four dimensions and was validated with structural equation modeling. The results of this study showed that practicing few minutes had a positive relationship on positive attitude, and positive attitude had a negative relationship on pandemic anxiety and a positive relationship on continuance use intention. Anxiety about the pandemic had a negative relationship on the intention to continue using the function. This showed that respiration practice can help to suppress the increase in anxiety levels regarding this pandemic.

Psychological Flexibility, Coronavirus Anxiety, Humor and Social Media Addiction During COVID-19 Pandemic in Turkey

Psychological flexibility is associated with psychological health and affected by various factors. The aim of the present study is to examine the role of coronavirus anxiety, humor and social media addiction on psychological flexibility during the COVID-19 pandemic in Turkey. Variables were measured with online self-report surveys and data were gathered from December 2020 to January 2021 in Turkey. The sample consisted of 376 people (295 female, M = 29.88, SD = 11.05). The relationships between the variables were tested with path analysis using structural equation modelling (SEM). According to results, the constructed model showed that COVID-19 anxiety significantly and directly increased social media addiction (β = .17, p < .01), decreased coping humor (β = -.11, p < .05) and decreased psychological flexibility indirectly through social media addictions (β = -.08, p < .01). Humor coping significantly and directly increased psychological flexibility (β = .25, p < .01), and social media addiction significantly and directly decreased psychological flexibility (β = -.31, p < .01). Findings indicated that psychological flexibility is influenced by coronavirus anxiety, social media addiction and humor coping.  Supporting humor coping and reducing anxiety and problematic social media use would be helpful to enhance psychological flexibility of individuals during the pandemic.

Psychological Flexibility Mediates Wellbeing for People with Adverse Childhood Experiences during COVID-19

BACKGROUND

The psychological impact of COVID-19 is multifaceted, both acute and chronic, and has not affected everyone equally.

METHOD

This longitudinal study compared those with and without Adverse Childhood Experiences (ACEs) on measures of psychological distress and wellbeing over time.

RESULTS

All groups (No ACE, Low ACE, and High ACE) had similar levels of distress at Time 1, with significant increases in psychological distress for those with ACEs over time, but not for those without. Psychological Flexibility was strongly and significantly associated with decreases in psychological distress and improved wellbeing. It significantly mediated the relationship between ACE and wellbeing.

CONCLUSIONS

Those with ACEs report significantly increased psychological distress over time, compared to those without ACE during the COVID-19 pandemic. Evidence-based interventions using Psychological Flexibility may improve mental health and wellbeing to help further mediate its effects.

Mindfulness May Buffer Psychological Distress in Adolescents during the COVID-19 Pandemic: The Differential Role of Mindfulness Facets

The COVID-19 pandemic strongly impacts adolescents’ mental health, a population particularly vulnerable to mental disorders, highlighting the need to identify protective factors against COVID-19 related psychological distress to inform policies and intervention strategies. Previous research suggests that mindfulness may be a promising factor that can lower the risk of detrimental psychological consequences related to the COVID-19 pandemic. However, it is currently unknown which aspects of mindfulness contribute most to its protective effects. Moreover, previous studies mainly focused on adult samples. The present study aimed to address this gap by investigating the impact of specific mindfulness facets on adolescents’ COVID-19 related psychological functioning. 246 Dutch-speaking adolescents were recruited via social media to complete a cross-sectional online survey between June 29 and October 11, 2020. Participants were 16–18 years of age, most of them women (71%), and the majority followed the highest level of Belgian secondary education. Logistic regression analyses were performed to test the differential effects of each mindfulness facet on psychological functioning. Our results identified decentering as the facet of mindfulness that was uniquely associated with decreased worry and stress, improved mental health and quality of life, as well as with an increase in social connectedness with others following the outbreak of the COVID-19 pandemic. Unexpectedly, decentering was negatively associated with adolescents’ helping behaviour during compared to before the pandemic. Implications for research on and application of mindfulness are discussed. Taken together, these findings suggest that the facet of decentering, among all facets of mindfulness, may represent the main protective factor against psychological distress during the COVID-19 pandemic.

Mindfulness-Based Stress Reduction Increases Mental Wellbeing and Emotion Regulation During the First Wave of the COVID-19 Pandemic: A Synchronous Online Intervention Study

The COVID-19 pandemic imposed extreme living conditions of social distancing, which triggered negative mental health problems and created challenges in seeking mental health support. Mindfulness-based interventions (MBIs) have been found to enhance wellbeing and mental health by reducing stress and anxiety and improving emotion regulation. Preliminary evidence suggests that online, synchronous MBIs may produce beneficial effects similar to face-to-face programs. However, the effectiveness of such online-MBIs to support mental health in highly stressful times, such as a global pandemic, requires further study. To this end, we investigated the effect of an online 8-week Mindfulness-Based Stress Reduction (MBSR) program on aspects of mental health during the first wave of the COVID-19 pandemic. Participants (N=92) who expressed interest in discounted online-MBSR programs were recruited for the study. The division into experimental and control groups was based on actual enrollment to the courses. Those who enrolled in a program were assigned to the experimental condition and those who decided not to enroll served as controls. Participants were assessed pre-intervention, post-intervention, and 1-month post-intervention for levels of mindfulness, perceived stress, anxiety, emotion regulation, and intolerance of uncertainty. Differences between the groups were tested using the general linear mixed effects model (GLMM) and Individual Growth Curve Models (IGCM) in intent to treat analysis. The findings indicated that, relative to the control group, MBSR improved mindfulness abilities (p <0.001), decreased anxiety (p <0.001), and stress (p <0.001) and increased emotion regulation (p <0.001). These effects were found to persist 1 month after the end of the program, despite the increased governmental public-health restrictions due to COVID-19 at that time. The ability to tolerate uncertainty, a central characteristic of the pandemic, was not found to be affected by the program. A mediation analysis revealed that the effect of the intervention on mental health improvement was partially mediated by the improvement in emotion regulation. Overall, the findings provide positive evidence for the feasibility of an online-MBSR program to support the mental health of individuals from the general population through the mediation of emotion regulation in challenging times, such as a global pandemic.

Mental health and resilience during the coronavirus pandemic: A machine learning approach

Objective

This study explored risk and resilience factors of mental health functioning during the coronavirus disease (COVID‐19) pandemic.

Methods

A sample of 467 adults (M age = 33.14, 63.6% female) reported on mental health (depression, anxiety, posttraumatic stress disorder [PTSD], and somatic symptoms), demands and impacts of COVID‐19, resources (e.g., social support, health care access), demographics, and psychosocial resilience factors.

Results

Depression, anxiety, and PTSD rates were 44%, 36%, and 23%, respectively. Supervised machine learning models identified psychosocial factors as the primary significant predictors across outcomes. Greater trauma coping self‐efficacy and forward‐focused coping, but not trauma‐focused coping, were associated with better mental health. When accounting for psychosocial resilience factors, few external resources and demographic variables emerged as significant predictors.

Conclusion

With ongoing stressors and traumas, employing coping strategies that emphasize distraction over trauma processing may be warranted. Clinical and community outreach efforts should target trauma coping self‐efficacy to bolster resilience during a pandemic.

Path Analysis to Assess Socio-Economic and Mitigation Measure Determinants for Daily Coronavirus Infections

(1) Background: With the rapid global spread of the coronavirus disease 2019 (COVID-19) and the relatively high daily cases recorded in a short time compared to other types of seasonal flu, the world remains under continuous threat unless we identify the key factors that contribute to these unexpected records. This identification is important for developing effective criteria and plans to reduce the spread of the COVID-19 pandemic and can guide national authorities to tighten or reduce mitigation measures, in addition to spreading awareness of the important factors that contribute to the propagation of the disease. (2) Methods: The data represents the daily infections (210 days) in four different countries (China, Italy, Iran, and Lebanon) taken approximately in the same duration, between January and March 2020. Path analysis was implemented on the data to detect the significant factors that affect the daily COVID-19 infections. (3) Results: The path coefficients show that quarantine commitment (β = −0.823) and full lockdown measures (β = −0.775) have the largest direct effect on COVID-19 daily infections. The results also show that more experience (β = −0.35), density in society (β = −0.288), medical resources (β = 0.136), and economic resources (β = 0.142) have indirect effects on daily COVID-19 infections. (4) Conclusions: The COVID-19 daily infections directly decrease with complete lockdown measures, quarantine commitment, wearing masks, and social distancing. COVID-19 daily cases are indirectly associated with population density, special events, previous experience, technology used, economic resources, and medical resources.

The Mindfulness and the Emotional Regulation Skills in Italian Nurses During the COVID-19 Pandemic: A Descriptive Survey-Correlational Study

Purpose: To analyze the differences in mindfulness level and emotional regulation skills, as cognitive reappraisal and expressive suppression subdimensions, according to sex and years of work experience in a sample of Italian nurses directly involved in the care of coronavirus disease 2019 (COVID-19) patients. Then, correlations were also performed in order to evidence relationships between the mindfulness tendency and the emotional regulation skills, both in cognitive reappraisal and expressive suppression, too. Design of study: Descriptive correlational study. Methods: In June 2020, an online questionnaire was administered. Data relating to sex and years of work experience, the Mindfulness Attention Awareness Scale (MAAS), and the Emotion Regulation Questionnaire (ERQ) in the cognitive reappraisal and expressive suppression subdimensions were collected. Findings: Two hundred nurses were enrolled. Males recorded higher MAAS values compared to females (p = .001). No significant differences were registered in the MAAS scores according to years of work experience and regarding the ERQ subscales according to sex and work of experience, too. Also, any correlations were reported between MAAS and ERQ subscales. Conclusions: Future training on the basic principles of mindfulness and Emotion Regulation were considered a priority in nurses to better self-modulate their own beings, particularly during the pandemic period.

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 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.

COVID-19 Anxiety-A Longitudinal Survey Study of Psychological and Situational Risks among Finnish Workers

Background: The COVID-19 crisis has changed the conditions of many all over the globe. One negative consequence of the ongoing pandemic is anxiety brought about by uncertainty and the COVID-19 disease. Increased anxiety is a potential risk factor for wellbeing at work. This study investigated psychological, situational, and socio-demographic predictors of COVID-19 anxiety using longitudinal data. Methods: A nationally representative sample of Finnish workers (N = 1308) was collected before and during the COVID-19 crisis. Eighty percent of the participants responded to the follow-up study (N = 1044). COVID-19 anxiety was measured with a modified Spielberger State-Trait Anxiety Inventory. Psychological and situational predictors included perceived loneliness, psychological distress, technostress, personality, social support received from the work community, and remote working. A number of socio-demographic factors were also investigated. Results: Perceived loneliness, psychological distress, technostress, and neuroticism were identified as robust psychological predictors of COVID-19 anxiety. Increase in psychological distress and technostress during the COVID-19 crisis predicted higher COVID-19 anxiety. A recent change in their field of work and decreased social support from work communities predicted COVID-19 anxiety. Women and young people experienced higher anxiety. Conclusions: Different factors explain workers' COVID-19 anxiety. Increased anxiety can disrupt wellbeing at work, emphasizing the organizations' role in maintaining an inclusive and caring work culture and providing technical and psychological support to workers during crisis.

What about the “Social Aspect of COVID”? Exploring the Determinants of Social Isolation on the Greek Population during the COVID-19 Lockdown

The COVID-19 pandemic, its duration, and its intensity are harbingers of demographic change. In the context of social demography, it is crucial to explore the social challenge emerging from the coronavirus disease. The main purpose of this study is (i) to explore the determinants that affected the population in Greece in terms of social isolation during the lockdown period and (ii) to examine possible differences in the assessment of the social isolation factors depending on whether individuals live in urban or rural areas or regions with relative geographical isolation. Field research was conducted with 4216 questionnaires during the first wave of COVID-19 (March to April 2020). Multivariate analysis methods were applied to detect the main factors that impacted the feeling of social isolation, and nonparametric tests were performed to detect possible differences between population groups. Despite the resistance shown to the spread of the disease, the Greek population totally complied with the measures of social distancing and thus was socially and psychologically affected. The results indicate that psychosomatic disorders, employment situations, changes in sleep habits, socialization on the Internet, demographic status, health concerns, and trust in government and the media response determine the Greeks’ social isolation feeling. Pandemic and confinement measures have consequences for individuals and social groups and may prejudice social cohesion at multiple levels. By understanding how the pandemic affected the societies, interventions and public policies may be implemented to ensure both social cohesion and populations’ wellbeing by addressing the social isolation feeling.