Profiles of Psychological Flexibility: A Latent Class Analysis of the Acceptance and Commitment Therapy Model

Psychological flexibility in somatic symptom and related disorders: A case control study

A key diagnostic criterion of Somatic Symptom and related Disorders (SSD) comprises significant distress and excessive time-and-energy consuming thoughts, feelings, and behavior pertaining to somatic symptoms. This diagnostic criterion is lacking in central sensitivity syndromes (CSS), such as fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome. This strong emphasis on disturbed psychological processing of somatic symptoms, suggests that psychological flexibility is low in SDD. Psychological flexibility is defined as the ability to approach difficult or challenging internal states (thoughts, emotions, and bodily sensations) in a non-judgmental, mindful way, and being committed to pursue one's values. To clarify the potential significance of psychological flexibility in SSD, we examined its levels in 154 people referred to specialized treatment for SDD, as compared to reference groups from the general population encompassing 597 people with CSS and 1422 people without SSD or CSS (controls). Mean levels of psychological flexibility (adjusted for demographic covariates) were lowest for SSD and highest for controls (F = 154.5, p < 0.001, pη2 = 0.13). Percentages of people with low psychological flexibility (<0.8 SD below the mean of controls) were: SSD 74%, CSS 42%, controls 21%. In SSD, higher psychological flexibility was associated with better mental health (β = 0.56, p < 0.001), but interaction analysis rejected that psychological flexibility preserved health when having more severe somatic symptoms (β ≤ 0.08, p ≥ 0.10). The results indicate that lower psychological flexibility is a prevalent problem in SSD that is associated with lower mental health. This suggests that it is worthwhile to take account of psychological flexibility in SSD in screening, monitoring, and therapy.

Profiles of psychological flexibility and caregiving experience in dementia family caregivers: A latent profile analysis

OBJECTIVES

To explore the profiles of psychological flexibility among dementia family caregivers and examine their associations with psychological well-being and caregiving factors.

METHODS

Participants were 521 dementia family caregivers in Japan. Latent profile analysis was conducted to explore the profiles of psychological flexibility. The analyses examined differences in depression, anxiety, life satisfaction, and work-family conflict/enrichment between the profiles, and whether sociodemographic variables and caregiving stressors predict the profile.

RESULTS

Four distinct profiles were identified: high psychological flexibility (14.2%), moderate psychological flexibility with high commitment (24.7%), moderate psychological flexibility with low commitment (48.0%), and low psychological flexibility (13.1%). The low psychological flexibility profile exhibited the highest scores of depression, anxiety and work-family conflict, followed by the moderate psychological flexibility with low/high commitment profiles, and the high psychological flexibility profile. The high psychological flexibility and moderate psychological flexibility with high commitment profiles exhibited higher life satisfaction than the moderate psychological flexibility with low commitment profile. Caregiving stressors, marital status, and caregiver status predicted the profile.

CONCLUSION

Enhancing defusion and acceptance, rather than increasing commitment to personal values, may be beneficial in supporting distressed caregivers. Having more caregiving stressors, being single/divorced/bereaved, and being a primary caregiver may be useful indicators of decreased psychological flexibility among dementia family caregivers.

The role of psychological flexibility in the relationships between burnout, job satisfaction, and mental health among nurses in combatting COVID-19: A two-region survey

BACKGROUND

A growing body of evidence suggests that the COVID-19 pandemic is adversely impacting the mental health and well-being of frontline nurses worldwide. It is therefore important to understand how such impact can be mitigated, including by studying psychological capacities that could help the nurses regulate and minimize the impact.

AIM

To examine the role of psychological flexibility in mitigating the adverse impacts of burnout and low job satisfaction on mental health problems (i.e., anxiety, depression, and stress) and well-being among the frontline nurses in Hong Kong and Switzerland during the COVID-19 pandemic.

DESIGN

Cross-sectional, two-region survey study.

METHOD

Four hundred fifty-two nurses from Hong Kong (n = 158) and Switzerland (n = 294) completed an online survey. An adjusted structured equation model was used to examine the interrelationship of the constructs.

RESULTS

Psychological flexibility was found to partially mediate the effects of job satisfaction on mental well-being (β = 0.32, 95% CI [0.19, 0.57], p = 0.001) and mental health problems (β = -0.79, 95% CI [-1.57, -0.44], p = 0.001), respectively. Similarly, this partial mediation was found in the effects of burnout on mental well-being (β = -0.35, 95% CI [-0.89, -0.15], p = 0.002) and mental health problems (β = 0.89, 95% CI [0.48, 3.65], p = 0.001).

CONCLUSION

Psychological flexibility could be a crucial psychological resilience factor against the adverse impact of nurses' burnout on their mental health problems and well-being during COVID-19.

CLINICAL RELEVANCE

Organizational measures should focus on fostering psychological flexibility in nurses through highly accessible, brief psychotherapeutic interventions, such as Acceptance and Commitment Therapy, to reduce the impact on mental health.

A Network Analysis Approach on the Psychological Flexibility/Inflexibility Model

Acceptance and Commitment Therapy (ACT) is purported to work via targeting six interrelated processes summarized as the Psychological Inflexibility/Psychological Flexibility (PI/PF) model. However, the theoretical structure and interconnections of this model have not been sufficiently explored. Lacking are examinations of the interrelations among its components. Network Analysis (NA) can model PI/PF as a system of interconnected variables. We aimed at exploring the role and associations of the PI/PF model's components using NA in two different samples and sets of scales, and compare its structure across sub-samples. Sample 1 consisted of 501 individuals, who completed an online battery of questionnaires including the Multidimensional Psychological Flexibility Inventory, and Sample 2 consisted of 428 people, who completed an online set of six ACT measures, each assessing a component of the PI/PF model. NA could not verify the six ACT dimensions as distinct components. Values and Committed Action components were found to be strongly associated and combined in a group in both sets of measures and samples. Interestingly, Acceptance and Defusion were not the most central components as purported in some ACT conceptualizations, whereas Self-as-Context had a key role on both sets of measures and its items were often merged with Present Moment Awareness items. No significant differences were found in the comparison of networks across different subsamples and sets of scales. After combining different sets of scales, the six ACT components could not be completely verified as distinct entities, which might reflect problems with the theoretical model, or with the scales used. All components had critical roles in the model, particularly Self-as-Context, which reflects the need to redirect research towards this understudied construct. Findings point towards considerations of a triflex instead of a hexaflex ACT model.

Psychological flexibility, cognitive emotion regulation and mental health outcomes among patients with asthma in Pakistan

Background/Objective

Adults with asthma who experience difficulties in emotion regulation are prone to developing psychopathological symptoms that may affect their self-management activities and symptom control. The current research investigated the role of psychological flexibility and cognitive emotion regulation strategies in relation to mental health outcomes (psychological distress and quality of life) among patients with asthma in Pakistan.

Method

A sample of 200 adults, diagnosed with asthma (32% men, 68% women; M_age = 42.32, SD_age = 16.99), completed the acceptance and action questionnaire (AAQ-II) cognitive emotion regulation questionnaire (CERQ), depression, anxiety, stress scale-21 (DASS-21), asthma-related quality of life questionnaire (AQLQ) and a self-structured demographic sheet.

Results

Results of Pearson product moment correlation showed that most of the adaptive cognitive emotion regulation strategies (positive refocusing, refocus on planning, and positive reappraisal) were positively correlated with psychological flexibility and quality of life, whereas negatively correlated with psychological distress. All the maladaptive strategies of cognitive emotion regulation had a significant inverse relationship with psychological flexibility and quality of life, while positively correlated with psychological distress. Results of serial mediation analysis through PROCESS MACRO showed that catastrophising and anxiety fully mediated the relationship between psychological flexibility and asthma-related quality of life.

Conclusion

Evidence-based interventions should focus on developing psychological flexibility and identifying maladaptive patterns of cognitive emotion regulation strategies for improved mental health and quality of life outcomes for adults with asthma.

Perceived Stress, Psychological Flexibility Profiles, and Mental Health During COVID-19: A Latent Profile Analysis

Purpose

Although the link between psychological flexibility and healthy functioning has been widely analyzed, the employed measurements often lacked accuracy. The current study introduced a person-centered approach that identified subgroups of college students across the dimensions of the Personalized Psychological Flexibility Index (PPFI) and explored how these subgroups relate to a risk factor (perceived stress) and mental health outcomes (depression, anxiety, negative affect, and positive affect) in the context of COVID-19.

Methods

A sample of 659 participants (M_age = 19. 99, SD = 1.27; 57.97% females) completed the questionnaires online. Latent profile analysis (LPA) was employed to determine the optimal number of subgroups or profiles. Then, multinomial logistic regression and analyses of variance were used to identify variables associated with profile membership.

Results

LPA identified three distinct profiles (active strategy, inconsistent strategy, and passive strategy). Furthermore, multinomial logistic regressions indicated that students with high perceived stress were more likely to be in the passive strategy group than the active strategy group (β = -0.104, OR = 0.901, p < 0.001) and the inconsistent strategy group (β = -0.087, OR = 0.917, p < 0.001). Additionally, analyses of variance revealed that the three profiles differed in depression (η² = 0.062, p < 0.001), anxiety (η² = 0.059, p < 0.001), negative affect (η² = 0.047, p < 0.001), and positive affect (η² = 0.048, p < 0.001).

Conclusion

The current study employed LPA based on the PPFI to identify and confirm three profiles of psychological flexibility. We found that perceived stress and mental health outcomes were associated with these three profiles. This study offers a new perspective on understanding psychological flexibility through a person-centered approach. Furthermore, interventions aimed at reducing college students' perceived stress during the COVID-19 crisis are critical for preventing the deterioration of psychological flexibility.

Acceptance and Commitment Therapy Processes Differentially Predict Aspects of Mental Health

Psychological flexibility relates to various aspects of mental health, including psychological distress and adaptive mental health. The CompACT has been developed to assess psychological flexibility by quantifying psychological flexibility as a multidimensional whole, and by three processes of psychological flexibility including, Openness to Experience (OE), Behavioral Awareness (BA), and Valued Action (VA). The current study examined the unique predictive property of each three process of the CompACT with aspects of mental health. Participants (N = 593) were a diverse sample of United States adults. Our results found OE and BA significantly predicted depression, anxiety, and stress. OE and VA significantly predicted satisfaction with life, and all three processes significantly predicted resilience. Our results support multidimensional assessment of psychological flexibility when examining aspects of mental health.

The relationship between stressful life events and school engagement for junior high school students in China: A serial mediation model

The purpose of this study is to examine the relationship between stressful life events (SLE) and school engagement and to determine if there are some likely mediating variables between them. A sample of 1517 Chinese junior high school students (51.5% female) completed the adolescent self-rating life events checklist (ASLEC), Utrecht Work Engagement Scale-student (UWES-s), cognitive fusion questionnaire (CFQ), and positive psychological capital questionnaire (PPQ). The model was calculated using the PROCESS macro in SPSS. The serial mediator model revealed a significant negative effect of SLE on school engagement through psychological flexibility and psychological capital (effect = −.08, 95% CI [−.10, −.06]). There was also a direct mediating effect through psychological capital (effect = −.17, 95% CI [−.21, −.13]). The results of the present study may help to clarify mechanisms that might explain the association between SLE and school engagement. Future research on improving school engagement should consider the critical roles of psychological flexibility and psychological capital.

Exploring the peer status prototypes: A large-scale latent profile analysis on high-school students from four European countries

Peer status - the regard other group members have of an individual - is fundamental for youth development. Different research traditions developed independent theoretical frameworks conceiving the dimensions underlying social status, and this led to identifying a variety of peer status prototypes. In this work, we explored whether a classification based on the four dimensions of popularity, aggression, dislike, and victimization could integrate the scattered peer status profiles found in the different traditions. A latent profile analysis on 16,224 European students identified the peer status prototypes of popular, bullies, disliked, victims, and average students. Both the peer- and self-reported correlates supported that the five profiles accounted for the large variety of the students' profiles in the literature. These findings suggest that the adoption of a multidimensional approach supported by advanced statistical procedures could identify students' peer status profiles more effectively, replacing classifications based on cutoffs, and leading to a unified students' classification.

The Relationship Between Psychological Flexibility and Depression, Anxiety and Stress: A Latent Profile Analysis

Purpose

To explore the potential classification of psychological flexibility (PF) among Chinese college students, analyze whether there is group heterogeneity in PF, and discuss the differences in the latent profile of PF in the negative emotions of depression, anxiety, and stress.

Methods

A total of 1769 college students were investigated using the Psychological Flexibility Questionnaire and Depression-Anxiety-Stress Self-rating Scale, and heterogeneity was tested by latent profile analysis.

Results

The PF of college students can be divided into three latent profiles: self-contradiction group (19.2%), high PF group (34.1%), and low PF group (46.7%). The scores of depression, anxiety, and stress are significantly different among the groups.

Conclusion

There is obvious group heterogeneity in the PF of college students, and they can be divided into the self-contradiction group, the high PF group, and the low PF group. The self-contradiction and low PF groups score significantly higher on the negative emotions of depression, anxiety, and stress than the high PF group.

The Persian version of the psychological flexibility in sport scale: a psychometric study

Background

There is a growing body of research suggesting that psychological flexibility (PF) is an important psychological construct related to psychological health and human performance. The Psychological Flexibility in Sport Scale (PFSS) is the first general scale to assess sport-related PF. So far, the PFSS has not yet been validated in other contexts than Sweden. Therefore, the current study sought to investigate a Persian version of the PFSS (P-PFSS) and extend the investigation of the psychometric properties of the PFSS in Iranian athletes.

Methods

A total of 302 athletes from both team and individual sports (average age of 20.7 years, SD ± 7.5, 62.3% were female) were involved in the current study. Statistical analysis was performed on the data to test validity and reliability. The validity of the P-PFSS was tested through face and content validity, construct validity, criterion validity, and known-groups validity. The reliability of P-PFSS was verified through internal consistency and temporal stability of the scale.

Results

Results revealed that validity of the P-PFSS was satisfactory. The instrument was determined to have strong face and content validity. With modifications, the confirmatory factor analysis confirmed the scale’s unidimensionality. The convergent validity of the P-PFSS was found to be acceptable (average variance extracted = 0.66) and satisfactory results were also found in the correlation matrix for the assessment of construct validity. The P-PFSS showed good criterion validity related to generic psychological flexibility and athletic-related variables. Also, the P-PFSS was able to differentiate PF between known groups. The P-PFSS was found to be reliable, with good internal consistency (Cronbach’s alpha = 0.92; composite reliability = 0.92) and temporal stability on retest (intraclass correlation coefficient = 0.95).

Conclusions

Overall, the Persian version of the PFSS showed good psychometric qualities in Iranian athletes. The current study provides additional support for the PFSS and extends the context-specific utility for practitioners and researchers in assessing sport-related PF.

Prevalence and predictors of mental health outcomes in UK doctors and final year medical students during the COVID-19 pandemic

BACKGROUND

The mental health of doctors is an ongoing concern, both prior to and during the COVID-19 pandemic. This study aimed to: i) assess the prevalence of symptoms of depression, anxiety, PTSD, and burnout in UK doctors and final year medical students during the pandemic, and ii) analyse the hypothesised relationships between psychological flexibility, intolerance of uncertainty and resilience with these mental health outcomes.

METHODS

A cross-sectional online study of UK-based doctors and final year medical students was conducted between 27/09/2020 and 31/01/2021. Outcomes were measured using the PHQ9, GAD7, PCL-5, and aMBI. Independent variables included the CompACT-SF, IUS-12, and CD-RISC-10. Descriptive statistics, between-group analyses, and multiple regression were performed.

RESULTS

Prevalence of anxiety symptoms was 26.3%, depression 21.9%, PTSD 11.8%, and burnout 10.8%. Psychological flexibility negatively predicted all outcomes, apart from low personal achievement. Intolerance of uncertainty positively predicted anxiety and PTSD scores. Resilience negatively predicted scores on burnout subscales.

LIMITATIONS

Cross-sectional design and non-probability sampling method means that assumptions about causality cannot be made and may have implications for bias and generalisability of results.

CONCLUSION

Doctors and medical students in the UK reported high levels of mental health symptoms during the pandemic, between September 2020 and January 2021. All three independent variables explained significant variance in mental health outcomes. Psychological flexibility was the most consistent predictor, over and above sociodemographic variables and other psychological predictors. These findings have implications for interventions to improve retention of our essential medical workforce, and for providing support at future times of national crisis.

Influence of discrimination perception on career exploration of higher vocational students: Chain mediating effect test

Explore the influence mechanism of discrimination perception on higher vocational Students’ career exploration, it provides empirical evidence for promoting vocational college Students’ career exploration and career development. Using the questionnaire survey method, 893 higher vocational students from four higher vocational colleges in Jiangsu Province were investigated by using the Discrimination Perception Scale, the Core Self-Evaluation Scale (CSES), the Chinese version of the Acceptance and Action Questionnaire, the Chinese version of the Cognitive Fusion Questionnaire (CFQ) and the Career Exploration Scale (CES). The data were analyzed using SPSS26.0 and Amos23.0, and the results showed that discrimination perception was significantly negatively correlated with core self-evaluation, psychological flexibility and career exploration (r = −0.487, −0.497, −0.326, p < 0.01), core self-evaluation was significantly positively correlated with psychological flexibility and career exploration (r = 0.518, 0.352, p < 0.01), and psychological flexibility was significantly positively correlated with career exploration (r = 0.386, p < 0.01); Core self-evaluation and psychological flexibility mediated the effect between discrimination perception and career exploration with effect sizes of −0.054 and −0.061, respectively; Core self-evaluation and psychological flexibility mediated the chain effect between discrimination perception and career exploration of higher vocational students with effect sizes of −0.030. Therefore, discrimination perception not only directly influences career exploration of higher vocational students, but also indirectly influences career exploration of higher vocational students through the separate mediating effects of core self-evaluation and psychological flexibility and the chain mediating effects of core self-evaluation and psychological flexibility. Accordingly, the following suggestions are put forward, which should pay attention to the cultivation of core self-evaluation and psychological flexibility of higher vocational students, strengthen the teaching quality and improve the image of vocational colleges.

The Role of Psychological Inflexibility and Experiential Approach on Mental Health in Children and Adolescents: An Exploratory Study

The prevalence of mental health problems during childhood and adolescence is on the rise. There is a growing interest in the examination of personal variables that may function as risk factors and that may be targeted for effective intervention. This study explores the relationships amongst different aspects of psychological inflexibility (one, typically studied, focusing on the individual’s responding to unwanted emotions and cognitions, and another, more recently explored, focusing on the individual’s responding to desired thoughts and affective states), emotional intelligence, and mental health symptoms. A total of 129 school-going children (mean age: 11.16 years old) completed a battery of instruments comprising the Avoidance and Fusion Questionnaire-Youth (AFQ-Y17), the Experiential Approach Scale (EAS), the Emotional Intelligence Quotient Inventory (EQi-YV), and the Revised Child Anxiety and Depression Scale (RCADS-30). Results showed that both the AFQ-Y17 score and an EAS subscale score (Anxious Clinging) were significant independent predictors of mental health symptoms in general. Emotional intelligence was predictive only for depression, and both the AFQ-Y17 and the Anxious Clinging EAS subscale significantly incremented the predictive power of a hierarchical linear regression model including all three variables. These results underscore the relevance of psychological inflexibility for child/adolescent mental health, and the need to further explore a specific aspect of inflexibility regarding positive emotions and other appetitive private events.

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.

Spanish Adaptation of the Experiential Approach Scale (EAS)

Psychological inflexibility is a transdiagnostic dimension associated to psychological distress and poor mental health and quality of life. While multiple instruments have been developed for the assessment of patterns of inflexible responding to aversive private events (e.g., unwanted cognitions and emotions), the Experiential Approach Scale (EAS) is the first instrument specifically designed to assess inflexible responding to appetitive private events (e.g., desired affective states). In this study, we explored the factor structure, internal consistency, and convergent validity of a Spanish adaptation of the EAS with a convenience sample of college students from Spain (n = 206; 79% female). A two-factor solution demonstrated very good fit to the data and was similar to the original two-subscale EAS structure: Anxious Clinging and Experience Prolonging. The scale showed adequate overall (α = 0.85) and subscale (αs: 0.90 and 0.89) internal consistency. Unlike the original instrument, both subscales were uncorrelated. Anxious Clinging correlated positively with experiential avoidance and with measures of negative affect and psychopathology, and negatively with positive affect, subjective happiness, and life satisfaction. In turn, Experience Prolonging correlated negatively with psychopathology and positively with positive affect, subjective happiness, and life satisfaction. Our results point to Anxious Clinging as the only EAS subscale contributing to psychological inflexibility.

The Impact of Psychological Flexibility on Psychological Well-Being in Adults With Obesity

Obesity is a global health problem that affects both physical and psychological health and well-being. Psychological flexibility is one of the key components related to psychological health. This cross-sectional study aims to investigate the impact of psychological flexibility on psychological well-being in a sample of 220 individuals with obesity. Multivariate analysis was performed to investigate the role of psychological flexibility in explaining psychological well-being, controlling for confounding factors (sex, age, and Body Mass Index). According to the results, psychological flexibility significantly explained psychological well-being. Our study provides additional evidence of the impact of psychological flexibility on psychological well-being. It also provides further support for the importance of integrating psychological flexibility in the psychological interventions for obesity.

Psychological inflexibility and mental health symptoms during the COVID-19 lockdown in Spain: A longitudinal study

Spain, one of the European countries most affected by the COVID-19 pandemic, underwent a strict lockdown between March and May 2020. This study examines longitudinally the evolution of both psychological inflexibility and mental health symptoms in a sample of college students from the beginning and throughout the end of the mandated lockdown period. We present the results from 197 participants who responded to an online survey at least at two of three data-collection waves scheduled at the beginning (N = 226), halfway (N = 172), and end (N = 188) of the lockdown. The analyses revealed that psychological inflexibility and symptomatology increased over time, and that inflexibility at the beginning of the lockdown indirectly predicted self-reported symptoms at the end of the lockdown via autoregressive parallel paths that also connected cross-sectionally to reveal that changes in inflexibility were predictive of changes in mental health. These results present a dynamic and robust relationship between psychological inflexibility and mental health symptoms throughout a relatively long and presumably stressful period of time.

Cognitive arousal mediates the relationship between perceived ostracism and sleep quality but it is not moderated by experiential avoidance

Previous research suggests that longer-term perceived ostracism is related to poor sleep quality. In this study, we investigated the mediating effect of cognitive arousal on the perceived ostracism-sleep quality relationship. We also investigated whether experiential avoidance was a moderator of the cognitive arousal-sleep quality relationship. Participants (N = 251) were recruited through online research portals to take part in an online survey. A path analysis was used to test a moderated mediation effect between variables. It was found that cognitive arousal mediated the perceived ostracism-sleep quality relationship; however, experiential avoidance was not a significant moderator. These findings suggest that further research needs to be conducted to elucidate the mechanism of experiential avoidance to account for when it may impact sleep quality. Moreover, treatment interventions targeted at reducing cognitive arousal (e.g., cognitive behavioural therapy) prior to sleep are likely to bear some fruit.

COVID-19: Psychological flexibility, coping, mental health, and wellbeing in the UK during the pandemic

The COVID-19 pandemic has profoundly altered the daily lives of many people across the globe, both through the direct interpersonal cost of the disease, and the governmental restrictions imposed to mitigate its spread and impact. The UK has been particularly affected and has one of the highest mortality rates in Europe. In this paper, we examine the impact of COVID-19 on psychological health and well-being in the UK during a period of 'lockdown' (15th-21st May 2020) and the specific role of Psychological Flexibility as a potential mitigating process. We observed clinically high levels of distress in our sample (N = 555). However, psychological flexibility was significantly and positively associated with greater wellbeing, and inversely related to anxiety, depression, and COVID-19-related distress. Avoidant coping behaviour was positively associated with all indices of distress and negatively associated with wellbeing, while engagement in approach coping only demonstrated weaker associations with outcomes of interest. No relationship between adherence to government guidelines and psychological flexibility was found. In planned regression models, psychological flexibility demonstrated incremental predictive validity for all distress and wellbeing outcomes (over and above both demographic characteristics and COVID-19-specific coping responses). Furthermore, psychological flexibility and COVID-19 outcomes were only part-mediated by coping responses to COVID-19, supporting the position that psychological flexibility can be understood as an overarching response style that is distinct from established conceptualisations of coping. We conclude that psychological flexibility represents a promising candidate process for understanding and predicting how an individual may be affected by, and cope with, both the acute and longer-term challenges of the pandemic.