Chong, Yuen YuChien, Wai TongCheng, Ho YuLamnisos, DemetrisĻubenko, JeļenaPresti, GiovambattistaSquatrito, ValeriaConstantinou, MariosNicolaou, ChristianaPapacostas, SavvasAydın, GökçenRuiz, Francisco J.Garcia Lopez, MariaObando-Posada, Diana P.Segura-Vargas, Miguel A.Vasiliou, Vasilis S.McHugh, Louise AnitaHöfer, StefanBaban, AdrianaNeto, David DiasSilva, Ana Nunes daMonestes, Jean-LouisAlvarez-Galvez, JavierPaez Blarrina, MarisaMontesinos, FranciscoSalas, Sonsoles ValdiviaŐri, DorottyaKleszcz, BartoszLappalainen, RaimoIvanović, IvaGosar, DavidDionne, FrederickMerwin, Rhonda M.Gloster, Andrew T.Karekla, MariaKassianos, Angelos P.2021-04-192021-04-192021MDPI Multidisciplinary Digital Publishing Institute, 18(8) 1-18 doi.: 10.3390/ijerph1808414316617827http://hdl.handle.net/10400.12/8072This 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.engCOVID-19Psychological flexibilityMental healthProsocialitySurveyjournal article10.3390/ijerph18084143