Psychology, Health & Medicine

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Exploring the association between coronavirus

stress, meaning in life, psychological flexibility, and
subjective well-being 

Gökmen Arslan & Kelly-Ann Allen

To cite this article: Gökmen Arslan & Kelly-Ann Allen (2021): Exploring the association between
coronavirus stress, meaning in life, psychological flexibility, and subjective well-being ,
Psychology, Health & Medicine

To link to this article: https://doi.org/10.1080/13548506.2021.1876892

Published online: 25 Jan 2021.

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PSYCHOLOGY, HEALTH & MEDICINE
https://doi.org/10.1080/13548506.2021.1876892

Exploring the association between coronavirus stress,

meaning in life, psychological flexibility, and subjective well-
being
Gökmen Arslana,b and Kelly-Ann Allenc,d
a
Department of Psychological Counseling and Guidance, Mehmet Akif Ersoy University, Burdur, Turkey;
b
International Network on Personal Meaning, Toronto, Ontario, Canada; cEducational Psychology and
Inclusive Education, Faculty of Education, Monash University, Clayton, Victoria, Australia; dCentre for Positive
Psychology, Melbourne Graduate School of Education, University of Melbourne, Victoria, Parkville, Australia

ABSTRACT ARTICLE HISTORY

There has been a call to action from much of the community to Received 20 June 2020
urgently investigate stress and well-being during the global health Accepted 8 January 2021
crisis instigated by COVID-19. This study seeks to investigate well- KEYWORDS
being, meaning in life, and psychological flexibility in relation to Well-being; meaningful life;
COVID-19 stress. Participants of the study consisted of 417 students covid-19; psychological
from a public university, and they were 40.3% male and 59.7% flexibility; positive
female, ranging in age from 18 to 40 years (M = 23.36, SD = 5.96). psychology
The study’s findings indicated that meaning in life and psychologi­
cal flexibility mediated the effect of coronavirus stress on student
well-being. Psychological flexibility also mitigated the effect of
stress on meaning in life. The study findings offer implications for
mental health professionals and officials responding to COVID-19
and provide insights into future planning and preparedness for
disasters of this scale that may occur in future years.

Stress and well-being have been found to be inversely related (Bell et al., 2012). Well-
being relates to an individual’s overall positive adaption and satisfaction in life (Matud
et al., 2019). Well-being is often thought to include positive thoughts and feelings,
including happiness, enthusiasm, optimism, confidence, and life-purpose (Kubzansky
et al., 2018). The promotion of well-being is understood to play a crucial role in the
prevention of psychopathology (Arslan et al., 2020, 2020a; Bartels et al., 2013) and one
way in which well-being is promoted in the literature and through psychological practice
is through the management of stress (Arslan et al., 2020b; Harris et al., 2016; Nyklíček &
Kuijpers, 2008). One applied example in the literature relates to the use of mindfulness
and meditation to manage stress (Harris et al., 2016; Nyklíček & Kuijpers, 2008; Waters
et al., 2014). While the current impact of stress following COVID-19 on well-being and
mental health has yet to be established, this study aims to redress this issue. Assessing
stress and psychological responses during a critical event is important for informing

CONTACT Gökmen Arslan gkmnarslan@gmail.com Department of Psychological Counseling and Guidance,

Faculty of Education, Mehmet Akif Ersoy University, Burdur, Turkey
Correspondence concerning this article should be addressed to Gökmen Arslan, Ph.D., Faculty of Education, Mehmet Akif
Ersoy University in Burdur, Turkey. E-mail: gkmnarslan@gmail.com
© 2021 Informa UK Limited, trading as Taylor & Francis Group
2 G. ARSLAN AND K.-A. ALLEN

disaster response and preparedness for future events (Almazan et al., 2019, 2018;
Mohammadinia et al., 2019).
Given that it is expected that there will be acute reactions to the pandemic such as
stress disorders, post-traumatic stress following preliminary reports on mental health
and case studies on psychiatric patients (Hao et al., 2020; Mucci et al., 2020) as well as the
continued financial and social stressors placed on people that may well exist long after the
pandemic, examining well-being remains a critical component of research in this field. In
an earlier study conducted in Wang et al., (2020)) used online surveys to measure the
psychological and mental health impact of COVID-19. At least one half of the respon­
dents experienced a moderate to severe psychological impact and at least one third
experienced moderate to severe mental health impact. In a follow-up study, Wang
et al., (2020)) re-surveyed respondents four weeks later to evaluate any change to their
psychological and mental health. However, there was no significant change. Both studies
did identify some protective factors that lessened the impact of COVID-19, such as trust
in both the health information received and the doctors treating the disease and the
respondents following precautionary measures like wearing a mask.

Psychological flexibility
Psychological resources that an individual may possess are essential in managing stress
and maintaining well-being, especially in adjusting to life during and after a global
pandemic such as COVID-19 (Di Giuseppe et al., 2020). Psychological flexibility refers
to an individual’s ability to adapt to different situations, change perspectives if necessary,
and balance one’s needs and desires (Tanhan, 2019; Kashdan & Rottenberg, 2010).
Wersebe et al. (2018) investigated the efficacy of Acceptance Commitment Therapy
(ACT), an intervention that employs psychological flexibility to manage stress and
enhance well-being. In the randomized control trial, the intervention effectively reduced
stress and promoted well-being, providing empirical support for psychological flexibility
in this relationship. Psychological flexibility may provide an adaptive pathway for
managing the stressors associated with COVID-19 (Polizzi et al., 2020). While less
research is available on the stress associated with coping with disasters, much research
points to the importance of coping strategies for resilience and recovery more generally
(Cutter et al., 2008; Jabeen et al., 2010; Nia et al., 2017; Shing et al., 2016). As a dimension
of resilience, psychological flexibility is considered an adaptive coping strategy that plays
an important role in recovering from adversity (Bryan et al., 2015). Bryan et al. (2015)
found evidence for psychological flexibility preventing post-traumatic stress disorder
following a traumatic event. Decreases in suicide ideation and depression also accom­
panied this. Hence, examining psychological flexibility within the context of stress
brought on by COVID-19 has potential implications for future interventions.

Meaning
Having meaning in life is often associated with finding purpose in life, which is
positively related to psychological well-being and optimal functioning (Brassai et al.,
2011; Park & Gutierrez, 2012). Having a sense of meaning in life is understood to
mitigate stress from complex events (Park & Gutierrez, 2012 https://doi.org/10.1080/
 PSYCHOLOGY, HEALTH & MEDICINE 3

09515070.2012). Park and Gutierrez (2012) found that meaning played a central yet
complex role in the way people adjusted to stressful life events. In adolescence,
a meaningful life has a notable protective impact on suicide prevention (Lew et al.,
2019). In a sample of over 2,000 undergraduate students, Lew et al. (2019) found that
the presence of a meaningful life was a powerful predictor of preventing suicide. Given
that suicide rates, depression, and anxiety are expected to rise following COVID-19,
investigating protective factors is critical (Mucci et al., 2020).
Meaning in life is a moderator between perceived stress and avoidant coping, suggest­
ing that having a sense of meaning in life may serve as a buffer towards negative
outcomes following a potentially traumatic event (Halama & Bakošova, 2009). This
explanation has been supported in a sample of military victims (Owens et al., 2009).
Owens et al. (2009) found that lower meaning in life predicted greater post-traumatic
stress disorder severity in those who had been exposed to traumatic events in the military.
J. Park and Baumeister (2017) investigated the daily stress experienced by individuals and
found that people with lower meaning in life had higher stress. The researchers also
noted the buffering effects of meaning in life. Therefore, in the literature, we see the
importance of meaning in life and psychological flexibility for well-being and mental
health. However, there is no research to date that has applied these psychological assets to
COVID-19 stress (Tran et al., 2020).

Purpose of the study

With the literature sketched above, the present study explores the associations between
coronavirus stress, meaning in life, psychological flexibility, and subjective well-being.
Specifically, we hypothesized that (i) meaning in life would mediate the association
between coronavirus stress and subjective well-being, (ii) psychological flexibility
would mediate the association between coronavirus stress and subjective well-being,
and (iii) psychological flexibility would mediate the association between coronavirus
stress and meaning in life. Given the impact of coronavirus, understanding the mitigating
factors is vital for health care providers and government officials to respond to the crisis,
and better prepare for future outbreaks or similar disasters.

Method
Participants
The study participants consisted of 417 undergraduate (94%) and graduate students from
a public university in a small urban city in Turkey. Students were 40.3% male and 59.7%
female, ranging in age from 18 to 40 years (M = 23.36, SD = 5.96). An online survey was
administered to students who volunteered to participate in the study. This study was
approved by the ethics committee of the first author’s institution.

Measures
Well-Being. The Satisfaction with Life Scale (SWLS) (Diener et al., 1985) was used to
measure individuals’ subjective well-being. The SWLS was also used to assess individuals’
4 G. ARSLAN AND K.-A. ALLEN

cognitive assessments of well-being. The scale is a 5–item self–report instrument (e.g.,

‘The conditions of my life are excellent’), scoring using a 7-point Likert type scale,
ranging from strongly agree (7) to strongly disagree (1). The reliability coefficients of
the SWLS were adequate for a Turkish sample (Dağlı & Baysal, 2016).
Coronavirus Stress. The Coronavirus Stress Scale (CSS) is a 5–item, self-reported
measure to assess coronavirus stress (Arslan et al., 2020). All items of the scale are scored
using a 5–point Likert type scale, ranging between 0 = never and 4 = very often (e.g., ‘How
often have you felt that you were unable to control the important things in your life due
to the COVID-19 pandemic?’). The scale had strong internal reliability with a Turkish
sample (Arslan et al., 2020).
Meaning in Life. Meaning in life was measured using Meaningful Living Measure
(MLM; Arslan et al., 2020) that is a 6-item self-report scale (e.g., ‘As a whole, I find my life
meaningful’). All items of the scale are scored using a 7-point Likert type scale ranging
from strongly disagree (1) to strongly agree (7). The MLM had strong internal reliability
estimates with a Turkish sample (Arslan et al., 2020).
Psychological Flexibility. Acceptance and Action Questionnaire–II was used to mea­
sure psychological flexibility, a 7–item self-report scale developed to assess psychological
flexibility (Bond et al., 2011). All items of the scale are scored based on a 7–point Likert
type scale, ranging from 1 = never true to 7 = always true (e.g., ‘My painful experiences
and memories make it difficult for me to live a life that I would value’). Yavuz et al. (2016)
investigated the scale’s psychometrics with a Turkish sample, indicating the strong
internal and test-retest reliability estimate.

Data analyses
A two-step process was conducted to examine the proposed structural model. In the first
phase of analysis, descriptive statistics, internal reliability estimate, and Pearson correla­
tion were examined. Skewness and kurtosis scores were used to evaluate the normality
assumption of the measures (skewness and kurtosis scores< |2|). Subsequently, the
Pearson product-moment correlation analysis was performed to investigate the associa­
tion between the study variables. In the second phase, a measurement and structural
equation model was performed to analyze the mediating effect of psychological flexibility
and meaning in life on the relationship between coronavirus stress and well–being. The
analyses were evaluated using several data–model fit statistics: CFI and TLI values
between .90 and .95 showed adequate data–model fit, and SRMR and scores between
.05 and .08 were considered an adequate data–model fit (Kline 2015). All data analyses
were conducted using SPSS version 25 and AMOS version 24.

Results
Descriptive statistics and correlation analysis
Findings from descriptive statistics indicated that skewness and kurtosis scores ranged
between −.803 to .478, and all scales were relatively normally distributed. The internal
reliability estimate of the measures was strong, ranging from .81 to .93, as shown in Table 1.
Further, the correlation analysis findings revealed that coronavirus stress was negatively
 PSYCHOLOGY, HEALTH & MEDICINE 5

Table 1. Descriptive statistics and correlation results.

Scales Range M SD Skew. Kurt. α 1. 2. 3. 4.
1. Life satisfaction 5–35 19.77 6.99 –.09 –.82 .91 – –.28** .65** .34**
2. Coronavirus stress 0–20 11.65 3.93 –.16 .03 .81 – –.20** –.42**
3. Meaning in life 12–42 31.48 7.40 –.78 –.13 .93 – .29**
4. Psychological flexibility 7–49 32.66 9.86 –.25 –.73 .92 –
Note. **Correlation is significant at the .001 level (2-tailed).

correlated with life satisfaction, meaning in life, and psychological flexibility. Meaning in
life and psychological flexibility were positively associated with life satisfaction. Similarly,
there was a positive correlation between meaning in life and psychological flexibility.

Structural equation model

All latent structures were determined using the items of the measures. Findings from the
measurement model indicated adequate data–model fit statistics (χ2 = 713.73, df = 224,
p < .001, RMSEA = .072 [90% CI for RMSEA: .067–.079], SRMR = .044, CFI = 92,
TLI = .92). All relationships between latent constructs were statistically significant, with
standardized regression estimates ranging from – .47 to .70. Findings showed that the
proposed model provided adequate data–model fit statistics. Similar to the measurement
model, the chi-square value was significant (χ2 = 713.73, df = 224, p < .001), and the χ2/df
ratio was 3.18. The RMSEA and the SRMR values were good (RMSEA = .072 [90% CI for
RMSEA: .067–.079], SRMR = .060). Moreover, the CFI and TLI scores were .90 and
higher, indicating an adequate data model fit (CFI = 92 and TLI = .91).
Findings from standardized regression estimates showed that coronavirus stress sig­
nificantly and negatively predicted psychological flexibility (β = – .47, p < .001), while
non–significantly predicting meaning in life (β = – .04, p= .49). Coronavirus stress
accounted for 22% of the variance in psychological flexibility, and coronavirus stress
and psychological flexibility together explained 10% of the variance in meaning in life.
Further, the results showed that subjective well–being was significantly and positively by
meaning in life (β = .65, p < .001) and psychological flexibility (β = .10, p < .05), while
negatively predicted by coronavirus stress (β = – .13, p < .05). Coronavirus stress had
a significant predictive effect on subjective well-being through meaning in life and
psychological inflexibility, as shown in Table 2. Finally, psychological flexibility signifi­
cantly and positively predicted meaning in life (β = .30, p < .001), and this construct
mediated the effect of psychological flexibility on subjective well-being. Together, all

Table 2. Standardized indirect effects.

Path Effect SE BootLLCI BootULCI
Stress–>Flexibility–>Meaning –.14 .03 –.21 –.08
Flexibility–>Meaning–>Satisfaction .19 .04 .11 .28
Stress–>Flexibility–>Meaning–>Satisfaction –.17 .04 –.26 –.08
Note. Number of bootstrap samples for percentile bootstrap confidence intervals: 10 000 with 95% bias-corrected
confidence interval predicting resilience scores

variables accounted for 53% of the variance in subjective well–being, as shown in Figure 1.
6 G. ARSLAN AND K.-A. ALLEN

Figure 1. Structural equation model indicating the association between variables. Note. *p < .05,
**p < .001.

Discussion
The present study sought to examine the mediation effect of psychological flexibility and
meaning in life on the association between coronavirus stress and subjective well-being
among Turkish undergraduate students. The study’s findings supported the first hypoth­
esis of the study, indicating that meaning in life mediated the association between
coronavirus stress and subjective well-being. Coronavirus became a global pandemic in
early 2020. The experience damages people’s well-being if they do not manage effectively
(Shahsavarani et al., 2015). Specifically, given the impacts of quarantine (Brooks et al.,
2020; Hawryluck et al., 2004; Reynolds et al., 2008), understanding the associated stress of
COVID-19 and the role of factors (e.g., psychological flexibility) that may help to explore
its impacts on the well-being of individuals is critical for mental health providers and
government officials to provide mental health services during and after the pandemic and
to also better prepare for similar disasters.
Consistent with the results of the present study, past research indicated that stress was
a significant factor for mental health and well-being (Bell et al., 2012; Brooks et al., 2020;
Garbarino et al., 2013; Harris et al., 2016; McLaughlin et al., 2010; Pflanz, 2001), and
meaning in life was key to protect and foster mental health and well-being during these
adverse times (Arslan et al., 2020; Frankl, 1985; Hicks & Routledge, 2013; Batthyany &
 PSYCHOLOGY, HEALTH & MEDICINE 7

Russo-Netzer, 2014). For example, individuals with high levels of the sense of meaning in
life reported greater subjective well-being, psychological well-being, quality of life, and
optimism (Ho et al., 2010) and adaptive coping strategies (Edwards & Holden, 2001) and
less psychological distress (Korte et al., 2012). Meaning in life may assist people to
overcome stressors and promote their mental health and well-being by helping them
move beyond not only to survive but also to a new level of resilience (Wong & McDonald,
2002). These results suggest that meaning in life is an important mechanism for promot­
ing individuals’ well-being in the context of pandemic.
Further results revealed that psychological flexibility mediated the association between
coronavirus stress and subjective well-being, supporting the present study’s second
hypothesis. Psychological flexibility is a significant resource in providing an adaptive
pathway for managing the adverse experience (Polizzi et al., 2020). Similar to previous
literature (Arslan et al., 2020; Tanhan, 2019; Tanhan et al., 2020; Wersebe et al., 2018), the
study results provide evidence suggesting that psychological flexibility might serve as an
adaptive coping strategy that helps individuals to recover from coronavirus stress. For
example, psychological flexibility was found to be highly effective for reducing stress and
promoting well-being (Wersebe et al., 2018) and a mediator in the association between
adverse events and well-being outcomes (Crosby et al., 2011; Gaudiano et al., 2017; Kurz
et al., 2014; Mendoza et al., 2018). Arslan et al. (2020) reported psychological flexibility
mediated the association between stress-related to COVID-19 and psychological health
problems (e.g., depression, anxiety). The study’s findings also showed that psychological
flexibility mediated the association between coronavirus stress and meaning in life.
Literature has supported this evidence indicating that psychologically flexible people
report greater meaning in life and well-being (Hayes et al., 2004; Kashdan & Rottenberg,
2010). Their ability to adapt to different kinds of situations, change perspectives if
necessary, and balance one’s needs and desires (Kashdan & Rottenberg, 2010) can
promote the use of strategies that might contribute to their sense of life meaning.

Implication and limitations

Findings of the study support that psychological flexibility is an essential contract in
improving well-being in the face of adversity. Given the literature suggesting the effec­
tiveness of ACT-based interventions on mental health and well-being (Wersebe et al.,
2018), mental health providers could design the prevention and intervention services to
foster mental health and well-being during and after the pandemic. Psychological flex­
ibility could be integrated with these programs, and these services could promote the
sense of meaning in life and well-being in individuals. Meaning in life has been found
another important construct in fostering individuals’ well-being in the context of stress
during the pandemic. Meaning in life is theoretically and empirically identified as
a critical mechanism to foster and protect mental health and well-being during difficult
times (Wong, 2012; Wong & McDonald, 2002). Therefore, mental health providers could
develop meaning-based interventions, and psychological flexibility may be integrated
into these programs to promote well-being during the pandemic.
Although the present study provides significant implications for research and practice,
it should be considered in the light of a few methodological limitations. First of all, the
data was collected using self-reported measures, and future studies should investigate the
8 G. ARSLAN AND K.-A. ALLEN

associations among the study variables using multiple assessment techniques. Next,
a cross-sectional design was used in the present study, which cannot ascertain a causal
association among the study variables. Longitudinal research could offer additional
insights into the associations between the variable of the study. In terms of the selection
of the measures, the CSS scale was selected in the absence of alternative COVID-specific
stress measures available in the literature. It is a brief measure of 5 items which carries
limitations in that it does not specifically measure depression or post-traumatic stress
specifically which may provide additional information in the context of the present
findings. Finally, participants of this study included 417 undergraduate and graduate
students from a public university in Turkey. Further research needs to be conducted with
diverse populations and contexts to explore the association between the variables.

Disclosure statement
The authors declared no conflicts of interest with respect to the research, authorship, and/or
publication of this article.

Funding
The authors received no financial support for the research, authorship, and/or publication of this
article

Ethical approval
All procedures performed in studies involving human participants were in accordance with the
ethical standards of the institutional and/or national research committee and with the 1964
Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent informed

Consent was obtained from all participants included in the study

References
Almazan, J. U., Albougami, A. S., Alamri, M. A., Colet, P. C., Adolfo, C. S., Allen, K. A.,
Gravoso, R., & Boyle, C. (2019). Disaster-related resiliency theory among older adults who
survived Typhoon Haiyan. International Journal of Disaster Risk Reduction, 35(1), 101070.
https://doi.org/10.1016/j.ijdrr.2019.101070
Almazan, J. U., Cruz, J. P., Alamri, M. S., Alotaibi, J. S. M., Albougami, A. S. B., Gravoso, R.,
Abocajo, F., Allen, K. A., & Bishwajit, G. (2018). Predicting patterns of disaster -related
resiliency among older adult typhoon Haiyan survivors. Geriatric Nursing, 39(6), 629–634.
https://doi.org/10.1016/j.gerinurse.2018.04.015
Anlaml? Ya?am Ölçe?inin geli?tirilmesi: Anlaml? ya?ama ili?kin k?sa ve etkili bir ölçme arac?
[Development of the Meaningful Living Measure: A brief and effective measure of meaningful
living]. Mehmet Akif Ersoy University Journal of Education Faculty, 56, 227–242. https://doi.
org/10.21764/maeuefd.773686
Arslan, G., Yıldırım, M., Karataş, Z., Kabasakal, Z., & Kılınç, M. (2020). Meaningful living to
promote complete mental health among university students in the context of the COVID-19
 PSYCHOLOGY, HEALTH & MEDICINE 9

pandemic. International Journal of Mental Health and Addiction. https://doi.org/10.1007/

s11469-020-00416–8
Arslan, G. ., & Co?kun, M. (2020). Student subjective wellbeing, school functioning, and psycho­
logical adjustment in high school adolescents: A latent variable analysis. Journal of Positive
School Psychology, 4(2),153–164. https://doi.org/10.47602/jpsp.v4i2.231
Arslan, G. (2020). Loneliness, college belongingness, subjective vitality, and psychological adjust­
ment during coronavirus pandemic: Development of the College Belongingness Questionnaire.
Journal of Positive School Psychology. Retrieved from https://journalppw.com/index.php/
JPPW/article/view/240
Arslan, G. (2020). Anlaml? Ya?am Ölçe?inin geli?tirilmesi: Anlaml? ya?ama ili?kin k?sa ve etkili bir
ölçme arac? [Development of the Meaningful Living Measure: A brief and effective measure of
meaningful living]. Mehmet Akif Ersoy University Journal of Education Faculty, 56, 227–242.
https://doi.org/10.21764/maeuefd.773686
Arslan, G., Allen, K. A., & Al-Adawi, S. (2020). School bullying, mental health, and wellbeing in
adolescents: Mediating impact of positive psychological orientations. Child Indicators Research,
1–29. https://doi.org/10.1007/s12187-020-09759-z
Arslan, G., Allen, K. A., & Ryan, T. (2020a). Exploring the impacts of school belonging on youth
wellbeing and mental health among Turkish adolescents. Child Indicators Research, 13(5),
1619–1635. https://doi.org/10.1007/s12187-020-09721-z
Arslan, G., Yıldırım, M., Tanhan, A., Buluş, M., & Allen, K. A. (2020b). Coronavirus stress,
optimism-pessimism, psychological inflexibility, and psychological health: Psychometric prop­
erties of the coronavirus stress measure. International Journal of Mental Health and Addiction
(IJMA), 1–17. https://doi.org/10.1007/s11469-020-00337-6
August, R., & Dapkewicz, A. (2020). Benefit finding in the COVID-19 pandemic: College students’
positive coping strategies. Journal of Positive School Psychology. Retrieved from https://jour
nalppw.com/index.php/JPPW/article/view/245
Batthyany, A., & Russo-Netzer, P. (Eds.). (2014). Meaning in positive and existential psychology.
New York, NY: Springer
Bartels, M., Cacioppo, J. T., van Beijsterveldt, T. C., & Boomsma, D. I. (2013). Exploring the
association between well-being and psychopathology in adolescents. Behavior Genetics, 43(3),
177–190. https://doi.org/10.1007/s10519-013-9589-7
Bell, A. S., Rajendran, D., & Theiler, S. (2012). Job stress, wellbeing, work-life balance of academics.
Electronic Journal of Applied Psychology, 8(1), 25–37. doi:10.7790/ejap.v8i1.320
Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K M.., Guenole, N., Orcutt, H. K., Waltz, T., &
Zettle, R. D.(2011). Preliminary psychometric properties of the Acceptance and Action
Questionnaire–II: A Revised Measure of Psychological Inflexibility and Experiential
Avoidance. Behavior Therapy,42,676–688.
Brassai, L., Piko, B., & Steger, M. (2011). Meaning in life: Is it a protective factor for adolescents’
psychological health? International Journal of Behavioral Medicine, 18(1), 44–51. https://doi.
org/10.1007/sl2529-010-9089-6
Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J.
(2020). The psychological impact of quarantine and how to reduce it: Rapid review of the
evidence. The Lancet, 395(10227), 912–920. https://doi.org/10.1016/S0140-6736(20)30460-8
Bryan, C. J., Ray-Sannerud, B., & Heron, E. A. (2015). Psychological flexibility as a dimension of
resilience for post-traumatic stress, depression, and risk for suicidal ideation among Air Force
personnel. Journal of Contextual Behavioral Science, 4(4), 263–268. https://doi.org/10.1016/j.
jcbs.2015.10.002
Crosby, J. M., Bates, S. C., & Twohig, M. P. (2011). Examination of the relationship between
perfectionism and religiosity as mediated by psychological inflexibility. Current Psychology,30
(2), 117–129. https://doi. org/10.1007/s12144-011-9104-3
Cutter, S. L., Barnes, L., Berry, M., Burton, C., Evans, E., Tate, E., & Webb, J. (2008). A place-based
model for understanding community resilience to natural disasters. Global Environmental
Change, 18(4), 598–606. https://doi.org/10.1016/j.gloenvcha.2008.07.013
10 G. ARSLAN AND K.-A. ALLEN

Dağlı, A., & Baysal, N. (2016). Yaşam Doyumu Ölçeğinin Türkçe’ye uyarlanması: Geçerlik ve
güvenirlik çalışması. Elektronik Sosyal Bilimler Dergisi,15(59), 1250–1262. https://doi.org/10.
17755/esosder.263229
Di Giuseppe, M., Gemignani, A., & Conversano, C. (2020). Psychological resources against the
traumatic experience of COVID-19. Clinical Neuropsychiatry, 17(2), 85–87.
Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale. Journal
of Personality Assessment, 49, 71–75.
Edwards, M. J., & Holden, R. R. (2001). Coping, meaning in life, and suicidal manifestations:
Examining gender differences. Journal of clinical psychology, 57(12),1517–1534. https://doi.
org/10.1002/jclp.1114
Frankl, V. E. (1985). Man’s search for meaning: An introduction to logotherapy. New York: Pocket
books.
Frydenberg, E., Deans, J., & O’Brien, K. A. (2012). Developing children’s coping in the early years:
Strategies for dealing with stress, change and anxiety. Bloomsbury.
Garbarino, S., Cuomo, G., Chiorri, C., & Magnavita, N. (2013). Association of work-related stress
with mental health problems in a special police force unit. BMJ Open, 3(7), e002791. https://doi.
org/10.1136/bmjopen-2013-002791
Gaudiano, B. A., Schofield, C. A., Davis, C., & Rifkin, L. S. (2017). Psychological inflexibility as a
mediator of the relationship between depressive symptom severity and public stigma in
depression. Journal of Contextual Behavioral Science, 6(2), 159–165. https://doi.org/10.1016/j.
jcbs.2017.04.010
Halama, P., & Bakošova, K. (2009). Meaning in life as a moderator of the relationship between
perceived stress and coping. Studia psychologica, 51(2–3), 143–148.
Hao, F., Tan, W., Jiang, L., Zhang, L., Zhao, X., Zou, Y., Hu, Y., Luo, X., Jiang, X., McIntyre, R. S.,
Tran, B., Sun, J., Zhang, Z., Ho, R., Ho, C., & Tam, W. (2020). Do psychiatric patients
experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A
case-control study with service and research implications for immunopsychiatry [published
online ahead of print, 2020 Apr 27]. Brain, Behavior, and Immunity, 87, 100–106. S0889-
1591(20)30626-7. https://doi.org/10.1016/j.bbi.2020.04.069
Harris, A. R., Jennings, P. A., Katz, D. A., Abenavoli, R. M., & Greenberg, M. T. (2016). Promoting
stress management and well-being in educators: Feasibility and efficacy of a school-based yoga
and mindfulness intervention. Mindfulness, 7(1), 143–154. https://doi.org/10.1007/s12671-015-
0451-2
Hawryluck, L., Gold, W. L., Robinson, S., Pogorski, S., Galea, S., & Styra, R. (2004). SARS control
and psychological effects of quarantine, Toronto, Canada. Emerging Infectious Diseases, 10(7),
1206–1212. https://doi.org/10.3201/eid1007.030703
Hayes, S. C., Strosahl, K., Wilson, K. G., Bissett, R. T., Pistorello, J., Toarmino, D., ... & McCurry, S.
M. (2004). Measuring experiential avoidance: A preliminary test of a working model. The
psychological record,54(4), 553–578. https://doi.org/10.1007/BF03395492
Hicks, J. A., & Routledge, C. (2013). The experience of meaning in life: Classical perspectives,
emerging themes, and controversies. New York, NY: Springer Science.
Jabeen, H., Johnson, C., & Allen, A. (2010). Built-in resilience: Learning from grassroots coping
strategies for climate variability. Environment and Urbanization, 22(2), 415–431. https://doi.
org/10.1177/0956247810379937
Kashdan, T. B., & Rottenberg, J. (2010). Psychological Flexibility as a Fundamental Aspect of
Health. Clinical Psychology Review, 30(7), 865–878. https://doi.org/10.1016/j.cpr.2010.03.001
Kline, R. B. (2015).Principles and practice of structural equation modeling. New York: Guilford.
Ko, H.-J., Hooker, K., Manoogian, M. M., & McAdams, D. P. (2019). Transitions to Older
Adulthood: Exploring Midlife Women’s Narratives Regarding Purpose in Life. Journal of
Positive School Psychology, 3(2),137–152.
Korte, J., Cappeliez, P., Bohlmeijer, E. T., & Westerhof, G. J. (2012). Meaning in life and mastery
mediate the relationship of negative reminiscence with psychological distress among older
adults with mild to moderate depressive symptoms. European journal of ageing,9(4), 343–351.
https://doi.org/10.1007/s10433-012-0239-3
 PSYCHOLOGY, HEALTH & MEDICINE 11

Kubzansky, L. D., Huffman, J. C., Boehm, J. K., Hernandez, R., Kim, E. S., Koga, H. K., Feig, E. H.,
Lloyd-Jones, D. M., Seligman, M. E. P., & Labarthe, D. L. (2018). Positive psychological
well-being and cardiovascular disease: JACC health promotion series. Journal of the American
College of Cardiology, 72(12), 1382–1396. https://doi.org/10.1016/j.jacc.2018.07.042
Kurz, A. S., Bethay, J. S., & Ladner-Graham, J. M. (2014). Mediating the relation between work­
place stressors and distress in ID support staff: comparison between the roles of psychological
inflexibility and coping styles. Research in Developmental Disabilities,35(10), 2359–2370.
Lew, B., Huen, J., Yu, P., Yuan, L., Wang, D. F., Ping, F., Abu Talib, M., Lester, D., & Jia, C. X.
(2019). Associations between depression, anxiety, stress, hopelessness, subjective well-being,
coping styles, and suicide in Chinese university students. PloS One, 14(7), e0217372. https://doi.
org/10.1371/journal.pone.0217372
Matud, M., Lopez-Curbelo, M., & Fortes, D. (2019). Gender and psychological well-being.
International Journal of Environmental Research and Public Health, 16(3531), 1–11. https://
doi.org/10.3390/ijerph16193531
McLaughlin, K. A., Conron, K. J., Koenen, K. C., & Gilman, S. E. (2010). Childhood adversity,
adult stressful life events, and risk of past-year psychiatric disorder: A test of the stress
sensitization hypothesis in a population-based sample of adults. Psychological Medicine, 40
(10), 1647–1658. https://doi.org/10.1017/S0033291709992121
Mendoza, H., Goodnight, B. L., Caporino, N. E., & Masuda, A. (2018). Psychological Distress
among Latina/o College Students: the Roles of Self-Concealment and Psychological Inflexibility.
Current Psychology,37(1), 172–179.
Minkkinen, J., Auvinen, E. ., & Mauno, S.. (2020). Meaningful Work Protects Teachers’ Self-Rated
Health under Stressors. Journal of Positive School Psychology, 4(2),140–152. https://doi.org/10.
47602/jpsp.v4i2.209
Mohammadinia, L., Ebadi, A., Malekafzali, H., Allen, K. A., & Nia, H. S. (2019). The design and
psychometric evaluation of the adolescents’ resilience in disaster tool (ARDT-Q37): A mixed
method study. Heliyon, 5(7), e02019. https://doi.org/10.1016/j.heliyon.2019.e02019
Mucci, F., Mucci, N., & Diolaiuti, F. (2020). Lockdown and isolation: Psychological aspects of
COVID-19 pandemic in the general population. Clinical Neuropsychiatry, 17(2), 63–64. https://
doi.org/10.36131/CN20200205
Nia, H. S., Sharif, S. P., Goudarzian, A. H., Allen, K. A., Jamali, S., & Heydari Gorji, M. A. (2017).
The relationship between religious coping and self-care behaviors in Iranian medical students.
Journal of Religion and Health, 56(6), 2109–2117. https://doi.org/10.1007/s10943-017-0376-2
Nyklíček, I., & Kuijpers, K. F. (2008). Effects of mindfulness-based stress reduction intervention on
psychological well-being and quality of life: Is increased mindfulness indeed the mechanism?
Annals of Behavioral Medicine, 35(3), 331–340. https://doi.org/10.1007/s12160-008-9030-2
Owens, G. P., Steger, M. F., Whitesell, A. A., & Herrera, C. J. (2009). Post-traumatic stress disorder,
guilt, depression, and meaning in life among military veterans. Journal of Traumatic Stress, 22
(6), 654–657. https://doi.org/10.1002/jts.20460
Park, C. L. & Gutierrez, I. A. (2012). Global and situational meaning in the context of trauma:
Relations with psychological well-being. Counselling Psychology Quaterly,26(1), 8–25. https://
doi.org/10.1080/09515070.2012
Park, J., & Baumeister, R. F. (2017). Meaning in life and adjustment to daily stressors. The Journal
of Positive Psychology, 12(4), 333–341. https://doi.org/10.1080/17439760.2016.1209542
Pflanz, S. (2001). Occupational stress and psychiatric illness in the military: Investigation of the
relationship between occupational stress and mental illness among military mental health
patients. Military Medicine, 166((6)), 457–462. https://doi.org/10.1093/milmed/166.6.457
Polizzi, C., Lynn, S. J., & Perry, A. (2020). Stress and coping in the time of COVID-19: Pathways to
resilience and recovery. Clinical Neuropsychiatry, 17, 59–62. https://doi.org/10.36131/
CN20200204
Reynolds, D. L., Garay, J. R., Deamond, S. L., Moran, M. K., Gold, W., & Styra, R. (2008).
Understanding, compliance, and psychological impact of the SARS quarantine experience.
Epidemiology and Infection, 136(7), 997–1007. https://doi.org/10.1017/S0950268807009156
12 G. ARSLAN AND K.-A. ALLEN

Shahsavarani, A., Abadi, E., & Kalkhoran, M. (2015). Stress: Facts and theories through literature
review. International Journal of Medical Reviews, 2(2), 230–241.
Shing, E. Z., Jayawickreme, E., & Waugh, C. E. (2016). Contextual positive coping as a factor
contributing to resilience after disasters. Journal of Clinical Psychology, 72(12), 1287–1306.
https://doi.org/10.1002/jclp.22327
Schulz, E. (2020). Perceived Wellbeing as Related to Spirituality and Stress Management: A Case
Study of the Purna Health Management System. Journal of Positive School Psychology, 4(1),1–
14.
Tanhan, A. (2019). Acceptance and Commitment Therapy with Ecological Systems Theory:
Addressing Muslim Mental Health Issues and Wellbeing. Journal of Positive School
Psychology, 3(2), 197–219. https://doi.org/10.47602/jpsp.v3i2.172 2
Tanhan, A., Yavuz K. F., Young, J. S., Nalbant, A., Arslan, G., Yıldırım, M., Ulusoy, S., Genç, E.,
Uğur, E., & Çiçek, İ. (2020). A Proposed Framework Based on Literature Review of Online
Contextual Mental Health Services to Enhance Wellbeing and Address Psychopathology During
COVID-19. Electronic Journal of General Medicine, 17(6), em254. https://doi.org/10.29333/
ejgm/8316
Tran, B. X., Ha, G. H., Nguyen, L. H., Vu, G. T., Hoang, M. T., Le, H. T., Latkin, C. A., Ho, C. S. H.,
& Ho, R. C. M. (2020). Studies of novel coronavirus disease 19 (COVID-19) pandemic: A global
analysis of literature. . International Journal of Environmental Research and Public Health, 17
(11), 4095. https://doi.org/10.3390/ijerph17114095
Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., & Ho, R. C. (2020). Immediate psychological
responses and associated factors during the initial stage of the 2019 coronavirus disease
(COVID-19) epidemic among the general population in China. International Journal of
Environmental Research and Public Health, 17 (5), 1729. Published 2020 Mar 6. https://doi.
org/10.3390/ijerph17051729.
Waters, L., Barsky, A., Ridd, A., & Allen, K. A. (2014). Contemplative education: A systematic,
evidence-based review of the effect of meditation interventions in schools. Educational
Psychology Review, 27(1), 103–134. https://doi.org/10.1007/s10648-014-9258-2
Wersebe, H., Lieb, R., Meyer, A. H., Hofer, P., & Gloster, A. T. (2018). The link between stress,
well-being, and psychological flexibility during an Acceptance and Commitment Therapy
self-help intervention. International Journal of Clinical and Health Psychology, 18((1)), 60–68.
https://doi.org/10.1016/j.ijchp.2017.09.002
Wong, P. T. P. (2012). The human quest for meaning: Theories, research, and applications.
Routledge.
Wong, P. T. P., & McDonald, M. (2002). Tragic optimism and personal meaning in counselling
victims of abuse. Pastoral Sciences, 20(2), 231–249.
Yavuz, F., Ulusoy, S., Iskin, M., Esen, F. B., Burhan, H. S., Karadere, M. E., & Yavuz, N. (2016).
Turkish Version of Acceptance and Action Questionnaire-II (AAQ-II): A reliability and validity
analysis in clinical and non-clinical samples. Klinik Psikofarmakoloji Bülteni-Bulletin of Clinical
Psychopharmacology,26(4),397–408 https://doi.org/10.5455/bcp.20160223124107 doi:10.5455/
bcp.20160223124107
Yildirim, M., & Belen, H. (2018). The Role of Resilience in the Relationships between Externality of
Happiness and Subjective Well-being and Flourishing: A Structural Equation Model Approach.
Journal of Positive School Psychology, 3(1),62–76.
Y?ld?r?m, M., & Çelik Tanr?verdi, F. (2020). Social Support, Resilience and Subjective Well-being
in College Students. Journal of Positive School Psychology. Retrieved from https://journalppw.
com/index.php/JPPW/article/view/229