Predicting Psychological Distress and Flourishing During the COVID-19 Pandemic in BrazilAbstract
This study investigated positive and negative predictors of depression, anxiety, stress, and flourishing among Brazilian adults during the first wave of the COVID-19 pandemic. The sample consisted of 665 adults (77% women), aged between 18 and 79 years (M= 36.70; SD = 13.12), who completed a sociodemographic questionnaire, the Brief-COPE Inventory, the Depression, Anxiety and Stress Scale, the PERMA Profiler, the Acceptance and Action Questionnaire-II, and the Meaning-Centered Coping Scale. Multiple regression analyses indicated that avoidance coping and psychological inflexibility were significant predictors of stress, anxiety, and depression. Age, flourishing, and perceived physical health acted as protective factors, with differences observed between participants with and without prior psychological diagnoses. Meaning-centered coping predicted flourishing in both groups. These findings suggest that interventions should consider previous diagnoses and promote dimensions of flourishing, alongside adaptive coping strategies, including meaning-centered coping.
Keywords:
depression; anxiety; stress; coping; COVID-19
Resumo
Este estudo investigou preditores positivos e negativos de depressão, ansiedade, estresse e florescimento entre adultos brasileiros durante a primeira onda da pandemia de COVID-19. A amostra consistiu em 665 adultos (77% mulheres), com idades entre 18 e 79 anos (M= 36,70; DP = 13,12), que responderam a um questionário sociodemográfico, ao Inventário Brief-COPE, à Escala de Depressão, Ansiedade e Estresse, ao PERMA Profiler, ao Acceptance and Action Questionnaire-II e à Escala de Coping Centrado no Sentido. Regressões múltiplas indicaram que evitação e inflexibilidade foram preditores significativos de estresse, ansiedade e depressão. Idade, florescimento e saúde física percebida atuaram como fatores protetores, com diferenças entre participantes com e sem diagnósticos psicológicos prévios. O coping centrado no sentido foi preditor de florescimento em ambos os grupos. Esses resultados sugerem que intervenções devem considerar diagnósticos prévios e promover dimensões do florescimento, juntamente com estratégias adaptativas de enfrentamento, incluindo o coping centrado no sentido.
Palavras-chave:
depressão; ansiedade; estresse; coping; COVID-19
Resumen
Este estudio investigó predictores positivos y negativos de depresión, ansiedad, estrés y florecimiento en adultos brasileños durante la primera ola de la pandemia de COVID-19. La muestra estuvo compuesta por 665 adultos (77% mujeres), con edades entre 18 y 79 años (M = 36,70; DP = 13,12), quienes completaron un cuestionario sociodemográfico, el Inventario Brief-COPE, la Escala de Depresión, Ansiedad y Estrés, el PERMA Profiler, el Acceptance and Action Questionnaire-II y la Escala de Afrontamiento Centrada en el Sentido. Regresiones múltiples indicaron que evitación e inflexibilidad fueron predictores significativos de estrés, ansiedad, y depresión. Edad, florecimiento y salud física percibida actuaron como factores protectores, con diferencias entre participantes con y sin diagnósticos psicológicos previos. El afrontamiento centrado en el sentido fue predictor de florecimiento en ambos grupos. Estos resultados sugieren que intervenciones deben considerar diagnósticos previos y promover dimensiones del florecimiento, junto con estrategias adaptativas de afrontamiento, incluido el afrontamiento centrado en el sentido.
Palabras clave:
depresión; ansiedad; estrés; afrontamiento; COVID-19
As the COVID-19 pandemic unfolded, it emerged as one of the most impactful events of a generation. Its harmful effects on the physical health of the world’s population have been extensively reported (United Nations, 2020). In 2020, during the pandemic’s first wave, the Brazilian government mandated the closure of shops, schools, universities, and all non-essential services to contain the spread of the virus. Social distancing measures were implemented, varying across states according to the regional severity of the pandemic.
Psychological distress during the pandemic was influenced by a range of factors, including threats to physical health, loneliness, grief, financial instability, uncertainty about the future, physical distancing from loved ones, and other related stressors (United Nations, 2020). Additional stressors included prolonged social distancing, frustration, boredom, multitasking, excessive workloads, lack of essential supplies, ambiguous information, fear of infection, lack of psychological support, concern for loved ones, and job-related risks (García-Iglesias et al., 2024; Hossain et al., 2020).
Research on the topic indicates a wide range of mental health problems associated with the pandemic, such as depression, anxiety, stress, panic attacks, irrational anger, impulsivity, substance use, sleep disorders, emotional dysregulation, posttraumatic stress disorder, social phobia, agoraphobia, and suicidal behavior (Hossain et al., 2020; Searby et al., 2024). Previous mental health diagnoses are also considered a risk factor, as individuals with pre-existing conditions are particularly vulnerable to stress, often showing impaired cognitive and emotional regulation of both positive and negative affect, a higher risk of relapse, and more severe symptoms (Liu et al., 2020).
Other factors influencing mental health during the pandemic included stigma, psychosocial support, coping mechanisms, age, income reduction, and high-risk occupations such as healthcare work (Duarte et al., 2020; Hossain et al., 2020). Additional variables have also been associated with decreased well-being and increased mental health disorders, including high negative affect, low positive affect, excessive media exposure, overuse of social networks, younger age, and lack of activities (Dubey et al., 2020; Kupcova et al., 2023; Prati, 2021).
Other studies have investigated social distancing (Duarte et al., 2020) and loneliness (Okruszek et al., 2020) as predictors of mental health problems. Social distancing was not considered a significant risk factor for depression, anxiety, and stress in Brazil’s South Region (Duarte et al., 2020). In contrast, loneliness, financial concerns, and social isolation were strongly associated with the development of mental health problems (Okruszek et al., 2020). Poor perceived physical health was also identified as a potential risk factor, as concerns about infection and vulnerability due to comorbidities may affect psychological well-being (Prati, 2021).
Psychological inflexibility - characterized by rigid patterns of thoughts, emotions, and/or behaviors - and avoidance of difficult experiences are associated with poorer mental health (Dawson & Golijani-Moghaddam, 2020). A longitudinal study conducted in Spain demonstrated that psychological inflexibility predicted mental health symptoms during lockdown (Hernández-López et al., 2021), highlighting the importance of investigating the association between psychological flexibility and distress.
In Brazil, studies primarily assessed anxiety, depression, and stress during the pandemic, emphasizing the relevance of examining both risk and protective factors. Severe depression was observed to be directly associated with confrontation, escape, or distancing coping strategies (Ferreira et al., 2021). Escaping, self-control, and accepting responsibility for the situation were also associated with depression, anxiety, and stress in the study by Patias et al. (2021). In both studies, only depressive symptoms were negatively associated with problem-solving and positive reappraisal strategies, suggesting that these strategies may function as potential protective factors.
Lewis et al. (2022) highlight the need to investigate factors associated with positive mental health outcomes. Effective coping mechanisms are important for individuals’ adaptation to situations perceived as threatening (Prati, 2021). Consequently, adaptive coping styles may play an important role as protective factors against psychological distress and may contribute to increased well-being. Acceptance, positive reinterpretation, and resilient coping strategies have been identified in the literature as potential protective factors against anxiety (Campos et al., 2024; Pires et al., 2024). Similarly, studies conducted during the pandemic have reported significant associations between hope, optimism, and gratitude and lower levels of anxiety (Almansa et al., 2024; Pires et al., 2024).
In the context of adaptation process required during quarantine, meaning-centered coping strategies (MCCS) may also be valuable. Defined as strategies that contribute to maintaining and restoring one’s sense of meaning and purpose in life, MCCS has been identified in the literature as a predictor of well-being (Eisenbeck et al., 2022).
Another possible protective factor is an individual’s level of flourishing. Defined as the psychological state “that arises from functioning well across multiple psychosocial domains” (Butler & Kern, 2016, p. 2), flourishing is composed of five domains within PERMA theory: positive emotion (P), engagement (E), relationships (R), meaning (M), and accomplishment (A). The importance of each of these domains for mental health was reviewed by Butler and Kern (2016). However, it is also important to investigate coping mechanisms associated with higher levels of flourishing.
To better understand which variables may be associated with increases or reductions in these symptoms, this study aimed to investigate positive and negative predictors of depression, anxiety, stress, and flourishing among Brazilian adults during the first wave of the COVID-19 pandemic.
Method
Participants
Participants were required to be at least 18 years old, provide informed consent, and complete the questionnaire in full. Individuals who did not agree to participate were not granted access to the questionnaire. Participants younger than 18 years old or those who did not complete the questionnaire in full were excluded from the study. No additional exclusion criteria were applied.
The final sample consisted of 665 adults who completed the survey, predominantly women (n = 510; 77%), aged 18 to 79 years (M = 36.7; SD = 13.12). Participants represented all five major regions of Brazil: Center-West (n = 75; 11%), North (n = 111; 17%), Northeast (n = 122; 18%), South (n= 156; 24%), and Southeast (n = 201; 30%). Most participants were single (n = 234; 35%). Respondents reported being religious in their own way (n = 334; 50%), having completed undergraduate education (n = 398; 60%), and having an average socioeconomic status (n = 399; 60%).
Instruments
This questionnaire is part of a larger international research project investigating the psychological impact of the COVID-19 pandemic using multiple instruments. However, for the purposes of the present study, only the measures relevant to this research were analyzed. Participants completed an online questionnaire including the instruments listed below.
Sociodemographic and psychological questions. Participants provided information regarding gender, age, relationship status, religiousness, state of residence, perceived socioeconomic status, highest level of education, and the number of days they had been practicing social distancing. They were also asked whether they had previously been diagnosed with any psychological or psychiatric disorder. Participants who responded affirmatively were asked to specify the diagnosis and indicate whether they were currently undergoing treatment and, if so, which type of treatment.
Depression, Anxiety and Stress Scale - Short Form (DASS-21). This instrument evaluates symptoms of common psychological/psychiatric disorders. It was adapted to Brazilian Portuguese by Vignola (2014). Participants indicated the extent to which each statement (e.g., I tended to over-react to situations) applied to them over the previous week using a scale ranging from 0 (“Did not apply to me at all”) to 3 (“Applied to me very much or most of the time”). Higher scores indicate more severe symptoms. Cronbach’s alpha coefficients for this sample were .86 for Anxiety, .91 for Stress, and .92 for Depression.
Brief Coping Orientation to Problems Experienced (Brief-COPE). The Brief-COPE is the shortened version of the COPE Inventory and was adapted to Brazilian Portuguese by Maroco et al. (2014). The instrument comprises 28 items grouped into 14 coping strategies dimensions. Items (e.g., I’ve been expressing my negative feelings) are rated on a Likert-type scale ranging from 1 (“I haven’t been doing this at all”) to 4 (“I’ve been doing this a lot”). Higher scores indicate greater use of the coping strategies. The second-order dimensions used in the present study were those proposed and tested by Guerra et al. (2023). Cronbach’s alpha for the inventory in this sample was .83.
PERMA Profiler. Adapted to the Brazilian context by Carvalho et al. (2023), this instrument consists of 23 items that measure the five dimensions of flourishing (Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment) with additional items evaluating negative emotions, loneliness, and physical health. Participants respond to the items (e.g., In general, to what extent do you lead a purposeful and meaningful life?) using a 7-point Likert-type scale. With the exception of the negative emotions and loneliness scales, higher scores indicate higher levels of flourishing. Cronbach’s alpha for the full scale in this sample was .93, with values for the subscales ranging from .65 (Engagement) to.88 (Positive Emotion).
Acceptance and Action Questionnaire - II. The AAQ-II was developed to measure psychological inflexibility and was adapted to Brazil by Barbosa and Murta (2015). The scale consists of seven items (e.g., Emotions cause problems in my life). Participants indicate how true each statement is for them on a scale ranging from 1 (“Never true”) to 7 (“Always true”). Higher scores indicate greater inflexibility. Cronbach’s alpha in this sample was .94.
Meaning-Centered Coping Scale - MCCS. This instrument assesses coping strategies focused on deriving meaning from traumatic experiences, including positive reframing, hope, life appreciation, and courage in the face of adversity (Eisenbeck et al., 2022). Participants rate the nine items on a 7-point scale ranging from 1 (“I do not agree at all”) to 7 (“I completely agree”), with higher scores indicating greater use of meaning-centered coping. To verify the scale´s structure in the Brazilian Portuguese sample, a confirmatory factor analysis was conducted using JASP with the DWLS estimator. All fit indexes supported the unidimensional structure: χ2 (27) = 15.47; p = .96; CFI = 1.00; NFI = 1.02; RMSEA = .000 (.000 - .000); SRMR = .062. Regression weights ranged from .406 (item 4) to .819 (item 6). The model showed an average variance extracted (AVE) of .520, and reliability indices were .90 for both Cronbach’s alpha and McDonald’s omega.
Procedures
Data collection. This study was part of an international project that aimed at understanding the psychological impact of the COVID-19 pandemic. Participants were recruited using a snowball sampling method during the second semester of 2020. A link to the questionnaire, created using Google Forms, was distributed via direct e-mail and social networking platforms and applications (e.g., Facebook, Instagram, and WhatsApp). The first page of the questionnaire contained the informed consent form, where participants indicated their agreement before accessing the full questionnaire.
Data analysis. The analyses conducted in this study were exploratory and descriptive. All analyses were performed using JASP (version 0.8.6.0.). The Shapiro-Wilk test was used to assess normality, and bootstrapping procedures (1,000 resamples; 95% BCa CI) were applied to address non-normal distributions and differences in group sizes. Descriptive statistics (e.g., medians, means, standard deviations, and frequencies) were calculated for sociodemographic variables, previous mental health diagnoses, and duration of social distancing. Independent-samples t tests were conducted to investigate possible gender differences and differences between participants with (PD) and without (ND) previous mental health diagnoses in levels of psychological distress. Pearson correlations were used to identify relationships among constructs. After examining these preliminary correlation analyses, multiple linear regression analyses using a forward method were conducted to investigate which of the proposed dimensions - coping strategies, meaning-centered coping, flourishing, perceived physical health, loneliness, psychological inflexibility, age, and number of days of social distancing -predicted depression, anxiety, stress, and flourishing (dependent variables).
Ethical considerations
The study was submitted to and approved by the Brazilian National Research Ethics Committee (CONEP; CAAE nº 30892620.3.0000.5542; Protocol nº 4.073.224). Participants did not receive any financial compensation for their participation.
Results
Participants indicated having practiced social distancing from 0 to 120 days (M = 43; SD = 21.9; Mdn = 40). Of the total sample, 157 participants (24%) reported having previously been diagnosed with a psychological and/or psychiatric disorder. The most frequently reported diagnosis was depression (n= 84), followed closely by anxiety (n= 82). Other disorders mentioned were panic disorder (n = 22), ADHD (n= 7), obsessive-compulsive disorder (n = 6), eating disorders (n= 4), bipolar disorder (n = 3), and borderline personality disorder (n = 2). A total of 178 participants (27%) indicated that they were currently receiving treatment. Psychotherapy was the most frequently reported treatment (n= 114; 52.5%), followed by prescribed medications (n= 85; 39.2%).
To determine whether participants without a prior diagnosis (ND; n = 508) differed from those with a prior diagnosis (PD; n = 157) in levels of psychological distress (stress, anxiety, and depression) and flourishing, independent-samples t tests were conducted. Results showed that ND participants presented lower scores on their levels of stress (M = 12.87; SD = 10.22), anxiety (M = 6.46; SD = 7.45), and depression (M = 12.08; SD = 10.62), and higher levels of flourishing (M= 4.02; SD= 1,09) when compared to PD participants: stress, M = 17.94 (SD = 11.33), t (663) = 5.29, p< .001, d= -0.48; anxiety, M = 11.06 (SD = 10.68), t (663) = 6.05, p < 0.001, d = -0.55; depression, M = 16.88 (SD = 12.57), t (663) = 4.72, p < .001, d = -0.43; and flourishing, M = 3.76 (SD= 1.21), t (663) = 2.497, p = .013, d = 0.22. Considering that these two groups of participants differed significantly from each other regarding the main variables, all subsequent analyses were conducted separately for these two groups.
An independent-samples t test was conducted to verify possible gender differences between participants identified as female and male regarding stress, anxiety, depression, and flourishing. Results showed no significant differences between PD men and women. However, ND women showed significantly higher levels of stress and anxiety when compared to men in the same group (see Table 1). No significant differences were observed regarding levels of flourishing.
Findings from the correlation analyses, presented in Table 2, showed that stress levels were positively correlated with loneliness, psychological inflexibility, and avoidance coping in both groups, and with seeking social support among ND participants. In both groups, negative correlations were observed with age, flourishing, physical health, hope-based coping, and meaning-centered coping. Among PD participants, stress was also negatively correlated with positive problem-solving.
Anxiety symptoms were positively associated with loneliness, psychological inflexibility, and avoidance coping in both groups. Among ND participants, a positive association was also observed between anxiety and seeking social support. Negative relations were observed with age, flourishing, physical health, and meaning-centered coping style in both groups.
Depression symptoms were significantly and positively associated with loneliness, psychological inflexibility, and avoidance coping in both groups. Among ND participants, a small positive association was also observed with seeking social support. Negative associations were observed in both groups with age, flourishing, physical health, positive problem-solving coping, hope-based coping, and meaning-centered coping style.
Based on these correlations, depression, anxiety, and stress were entered as dependent variables in multiple linear regression analyses using a forward method. The proposed predictors, entered simultaneously while controlling for each other’s covariances, were coping strategies, meaning-centered coping style, flourishing, perceived physical health, loneliness, psychological inflexibility, age, and number of days of social distancing. Predictors of flourishing were also investigated. Results for ND participants are presented in Table 3 and for PD participants in Table 4.
For ND participants, direct predictors of stress were avoidance coping, psychological inflexibility, and seeking social support. Age and flourishing acted as protective factors against stress (R 2 adj = .46, F (5, 458) = 77.873, p < .001). For anxiety, direct predictors were also avoidance coping, psychological inflexibility, and seeking social support, whereas the only negative predictor was perceived physical health (R 2 adj = .35, F (4, 459) = 64.41, p < .001).
For depressive symptoms in the same group, the direct predictors were psychological inflexibility, avoidance coping, and loneliness. Age, flourishing, and hope-based coping acted as protective factors against these symptoms (R 2 adj = .57, F (6, 457) = 102.52, p < .001). Flourishing was positively predicted by MCCS, positive problem-solving, and seeking social support. Negative predictors were psychological inflexibility, hope-based coping, and avoidance coping (R 2 adj = .63, F (6, 457) = 134.58, p < .001).
Regarding PD participants, direct predictors of stress were psychological inflexibility, avoidance coping, and seeking social support. Negative predictors were perceived physical health and age (R 2 adj = .47, F (5, 144) = 27.15, p< .001). For anxiety, positive associations were observed with avoidance coping and psychological inflexibility, whereas the only negative predictor was perceived physical health (R 2 adj = .38, F (3, 146) = 32.02, p< .001). Depressive symptoms were directly predicted by psychological inflexibility and avoidance coping. Meaning-centered coping and perceived physical health acted as protective factors against depression (R 2 adj = .60, F (4, 145) = 57.04, p < .001). Flourishing was positively predicted by MCCS and positive problem-solving and negatively predicted by psychological inflexibility and avoidance coping (R 2 adj = .67, F (4, 145) = 76.27, p < .001).
Discussion
Given the projected increase in the number and severity of mental health problems resulting from the impact of the COVID-19 pandemic (United Nations, 2020), this study aimed to identify predictors of depression, anxiety, and stress among Brazilian participants during the period of safety measures implemented by regional and national health authorities in 2020. Notably, the results underscore the importance of paying greater attention to individuals with prior diagnoses, as they appear to be more vulnerable to the psychological effects of the pandemic.
Supporting prior research on the vulnerability of this population (Duarte et al., 2020; Ferreira et al., 2021; Hossain et al., 2020; Liu et al., 2020), participants with mental health disorders showed higher levels of stress, anxiety, and depression, and lower levels of flourishing. Although social isolation is an important risk factor for this group (Okruszek et al., 2020), no relationship was observed between the number of days of social distancing and levels of psychological distress.
Gender emerged as a significant variable only in the ND group, indicating women’s heightened vulnerability to stress and depression in the current context. These results corroborate previous research (Giordani et al., 2021; Hossain et al., 2020; Kupcova et al., 2023). The literature suggests that during the pandemic women were more likely to lose their jobs and experience income reductions compared to men (Dang & Nguyen, 2020). Possible contributors include increased childcare and household responsibilities, as schools were closed and children required full-time care (Ribarovska et al., 2021), as well as lack of social support (Okruszek et al., 2020). Further research is needed to investigate the factors associated with this expression of gender inequality and how interventions and public policies might address this issue.
The main risk factors observed across all symptoms in both groups were avoidance coping (Dawson & Golijani-Moghaddam, 2020; Ferreira et al., 2021; Hossain et al., 2020; Patias et al., 2021; Prati, 2021) and psychological inflexibility (Dawson & Golijani-Moghaddam, 2020). Further research could investigate whether these results are related to high levels of distress intolerance and/or intolerance of uncertainty regarding the situation. These two constructs were associated with higher levels of stress, anxiety, and depression even when controlling for each other’s variance. These findings suggest that interventions should focus on improving psychological flexibility as a mechanism that promotes adaptive coping strategies, as well as strengthening emotional regulation to reduce their negative impact (Hernández-López et al., 2021; Pires et al., 2024; Tindle et al., 2022).
Seeking social support was associated with increased symptoms of stress and anxiety, but not depression, among ND participants, and with increased stress symptoms among PD participants. During the isolation period, seeking instrumental and emotional support may have been stressful due to the risk of contamination, lack of reliable information, and widespread misinformation surrounding the disease. Further research on this topic is warranted.
The main protective factors were flourishing, age, and physical health, especially for PD participants. While MCCS was a significant predictor of depressive symptoms in PD participants, its primary relevance was as the main predictor of flourishing in both groups. This indicates that addressing the psychosocial domains central to the theory of flourishing (i.e., positive emotion, engagement, relationships, meaning, and accomplishment) might have an important positive impact in protecting individuals from the detrimental effects of the pandemic (Eisenbeck et al., 2022). In addition, these findings emphasize the relevance of investigating positive variables that may inform future interventions (Almansa et al., 2024; Pires et al., 2024).
Regarding the impact of age, which played an important role in understanding stress and depression among ND participants, the results corroborate previous research in Brazil (Campos et al., 2024; Giordani et al., 2021) and elsewhere (Hossain et al., 2020; Prati, 2021). Younger participants appear to be more vulnerable to the pressures associated with social distancing measures during the pandemic, showing higher levels of stress and depressive symptoms. The literature reports a higher prevalence of generalized anxiety and depression among younger individuals (Hossain et al., 2020), as well as lower scores on adaptive coping strategies (Campos et al., 2024). This higher prevalence of mental health disorders places them within a vulnerable group, characterized by increasing levels of psychological distress (Kupcova et al., 2023).
The perception of one´s physical health was important in mitigating anxiety among ND participants and symptoms of stress, anxiety, and depression among PD participants. These results suggest that PD participants, who are already more vulnerable to relapse, rely on their physical health as a buffer against the impact of the pandemic. Some of these findings corroborate previous research conducted during the pandemic (Prati, 2021), reinforcing their relevance and highlighting the importance of promoting both physical and mental health care for the population through public policy.
Although the pandemic occurred approximately five years ago, when the data were collected, it is important to highlight the relevance of these findings in the current context. First, the prolonged negative impact of elevated stress levels during the COVID-19 pandemic has been described as a “mental health pandemic” (Parrish, 2020), reflecting a significant increase in mental health disorders since 2020. Therefore, its effects are still evident, and data regarding the association between psychological distress and different constructs remain valid and may be useful in informing treatment.
Additionally, registering and sharing data regarding the mental health impact of a potentially traumatic event such as the pandemic is relevant, as it contributes to identifying potential risk and protective factors associated with prolonged stress. Future interventions may consider this information when planning actions aimed at reducing the impact of similar events in the future.
Regarding the limitations of this study, it is important to acknowledge that these findings are based on self-report measures of psychological distress, coping, and other variables. The most vulnerable groups with respect to psychological disorders are underrepresented in the sample. Penninx et al. (2022) emphasize that studies using online data collection and self-reported measures of psychological distress during the pandemic presented high levels of anxiety and depression symptoms, which should be interpreted as indicating increased vulnerability and risk for developing mental disorders, rather than a causal effect reflected in an increase in the number of clinical cases. Although these limitations must be recognized, they do not diminish the significance of the findings.
The sociodemographic heterogeneity of the sample is also a relevant factor, considering that adverse outcomes may vary across different population subgroups. In a country such as Brazil, where diversity is an intrinsic cultural, economic, and sociodemographic characteristic, it is important to recognize the impact of various social determinants on mental health (Moeti et al., 2022). In this study, we focused on gender and previous diagnoses of mental disorders. Further research could also examine the intersection of these aspects with race, geographical region, religious beliefs, relationship status, and other variables relevant to mental health.
Further studies could examine high resilience levels as a protective factor and test their relationship with psychological inflexibility. In conclusion, it is necessary to propose psychological interventions that help individuals manage these symptoms. Schmidt et al. (2021) suggest interventions directed toward the public, such as booklets and other informational materials, psychological first-aid, psychological support provided online or by phone, and the development of online research projects that may provide information to better understand the state of the population´s mental health and support adequate care.
Based on the results presented here and the growing literature on mental health during the COVID-19 pandemic, interventions should focus on developing psychological flexibility, resilience, physical health, and psychological well-being as protective factors. Remote psychotherapeutic services should be offered, along with improved remote communication with work, friends, and family; shorter work hours, regular rest periods, and rotating shifts for health workers (Hamouche, 2023); as well as practical guidance to help people maintain regular sleep cycles and engage in physical activities. In addition, especially for individuals with previous mental health disorders, it is necessary to maintain access to prescribed medications and psychotherapy through remote methods, as well as long-term psychological follow-up (Dubey et al., 2020). These findings are relevant and valid in the current context, particularly when informing the development of mental health care strategies and psychosocial support for individuals in need of psychological care.
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Data Availability
The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.
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How to cite this article:
Guerra, V. M., Carreno, D. F., Eisenbeck, N., Vazquez. A. C. S., Miranda, G. U., Monteiro, R. P., Giacomoni, C. H., Oliveira, C. M., Freires, L. A., Henklain, M. H. O., & Silva, J. A. (2026). Predicting Psychological Distress, and Flourishing During the COVID-19 Pandemic in Brazil. Paidéia (Ribeirão Preto), 36, e3613. https://doi.org/10.1590/1982-4327e3613
The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.
