Flexibility in coping deployment and psychological adjustment during COVID-19: A three-level meta-analysis across 33 countries.

Introduction: Coping flexibility is proposed as an important framework for explicating psychological adjustment to major life stress. This meta-analysis investigates the hypothesized mental health benefits of coping flexibility in the context of COVID-19, evaluating the sources of variation across diverse studies.

Methods: A three-level meta-analysis was performed on 89 studies from 33 countries (total N = 102,304), testing 243 effect sizes. These eligible studies were conducted during the COVID-19 pandemic, and included at least one measure of coping flexibility and one positive (psychological adjustment) or negative (psychological maladjustment) criterion measure.

Results: The overall effect size was moderately strong (r = 0.28, 95 % CI [0.25, 0.31], k = 243), with significant between-study heterogeneity. Studies employing positive criterion measures reported stronger associations than those employing negative ones (b = 0.12, SE = 0.041, 95 % CI [0.037, 0.100], p = .005, k = 243, R = 0.051, R = 0.042). Significant moderation effects were also found for national COVID-19 mortality rates (b = 0.034, SE = 0.011, 95 % CI [0.012, 0.055], p = .003, k = 216, R = 0.028, R = 0.035), but no such moderations were observed for cultural individualism.

Discussion: Findings highlight the mental health benefits of coping flexibility amid the pandemic, but its role varies by contextual health-related stressors. The moderating effect of adjustment valence suggests dual pathways in which coping flexibility relates to positive versus negative mental health criteria. Practical implications are drawn for the design of targeted interventions to foster flexible coping with future health outbreaks.