Coping style and mental health amid the first wave of the COVID-19 pandemic: a culture-moderated meta-analysis of 44 nations

In the first wave of the COVID-19 pandemic, the rapid transmission of a novel virus and the unprecedented disease-mitigation measures have elicited considerable stress in many countries worldwide. Coping with pandemic stress may be differentially related to psychological symptoms across countries characterised by distinct cultural values. This study aimed to: (a) synthesise the literature by investigating the associations between some major types of coping style and psychological symptoms, and (b) investigate the moderating effects of culture on these associations. We performed a three-level random-effects meta-analysis, which included 151 independent samples from 44 countries across eight world regions (n = 137,088, 66% women, M-age = 36.08). For both problem-focused and avoidant coping styles, their hypothesised associations with psychological symptoms were robust across the countries (anxiety: rs = -.11 and .31; depression: rs = -.19 and .33; ps < .0001). For both emotion-focused and social support seeking styles, their associations with psychological symptoms were moderated by two Hofstede's cultural dimensions: uncertainty avoidance (intolerance of ambiguity) and masculinity (concern for achievement and success). The hypothesised negative coping style-symptom associations were found only in the countries with lower levels of uncertainty avoidance or masculinity, but opposite patterns of findings were found in those with higher levels of either of these two cultural dimensions.