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. 2022 Dec 22:10.1002/capr.12606. Online ahead of print. doi: 10.1002/capr.12606

Mindfulness and psychological distress in men during the COVID‐19 pandemic: The mediating role of environmental mastery and purpose in life

Emanuel Missias Silva Palma 1,✉, Anderson Reis de Sousa 2, Carolina Villa Nova Aguiar 1, Nathali Guimarães Nilo 1, Tácio Matos dos Santos 2
PMCID: PMC9880643  PMID: 36721644

Abstract

Men's mental health has been severely affected during the COVID‐19 pandemic, with many studies focussing on the determinants of men's psychological distress. This study aimed at examining the relationships between mindfulness, environmental mastery (EM), purpose in life (PL) and indicators of psychological distress (i.e., common mental disorders and perceived stress). This was a cross‐sectional online study in which participants were 1,006 men aged between 29 and 39 years (45.1%), residing in Brazil during the first wave of the COVID‐19 pandemic. A parallel multiple mediator model was used to test the study variables' relationships, using mindfulness as the independent variable and indicators of psychological distress as the dependent variables. Results indicated that EM and PL significantly mediated the effects of mindfulness on men's psychological distress, lowering its levels and accounting for 31% of common mental disorders and 51% of perceived stress. Implications for public health policies and clinical practice are discussed.

Keywords: environmental mastery, mindfulness, psychological distress, purpose in life

Implications for Practice and Policy.

  • This study suggests that the relations between mindfulness, environmental mastery, and a sense of purpose in life might attenuate men’s psychological distress during the COVID‐19 pandemic.

  • Furthermore, it underscores that environmental mastery and purpose in life might help extend the positive effects of mindfulness to their mental health.

  • Finally, these findings highlight that mental health practitioners might want to invest their time and resources to cultivate a sense of mindfulness in their patients through formal and informal practices.

1. INTRODUCTION

Substantial increases in psychological distress have been consistently reported worldwide in the months following the COVID‐19 outbreak in Wuhan, China, in December 2019 (Cullen et al., 2020). Since then, researchers have been interested in examining the symptoms of psychological disorders such as depression, anxiety and post‐traumatic stress and identifying the contextual and intraindividual predictors associated with the onset, maintenance and severity of these disorders. Furthermore, attention has been paid to how some populations, such as healthcare workers (Prado et al., 2020), adolescents (Miliauskas & Faus, 2020) and women (Souza et al., 2020), have been affected by and coped with the harmful effects of COVID‐19.

Regarding specific populations, studies have recently addressed how men's physical and mental health has been impacted by COVID‐19 (Ellison et al., 2021; Palma, de Sousa, et al., 2022; Palma, Sousa, et al., 2022). For instance, according to Capuano et al. (2020) and Ellison et al. (2021), men are more likely to be infected with SARS‐CoV‐2, be hospitalised, and die from COVID‐19 and its associated complications. Therefore, these variables might constitute vulnerability factors for men's psychological suffering (Palma, de Sousa, et al., 2022; Palma, Sousa, et al., 2022). In this sense, Ellison et al. (2021) point out that COVID‐19 has posed specific challenges for this population. One study suggested that, during the pandemic, men reported more depressive symptoms and suicidal ideation compared to women (Czeisler et al., 2020). Moreover, in the United States, an increase in mental health visits by men has been observed (Ellison et al., 2021), despite previous research indicating men's lower probability of seeking help from mental health services (Nam et al., 2010). Research has also suggested gender differences in how men and women manifest psychological suffering (Addis, 2008), underscoring the importance of focussing on men's specific psychological needs. Therefore, studies in this area might consider the interplay between factors from various dimensions.

Individual, interpersonal and contextual factors, such as intolerance of uncertainty, emotion regulation, poor or lack of social support, isolation, financial stressors and increasing unemployment rates (Ellison et al., 2021; Palma, de Sousa, et al., 2022; Palma, Sousa, et al., 2022; Park & Yu, 2022) might lead to greater psychological suffering in men. For example, Park and Yu (2022) highlighted that isolation and loneliness severely impacted men’s mental health during the COVID‐19 pandemic. Further, they observed an increase in studies dealing with men's adverse mental health outcomes, such as depression, anxiety, insomnia and use of substances (e.g., alcohol and tobacco). However, although some intervention studies have focussed on this population's specific mental health needs, few studies have emphasised variables that might serve as protective factors for men's health during the pandemic.

In fact, several determinants of men's psychological distress have been reported over the last 2 years (Palma, de Sousa, et al., 2022; Palma, Sousa, et al., 2022; Park & Yu, 2022). For instance, common mental disorders (i.e., indicators of anxiety, depression and stress‐related disorders) and perceived stress (i.e., individuals' appraisal of life stressors and their ability to cope with them effectively) have been consistently associated with intraindividual (e.g., intolerance of uncertainty, emotion regulation and coping strategies) and contextual (e.g., socio‐economic status, monthly income and marital status) variables, to varying degrees (Palma, de Sousa, et al., 2022; Palma, Sousa, et al., 2022; Park & Yu, 2022). However, the processes that might help protect individuals against psychological distress in the COVID‐19 context still warrant further investigation. In this study, we focussed on three processes (i.e., mindfulness, environmental mastery [EM] and purpose in life [PM]) and their direct and indirect effects on indicators of men's psychological suffering.

According to Neff's (2022) theoretical model, mindfulness is one of six elements of self‐compassion, and it involves individuals' stable and nonjudgemental awareness of emotional distress as it occurs in the present. In this model, mindfulness is thought to support different personal resources (e.g., self‐kindness and common humanity) that lead to better mental health outcomes (Neff, 2022). Additionally, the literature has regarded mindfulness as a healthy foundation that enhances other behavioural change processes (Schuman‐Olivier et al., 2020; Weis et al., 2021).

For instance, in a study by Bowlin and Baer (2012), dispositional mindfulness was associated with self‐control and predicted lower emotional distress and greater well‐being. In addition, research conducted during the COVID‐19 pandemic has shown that mindfulness‐based interventions reduced anxiety, depression and stress levels (Yeun & Kim, 2022). Conversano et al. (2020) also revealed that dispositional mindfulness served as a protective factor against psychological suffering in the early stages of the pandemic. In sum, these results point out that mindfulness as a trait and intervention might help individuals better cope with the daily challenges posed by the pandemic. However, some research has primarily underscored the direct effects of mindfulness on mental health (e.g., Conversano et al., 2020; Dillard & Meier, 2021). In this sense, the mechanisms through which mindfulness positively impacts mental health outcomes need further investigation because such understanding will enhance future intervention models by providing important mediator links clinicians will need to consider in their practice (Hofmann & Hayes, 2019). In this study, we focussed on two possible theoretically derived intermediary paths in the relation between mindfulness and psychological distress: EM and PL. Both variables appear to contribute to positive mental health and be linked to mindfulness, as shown in the literature (Fard et al., 2018; Matiz et al., 2020).

EM and PL are two core components of the psychological well‐being theoretical model (Ryff, 2018). EM involves arranging or creating different life contexts to meet various psychological, practical and physiological needs (Ryff, 2018). It also encompasses feelings of competence, self‐efficacy and self‐control (Joshanloo et al., 2021). PL, in turn, comprises a sense of direction and pursuing personally meaningful goals (Ryff, 2018). Both dimensions have been empirically related to positive mental health outcomes (Palma & Gondim, 2021; Ryff, 2018). In the COVID‐19 context, for instance, Mirabito and Verhaeghen (2022) found that an online mindfulness‐based intervention with college students was associated with lower psychological distress and higher environmental mastery. Similarly, Matiz et al. (2020) reported that teachers benefited from an 8‐week mindfulness‐oriented meditation course, demonstrating lower levels of psychological distress and greater EM and PL. Concerning PL, there have been studies showing its associations with mental health outcomes and mindfulness. For instance, Kang et al. (2021) found adults high in PL were more likely to report lower levels of loneliness and be more engaged in COVID‐19‐protective behaviours. Similarly, Echeverria et al. (2022) pointed out that PL protected college students' mental health against depression and other indicators of psychopathology during the pandemic. In studying the same population, Verhaeghen (2021) observed that mindfulness significantly predicted PL. Essentially, these studies have shown not only direct associations between EM, PL and positive mental health outcomes, but also evidence of their relations with mindfulness.

When carefully examining the literature, it becomes apparent that there exist different links between mindfulness, EM, PL and indicators of psychological distress. Nevertheless, to date, no study has tested multiple mediator models in which all these variables interact in a theoretically sensible manner. Such models might help clarify the intricate relations between these variables. In this context, the main objective of this study was to examine the relationships between mindfulness, EM, PL and psychological distress, in a sample of men residing in Brazil during the COVID‐19 pandemic.

2. METHOD

2.1. Participants

Participants in the study were 1006 men residing in Brazil, aged between 29 and 39 years old (n = 454; 45.1%). Four hundred and thirty‐four (45.9%) men self‐identified as heterosexual, and 511 (54.1%) were nonheterosexual. Most self‐identified as brown‐skinned (39.5%), single (64.2%), had a college degree (73.8%) and were employed (75%). Seventeen men (1.7%) reported having been diagnosed with COVID‐19 by a healthcare professional. Detailed sociodemographic data of the participants are provided in Table 1.

TABLE 1.

Participants' sociodemographic characteristics

Variables N %
Sexual identity (N = 945)
Heterosexual 434 45.9
Nonheterosexual 511 54.1
Age group (in years)
18–28 314 31.2
29–39 454 45.1
≥40 238 23.7
Educational level
Elementary/high school 264 26.2
College education 742 73.8
Race/Colour (N = 1001)
White 376 37.4
Yellow 19 1.9
Brown 397 39.5
Black 196 19.5
Indigenous 13 1.3
Monthly income
Up to 2 salaries 418 41.6
3–4 salaries 228 22.7
5 salaries or more 360 35.8
Employment situation
Employed 755 75.0
Unemployed 251 25.0
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Note: The total sample consisted of 1006 men. However, the number for each variable differed due to losses ranging from 0.4% to 6.0%.

2.2. Instruments

Psychological distress was a general term used to refer to indicators of common mental disorders and perceived stress. It was measured using the following two instruments:

2.2.1. The Self Reporting Questionnaire 20 (SRQ‐20)

The SRQ‐20 is a self‐report measure developed by the World Health Organization to check for symptoms (e.g., worry, insomnia, fatigue, indigestion and poor appetite) of nonpsychotic mental disorders, otherwise known as common mental disorders (CMD) (Beusenberg & Orley, 1994). Therefore, it serves as a screening, not a diagnostic, instrument. It consists of 20 items (e.g., Do you feel nervous, tense, or worried? Have you lost interest in things?) assessed using a yes (scored 1)/no (scored 0) response scale. When responding, individuals should consider the last 30 days. The maximum score is 20. Higher scores indicate the presence of severe emotional suffering. It was validated in Brazil by De Jesus Mari and Williams (1986) and has shown good psychometric properties. In this study, reliability, as assessed by Cronbach's alpha, was 0.87.

2.2.2. Perceived Stress Scale (PSS‐14)

The PSS‐14 is a 14‐item measure used to evaluate individuals' appraisal of stress levels in the last month (e.g., In the last month, how often have you found that you could not cope with all the things you had to do? In the last month, how often have you felt difficulties piling up so high that you could not overcome them?; Cohen et al., 1983). It is rated using a 5‐point Likert‐type scale in which 0 indicates “never,” and 4 “very often.” The maximum score is 56, and higher scores indicate greater perceived stress. It was validated in Brazil by Reis et al. (2010) and showed good psychometric properties. Reliability, assessed by Cronbach's alpha, was 0.88 in this study.

2.2.3. Mindfulness subscale of the Self‐Compassion Scale

This subscale assesses how an individual approaches feelings using a mindful stance of balance, curiosity and openness (Neff, 2003). It comprises four items (e.g., When I'm feeling down, I try to approach my feelings with curiosity and openness). It is rated using a Likert‐type response format in which 1 refers to “almost never,” and 5 “almost always.” The maximum score is 20, with higher scores indicating greater mindfulness. de Souza and Hutz (2016) adapted and validated the scale in Brazil, demonstrating good psychometric properties. Reliability, as assessed by Cronbach's alpha, was 0.78 in this study.

2.2.4. Environmental Mastery subscale of the Psychological Well‐Being Scale

This subscale consists of six items measuring the capacity to manage the environment to satisfy personal needs and deal with everyday life demands (e.g., In general, I feel I am in charge of the situation in which I live, and I am quite good at managing the many responsibilities of my daily life; Ryff, 1989). It is rated using a Likert‐type response scale in which 1 indicates “strongly disagree,” and 6 “strongly agree.” The maximum score is 36, and higher scores indicate individuals' ability to coordinate environmental demands successfully. It was validated in Brazil by Machado et al. (2013) and has shown good psychometric properties. Reliability, assessed by Cronbach's alpha, was 0.79 in this study.

2.2.5. Purpose in Life subscale of the Psychological Well‐Being Scale

This subscale consists of six items measuring individuals' sense of meaning and goal‐directed behaviour (e.g., Some people wander through life, but I am not one of them and I have a sense of direction and purpose in life; Ryff, 1989). It is rated using a Likert‐type response scale in which 1 indicates “strongly disagree,” and 6 “strongly agree.” The maximum score is 36, and higher scores indicate a greater sense of PL. It was validated in Brazil by Bandeira et al. (2013) and has shown good psychometric properties. Reliability, as assessed by Cronbach's alpha, was 0.78 in this study.

2.2.6. Sociodemographic questionnaire

The sociodemographic questionnaire contained questions about participants' age, educational level, race/colour, employment status, etc. and was used to describe the characteristics of the participants of this study.

2.3. Procedure

2.3.1. Data collection and sample size

Data were collected using an online questionnaire between April and June 2020, considered the first wave of the COVID‐19 pandemic in Brazil (Sousa et al., 2021). A snowball sampling technique was used, and potential participants were voluntarily invited to complete the research questionnaire through social media. In this online invitation, they received information about the study, an informed consent document and a link to the questionnaire containing the measures of the study variables. Before completing the questionnaire, participants had to agree with the online informed consent. They were also encouraged to forward this invitation to other potential participants. A sample consisting of at least 923 participants was estimated following the parameters of the population (N) of 69,324,099 men residing in Brazil who have access to the Internet (NIC.br, 2020). An expected proportion of 50% for the event of interest, a confidence level of 95%, 5% accuracy, 80% power, a design effect equal to 2 and a 20% increase in dropouts or problems during the completion of the online questionnaire were considered to calculate the sample size.

2.3.2. Data analysis

First, zero‐order correlations among all study variables and descriptive statistics were run using SPSS (v23, IBM). Next, the internal consistency of the measures was assessed using Cronbach's alpha. Then, two parallel multiple mediator models were conducted using PROCESS Macro (Hayes, 2017). In both models, mindfulness (the antecedent variable) was predicted to influence the levels of common mental disorders (Model 1) and perceived stress (Model 2) directly and indirectly via EM and PL (the mediators). Standardised coefficients were reported for the mediation models. Next, the effect size of mediated effects was measured using the proportion mediated (PM), as suggested by Preacher and Kelley (2011), and calculated by PROCESS Macro (Hayes, 2017) for SPSS. This measure shows the proportion of the total effect mediated by the intermediary variables. Finally, inference tests for total, direct and indirect effects were performed using a 95% bias‐corrected confidence interval based on a 5,000‐bootstrap sample.

2.3.3. Ethical considerations

This study is part of a larger research project approved by the Ethics Committee (Report number 4.076.529/2020) at the Universidade Federal da Bahia.

3. RESULTS

Table 2 shows the zero‐order correlations among all study variables. It also presents the means and standard deviations of the measures used in this study. As shown, all study variables had low‐to‐moderate significant relationships. Mindfulness, EM and PL were all significantly and inversely correlated with common mental disorders and perceived stress.

TABLE 2.

Means, standard deviations, and correlations among study variables

Variable M SD 1 2 3 4 5
1. MF 3.59 0.85
2. EM 3.62 0.76 0.36**
3. PL 4.70 0.79 0.39** 0.66**
4. CMD 5.99 4.73 −0.30** −0.48** −0.51**
5. PS 27.28 9.44 −0.49** −0.61** −0.62** 0.65**
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Abbreviations: CMD, common mental disorders; PS, perceived stress.

**

p < 0.01.

Figure 1 depicts the first mediation model, and the analysis shows that EM (β = −0.12, p ˂ 0.001, 95% CI [−0.16, −0.09]) and PL (β = − 0.09, p ˂ 0.001, 95% CI [−0.12, −0.06]) mediated the relationship between men's mindfulness and common mental disorders. The total PM was 0.68, of which 0.28 was attributed to EM and 0.40 was attributed to PL.

FIGURE 1.

FIGURE 1

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Mediation model of relationships between mindfulness, environmental mastery, purpose in life and common mental disorders

Figure 2 depicts the second mediation model, and the analysis shows that EM (β = −0.11, p ˂ 0.001, 95% CI [−0.14, −0.08]) and PL (β = −0.13, p ˂ 0.001, 95% CI [−0.16, −0.10]) mediated the relationship between men's mindfulness and perceived stress. The total PM was 0.48, of which 0.22 was attributed to EM and 0.26 was attributed to PL.

FIGURE 2.

FIGURE 2

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Mediation model of relationships between mindfulness, environmental mastery, purpose in life and perceived stress

4. DISCUSSION

Recent studies have shown that mindfulness is a promising intervention and a critical predictor of psychological well‐being across work settings, populations and crisis situations (Schuman‐Olivier et al., 2020; Yeun & Kim, 2022). For example, during the COVID‐19 pandemic, some studies have shown that it plays a vital role in protecting individuals' mental health against the adverse effects of aversive environments (Conversano et al., 2020; Mirabito & Verhaeghen, 2022; Yeun & Kim, 2022). However, the literature review evidenced that the mechanisms through which mindfulness positively influences mental health outcomes still require careful attention (Roca et al., 2021; Zhang et al., 2021).

The present study aimed at examining the relationships between mindfulness, EM, PL and indicators of psychological distress (i.e., symptoms of common mental disorders and perceived stress) in a sample of men residing in Brazil during the early stages of the COVID‐19 pandemic. Consistent with the literature (Bowlin & Baer, 2012; Voci et al., 2019), this research found that men who reported higher levels of mindfulness, EM and PL also reported lower levels of emotional distress. This literature has progressively highlighted the direct effects of these variables on mental health outcomes.

Individuals high in mindfulness, for instance, might be more psychologically flexible in dealing with environmental demands that pose a risk to their mental health (Hayes & Hofmann, 2018). In fact, Hayes and Hofmann (2018) highlight that mindfulness is an attentional style involving intentional engagement with, and awareness of, ongoing present‐moment events without judging them as either positive or negative. Therefore, mindfully paying attention might promote better observation of environmental opportunities to act flexibly and foster several change processes, such as EM and PL.

EM and PL were also negatively associated with psychological distress directly. This association might be explained, at least in part, by the known benefits of arranging one's contexts in ways conducive to using adaptive coping strategies in the face of adversities and having greater life satisfaction (Perron, 2006; Ryff, 2018). For example, Knight et al. (2011) reported that EM was the strongest negative predictor of depression in older adults, suggesting that it might be a critical focus of intervention by mental health practitioners. In turn, PL might protect one's mental health by fostering a sense of direction and meaning amid stressful events. In fact, White (2020) reports that individuals high in PL are more resilient, hopeful, open to new experiences and willing to contribute to their communities. Moreover, these repertoires might help them connect with larger life values, leading to better health outcomes. Taken together, these findings corroborate the literature on how these personal resources might act as protective factors against the deleterious effects of stressors on mental health, especially in the COVID‐19 context (Echeverria et al., 2022; Kang et al., 2021). In the present study, what is surprising, however, is the mediating role that EM and PL played in the relationships between mindfulness and psychological distress indicators.

The mediation models reveal something about the nature of the change mechanisms enhanced by mindfulness. Therefore, they add to a growing body of evidence that suggests mindfulness fosters personal resources that might indirectly impact mental health (Hayes & Hofmann, 2018). For example, in this study, mindful men (i.e., those who reported higher levels of mindfulness) might have been more likely to effectively arrange or control their different life domains to suit their varied needs and experience a greater sense of direction even in an uncertain and adverse context such as the one created by the COVID‐19 pandemic. These personal resources were then helpful in providing a sense of relief from psychological distress. Our results appear to be consistent with previous findings indicating that mindfulness not only directly affects mental health outcomes (Mirabito & Verhaeghen, 2022) but also indirectly activates paths leading to psychological well‐being (Verhaeghen, 2021). This offers strong support for our mediational model because it has demonstrated a more complex and nuanced network of relations between mindfulness and psychological distress.

In sum, mindfulness might promote greater EM and PL, which, in turn, help, at least in part, carry the beneficial effects of mindfulness, thus lessening psychological suffering. This is an important issue for future studies, especially for clinical research dealing with the mechanisms activated by mindfulness practice and for public health policies concerning men's well‐being.

Future clinical studies could, for instance, test how mindfulness training leads to a greater sense of EM and PL, and how these three variables might impact mental health outcomes through different time points during an intervention. In this sense, pretest and post‐test designs could help determine the effectiveness of an intervention, thus offering stronger support for our mediational model.

Concerning public health policies for men, Baker et al. (2020) highlighted that the COVID‐19 pandemic has evidenced how men and women are affected differently, with men's health being traditionally overlooked at several levels. According to these authors, studies investigating the determinants of men's health should assume an equity‐based approach that considers, for instance, vulnerable groups, male gender norms and strength‐based views. In this sense, the current study provides an invaluable examination of men's resources and their impacts on their health.

Undoubtedly, this work contributes to existing knowledge of predictors of mental health outcomes in specific populations by providing insight into how mindfulness, EM and PL protect men's mental health against the deleterious effects of the COVID‐19 pandemic. However, a few limitations need to be considered. For example, alternative ordering of the variables could lead to other reasonable mediation models, especially considering concurrent data were used in the present study. This issue could be tackled using experimental mediation tests using the model proposed in the current study. Therefore, the variables could be temporally arranged. In this regard, data collected over a period of time could also be helpful because longitudinal designs help determine cause‐and‐effect relationships more precisely by observing the real‐time sequence of events. Moreover, other critical contextual variables could be included in these models, such as men's socio‐economic status, social support, marital status, quality of family and friendship relationships, spirituality and the practice of mindfulness. These seem appropriate variables to consider in future mindfulness studies with men because they might serve as protective factors (Palma, de Sousa, et al., 2022; Palma, Sousa, et al., 2022; Park & Yu, 2022) and provide an even more complex picture of the relationship between mindfulness and psychological distress.

Notwithstanding these limitations, the current study suggests that mindfulness might indirectly influence favourable mental health outcomes by fostering one's sense of EM and PL. This has critical implications for clinical practice with men because the male population has been traditionally described as more resistant to psychological treatment (Nam et al., 2010) and more restrictive in their affect expression and regulation (Addis, 2008) due to a complex set of factors, such as the adherence to masculinity norms (e.g., dominance, aggressiveness, emotional inexpressiveness and self‐sufficiency) (Sousa et al., 2021).

In this context, mental health practitioners might want to focus their interventions on developing mindfulness through either formal (e.g., doing guided/planned exercises in and out of session) or informal (e.g., mindfully doing daily life activities) practices in diverse settings using different formats (e.g., individual or group). The benefits of mindfulness with men have been reported over the last few years (Lomas et al., 2020; Ramon et al., 2020). Intervention research, for instance, has shown that men from various age groups and ethnic backgrounds benefit from participating in mindfulness programmes by experiencing less anxiety, rumination and negative coping (Sibinga et al., 2013) and developing emotional intelligence (Lomas et al., 2014), emotional competencies, self‐control and mastery (Lomas et al., 2020).

Biographies

EMANUEL MISSIAS SILVA PALMA received his MS and PhD in psychology from the Federal University of Bahia. He is currently an adjunct professor at Escola Bahiana de Medicina e Saúde Pública (Bahiana School of Medicine and Public Health). His areas of professional interest include psychotherapy training, personal epistemology, positive psychology and behaviour analysis.

ANDERSON REIS DE SOUSA received his PhD in nursing from the Federal University of Bahia. He is currently an adjunct professor at the Federal University of Bahia. His areas of professional interest include men's health and health care.

CAROLINA VILLA NOVA AGUIAR received her PhD in psychology from the Federal University of Bahia. She is currently an adjunct professor at Escola Bahiana de Medicina e Saúde Pública. Her areas of professional interest include organisational psychology and work–family conflict.

NATHALI GUIMARÃES NILO is an undergraduate student of psychology at Escola Bahiana de Medicina e Saúde Pública. Her areas of interest include psychological research and clinical psychology.

TÁCIO MATOS DOS SANTOS is an undergraduate nursing student at the Federal University of Bahia. His areas of interest include men's health and nursing research.

Palma, E. M. S. , Reis de Sousa, A. , Aguiar, C. V. N. , Nilo, N. G. , & dos Santos, T. M. (2022). Mindfulness and psychological distress in men during the COVID‐19 pandemic: The mediating role of environmental mastery and purpose in life. Counselling and Psychotherapy Research, 00, 1–9. 10.1002/capr.12606

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