{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T18:32:36Z","timestamp":1790274756283,"version":"4.1.0"},"reference-count":63,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Psychotherapy patients are particularly vulnerable to the experience of eco-distress, often referred to as climate anxiety or eco-anxiety. Eco-distress can foster pro-environmental behavior, but its various symptoms might as well be functionally impairing and are negatively correlated with psychological well-being. The link between eco-distress and depressive and anxiety symptoms, as well as the use of dysfunctional emotion regulation strategies, may explain this vulnerability and suggest ways to promote resilience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Psychotherapy out-patients were screened at T1 (\n                      <jats:italic>n<\/jats:italic>\n                      = 203) and again five months later (T2;\n                      <jats:italic>n<\/jats:italic>\n                      = 79) for anxious (Generalized Anxiety Disorder Scale; GAD-7) and depressive symptoms (Patient Health Questionnaire; PHQ-9) and for eco-distress (Eco-Anxiety Questionnaire, EAQ-22; Generalized Anxiety Disorder Scale-Climate Version; GAD-7-C; Climate Change-Man-Made Disaster Distress Scale; CC-MMDS). Emotion regulation strategies were assessed at T1. Factorial validity was tested for eco-distress questionnaires. The relationship of eco-distress, depressive and anxious symptoms, and emotion regulation strategies was tested via multivariate models, multiple regression analysis, and mediation analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The EAQ-22 and GAD-7-C showed good model fit, the factorial structure of the CC-MMDS had to be adapted. Participants who screened positive for a generalized anxiety disorder and\/or a depressive disorder at T1 reported higher levels of eco-distress, but changes in anxious or depressive symptoms from T1 to T2 did not predict a change in eco-distress. At T1,\n                      <jats:italic>Rumination<\/jats:italic>\n                      and\n                      <jats:italic>Catastrophizing<\/jats:italic>\n                      predicted higher scores of eco-distress for all three questionnaires. However, emotion regulation strategies did not mediate the effect of depressive and anxious symptoms on eco-distress.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Eco-distress is associated with the frequent use of the emotion regulation strategies\n                      <jats:italic>Catastrophizing<\/jats:italic>\n                      and\n                      <jats:italic>Rumination<\/jats:italic>\n                      and is higher in individuals with depressive and anxious symptoms. Addressing the use of these emotion regulation strategies in individuals could promote psychological resilience when facing the climate crisis.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2025.1664040","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:42:46Z","timestamp":1761824566000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Higher levels of eco-distress in psychotherapy out-patients with depressive and anxious symptoms are predicted by emotion regulation 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