Physical disorders and anxiety are frequently comorbid. This study investigates the characteristics of physical disorders, self-rated heath, subjective well-being and anxiety in adolescents. Data were drawn from the Saving and Empowering Young Lives in Europe cohort study. From 11 countries 11,230 adolescents, aged 14–16 years were included. Zung Self-Rating Anxiety Scale (SAS), WHO-5 Well-Being Index and five questions prepared for this study to evaluate physical illnesses and self-rated heath were administered. Anxiety levels were significantly higher in adolescents who reported having physical disability (p < 0.001, Cohen’s d = 0.40), suffering from chronic illnesses (p < 0.001, Cohen’s d = 0.40), impairments associated to health conditions (p < 0.001, Cohen’s d = 0.61), or reported poor to very poor self-rated health (p < 0.001, Cohen’s d = 1.11). Mediational analyses revealed no direct effect of having a chronic illness/physical disability on subjective well-being, but the indirect effects through higher levels of anxiety were significant. Functional impairment related to health conditions was both directly and indirectly (through higher levels of anxiety) associated with lower well-being. The co-occurrence of anxiety and physical disorders may confer a greater level of disability and lower levels of subjective well-being. Clinicians have to screen anxiety, even in a subthreshold level in patients with choric physical illness or with medically unexplained physical symptoms.

Chronic stress leads to deficits in executive functions; its effect on cognitive emotion regulation has yet to be investigated. The present study explores the possible role of cognitive emotion regulation strategies in mediating the well-established association between perceived stress and anxiety. We assumed it should be that, via impaired prefrontal activity and executive functions, stress leads to the reduced use of executive strategies and the increased use of non-executive strategies, resulting in higher levels of anxiety. A cross-sectional sample of 162 university students completed the Perceived Stress Scale, the Spielberger Trait Anxiety Inventory, and the Cognitive Emotion Regulation Questionnaire. Multiple mediation analysis resulted in a significant model, in which cognitive emotion regulation strategies mediated the effect of perceived stress on anxiety (Adjusted R² = 0.68, F_12,149 = 29.30, p < 0.001, effect ratio = 0.22). Specifically, greater stress was found to be uniquely related to increased use of non-executive strategies (self-blame, rumination, and catastrophizing) and decreased use of cognitive strategies involving executive functions (positive reappraisal and putting into perspective). Greater use of non-executive strategies and reduced use of executive strategies (except for putting into perspective) was in turn found to be associated with higher levels of anxiety. These results seem to suggest that under stressful conditions — precisely when control is most needed — cognitive regulation may be ineffective in controlling emotional responses. Implications for preventing the negative effects of stress are highlighted.

Objective To explore the role of cognitive emotion regulation (CER) in the association between parenting self-efficacy (PSE) and state anxiety in parents of children undergoing surgery. Method In a prospective design, parents of 114 children admitted to hospital for planned surgical interventions completed self-report questionnaires assessing PSE, CER, and state anxiety. Mediational and moderational analyses were conducted to test competing theoretical models regarding the role of CER in the relationship between PSE and parents’ anxiety. Results The mediational model was rejected, whereas the findings supported a moderational model. The use of nonadaptive CER moderated the effect of PSE on parents’ anxiety. Higher PSE only predicted lower postsurgery anxiety when low use of nonadaptive CER was present. Conclusions Interacting cognitive factors contribute to parents’ anxiety after a child’s surgery. Both PSE and CER should be targeted in parent interventions promoting successful adjustments to surgery on children.