<?xml version="1.0" encoding="utf-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" "journalpublishing.dtd">
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" article-type="research-article" dtd-version="2.3" xml:lang="EN">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Psychol.</journal-id>
<journal-title>Frontiers in Psychology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Psychol.</abbrev-journal-title>
<issn pub-type="epub">1664-1078</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fpsyg.2025.1517441</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Psychology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Future anxiety, depression and stress among undergraduate students: psychological flexibility and emotion regulation as mediators</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>&#x00D6;ztekin</surname> <given-names>G&#x00FC;l&#x00E7;in G&#x00FC;ler</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="author-notes" rid="fn0001"><sup>&#x2020;</sup></xref>
<uri xlink:href="https://loop.frontiersin.org/people/2624271/overview"/>
<role content-type="https://credit.niso.org/contributor-roles/conceptualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/data-curation/"/>
<role content-type="https://credit.niso.org/contributor-roles/formal-analysis/"/>
<role content-type="https://credit.niso.org/contributor-roles/investigation/"/>
<role content-type="https://credit.niso.org/contributor-roles/methodology/"/>
<role content-type="https://credit.niso.org/contributor-roles/project-administration/"/>
<role content-type="https://credit.niso.org/contributor-roles/resources/"/>
<role content-type="https://credit.niso.org/contributor-roles/software/"/>
<role content-type="https://credit.niso.org/contributor-roles/validation/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author">
<name><surname>G&#x00F3;mez-Salgado</surname> <given-names>Juan</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
<xref ref-type="author-notes" rid="fn0002"><sup>&#x2020;</sup></xref>
<uri xlink:href="https://loop.frontiersin.org/people/536123/overview"/>
<role content-type="https://credit.niso.org/contributor-roles/funding-acquisition/"/>
<role content-type="https://credit.niso.org/contributor-roles/validation/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Y&#x0131;ld&#x0131;r&#x0131;m</surname> <given-names>Murat</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff4"><sup>4</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>&#x002A;</sup></xref>
<xref ref-type="author-notes" rid="fn0003"><sup>&#x2020;</sup></xref>
<uri xlink:href="https://loop.frontiersin.org/people/949552/overview"/>
<role content-type="https://credit.niso.org/contributor-roles/funding-acquisition/"/>
<role content-type="https://credit.niso.org/contributor-roles/resources/"/>
<role content-type="https://credit.niso.org/contributor-roles/supervision/"/>
<role content-type="https://credit.niso.org/contributor-roles/validation/"/>
<role content-type="https://credit.niso.org/contributor-roles/visualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
</contrib-group>
<aff id="aff1"><sup>1</sup><institution>Department of Psychology, Faculty of Science and Letters, Agri Ibrahim Cecen University</institution>, <addr-line>A&#x011F;r&#x0131;</addr-line>, <country>T&#x00FC;rkiye</country></aff>
<aff id="aff2"><sup>2</sup><institution>Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva</institution>, <addr-line>Huelva</addr-line>, <country>Spain</country></aff>
<aff id="aff3"><sup>3</sup><institution>Safety and Health Postgraduate Program, Universidad Esp&#x00ED;ritu Santo</institution>, <addr-line>Guayaquil</addr-line>, <country>Ecuador</country></aff>
<aff id="aff4"><sup>4</sup><institution>Psychology Research Centre, Khazar University</institution>, <addr-line>Baku</addr-line>, <country>Azerbaijan</country></aff>
<author-notes>
<fn fn-type="edited-by" id="fn0004">
<p>Edited by: Giorgia Varallo, University of Modena and Reggio Emilia, Italy</p>
</fn>
<fn fn-type="edited-by" id="fn0005">
<p>Reviewed by: Marco Tommasi, University of Studies G. d&#x2019;Annunzio Chieti and Pescara, Italy</p>
<p>Valentina Baldini, University of Bologna, Italy</p>
</fn>
<corresp id="c001">&#x002A;Correspondence: Murat Y&#x0131;ld&#x0131;r&#x0131;m, <email>muratyildirim@agri.edu.tr</email>; <email>muratyildirimphd@gmail.com</email></corresp>
<fn fn-type="other" id="fn0001">
<p><sup>&#x2020;</sup>ORCID: G&#x00FC;l&#x00E7;in G&#x00FC;ler &#x00D6;ztekin, <ext-link ext-link-type="uri" xlink:href="https://orcid.org/0000-0001-6205-642X">orcid.org/0000-0001-6205-642X</ext-link></p>
</fn>
<fn fn-type="other" id="fn0002">
<p>Juan G&#x00F3;mez-Salgado, <ext-link ext-link-type="uri" xlink:href="https://orcid.org/0000-0001-9053-7730">orcid.org/0000-0001-9053-7730</ext-link></p>
</fn>
<fn fn-type="other" id="fn0003">
<p>Murat Y&#x0131;ld&#x0131;r&#x0131;m, <ext-link ext-link-type="uri" xlink:href="https://orcid.org/0000-0003-1089-1380">orcid.org/0000-0003-1089-1380</ext-link></p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>31</day>
<month>01</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="collection">
<year>2025</year>
</pub-date>
<volume>16</volume>
<elocation-id>1517441</elocation-id>
<history>
<date date-type="received">
<day>26</day>
<month>10</month>
<year>2024</year>
</date>
<date date-type="accepted">
<day>20</day>
<month>01</month>
<year>2025</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2025 &#x00D6;ztekin, G&#x00F3;mez-Salgado and Y&#x0131;ld&#x0131;r&#x0131;m.</copyright-statement>
<copyright-year>2025</copyright-year>
<copyright-holder>&#x00D6;ztekin, G&#x00F3;mez-Salgado and Y&#x0131;ld&#x0131;r&#x0131;m</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<sec>
<title>Introduction</title>
<p>Mental health and wellbeing are fundamental and integral components of healthy functioning, and psychological resources significantly contribute to its maintenance and enhancement. This study aimed to investigate the mediating effects of psychological flexibility and emotion regulation in the association between future anxiety, depression, and stress.</p>
</sec>
<sec>
<title>Methods</title>
<p>A total of 528 undergraduate students participated in this study (<italic>M</italic>&#x202F;=&#x202F;20.14, <italic>SD</italic>&#x202F;=&#x202F;1.76).</p>
</sec>
<sec>
<title>Results</title>
<p>The findings of the study showed that future anxiety was negatively associated with psychological flexibility and cognitive reappraisal, and positively associated with expressive suppression, depression and stress. Psychological flexibility and cognitive reappraisal had negative relationships with depression and stress, and expressive suppression had a positive relationship with depression and stress. The associations between future anxiety, depression and stress were mediated by psychological flexibility, cognitive reappraisal and expressive suppression.</p>
</sec>
<sec>
<title>Discussion</title>
<p>This study deepened our understanding of the possible mechanisms of depression and stress. For individuals suffering from future anxiety, psychological flexibility and emotion regulation may be a coping strategy that leads individuals to less depression and stress. This study suggests that psychological flexibility and emotion regulation skills are fundamental aspects of psychological health.</p>
</sec>
</abstract>
<kwd-group>
<kwd>future anxiety</kwd>
<kwd>psychological flexibility</kwd>
<kwd>cognitive reappraisal</kwd>
<kwd>expressive suppression</kwd>
<kwd>depression</kwd>
<kwd>stress</kwd>
</kwd-group>
<counts>
<fig-count count="1"/>
<table-count count="3"/>
<equation-count count="0"/>
<ref-count count="87"/>
<page-count count="9"/>
<word-count count="7742"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Health Psychology</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec sec-type="intro" id="sec1">
<title>Introduction</title>
<p>Mental health and wellbeing are fundamental and integral components of healthy functioning, and psychological resources significantly contribute to its maintenance and enhancement (<xref ref-type="bibr" rid="ref50">Masoom Ali et al., 2020</xref>; <xref ref-type="bibr" rid="ref77">Y&#x0131;ld&#x0131;r&#x0131;m, 2020</xref>; <xref ref-type="bibr" rid="ref79">Y&#x0131;ld&#x0131;r&#x0131;m et al., 2023a</xref>). A portion of the global burden of disease is due to neuropsychiatric disorders because of the chronically damaging nature of depression and other common mental disorders, alcohol and substance use disorders, and psychoses (<xref ref-type="bibr" rid="ref59">Prince et al., 2007</xref>). Depression, anxiety and stress are mental health problems that are frequently experienced by individuals and significantly affect their wellbeing and health (<xref ref-type="bibr" rid="ref32">Karyotaki et al., 2020</xref>; <xref ref-type="bibr" rid="ref62">Rashid et al., 2023</xref>; <xref ref-type="bibr" rid="ref83">Y&#x0131;ld&#x0131;r&#x0131;m and &#x00D6;zaslan, 2022</xref>). Depression refers to a mental health disorder that occurs in a person&#x2019;s life, with symptoms including sad mood, somatic complaints, loss of interest, regression, pessimism, worthlessness, and guilt (<xref ref-type="bibr" rid="ref18">Fried, 2017</xref>). Depression negatively affected the indicators of psychological wellbeing: autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance (<xref ref-type="bibr" rid="ref71">Strauss et al., 2012</xref>). Depressed individuals had a low quality of life (<xref ref-type="bibr" rid="ref53">Mei et al., 2021</xref>) and poor life satisfaction (<xref ref-type="bibr" rid="ref42">Li et al., 2021</xref>). These individuals adopted maladaptive coping strategies such as behavioral disengagement, denial, self-blame, self-distraction, and substance use rather than adaptive coping strategies such as active coping, planning, and positive reframing (<xref ref-type="bibr" rid="ref45">Lopes and Nihei, 2021</xref>). Depression also increased the risk of many problems such as sleep problems (<xref ref-type="bibr" rid="ref54">Morssinkhof et al., 2020</xref>), eating disorder (<xref ref-type="bibr" rid="ref66">Sander et al., 2021</xref>), cardiovascular disease (<xref ref-type="bibr" rid="ref37">Kwapong et al., 2023</xref>), and even suicidal ideation, suicide attempts and suicide death (<xref ref-type="bibr" rid="ref41">Li et al., 2022</xref>). Therefore, depression is not a temporary state of sadness but is considered a serious mental health problem that may require professional intervention.</p>
<p>Stress is a complex phenomenon that leads to mental health disorders and chronic health conditions, and reduces productivity and quality of life. &#x201C;Eustress,&#x201D; a positive psychological response to a stressor, is beneficial because it motivates the individual to cope with the demands, but chronic and prolonged stress overwhelms the body&#x2019;s coping mechanisms (<xref ref-type="bibr" rid="ref49">Manosso et al., 2022</xref>). Stress had deleterious effects on mental wellbeing, subjective wellbeing and psychological wellbeing (<xref ref-type="bibr" rid="ref40">Lee, 2017</xref>). Stress caused a weakened immune system (<xref ref-type="bibr" rid="ref48">Lueke and Assar, 2024</xref>), sleep problems, mental disorders (<xref ref-type="bibr" rid="ref35">Kaur et al., 2021</xref>), and heart diseases (<xref ref-type="bibr" rid="ref85">Yin et al., 2021</xref>). The ability to cope with depression and stress is critical for individuals to maintain their health and live a healthy life. Therefore, factors that lead to depression and stress should be identified for the mental health of both individuals and societies.</p>
<p>Future anxiety refers to a state of worry, uncertainty, fear and concern about negative changes in the future. In an extreme case, this could be a threat in which something catastrophic may happen to a person. More importantly, future anxiety involves subjective states where the personal future is at stake. Although the fear experienced is clear and conscious, it is due to cognitive representations of the future rather than actual events. In other words, the fear is experienced here and now but refers to future events (<xref ref-type="bibr" rid="ref86">Zaleski, 1996</xref>). Future anxiety and pessimism, while related, are distinct concepts. Future anxiety refers to a sense of uncertainty about what lies ahead, which can restrict individuals in their planning and decision-making processes (<xref ref-type="bibr" rid="ref86">Zaleski, 1996</xref>). In contrast, pessimism is more self-oriented and involves a perception that negative outcomes are inevitable. It represents a deeply ingrained mindset, where individuals consistently believe that unfavorable events will persist in the future (<xref ref-type="bibr" rid="ref67">Scheier et al., 2001</xref>). Future anxiety undermined self-efficacy (<xref ref-type="bibr" rid="ref61">Rabei et al., 2020</xref>), quality of life (<xref ref-type="bibr" rid="ref34">K&#x00E4;stner et al., 2022</xref>), and decision-making skills (<xref ref-type="bibr" rid="ref3">Al Hwayan, 2020</xref>). Future anxiety was identified as a factor of sleep disturbances that led to risky behaviors such as suicide and psychological problems (<xref ref-type="bibr" rid="ref1">Ahmad et al., 2024</xref>; <xref ref-type="bibr" rid="ref5">Baldini et al., 2024</xref>). This anxiety contributed to loneliness (<xref ref-type="bibr" rid="ref31">Jannini et al., 2024</xref>), behavioral addictions (<xref ref-type="bibr" rid="ref56">Pan et al., 2024</xref>), and psychological distress (<xref ref-type="bibr" rid="ref12">Dey et al., 2022</xref>). In particular, anxiety about the future was related to general malaise and considered a risk factor for depression and stress (<xref ref-type="bibr" rid="ref63">Regnoli et al., 2024a</xref>). As can be understood from these studies, anxiety about the future can negatively affect psychological health and lead to depression and stress. Determining protective factors to reduce the negative effects of this relationship is necessary for the mental health of individuals.</p>
<sec id="sec2">
<title>The mediating roles of psychological flexibility and emotion regulation</title>
<p>Psychological flexibility refers to the ability to connect with the present moment by completely distancing oneself from past and future concerns; this occurs through the ability to actively, openly, and nonjudgmentally embrace inner experiences and the reduced tendency to control these inner experiences. This also refers to the ability of a person to persist in or modify behavior toward the attainment of chosen goals or values (<xref ref-type="bibr" rid="ref7">Bond et al., 2008</xref>; <xref ref-type="bibr" rid="ref29">Hayes et al., 2006</xref>). A growing body of research has highlighted the numerous benefits of psychological flexibility for individuals (<xref ref-type="bibr" rid="ref74">Tanhan et al., 2024</xref>; <xref ref-type="bibr" rid="ref81">Y&#x0131;ld&#x0131;r&#x0131;m et al., 2024a</xref>, <xref ref-type="bibr" rid="ref80">2024b</xref>). For example, increasing the psychological flexibility ability of individuals decreases emotional exhaustion (<xref ref-type="bibr" rid="ref44">Lloyd et al., 2013</xref>) and future anxiety (<xref ref-type="bibr" rid="ref27">Hasan Alam et al., 2023</xref>), and increased life satisfaction (<xref ref-type="bibr" rid="ref47">Lucas and Moore, 2020</xref>) and wellbeing (<xref ref-type="bibr" rid="ref76">Wersebe et al., 2018</xref>). Psychological flexibility contributed significantly to enhancing psychological wellbeing (<xref ref-type="bibr" rid="ref25">Guerrini Usubini et al., 2021</xref>). However, low psychological flexibility led to poor psychological health and emotional distress (<xref ref-type="bibr" rid="ref51">Masuda et al., 2010</xref>). In particular, this poor flexibility ability contributed to somatization, depression, anxiety, and general distress (<xref ref-type="bibr" rid="ref52">Masuda and Tully, 2012</xref>).</p>
<p>Previous studies have also provided evidence of the mediating role of psychological flexibility. Psychological flexibility acted as a mediator in the association between health anxiety and psychological distress (<xref ref-type="bibr" rid="ref38">Landi et al., 2020</xref>). Psychological flexibility buffered the adverse relationship between symptoms and functioning (<xref ref-type="bibr" rid="ref19">Gentili et al., 2019</xref>). Psychological flexibility mediated the relationship between self-concealment and emotional distress and general psychological ill-health in stressful interpersonal environments (<xref ref-type="bibr" rid="ref52">Masuda and Tully, 2012</xref>). Psychological inflexibility mediated the relationship between anxiety, depression, and emotional eating (<xref ref-type="bibr" rid="ref24">Guerrini Usubini et al., 2022b</xref>). These studies highlight the protective role of psychological flexibility.</p>
<p>Emotion regulation refers to a process by which individuals modify their emotions, their reactions to emotions, or the situations that elicit emotions to respond appropriately to environmental demands (<xref ref-type="bibr" rid="ref21">Gross, 1998</xref>). Two specific strategies for emotion regulation are cognitive reappraisal and expressive suppression. Cognitive reappraisal can be defined as the attempt to reinterpret an emotionally arousing situation in a way that changes its emotional impact (<xref ref-type="bibr" rid="ref22">Gross and John, 2003</xref>; <xref ref-type="bibr" rid="ref39">Lazarus and Alfert, 1964</xref>). Expressive suppression can be defined as an attempt to inhibit ongoing emotion-expressive behavior (<xref ref-type="bibr" rid="ref21">Gross, 1998</xref>). Many studies have shown that greater use of cognitive reappraisal strategies contributed to resilience and better mental health (<xref ref-type="bibr" rid="ref8">Cardi et al., 2021</xref>) and frequent use of expressive suppression strategies led to increased psychological symptoms, poor mental health and low wellbeing (<xref ref-type="bibr" rid="ref9">Chervonsky and Hunt, 2019</xref>). Social anxiety and anxiety sensitivity had a positive relationship with emotion regulation difficulties (<xref ref-type="bibr" rid="ref57">Paulus et al., 2016</xref>; <xref ref-type="bibr" rid="ref69">Sertba&#x015F; et al., 2020</xref>). On the other hand, low emotion regulation levels led to psychological distress such as depression and stress (<xref ref-type="bibr" rid="ref6">Berking et al., 2014</xref>; <xref ref-type="bibr" rid="ref68">Seligowski et al., 2015</xref>) and impulsive behaviors (<xref ref-type="bibr" rid="ref4">Alfonsi et al., 2023</xref>; <xref ref-type="bibr" rid="ref23">Guerrini Usubini et al., 2022a</xref>). Previous studies have also indicated the mediator role of emotion regulation. For example, the link between attachment anxiety and depression was mediated by emotion regulation (<xref ref-type="bibr" rid="ref10">Colonnello et al., 2022</xref>). Heightened use of cognitive reappraisal and dampened use of expressive suppression served as mediators in the relationship between beliefs about emotion controllability and psychological health (<xref ref-type="bibr" rid="ref11">Deplancke et al., 2023</xref>). These studies indicate the positive effects of cognitive reappraisal and the negative effects of expressive suppression on mental health.</p>
<p>University students are plagued by higher uncertainty and less permanence in their current lives and also in the anticipated future. <xref ref-type="bibr" rid="ref61">Rabei et al. (2020)</xref> reported that students&#x2019; future anxiety increased throughout their school life, especially in the last years of their education. Future anxiety is increasingly emerging among university students not only from the fear of failing their studies but also from the fear of lack of job opportunities. <xref ref-type="bibr" rid="ref26">Hammad (2016)</xref> declared that this affects these students&#x2019; participation in their specialization. In this regard, probable future events increase the possibility of experiencing anxiety and depression (<xref ref-type="bibr" rid="ref16">Eysenck et al., 2006</xref>). Given that students cope with this anxiety during their university years, which significantly impacts their career plans and psychological wellbeing, identifying factors that can mitigate these negative effects is important for safeguarding both their mental health and future prospects. Based on the theoretical framework and empirical evidence documented above, we propose that psychological flexibility and cognitive reappraisal may reduce the relationship between future anxiety, depression and stress, while expressive suppression may foster this relationship.</p>
</sec>
<sec id="sec3">
<title>Present study</title>
<p>The above-mentioned previous literature has identified a positive relationship between future anxiety, depression and stress. However, to our knowledge, there is no study on the mediation of psychological flexibility, cognitive reappraisal, and expressive suppression in this relationship. Therefore, this study aimed to examine the mediation roles of psychological flexibility, cognitive reappraisal, and expressive suppression in the relationship between future anxiety, depression and stress. To this end, we proposed the following hypotheses:</p>
<disp-quote>
<p>H1: Future anxiety will have a negative association with psychological flexibility and cognitive reappraisal, and a positive association with expressive suppression, depression and stress.</p>
</disp-quote>
<disp-quote>
<p>H2: Psychological flexibility and cognitive reappraisal will be negatively related to depression and stress, and expressive suppression will be positively related to depression and stress.</p>
</disp-quote>
<disp-quote>
<p>H3: Psychological flexibility, cognitive reappraisal, and expressive suppression will mediate the association between future anxiety depression and stress.</p>
</disp-quote>
<p>The conceptual model is illustrated in <xref ref-type="fig" rid="fig1">Figure 1</xref>.</p>
<fig position="float" id="fig1">
<label>Figure 1</label>
<caption>
<p>The conceptual model.</p>
</caption>
<graphic xlink:href="fpsyg-16-1517441-g001.tif"/>
</fig>
</sec>
</sec>
<sec sec-type="methods" id="sec4">
<title>Method</title>
<sec id="sec5">
<title>Participants</title>
<p>Participants included 528 undergraduate students. 59.7% of the participants (<italic>n</italic> =&#x202F;315) were women and 40.3% were men. The students&#x2019; ages ranged from 18 to 28, with a mean age of 20.14&#x202F;years (<italic>SD</italic> =&#x202F;1.76). 181 (34.3%) of the students were freshmen, 158 (29.9%) were sophomores, 108 (20.5%) were juniors, and 81 (15.3%) were senior students. Among the participants, 20.5% perceived their household income as low, 68% as middle, and 11.5% as high.</p>
</sec>
<sec id="sec6">
<title>Measures</title>
<sec id="sec7">
<title>Dark future scale</title>
<p>This scale was developed by <xref ref-type="bibr" rid="ref87">Zaleski et al. (2019)</xref> and adopted to Turkish culture by <xref ref-type="bibr" rid="ref82">Y&#x0131;ld&#x0131;r&#x0131;m et al. (2023b)</xref> to measure concern and anxiety toward the future. The scale is unidimensional and consists of five items. Participants respond on a 6-point Likert scale ranging from 1 (decidedly false) to 6 (decidedly true). The sample item of the scale is &#x201C;I am afraid that the problems which trouble me now will continue for a long time.&#x201D; High scores indicate greater levels of future anxiety. The Cronbach&#x2019;s alpha coefficient was 0.79. In the current study, the Cronbach&#x2019;s alpha coefficient was calculated as 0.89.</p>
</sec>
<sec id="sec8">
<title>Psy-flex scale</title>
<p>This scale was developed by <xref ref-type="bibr" rid="ref20">Gloster et al. (2021)</xref> and adopted to Turkish culture by <xref ref-type="bibr" rid="ref78">Y&#x0131;ld&#x0131;r&#x0131;m and Aziz (2023)</xref> to assess the psychological flexibility levels of individuals. The scale is unidimensional and consists of six items. Participants respond on a 5-point Likert scale ranging from 1 (very seldom) to 5 (very often). The sample item of the scale is &#x201C;I am completely interested in things that are important, useful or meaningful to me.&#x201D; High scores reflect higher levels of psychological flexibility. The Cronbach&#x2019;s alpha coefficient was calculated as 0.80. In the current study, the Cronbach&#x2019;s alpha coefficient was 0.85.</p>
</sec>
<sec id="sec9">
<title>Emotion regulation questionnaire-short form (ERQ-S)</title>
<p>This scale was developed by <xref ref-type="bibr" rid="ref58">Preece et al. (2023)</xref> and adopted to Turkish culture by <xref ref-type="bibr" rid="ref13">Dilek&#x00E7;i and Y&#x0131;ld&#x0131;r&#x0131;m (submitted for publication)</xref> to measure the emotion regulation levels of individuals. The scale consists of two subscales with six items: cognitive reappraisal and expressive suppression. Participants score on a 7-point Likert scale ranging from 1 (strongly disagree) to 7 (strongly agree). The sample item of the scale is &#x201C;I control my emotions by not expressing them.&#x201D; High scores show higher cognitive reappraisal and expressive suppression levels. Adequate evidence of Cronbach&#x2019;s alpha has been reported in previous research (<xref ref-type="bibr" rid="ref13">Dilek&#x00E7;i and Y&#x0131;ld&#x0131;r&#x0131;m, submitted for publication</xref>; <xref ref-type="bibr" rid="ref58">Preece et al., 2023</xref>). In the current study, the Cronbach&#x2019;s alpha coefficients were 0.86 and 0.81, respectively.</p>
</sec>
<sec id="sec10">
<title>Depression, stress and anxiety scale (DASS21)-short form</title>
<p>This scale was developed by <xref ref-type="bibr" rid="ref46">Lovibond and Lovibond (1995)</xref> and adopted to Turkish culture by <xref ref-type="bibr" rid="ref84">Y&#x0131;lmaz et al. (2017)</xref> to assess depression, anxiety and stress levels of individuals. The scale consists of three subscales with 21 items: depression, anxiety and stress. Participants score on a 4-point Likert scale ranging from 0 (not suitable for me) to 3 (completely suitable for me). The sample item of the scale is &#x201C;I could not stand things that distracted me from what I was doing.&#x201D; High scores indicate higher levels of depression, anxiety and stress. In this study, the depression and stress sub-dimensions of the scale were applied. The Cronbach&#x2019;s alpha coefficient was calculated as 0.81 for depression and 0.75 for stress. In the current study, Cronbach&#x2019;s alpha coefficients were 0.80 and 0.79 for depression and stress, respectively.</p>
</sec>
</sec>
<sec id="sec11">
<title>Procedure</title>
<p>Necessary ethical permission was obtained from the Institutional Review Board and the Declaration of Helsinki guidelines were followed (Date: 26 September 2024, Ethic Code: E-95531838-050.99-112421). Data was collected via a web-based survey. The online survey form was sent to university students using the snowball sampling method. Participants were informed about their rights before, during and after participation. Participation was completely voluntary. Informed consent was obtained from all participants, and they were subsequently invited to participate in the survey. Anonymity and confidentiality were ensured, and no compensation was provided.</p>
</sec>
<sec id="sec12">
<title>Statistical analyses</title>
<p>First, descriptive statistics were conducted. Normality was evaluated using kurtosis and skewness values, with acceptable ranges falling between +1.5 and &#x2212;1.5 (<xref ref-type="bibr" rid="ref73">Tabachnick et al., 2013</xref>). Then, correlation analysis was performed to examine the relationship between the study variables. Finally, mediation analyses were performed using Hayes&#x2019; PROCESS-Macro v4.2 (Model 4). To investigate indirect mediation effects, bootstrapping was applied with 5,000 resampling and 95% confidence intervals with bias correction (<xref ref-type="bibr" rid="ref28">Hayes, 2009</xref>). All data analyses were performed with SPSS version 27 for Windows.</p>
</sec>
</sec>
<sec sec-type="results" id="sec13">
<title>Results</title>
<p>The preliminary analysis results are presented in <xref ref-type="table" rid="tab1">Table 1</xref>. Skewness values were between 0.41 and &#x2212;0.18, kurtosis values were between 0.01 and &#x2212;1.21. These values indicated that the normality assumption was met. Correlation analysis results showed that future anxiety had significant positive correlations with expressive suppression, depression and stress, and significant negative correlations with psychological flexibility and cognitive reappraisal. Psychological flexibility and cognitive reappraisal had significant negative correlations with depression and stress. Expressive suppression had significant positive correlations with depression and stress.</p>
<table-wrap position="float" id="tab1">
<label>Table 1</label>
<caption>
<p>Descriptive statistics, skewness, kurtosis, and correlations.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="top" rowspan="2">Variables</th>
<th align="center" valign="top" rowspan="2"><italic>M</italic></th>
<th align="center" valign="top" rowspan="2"><italic>SD</italic></th>
<th align="center" valign="top" rowspan="2">Skewness</th>
<th align="center" valign="top" rowspan="2">Kurtosis</th>
<th align="center" valign="top" colspan="6">Correlation</th>
</tr>
<tr>
<th align="center" valign="top">1</th>
<th align="center" valign="top">2</th>
<th align="center" valign="top">3</th>
<th align="center" valign="top">4</th>
<th align="center" valign="top">5</th>
<th align="center" valign="top">6</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="middle">1. Future anxiety</td>
<td align="center" valign="middle">18.37</td>
<td align="center" valign="middle">6.01</td>
<td align="center" valign="middle">&#x2212;0.18</td>
<td align="center" valign="middle">&#x2212;0.92</td>
<td align="center" valign="middle">&#x2013;</td>
<td/>
<td/>
<td/>
<td/>
<td/>
</tr>
<tr>
<td align="left" valign="middle">2. Psychological flexibility</td>
<td align="center" valign="middle">17.81</td>
<td align="center" valign="middle">5.13</td>
<td align="center" valign="middle">&#x2212;0.07</td>
<td align="center" valign="middle">&#x2212;0.31</td>
<td align="center" valign="middle">&#x2212;0.58&#x002A;&#x002A;</td>
<td align="center" valign="middle">&#x2013;</td>
<td/>
<td/>
<td/>
<td/>
</tr>
<tr>
<td align="left" valign="middle">3. Cognitive reappraisal</td>
<td align="center" valign="middle">12.85</td>
<td align="center" valign="middle">4.58</td>
<td align="center" valign="middle">&#x2212;0.09</td>
<td align="center" valign="middle">&#x2212;1.21</td>
<td align="center" valign="middle">&#x2212;0.35&#x002A;&#x002A;</td>
<td align="center" valign="middle">0.59&#x002A;&#x002A;</td>
<td align="center" valign="middle">&#x2013;</td>
<td/>
<td/>
<td/>
</tr>
<tr>
<td align="left" valign="middle">4. Expressive suppression</td>
<td align="center" valign="middle">11.66</td>
<td align="center" valign="middle">4.53</td>
<td align="center" valign="middle">0.09</td>
<td align="center" valign="middle">&#x2212;1.05</td>
<td align="center" valign="middle">0.59&#x002A;&#x002A;</td>
<td align="center" valign="middle">&#x2212;0.40&#x002A;&#x002A;</td>
<td align="center" valign="middle">&#x2212;0.54&#x002A;&#x002A;</td>
<td align="center" valign="middle">&#x2013;</td>
<td/>
<td/>
</tr>
<tr>
<td align="left" valign="middle">5. Depression</td>
<td align="center" valign="middle">8.73</td>
<td align="center" valign="middle">3.85</td>
<td align="center" valign="middle">0.14</td>
<td align="center" valign="middle">&#x2212;0.31</td>
<td align="center" valign="middle">0.51&#x002A;&#x002A;</td>
<td align="center" valign="middle">&#x2212;0.56&#x002A;&#x002A;</td>
<td align="center" valign="middle">&#x2212;0.59&#x002A;&#x002A;</td>
<td align="center" valign="middle">0.50&#x002A;&#x002A;</td>
<td align="center" valign="top">&#x2013;</td>
<td/>
</tr>
<tr>
<td align="left" valign="middle">6. Stress</td>
<td align="center" valign="middle">8.94</td>
<td align="center" valign="middle">3.68</td>
<td align="center" valign="middle">0.41</td>
<td align="center" valign="middle">0.01</td>
<td align="center" valign="middle">0.50&#x002A;&#x002A;</td>
<td align="center" valign="middle">&#x2212;0.53&#x002A;&#x002A;</td>
<td align="center" valign="middle">&#x2212;0.61&#x002A;&#x002A;</td>
<td align="center" valign="middle">0.53&#x002A;&#x002A;</td>
<td align="center" valign="top">0.64&#x002A;&#x002A;</td>
<td align="center" valign="top">&#x2013;</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<p>M, mean; SD, standard deviations; &#x002A;&#x002A;<italic>p</italic>&#x202F;&#x003C;&#x202F;0.001.</p>
</table-wrap-foot>
</table-wrap>
<p><xref ref-type="table" rid="tab2">Table 2</xref> presents the results of the mediation analyses. Future anxiety significantly predicted psychological flexibility (<italic>&#x03B2;</italic>&#x202F;=&#x202F;&#x2212;0.50, <italic>p</italic>&#x202F;&#x003C;&#x202F;0.001), cognitive reappraisal (<italic>&#x03B2;</italic>&#x202F;=&#x202F;&#x2212;0.27, <italic>p</italic>&#x202F;&#x003C;&#x202F;0.001), expressive suppression (<italic>&#x03B2;</italic>&#x202F;=&#x202F;0.45, <italic>p</italic>&#x202F;&#x003C;&#x202F;0.001), depression (<italic>&#x03B2;</italic>&#x202F;=&#x202F;0.13, <italic>p</italic>&#x202F;&#x003C;&#x202F;0.001), and stress (<italic>&#x03B2;</italic>&#x202F;=&#x202F;0.12, <italic>p</italic>&#x202F;&#x003C;&#x202F;0.001). Future anxiety explained 34% of the variance in psychological flexibility, 13% of the variance in cognitive reappraisal and 35% of the variance in expressive suppression. Psychological flexibility (<italic>&#x03B2;</italic>&#x202F;=&#x202F;&#x2212;0.14, <italic>p</italic>&#x202F;&#x003C;&#x202F;0.001), cognitive reappraisal (<italic>&#x03B2;</italic>&#x202F;=&#x202F;&#x2212;0.28, <italic>p</italic>&#x202F;&#x003C;&#x202F;0.001) and expressive suppression (<italic>&#x03B2;</italic>&#x202F;=&#x202F;0.10, <italic>p</italic>&#x202F;&#x003C;&#x202F;0.001) significantly predicted depression, explaining 48% of the variance. Psychological flexibility (<italic>&#x03B2;</italic>&#x202F;=&#x202F;&#x2212;0.09, <italic>p</italic>&#x202F;&#x003C;&#x202F;0.001), cognitive reappraisal (<italic>&#x03B2;</italic>&#x202F;=&#x202F;&#x2212;0.30, <italic>p</italic>&#x202F;&#x003C;&#x202F;0.001) and expressive suppression (<italic>&#x03B2;</italic>&#x202F;=&#x202F;0.13, <italic>p</italic>&#x202F;&#x003C;&#x202F;0.001) significantly predicted stress, explaining 49% of the variance.</p>
<table-wrap position="float" id="tab2">
<label>Table 2</label>
<caption>
<p>Unstandardized coefficients for the mediation model.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="center" valign="top" colspan="25">Consequent</th>
</tr>
<tr>
<th align="left" valign="top">Antecedent</th>
<th/>
<th align="center" valign="top" colspan="4">M<sub>1</sub> (Psychological flexibility)</th>
<th/>
<th align="center" valign="top" colspan="4">M<sub>2</sub> (Cognitive reappraisal)</th>
<th/>
<th align="center" valign="top" colspan="4">M<sub>3</sub> (Expressive suppression)</th>
<th/>
<th align="center" valign="top" colspan="4">Y<sub>1</sub> (Depression)</th>
<th align="center" valign="top" colspan="4">Y<sub>2</sub> (Stress)</th>
</tr>
<tr>
<th/>
<th/>
<th align="center" valign="top">Coeff.</th>
<th align="center" valign="top">SE</th>
<th align="center" valign="top"><italic>t</italic></th>
<th align="center" valign="top"><italic>p</italic></th>
<th/>
<th align="center" valign="top">Coeff.</th>
<th align="center" valign="top">SE</th>
<th align="center" valign="top"><italic>t</italic></th>
<th align="center" valign="top"><italic>p</italic></th>
<th/>
<th align="center" valign="top">Coeff.</th>
<th align="center" valign="top">SE</th>
<th align="center" valign="top"><italic>t</italic></th>
<th align="center" valign="top"><italic>p</italic></th>
<th/>
<th align="center" valign="top">Coeff.</th>
<th align="center" valign="top">SE</th>
<th align="center" valign="top"><italic>t</italic></th>
<th align="center" valign="top"><italic>p</italic></th>
<th align="center" valign="top">Coeff.</th>
<th align="center" valign="top">SE</th>
<th align="center" valign="top"><italic>t</italic></th>
<th align="center" valign="top"><italic>p</italic></th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">X (Future anxiety)</td>
<td align="center" valign="top">a<sub>1</sub></td>
<td align="center" valign="top">&#x2212;0.50</td>
<td align="center" valign="top">0.03</td>
<td align="center" valign="top">&#x2212;16.65</td>
<td align="center" valign="top">0.00</td>
<td align="center" valign="top">a<sub>2</sub></td>
<td align="center" valign="top">&#x2212;0.27</td>
<td align="center" valign="top">0.03</td>
<td align="center" valign="top">&#x2212;8.82</td>
<td align="center" valign="top">0.00</td>
<td align="center" valign="top">a<sub>3</sub></td>
<td align="center" valign="top">0.45</td>
<td align="center" valign="top">0.02</td>
<td align="center" valign="top">17.04</td>
<td align="center" valign="top">0.00</td>
<td align="center" valign="top">c&#x2019;</td>
<td align="center" valign="top">0.13</td>
<td align="center" valign="top">0.02</td>
<td align="center" valign="top">4.54</td>
<td align="center" valign="top">0.00</td>
<td align="center" valign="top">0.12</td>
<td align="center" valign="top">0.02</td>
<td align="center" valign="top">4.35</td>
<td align="center" valign="top">0.00</td>
</tr>
<tr>
<td align="left" valign="top">M<sub>1</sub> (Psychological flexibility)</td>
<td/>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td/>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td/>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">b<sub>1</sub></td>
<td align="center" valign="top">&#x2212;0.14</td>
<td align="center" valign="top">0.03</td>
<td align="center" valign="top">&#x2212;4.09</td>
<td align="center" valign="top">0.00</td>
<td align="center" valign="top">&#x2212;0.09</td>
<td align="center" valign="top">0.03</td>
<td align="center" valign="top">&#x2212;2.96</td>
<td align="center" valign="top">0.00</td>
</tr>
<tr>
<td align="left" valign="top">M<sub>2</sub> (Cognitive reappraisal)</td>
<td/>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td/>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td/>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">b<sub>2</sub></td>
<td align="center" valign="top">&#x2212;0.28</td>
<td align="center" valign="top">0.03</td>
<td align="center" valign="top">&#x2212;7.79</td>
<td align="center" valign="top">0.00</td>
<td align="center" valign="top">&#x2212;0.30</td>
<td align="center" valign="top">0.03</td>
<td align="center" valign="top">&#x2212;8.51</td>
<td align="center" valign="top">0.00</td>
</tr>
<tr>
<td align="left" valign="top">M<sub>3</sub> (Expressive suppression)</td>
<td/>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td/>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td/>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">&#x2013;</td>
<td align="center" valign="top">b<sub>3</sub></td>
<td align="center" valign="top">0.10</td>
<td align="center" valign="top">0.03</td>
<td align="center" valign="top">2.73</td>
<td align="center" valign="top">0.00</td>
<td align="center" valign="top">0.13</td>
<td align="center" valign="top">0.03</td>
<td align="center" valign="top">3.65</td>
<td align="center" valign="top">0.00</td>
</tr>
<tr>
<td align="left" valign="top">Constant</td>
<td align="center" valign="top">i<sub>M1</sub></td>
<td align="center" valign="top">27.04</td>
<td align="center" valign="top">0.58</td>
<td align="center" valign="top">46.40</td>
<td align="center" valign="top">0.00</td>
<td align="center" valign="top">i<sub>M2</sub></td>
<td align="center" valign="top">17.88</td>
<td align="center" valign="top">0.59</td>
<td align="center" valign="top">29.83</td>
<td align="center" valign="top">0.00</td>
<td align="center" valign="top">i<sub>M3</sub></td>
<td align="center" valign="top">3.38</td>
<td align="center" valign="top">0.51</td>
<td align="center" valign="top">6.63</td>
<td align="center" valign="top">0.00</td>
<td align="center" valign="top">i<sub>y</sub></td>
<td align="center" valign="top">11.29</td>
<td align="center" valign="top">0.92</td>
<td align="center" valign="top">12.15</td>
<td align="center" valign="top">0.00</td>
<td align="center" valign="top">10.76</td>
<td align="center" valign="top">0.88</td>
<td align="center" valign="top">12.21</td>
<td align="center" valign="top">0.00</td>
</tr>
<tr>
<td/>
<td/>
<td align="center" valign="top" colspan="4"><italic>R</italic><sup>2</sup>&#x202F;=&#x202F;0.34</td>
<td/>
<td align="center" valign="top" colspan="4"><italic>R</italic><sup>2</sup>&#x202F;=&#x202F;0.13</td>
<td/>
<td align="center" valign="top" colspan="4"><italic>R</italic><sup>2</sup>&#x202F;=&#x202F;0.35</td>
<td/>
<td align="center" valign="top" colspan="4"><italic>R</italic><sup>2</sup>&#x202F;=&#x202F;0.48</td>
<td align="center" valign="top" colspan="4"><italic>R</italic><sup>2</sup>&#x202F;=&#x202F;0.49</td>
</tr>
<tr>
<td/>
<td/>
<td align="center" valign="top" colspan="4"><italic>F</italic>&#x202F;=&#x202F;277.50; <italic>p</italic>&#x202F;&#x003C;&#x202F;0.001</td>
<td/>
<td align="center" valign="top" colspan="4"><italic>F</italic>&#x202F;=&#x202F;77.95; <italic>p</italic>&#x202F;&#x003C;&#x202F;0.001</td>
<td/>
<td align="center" valign="top" colspan="4"><italic>F</italic>&#x202F;=&#x202F;290.64; <italic>p</italic>&#x202F;&#x003C;&#x202F;0.001</td>
<td/>
<td align="center" valign="top" colspan="4"><italic>F</italic>&#x202F;=&#x202F;120.71; <italic>p</italic>&#x202F;&#x003C;&#x202F;0.001</td>
<td align="center" valign="top" colspan="4"><italic>F</italic>&#x202F;=&#x202F;124.65; <italic>p</italic>&#x202F;&#x003C;&#x202F;0.001</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<p>X&#x202F;=&#x202F;independent variable, M&#x202F;=&#x202F;mediator variable, Y&#x202F;=&#x202F;dependent variable, Coeff.&#x202F;=&#x202F;unstandardized coefficient, SE&#x202F;=&#x202F;standard error.</p>
</table-wrap-foot>
</table-wrap>
<p><xref ref-type="table" rid="tab3">Table 3</xref> showed that future anxiety had a direct effect on depression (effect&#x202F;=&#x202F;0.13, [0.07, 0.19]), and future anxiety had an indirect effect on depression through psychological flexibility (effect&#x202F;=&#x202F;0.07, [0.02, 0.12]), cognitive reappraisal (effect&#x202F;=&#x202F;0.08, [0.04, 0.11]) and expressive suppression (effect&#x202F;=&#x202F;0.04, [0.01, 0.08]). Future anxiety had a direct effect on stress (effect&#x202F;=&#x202F;0.12, [0.06, 0.17]), and future anxiety had an indirect effect on stress through psychological flexibility (effect&#x202F;=&#x202F;0.04, [0.01, 0.09]), cognitive reappraisal (effect&#x202F;=&#x202F;0.08, [0.05, 0.11]) and expressive suppression (effect&#x202F;=&#x202F;0.05, [0.02, 0.10]).</p>
<table-wrap position="float" id="tab3">
<label>Table 3</label>
<caption>
<p>Total, direct, and indirect effects.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th/>
<th align="center" valign="top">Effect</th>
<th align="center" valign="top"><italic>SE</italic></th>
<th align="center" valign="top">BootLLCI</th>
<th align="center" valign="top">BootULCI</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top" colspan="5">Path 1</td>
</tr>
<tr>
<td align="left" valign="top">Future anxiety&#x202F;&#x2192;&#x202F;Psychological flexibility&#x202F;&#x2192;&#x202F;Depression</td>
<td align="center" valign="top">0.07</td>
<td align="center" valign="top">0.02</td>
<td align="center" valign="top">0.02</td>
<td align="center" valign="top">0.12</td>
</tr>
<tr>
<td align="left" valign="top">Future anxiety&#x202F;&#x2192;&#x202F;Cognitive reappraisal&#x202F;&#x2192;&#x202F;Depression</td>
<td align="center" valign="top">0.08</td>
<td align="center" valign="top">0.01</td>
<td align="center" valign="top">0.04</td>
<td align="center" valign="top">0.11</td>
</tr>
<tr>
<td align="left" valign="top">Future anxiety&#x202F;&#x2192;&#x202F;Expressive suppression&#x202F;&#x2192;&#x202F;Depression</td>
<td align="center" valign="top">0.04</td>
<td align="center" valign="top">0.02</td>
<td align="center" valign="top">0.01</td>
<td align="center" valign="top">0.08</td>
</tr>
<tr>
<td align="left" valign="top">Total indirect effect</td>
<td align="center" valign="top">0.19</td>
<td align="center" valign="top">0.02</td>
<td align="center" valign="top">0.14</td>
<td align="center" valign="top">0.25</td>
</tr>
<tr>
<td align="left" valign="top">Direct effect</td>
<td align="center" valign="top">0.13</td>
<td align="center" valign="top">0.02</td>
<td align="center" valign="top">0.07</td>
<td align="center" valign="top">0.19</td>
</tr>
<tr>
<td align="left" valign="top">Total effect</td>
<td align="center" valign="top">0.33</td>
<td align="center" valign="top">0.02</td>
<td align="center" valign="top">0.28</td>
<td align="center" valign="top">0.37</td>
</tr>
<tr>
<td align="left" valign="top" colspan="5">Path 2</td>
</tr>
<tr>
<td align="left" valign="top">Future anxiety&#x202F;&#x2192;&#x202F;Psychological flexibility&#x202F;&#x2192;&#x202F;Stress</td>
<td align="center" valign="top">0.04</td>
<td align="center" valign="top">0.02</td>
<td align="center" valign="top">0.01</td>
<td align="center" valign="top">0.09</td>
</tr>
<tr>
<td align="left" valign="top">Future anxiety&#x202F;&#x2192;&#x202F;Cognitive reappraisal&#x202F;&#x2192;&#x202F;Stress</td>
<td align="center" valign="top">0.08</td>
<td align="center" valign="top">0.01</td>
<td align="center" valign="top">0.05</td>
<td align="center" valign="top">0.11</td>
</tr>
<tr>
<td align="left" valign="top">Future anxiety&#x202F;&#x2192;&#x202F;Expressive suppression&#x202F;&#x2192;&#x202F;Stress</td>
<td align="center" valign="top">0.05</td>
<td align="center" valign="top">0.01</td>
<td align="center" valign="top">0.02</td>
<td align="center" valign="top">0.10</td>
</tr>
<tr>
<td align="left" valign="top">Total indirect effect</td>
<td align="center" valign="top">0.18</td>
<td align="center" valign="top">0.02</td>
<td align="center" valign="top">0.14</td>
<td align="center" valign="top">0.23</td>
</tr>
<tr>
<td align="left" valign="top">Direct effect</td>
<td align="center" valign="top">0.12</td>
<td align="center" valign="top">0.02</td>
<td align="center" valign="top">0.06</td>
<td align="center" valign="top">0.17</td>
</tr>
<tr>
<td align="left" valign="top">Total effect</td>
<td align="center" valign="top">0.31</td>
<td align="center" valign="top">0.02</td>
<td align="center" valign="top">0.26</td>
<td align="center" valign="top">0.35</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<p>Number of bootstrap samples for percentile bootstrap confidence intervals: 5.000.</p>
</table-wrap-foot>
</table-wrap>
</sec>
<sec sec-type="discussion" id="sec14">
<title>Discussion</title>
<p>University students need to have good mental health for their academic life, their general life as well as their future. The findings of the present study showed that future anxiety had an inverse relationship with psychological flexibility and cognitive reappraisal, and a positive relationship with expressive suppression, depression and stress. University students experiencing future anxiety reported low psychological flexibility and cognitive reappraisal levels, whereas high expressive suppression, depression and stress levels. Consistent with our results, <xref ref-type="bibr" rid="ref27">Hasan Alam et al. (2023)</xref> found a relationship between decreasing future anxiety and increasing psychological flexibility. <xref ref-type="bibr" rid="ref72">Szota et al. (2024)</xref> revealed that future anxiety exacerbated depression. A negative attitude toward the future or a negative representation of the future leads to depression and stress and is a risk factor for mental suffering (<xref ref-type="bibr" rid="ref64">Regnoli et al., 2024b</xref>). Anxiety appeared to be associated with less use of cognitive reappraisal and greater use of expressive suppression (<xref ref-type="bibr" rid="ref14">Dryman and Heimberg, 2018</xref>). These findings indicate the adverse effects of future anxiety on individuals in many areas such as psychological, cognitive and emotional functions.</p>
<p>The current study showed that psychological flexibility and cognitive reappraisal were negatively related to depression and stress, and expressive suppression was positively related to depression and stress. Participants who were psychologically flexible and regulated their emotions using cognitive reappraisal reported lower levels of depression and stress, whereas participants who used expressive suppression reported higher levels of depression and stress. There are studies in existing literature that support these results. For example, low psychological flexibility was associated with higher general distress (<xref ref-type="bibr" rid="ref36">Kroska et al., 2020</xref>). Psychological flexibility was also identified as a resilience factor in individuals experiencing chronic pain and psychological distress (<xref ref-type="bibr" rid="ref19">Gentili et al., 2019</xref>). On the other hand, emotion regulation difficulties increase depression and stress (<xref ref-type="bibr" rid="ref30">Honan et al., 2023</xref>). In particular, cognitive reappraisal was negatively associated with health anxiety, but expressive suppression was positively associated with this anxiety (<xref ref-type="bibr" rid="ref2">Akbari et al., 2021</xref>). A systematic review study found that cognitive reappraisal had an inverse relationship with depression, and expressive suppression had a positive relationship with depression (<xref ref-type="bibr" rid="ref14">Dryman and Heimberg, 2018</xref>). These studies show that psychological flexibility and cognitive reappraisal contribute positively to the reduction of depression and stress, while expressive suppression contributes to the increase of these psychological distress.</p>
<p>The results of the present study also determined the mediating roles of psychological flexibility, cognitive reappraisal, and expressive suppression in the link between future anxiety, depression and stress. University students with high future anxiety reported low psychological flexibility and cognitive reappraisal levels and high expressive suppression levels, which in turn led to high depression and stress. Similarly, in individuals with pandemic-related concerns, psychological flexibility reduced psychological distress by reducing avoidant coping and increasing approach coping strategies (<xref ref-type="bibr" rid="ref75">Tindle et al., 2022</xref>). Psychological flexibility mediated the relationship between negative early trauma effects and symptoms (<xref ref-type="bibr" rid="ref65">Richardson and Jost, 2019</xref>) and between temperament and symptoms of stress and depression (<xref ref-type="bibr" rid="ref60">Puolakanaho et al., 2023</xref>). The association between health anxiety and COVID-19 distress, anxiety, and depression was also mediated by psychological flexibility (<xref ref-type="bibr" rid="ref38">Landi et al., 2020</xref>). In addition, cognitive reappraisal mediated the relationship between trait anxiety and expressive flexibility, but expressive suppression failed to mediate these associations (<xref ref-type="bibr" rid="ref70">Shangguan et al., 2024</xref>). Emotion regulation buffered the deleterious effect of anxiety sensitivity, which plays an important role in the development and maintenance of anxiety symptoms, on depression (<xref ref-type="bibr" rid="ref55">Ouimet et al., 2016</xref>). These results suggest that psychological flexibility and cognitive reappraisal are powerful assets that reduce the risk of mental health problems, while expressive suppression is a factor that exaggerates these problems.</p>
<p>The findings of this study contribute to the body of knowledge in literature on how to support the mental health of university students. The current results also offer several practical implications. A study conducted in T&#x00FC;rkiye determined that factors such as employment anxiety, anxiety about not being appointed, stress about the exam required for appointment, difficulty of courses, inability to adapt, economic problems, hopelessness, difficulty of life, wrong department choice and high number of graduates were related to future anxiety (<xref ref-type="bibr" rid="ref15">Esmer and Ar&#x0131;ba&#x015F;, 2023</xref>). In addition, the current study determined a positive relationship between future anxiety, depression and stress. These results emphasize the necessity of dealing with these sources of anxiety to protect and improve the psychological health of university students. In this regard, creating awareness programs, organizing events for students to recognize their strengths and weaknesses, guiding them to acquire professional skills specific to their fields, and organizing development-oriented events that can help them create future plans in areas such as time management, problem-solving, goal setting, and creativity can be helpful for these students at universities. Furthermore, this study revealed that psychological flexibility and emotion regulation mediated the relationship between future anxiety, depression and stress. People have the potential to tolerate and effectively use emotions, thoughts, and behaviors to achieve the best possible outcomes in changing situations. These dynamic capabilities form the building blocks of health. In addition, a healthy person is aware of the possibility of novelty and change and who can manage themselves in the uncertain, unpredictable world around them (<xref ref-type="bibr" rid="ref33">Kashdan and Rottenberg, 2010</xref>). In many forms of psychopathology, such as depression, anxiety, and stress, these flexibility processes and emotion regulation skills are deficient (<xref ref-type="bibr" rid="ref17">Fischer et al., 2016</xref>; <xref ref-type="bibr" rid="ref43">Lincoln et al., 2022</xref>). Therefore, to support mental health, mental health professionals should integrate practices aimed at increasing psychological flexibility and emotion regulation into their interventions. Specifically, these interventions should include practices such as helping individuals recognize, understand, control, and effectively express their emotions, reframing thoughts, recognizing automatic thoughts, coping with stress and challenges, identifying alternative routes, self-acceptance, and future-oriented thinking.</p>
<p>Although this study provides valuable contributions to existing literature, there are important limitations that should be considered when interpreting the study findings. The cross-sectional, correlational nature of the data was a limitation that prevented robust conclusions about directionality. Despite the anonymous nature of data collection, reliability was likely subject to social desirability and demand artifacts because the data were collected using self-report measures. Data were collected from undergraduate students at a public university, which limits the generalizability of the results to a larger population.</p>
<p>In conclusion, to benefit from the many advantages offered by university years, psychological support for students at this educational level should be a priority. The present study found that future anxiety was negatively related to psychological flexibility and cognitive reappraisal, and positively related to expressive suppression, depression and stress. Psychological flexibility and cognitive reappraisal were negatively associated with depression and stress, and expressive suppression was positively associated with depression and stress. Effective psychological flexibility and emotion regulation through increased use of cognitive reappraisal and reduced use of expressive suppression served as a mechanism to protect against the negative impact of future anxiety, depression, and stress. In this regard, the need to improve the psychological flexibility and emotion regulation skills of university students has emerged to achieve better mental health outcomes.</p>
</sec>
</body>
<back>
<sec sec-type="data-availability" id="sec15">
<title>Data availability statement</title>
<p>The raw data supporting the conclusions of this article will be made available by the authors without undue reservation.</p>
</sec>
<sec sec-type="ethics-statement" id="sec16">
<title>Ethics statement</title>
<p>The studies involving humans were approved by Ethics Committee of Agri Ibrahim Cecen University (Ethic Code: E-95531838-050.99-112421). The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.</p>
</sec>
<sec sec-type="author-contributions" id="sec17">
<title>Author contributions</title>
<p>G&#x00D6;: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Software, Validation, Writing &#x2013; original draft, Writing &#x2013; review &#x0026; editing. JG-S: Funding acquisition, Validation, Writing &#x2013; review &#x0026; editing. MY: Funding acquisition, Resources, Supervision, Validation, Visualization, Writing &#x2013; original draft, Writing &#x2013; review &#x0026; editing.</p>
</sec>
<sec sec-type="funding-information" id="sec18">
<title>Funding</title>
<p>The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.</p>
</sec>
<ack>
<p>We thank all participants who voluntarily contributed to this study.</p>
</ack>
<sec sec-type="COI-statement" id="sec19">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
<p>The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.</p>
</sec>
<sec sec-type="ai-statement" id="sec20">
<title>Generative AI statement</title>
<p>The authors declare that no Gen AI was used in the creation of this manuscript.</p>
</sec>
<sec sec-type="disclaimer" id="sec21">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<ref-list>
<title>References</title>
<ref id="ref1"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ahmad</surname> <given-names>N. F.</given-names></name> <name><surname>Murdiana</surname> <given-names>S.</given-names></name> <name><surname>Nur</surname> <given-names>H.</given-names></name></person-group> (<year>2024</year>). <article-title>The influence of future anxiety on students' tendency to experience insomnia</article-title>. <source>Indonesian J. Learn. Educ. Counsel.</source> <volume>7</volume>, <fpage>125</fpage>&#x2013;<lpage>132</lpage>. doi: <pub-id pub-id-type="doi">10.31960/ijolec.v7i1.2491</pub-id></citation></ref>
<ref id="ref2"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Akbari</surname> <given-names>M.</given-names></name> <name><surname>Spada</surname> <given-names>M. M.</given-names></name> <name><surname>Nik&#x010D;evi&#x0107;</surname> <given-names>A. V.</given-names></name> <name><surname>Zamani</surname> <given-names>E.</given-names></name></person-group> (<year>2021</year>). <article-title>The relationship between fear of COVID-19 and health anxiety among families with COVID-19 infected: the mediating role of metacognitions, intolerance of uncertainty and emotion regulation</article-title>. <source>Clin. Psychol. Psychother.</source> <volume>28</volume>, <fpage>1354</fpage>&#x2013;<lpage>1366</lpage>. doi: <pub-id pub-id-type="doi">10.1002/cpp.2628</pub-id>, PMID: <pub-id pub-id-type="pmid">34110670</pub-id></citation></ref>
<ref id="ref3"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Al Hwayan</surname> <given-names>O.</given-names></name></person-group> (<year>2020</year>). <article-title>Predictive ability of future anxiety in professional decision-making skill among a Syrian refugee adolescent in Jordan</article-title>. <source>Occup. Ther. Int.</source> <volume>2020</volume>:<fpage>4959785</fpage>. doi: <pub-id pub-id-type="doi">10.1155/2020/4959785</pub-id>, PMID: <pub-id pub-id-type="pmid">32292305</pub-id></citation></ref>
<ref id="ref4"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Alfonsi</surname> <given-names>V.</given-names></name> <name><surname>Varallo</surname> <given-names>G.</given-names></name> <name><surname>Scarpelli</surname> <given-names>S.</given-names></name> <name><surname>Gorgoni</surname> <given-names>M.</given-names></name> <name><surname>Filosa</surname> <given-names>M.</given-names></name> <name><surname>De Gennaro</surname> <given-names>L.</given-names></name> <etal/></person-group>. (<year>2023</year>). <article-title>&#x2018;This is the last episode&#x2019;: the association between problematic binge-watching and loneliness, emotion regulation, and sleep-related factors in poor sleepers</article-title>. <source>J. Sleep Res.</source> <volume>32</volume>:<fpage>e13747</fpage>. doi: <pub-id pub-id-type="doi">10.1111/jsr.13747</pub-id>, PMID: <pub-id pub-id-type="pmid">36254098</pub-id></citation></ref>
<ref id="ref5"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Baldini</surname> <given-names>V.</given-names></name> <name><surname>Gnazzo</surname> <given-names>M.</given-names></name> <name><surname>Rapelli</surname> <given-names>G.</given-names></name> <name><surname>Marchi</surname> <given-names>M.</given-names></name> <name><surname>Pingani</surname> <given-names>L.</given-names></name> <name><surname>Ferrari</surname> <given-names>S.</given-names></name> <etal/></person-group>. (<year>2024</year>). <article-title>Association between sleep disturbances and suicidal behavior in adolescents: a systematic review and meta-analysis</article-title>. <source>Front. Psych.</source> <volume>15</volume>:<fpage>1341686</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fpsyt.2024.1341686</pub-id>, PMID: <pub-id pub-id-type="pmid">39421072</pub-id></citation></ref>
<ref id="ref6"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Berking</surname> <given-names>M.</given-names></name> <name><surname>Wirtz</surname> <given-names>C. M.</given-names></name> <name><surname>Svaldi</surname> <given-names>J.</given-names></name> <name><surname>Hofmann</surname> <given-names>S. G.</given-names></name></person-group> (<year>2014</year>). <article-title>Emotion regulation predicts symptoms of depression over five years</article-title>. <source>Behav. Res. Ther.</source> <volume>57</volume>, <fpage>13</fpage>&#x2013;<lpage>20</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.brat.2014.03.003</pub-id>, PMID: <pub-id pub-id-type="pmid">24754907</pub-id></citation></ref>
<ref id="ref7"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Bond</surname> <given-names>F. W.</given-names></name> <name><surname>Flaxman</surname> <given-names>P. E.</given-names></name> <name><surname>Bunce</surname> <given-names>D.</given-names></name></person-group> (<year>2008</year>). <article-title>The influence of psychological flexibility on work redesign: mediated moderation of a work reorganization intervention</article-title>. <source>J. Appl. Psychol.</source> <volume>93</volume>, <fpage>645</fpage>&#x2013;<lpage>654</lpage>. doi: <pub-id pub-id-type="doi">10.1037/0021-9010.93.3.645</pub-id>, PMID: <pub-id pub-id-type="pmid">18457492</pub-id></citation></ref>
<ref id="ref8"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Cardi</surname> <given-names>V.</given-names></name> <name><surname>Albano</surname> <given-names>G.</given-names></name> <name><surname>Gentili</surname> <given-names>C.</given-names></name> <name><surname>Sudulich</surname> <given-names>L.</given-names></name></person-group> (<year>2021</year>). <article-title>The impact of emotion regulation and mental health difficulties on health behaviours during COVID19</article-title>. <source>J. Psychiatr. Res.</source> <volume>143</volume>, <fpage>409</fpage>&#x2013;<lpage>415</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.jpsychires.2021.10.001</pub-id>, PMID: <pub-id pub-id-type="pmid">34655950</pub-id></citation></ref>
<ref id="ref9"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Chervonsky</surname> <given-names>E.</given-names></name> <name><surname>Hunt</surname> <given-names>C.</given-names></name></person-group> (<year>2019</year>). <article-title>Emotion regulation, mental health, and social wellbeing in a young adolescent sample: a concurrent and longitudinal investigation</article-title>. <source>Emotion</source> <volume>19</volume>, <fpage>270</fpage>&#x2013;<lpage>282</lpage>. doi: <pub-id pub-id-type="doi">10.1037/emo0000432</pub-id>, PMID: <pub-id pub-id-type="pmid">29697988</pub-id></citation></ref>
<ref id="ref10"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Colonnello</surname> <given-names>V.</given-names></name> <name><surname>Fino</surname> <given-names>E.</given-names></name> <name><surname>Russo</surname> <given-names>P. M.</given-names></name></person-group> (<year>2022</year>). <article-title>Attachment anxiety and depressive symptoms in undergraduate medical students: the mediating role of emotion regulation strategies</article-title>. <source>Perspect. Med. Educ.</source> <volume>11</volume>, <fpage>207</fpage>&#x2013;<lpage>212</lpage>. doi: <pub-id pub-id-type="doi">10.1007/s40037-022-00713-z</pub-id>, PMID: <pub-id pub-id-type="pmid">35587333</pub-id></citation></ref>
<ref id="ref11"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Deplancke</surname> <given-names>C.</given-names></name> <name><surname>Somerville</surname> <given-names>M. P.</given-names></name> <name><surname>Harrison</surname> <given-names>A.</given-names></name> <name><surname>Vuillier</surname> <given-names>L.</given-names></name></person-group> (<year>2023</year>). <article-title>It&#x2019;s all about beliefs: believing emotions are uncontrollable is linked to symptoms of anxiety and depression through cognitive reappraisal and expressive suppression</article-title>. <source>Curr. Psychol.</source> <volume>42</volume>, <fpage>22004</fpage>&#x2013;<lpage>22012</lpage>. doi: <pub-id pub-id-type="doi">10.1007/s12144-022-03252-2</pub-id></citation></ref>
<ref id="ref12"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Dey</surname> <given-names>N. E. Y.</given-names></name> <name><surname>Oti-Boadi</surname> <given-names>M.</given-names></name> <name><surname>Malm</surname> <given-names>E.</given-names></name> <name><surname>Selormey</surname> <given-names>R. K.</given-names></name> <name><surname>Ansah</surname> <given-names>K. O.</given-names></name></person-group> (<year>2022</year>). <article-title>Fear of COVID-19, perceived academic stress, future anxiety, and psychological distress of Ghanaian university students: a serial mediation examination</article-title>. <source>J. Psychol. Afr.</source> <volume>32</volume>, <fpage>423</fpage>&#x2013;<lpage>430</lpage>. doi: <pub-id pub-id-type="doi">10.1080/14330237.2022.2120703</pub-id></citation></ref>
<ref id="ref13"><citation citation-type="other"><person-group person-group-type="author"><name><surname>Dilek&#x00E7;i</surname> <given-names>&#x00DC;.</given-names></name> <name><surname>Y&#x0131;ld&#x0131;r&#x0131;m</surname> <given-names>M.</given-names></name></person-group> (<year>submitted for publication</year>). <article-title>Emotion regulation, life satisfaction, and Eudaimonic well-being among undergraduate and associate degree students: validation of the Turkish version of the emotion regulation questionnaire-short form</article-title>.</citation></ref>
<ref id="ref14"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Dryman</surname> <given-names>M. T.</given-names></name> <name><surname>Heimberg</surname> <given-names>R. G.</given-names></name></person-group> (<year>2018</year>). <article-title>Emotion regulation in social anxiety and depression: a systematic review of expressive suppression and cognitive reappraisal</article-title>. <source>Clin. Psychol. Rev.</source> <volume>65</volume>, <fpage>17</fpage>&#x2013;<lpage>42</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.cpr.2018.07.004</pub-id>, PMID: <pub-id pub-id-type="pmid">30064053</pub-id></citation></ref>
<ref id="ref15"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Esmer</surname> <given-names>Y.</given-names></name> <name><surname>Ar&#x0131;ba&#x015F;</surname> <given-names>A. N.</given-names></name></person-group> (<year>2023</year>). <article-title>&#x00D6;nlisans &#x00F6;&#x011F;rencilerinin gelecek kayg&#x0131;lar&#x0131;na y&#x00F6;nelik nitel bir ara&#x015F;t&#x0131;rma</article-title>. <source>Karamano&#x011F;lu Mehmetbey &#x00DC;niversitesi Sosyal ve Ekonomik Ara&#x015F;t&#x0131;rmalar Dergisi</source> <volume>25</volume>, <fpage>330</fpage>&#x2013;<lpage>347</lpage>.</citation></ref>
<ref id="ref16"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Eysenck</surname> <given-names>M.</given-names></name> <name><surname>Payne</surname> <given-names>S.</given-names></name> <name><surname>Santos</surname> <given-names>R.</given-names></name></person-group> (<year>2006</year>). <article-title>Anxiety and depression: past, present, and future events</article-title>. <source>Cognit. Emot.</source> <volume>20</volume>, <fpage>274</fpage>&#x2013;<lpage>294</lpage>. doi: <pub-id pub-id-type="doi">10.1080/02699930500220066</pub-id></citation></ref>
<ref id="ref17"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Fischer</surname> <given-names>T. D.</given-names></name> <name><surname>Smout</surname> <given-names>M. F.</given-names></name> <name><surname>Delfabbro</surname> <given-names>P. H.</given-names></name></person-group> (<year>2016</year>). <article-title>The relationship between psychological flexibility, early maladaptive schemas, perceived parenting and psychopathology</article-title>. <source>J. Contextual Behav. Sci.</source> <volume>5</volume>, <fpage>169</fpage>&#x2013;<lpage>177</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.jcbs.2016.06.002</pub-id></citation></ref>
<ref id="ref18"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Fried</surname> <given-names>E. I.</given-names></name></person-group> (<year>2017</year>). <article-title>The 52 symptoms of major depression: lack of content overlap among seven common depression scales</article-title>. <source>J. Affect. Disord.</source> <volume>208</volume>, <fpage>191</fpage>&#x2013;<lpage>197</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.jad.2016.10.019</pub-id></citation></ref>
<ref id="ref19"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Gentili</surname> <given-names>C.</given-names></name> <name><surname>Rickardsson</surname> <given-names>J.</given-names></name> <name><surname>Zetterqvist</surname> <given-names>V.</given-names></name> <name><surname>Simons</surname> <given-names>L. E.</given-names></name> <name><surname>Lekander</surname> <given-names>M.</given-names></name> <name><surname>Wicksell</surname> <given-names>R. K.</given-names></name></person-group> (<year>2019</year>). <article-title>Psychological flexibility as a resilience factor in individuals with chronic pain</article-title>. <source>Front. Psychol.</source> <volume>10</volume>:<fpage>2016</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fpsyg.2019.02016</pub-id>, PMID: <pub-id pub-id-type="pmid">31551871</pub-id></citation></ref>
<ref id="ref20"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Gloster</surname> <given-names>A. T.</given-names></name> <name><surname>Block</surname> <given-names>V. J.</given-names></name> <name><surname>Klotsche</surname> <given-names>J.</given-names></name> <name><surname>Villanueva</surname> <given-names>J.</given-names></name> <name><surname>Rinner</surname> <given-names>M. T.</given-names></name> <name><surname>Benoy</surname> <given-names>C.</given-names></name> <etal/></person-group>. (<year>2021</year>). <article-title>Psy-flex: a contextually sensitive measure of psychological flexibility</article-title>. <source>J. Contextual Behav. Sci.</source> <volume>22</volume>, <fpage>13</fpage>&#x2013;<lpage>23</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.jcbs.2021.09.001</pub-id></citation></ref>
<ref id="ref21"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Gross</surname> <given-names>J. J.</given-names></name></person-group> (<year>1998</year>). <article-title>Antecedent-and response-focused emotion regulation: divergent consequences for experience, expression, and physiology</article-title>. <source>J. Pers. Soc. Psychol.</source> <volume>74</volume>, <fpage>224</fpage>&#x2013;<lpage>237</lpage>. doi: <pub-id pub-id-type="doi">10.1037/0022-3514.74.1.224</pub-id>, PMID: <pub-id pub-id-type="pmid">9457784</pub-id></citation></ref>
<ref id="ref22"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Gross</surname> <given-names>J. J.</given-names></name> <name><surname>John</surname> <given-names>O. P.</given-names></name></person-group> (<year>2003</year>). <article-title>Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being</article-title>. <source>J. Pers. Soc. Psychol.</source> <volume>85</volume>, <fpage>348</fpage>&#x2013;<lpage>362</lpage>. doi: <pub-id pub-id-type="doi">10.1037/0022-3514.85.2.348</pub-id>, PMID: <pub-id pub-id-type="pmid">12916575</pub-id></citation></ref>
<ref id="ref23"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Guerrini Usubini</surname> <given-names>A.</given-names></name> <name><surname>Terrone</surname> <given-names>G.</given-names></name> <name><surname>Varallo</surname> <given-names>G.</given-names></name> <name><surname>Cattivelli</surname> <given-names>R.</given-names></name> <name><surname>Plazzi</surname> <given-names>G.</given-names></name> <name><surname>Castelnuovo</surname> <given-names>G.</given-names></name> <etal/></person-group>. (<year>2022a</year>). <article-title>The mediating role of emotion dysregulation and problematic internet use in the relationship between negative affect and excessive daytime sleepiness: a structural equation model</article-title>. <source>Nat. Sci. Sleep</source> <volume>14</volume>, <fpage>291</fpage>&#x2013;<lpage>302</lpage>. doi: <pub-id pub-id-type="doi">10.2147/NSS.S346485</pub-id></citation></ref>
<ref id="ref24"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Guerrini Usubini</surname> <given-names>A.</given-names></name> <name><surname>Varallo</surname> <given-names>G.</given-names></name> <name><surname>Giusti</surname> <given-names>E. M.</given-names></name> <name><surname>Cattivelli</surname> <given-names>R.</given-names></name> <name><surname>Granese</surname> <given-names>V.</given-names></name> <name><surname>Consoli</surname> <given-names>S.</given-names></name> <etal/></person-group>. (<year>2022b</year>). <article-title>The mediating role of psychological inflexibility in the relationship between anxiety, depression, and emotional eating in adult individuals with obesity</article-title>. <source>Front. Psychol.</source> <volume>13</volume>:<fpage>861341</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fpsyg.2022.861341</pub-id>, PMID: <pub-id pub-id-type="pmid">35432111</pub-id></citation></ref>
<ref id="ref25"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Guerrini Usubini</surname> <given-names>A.</given-names></name> <name><surname>Varallo</surname> <given-names>G.</given-names></name> <name><surname>Granese</surname> <given-names>V.</given-names></name> <name><surname>Cattivelli</surname> <given-names>R.</given-names></name> <name><surname>Consoli</surname> <given-names>S.</given-names></name> <name><surname>Bastoni</surname> <given-names>I.</given-names></name> <etal/></person-group>. (<year>2021</year>). <article-title>The impact of psychological flexibility on psychological well-being in adults with obesity</article-title>. <source>Front. Psychol.</source> <volume>12</volume>:<fpage>636933</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fpsyg.2021.636933</pub-id>, PMID: <pub-id pub-id-type="pmid">33828505</pub-id></citation></ref>
<ref id="ref26"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Hammad</surname> <given-names>M. A.</given-names></name></person-group> (<year>2016</year>). <article-title>Future anxiety and its relationship to students' attitude toward academic specialization</article-title>. <source>J. Educ. Pract.</source> <volume>7</volume>, <fpage>54</fpage>&#x2013;<lpage>65</lpage>.</citation></ref>
<ref id="ref27"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Hasan Alam</surname> <given-names>F.</given-names></name> <name><surname>EL Berry</surname> <given-names>K. I.</given-names></name> <name><surname>Kamal Mohamed Sweelam</surname> <given-names>R.</given-names></name> <name><surname>Mostafa Arrab</surname> <given-names>M.</given-names></name> <name><surname>Sh Shehata</surname> <given-names>H.</given-names></name></person-group> (<year>2023</year>). <article-title>Effectiveness of acceptance and commitment based intervention on stress, future anxiety and quality of life among mothers of children with cerebral palsy</article-title>. <source>Int. Egypt. J. Nurs. Sci. Res.</source> <volume>3</volume>, <fpage>281</fpage>&#x2013;<lpage>306</lpage>. doi: <pub-id pub-id-type="doi">10.21608/ejnsr.2023.277922</pub-id></citation></ref>
<ref id="ref28"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Hayes</surname> <given-names>A. F.</given-names></name></person-group> (<year>2009</year>). <article-title>Beyond baron and Kenny: statistical mediation analysis in the new millennium</article-title>. <source>Commun. Monogr.</source> <volume>76</volume>, <fpage>408</fpage>&#x2013;<lpage>420</lpage>. doi: <pub-id pub-id-type="doi">10.1080/03637750903310360</pub-id></citation></ref>
<ref id="ref29"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Hayes</surname> <given-names>S. C.</given-names></name> <name><surname>Luoma</surname> <given-names>J. B.</given-names></name> <name><surname>Bond</surname> <given-names>F. W.</given-names></name> <name><surname>Masuda</surname> <given-names>A.</given-names></name> <name><surname>Lillis</surname> <given-names>J.</given-names></name></person-group> (<year>2006</year>). <article-title>Acceptance and commitment therapy: model, processes and outcomes</article-title>. <source>Behav. Res. Ther.</source> <volume>44</volume>, <fpage>1</fpage>&#x2013;<lpage>25</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.brat.2005.06.006</pub-id>, PMID: <pub-id pub-id-type="pmid">16300724</pub-id></citation></ref>
<ref id="ref30"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Honan</surname> <given-names>I.</given-names></name> <name><surname>Waight</surname> <given-names>E.</given-names></name> <name><surname>Bratel</surname> <given-names>J.</given-names></name> <name><surname>Given</surname> <given-names>F.</given-names></name> <name><surname>Badawi</surname> <given-names>N.</given-names></name> <name><surname>McIntyre</surname> <given-names>S.</given-names></name> <etal/></person-group>. (<year>2023</year>). <article-title>Emotion regulation is associated with anxiety, depression and stress in adults with cerebral palsy</article-title>. <source>J. Clin. Med.</source> <volume>12</volume>:<fpage>2527</fpage>. doi: <pub-id pub-id-type="doi">10.3390/jcm12072527</pub-id>, PMID: <pub-id pub-id-type="pmid">37048620</pub-id></citation></ref>
<ref id="ref31"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Jannini</surname> <given-names>T. B.</given-names></name> <name><surname>Mordacchini</surname> <given-names>I.</given-names></name> <name><surname>Rossi</surname> <given-names>R.</given-names></name> <name><surname>Socci</surname> <given-names>V.</given-names></name> <name><surname>Lorenzo</surname> <given-names>G. D.</given-names></name></person-group> (<year>2024</year>). <article-title>The influence of age on the relationship between future anxiety, loneliness, and quality of life: evidence from a sample of 5409 individuals in the general population in Italy</article-title>. <source>Curr. Psychol.</source> <volume>43</volume>, <fpage>30148</fpage>&#x2013;<lpage>30155</lpage>. doi: <pub-id pub-id-type="doi">10.1007/s12144-024-06517-0</pub-id>, PMID: <pub-id pub-id-type="pmid">39831055</pub-id></citation></ref>
<ref id="ref32"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Karyotaki</surname> <given-names>E.</given-names></name> <name><surname>Cuijpers</surname> <given-names>P.</given-names></name> <name><surname>Albor</surname> <given-names>Y.</given-names></name> <name><surname>Alonso</surname> <given-names>J.</given-names></name> <name><surname>Auerbach</surname> <given-names>R. P.</given-names></name> <name><surname>Bantjes</surname> <given-names>J.</given-names></name> <etal/></person-group>. (<year>2020</year>). <article-title>Sources of stress and their associations with mental disorders among college students: results of the world health organization world mental health surveys international college student initiative</article-title>. <source>Front. Psychol.</source> <volume>11</volume>:<fpage>1759</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fpsyg.2020.01759</pub-id>, PMID: <pub-id pub-id-type="pmid">32849042</pub-id></citation></ref>
<ref id="ref33"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kashdan</surname> <given-names>T. B.</given-names></name> <name><surname>Rottenberg</surname> <given-names>J.</given-names></name></person-group> (<year>2010</year>). <article-title>Psychological flexibility as a fundamental aspect of health</article-title>. <source>Clin. Psychol. Rev.</source> <volume>30</volume>, <fpage>865</fpage>&#x2013;<lpage>878</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.cpr.2010.03.001</pub-id>, PMID: <pub-id pub-id-type="pmid">21151705</pub-id></citation></ref>
<ref id="ref34"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>K&#x00E4;stner</surname> <given-names>A.</given-names></name> <name><surname>L&#x00FC;cker</surname> <given-names>P.</given-names></name> <name><surname>Hannich</surname> <given-names>A.</given-names></name> <name><surname>Schmeyers</surname> <given-names>L.</given-names></name> <name><surname>L&#x00FC;cker</surname> <given-names>J.</given-names></name> <name><surname>Hoffmann</surname> <given-names>W.</given-names></name></person-group> (<year>2022</year>). <article-title>COVID-19-related future anxiety is associated with the health-related quality of life in school-aged children and adolescents&#x2014;a cross-sectional study</article-title>. <source>Front. Public Health</source> <volume>10</volume>:<fpage>1003876</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fpubh.2022.1003876</pub-id>, PMID: <pub-id pub-id-type="pmid">36438295</pub-id></citation></ref>
<ref id="ref35"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kaur</surname> <given-names>T.</given-names></name> <name><surname>Ranjan</surname> <given-names>P.</given-names></name> <name><surname>Chakrawarty</surname> <given-names>A.</given-names></name> <name><surname>Kasi</surname> <given-names>K.</given-names></name> <name><surname>Berry</surname> <given-names>P.</given-names></name> <name><surname>Suryansh</surname> <given-names>S.</given-names></name> <etal/></person-group>. (<year>2021</year>). <article-title>Association of sociodemographic parameters with depression, anxiety, stress, sleep quality, psychological trauma, mental well-being, and resilience during the second wave of COVID-19 pandemic: a cross-sectional survey from India</article-title>. <source>Cureus</source> <volume>13</volume>:<fpage>e16420</fpage>. doi: <pub-id pub-id-type="doi">10.7759/cureus.16420</pub-id>, PMID: <pub-id pub-id-type="pmid">34414046</pub-id></citation></ref>
<ref id="ref36"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kroska</surname> <given-names>E. B.</given-names></name> <name><surname>Roche</surname> <given-names>A. I.</given-names></name> <name><surname>Adamowicz</surname> <given-names>J. L.</given-names></name> <name><surname>Stegall</surname> <given-names>M. S.</given-names></name></person-group> (<year>2020</year>). <article-title>Psychological flexibility in the context of COVID-19 adversity: associations with distress</article-title>. <source>J. Contextual Behav. Sci.</source> <volume>18</volume>, <fpage>28</fpage>&#x2013;<lpage>33</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.jcbs.2020.07.011</pub-id>, PMID: <pub-id pub-id-type="pmid">32837889</pub-id></citation></ref>
<ref id="ref37"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kwapong</surname> <given-names>Y. A.</given-names></name> <name><surname>Boakye</surname> <given-names>E.</given-names></name> <name><surname>Khan</surname> <given-names>S. S.</given-names></name> <name><surname>Honigberg</surname> <given-names>M. C.</given-names></name> <name><surname>Martin</surname> <given-names>S. S.</given-names></name> <name><surname>Oyeka</surname> <given-names>C. P.</given-names></name> <etal/></person-group>. (<year>2023</year>). <article-title>Association of depression and poor mental health with cardiovascular disease and suboptimal cardiovascular health among young adults in the United States</article-title>. <source>J. Am. Heart Assoc.</source> <volume>12</volume>:<fpage>e028332</fpage>. doi: <pub-id pub-id-type="doi">10.1161/JAHA.122.028332</pub-id>, PMID: <pub-id pub-id-type="pmid">36688365</pub-id></citation></ref>
<ref id="ref38"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Landi</surname> <given-names>G.</given-names></name> <name><surname>Pakenham</surname> <given-names>K. I.</given-names></name> <name><surname>Boccolini</surname> <given-names>G.</given-names></name> <name><surname>Grandi</surname> <given-names>S.</given-names></name> <name><surname>Tossani</surname> <given-names>E.</given-names></name></person-group> (<year>2020</year>). <article-title>Health anxiety and mental health outcome during COVID-19 lockdown in Italy: the mediating and moderating roles of psychological flexibility</article-title>. <source>Front. Psychol.</source> <volume>11</volume>:<fpage>2195</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fpsyg.2020.02195</pub-id>, PMID: <pub-id pub-id-type="pmid">32982888</pub-id></citation></ref>
<ref id="ref39"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lazarus</surname> <given-names>R. S.</given-names></name> <name><surname>Alfert</surname> <given-names>E.</given-names></name></person-group> (<year>1964</year>). <article-title>Short-circuiting of threat by experimentally altering cognitive appraisal</article-title>. <source>J. Abnorm. Soc. Psychol.</source> <volume>69</volume>, <fpage>195</fpage>&#x2013;<lpage>205</lpage>. doi: <pub-id pub-id-type="doi">10.1037/h0044635</pub-id>, PMID: <pub-id pub-id-type="pmid">14213291</pub-id></citation></ref>
<ref id="ref40"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lee</surname> <given-names>E.-S.</given-names></name></person-group> (<year>2017</year>). <article-title>Impact of life stress on depression, subjective well-being and psychological well-being in nursing students: mediation effects of coping</article-title>. <source>J. Korea Acad. Ind. Cooper. Soc.</source> <volume>18</volume>, <fpage>55</fpage>&#x2013;<lpage>65</lpage>. doi: <pub-id pub-id-type="doi">10.5762/KAIS.2017.18.1.55</pub-id></citation></ref>
<ref id="ref41"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Li</surname> <given-names>X.</given-names></name> <name><surname>Mu</surname> <given-names>F.</given-names></name> <name><surname>Liu</surname> <given-names>D.</given-names></name> <name><surname>Zhu</surname> <given-names>J.</given-names></name> <name><surname>Yue</surname> <given-names>S.</given-names></name> <name><surname>Liu</surname> <given-names>M.</given-names></name> <etal/></person-group>. (<year>2022</year>). <article-title>Predictors of suicidal ideation, suicide attempt and suicide death among people with major depressive disorder: a systematic review and meta-analysis of cohort studies</article-title>. <source>J. Affect. Disord.</source> <volume>302</volume>, <fpage>332</fpage>&#x2013;<lpage>351</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.jad.2022.01.103</pub-id>, PMID: <pub-id pub-id-type="pmid">35101521</pub-id></citation></ref>
<ref id="ref42"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Li</surname> <given-names>A.</given-names></name> <name><surname>Wang</surname> <given-names>D.</given-names></name> <name><surname>Lin</surname> <given-names>S.</given-names></name> <name><surname>Chu</surname> <given-names>M.</given-names></name> <name><surname>Huang</surname> <given-names>S.</given-names></name> <name><surname>Lee</surname> <given-names>C.-Y.</given-names></name> <etal/></person-group>. (<year>2021</year>). <article-title>Depression and life satisfaction among middle-aged and older adults: mediation effect of functional disability</article-title>. <source>Front. Psychol.</source> <volume>12</volume>:<fpage>755220</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fpsyg.2021.755220</pub-id>, PMID: <pub-id pub-id-type="pmid">34899497</pub-id></citation></ref>
<ref id="ref43"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lincoln</surname> <given-names>T. M.</given-names></name> <name><surname>Schulze</surname> <given-names>L.</given-names></name> <name><surname>Renneberg</surname> <given-names>B.</given-names></name></person-group> (<year>2022</year>). <article-title>The role of emotion regulation in the characterization, development and treatment of psychopathology</article-title>. <source>Nat. Rev. Psychol.</source> <volume>1</volume>, <fpage>272</fpage>&#x2013;<lpage>286</lpage>. doi: <pub-id pub-id-type="doi">10.1038/s44159-022-00040-4</pub-id></citation></ref>
<ref id="ref44"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lloyd</surname> <given-names>J.</given-names></name> <name><surname>Bond</surname> <given-names>F. W.</given-names></name> <name><surname>Flaxman</surname> <given-names>P. E.</given-names></name></person-group> (<year>2013</year>). <article-title>The value of psychological flexibility: examining psychological mechanisms underpinning a cognitive behavioural therapy intervention for burnout</article-title>. <source>Work Stress</source> <volume>27</volume>, <fpage>181</fpage>&#x2013;<lpage>199</lpage>. doi: <pub-id pub-id-type="doi">10.1080/02678373.2013.782157</pub-id></citation></ref>
<ref id="ref45"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lopes</surname> <given-names>A. R.</given-names></name> <name><surname>Nihei</surname> <given-names>O. K.</given-names></name></person-group> (<year>2021</year>). <article-title>Depression, anxiety and stress symptoms in Brazilian university students during the COVID-19 pandemic: predictors and association with life satisfaction, psychological well-being and coping strategies</article-title>. <source>PLoS One</source> <volume>16</volume>:<fpage>e0258493</fpage>. doi: <pub-id pub-id-type="doi">10.1371/journal.pone.0258493</pub-id>, PMID: <pub-id pub-id-type="pmid">34644347</pub-id></citation></ref>
<ref id="ref46"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lovibond</surname> <given-names>P. F.</given-names></name> <name><surname>Lovibond</surname> <given-names>S. H.</given-names></name></person-group> (<year>1995</year>). <article-title>The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the Beck depression and anxiety inventories</article-title>. <source>Behav. Res. Ther.</source> <volume>33</volume>, <fpage>335</fpage>&#x2013;<lpage>343</lpage>. doi: <pub-id pub-id-type="doi">10.1016/0005-7967(94)00075-U</pub-id>, PMID: <pub-id pub-id-type="pmid">7726811</pub-id></citation></ref>
<ref id="ref47"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lucas</surname> <given-names>J. J.</given-names></name> <name><surname>Moore</surname> <given-names>K. A.</given-names></name></person-group> (<year>2020</year>). <article-title>Psychological flexibility: positive implications for mental health and life satisfaction</article-title>. <source>Health Promot. Int.</source> <volume>35</volume>, <fpage>312</fpage>&#x2013;<lpage>320</lpage>. doi: <pub-id pub-id-type="doi">10.1093/heapro/daz036</pub-id>, PMID: <pub-id pub-id-type="pmid">31071217</pub-id></citation></ref>
<ref id="ref48"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lueke</surname> <given-names>N. A.</given-names></name> <name><surname>Assar</surname> <given-names>A.</given-names></name></person-group> (<year>2024</year>). <article-title>Poor sleep quality and reduced immune function among college students: perceived stress and depression as mediators</article-title>. <source>J. Am. Coll. Heal.</source> <volume>72</volume>, <fpage>1112</fpage>&#x2013;<lpage>1119</lpage>. doi: <pub-id pub-id-type="doi">10.1080/07448481.2022.2068350</pub-id>, PMID: <pub-id pub-id-type="pmid">35549834</pub-id></citation></ref>
<ref id="ref49"><citation citation-type="book"><person-group person-group-type="author"><name><surname>Manosso</surname> <given-names>L. M.</given-names></name> <name><surname>Gasparini</surname> <given-names>C. R.</given-names></name> <name><surname>R&#x00E9;us</surname> <given-names>G. Z.</given-names></name> <name><surname>Pavlovic</surname> <given-names>Z. M.</given-names></name></person-group> (<year>2022</year>). &#x201C;<article-title>Definitions and concepts of stress</article-title>&#x201D; in <source>Glutamate and neuropsychiatric disorders. current and emerging treatments</source>. (<publisher-loc>Cham</publisher-loc>: <publisher-name>Springer</publisher-name>), <fpage>27</fpage>&#x2013;<lpage>63</lpage>.</citation></ref>
<ref id="ref50"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Masoom Ali</surname> <given-names>S.</given-names></name> <name><surname>Yildirim</surname> <given-names>M.</given-names></name> <name><surname>Abdul Hussain</surname> <given-names>S.</given-names></name> <name><surname>Vostanis</surname> <given-names>P.</given-names></name></person-group> (<year>2020</year>). <article-title>Self-reported mental health problems and post-traumatic growth among children in Pakistan care homes</article-title>. <source>Asia Pac. J. Soc. Work Dev.</source> <volume>30</volume>, <fpage>62</fpage>&#x2013;<lpage>76</lpage>. doi: <pub-id pub-id-type="doi">10.1080/02185385.2019.1710726</pub-id></citation></ref>
<ref id="ref51"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Masuda</surname> <given-names>A.</given-names></name> <name><surname>Price</surname> <given-names>M.</given-names></name> <name><surname>Anderson</surname> <given-names>P. L.</given-names></name> <name><surname>Wendell</surname> <given-names>J. W.</given-names></name></person-group> (<year>2010</year>). <article-title>Disordered eating-related cognition and psychological flexibility as predictors of psychological health among college students</article-title>. <source>Behav. Modif.</source> <volume>34</volume>, <fpage>3</fpage>&#x2013;<lpage>15</lpage>. doi: <pub-id pub-id-type="doi">10.1177/0145445509351569</pub-id>, PMID: <pub-id pub-id-type="pmid">20051522</pub-id></citation></ref>
<ref id="ref52"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Masuda</surname> <given-names>A.</given-names></name> <name><surname>Tully</surname> <given-names>E. C.</given-names></name></person-group> (<year>2012</year>). <article-title>The role of mindfulness and psychological flexibility in somatization, depression, anxiety, and general psychological distress in a nonclinical college sample</article-title>. <source>J. Evid. Based Complement. Alternative Med.</source> <volume>17</volume>, <fpage>66</fpage>&#x2013;<lpage>71</lpage>. doi: <pub-id pub-id-type="doi">10.1177/2156587211423400</pub-id></citation></ref>
<ref id="ref53"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Mei</surname> <given-names>S.</given-names></name> <name><surname>Qin</surname> <given-names>Z.</given-names></name> <name><surname>Yang</surname> <given-names>Y.</given-names></name> <name><surname>Gao</surname> <given-names>T.</given-names></name> <name><surname>Ren</surname> <given-names>H.</given-names></name> <name><surname>Hu</surname> <given-names>Y.</given-names></name> <etal/></person-group>. (<year>2021</year>). <article-title>Influence of life satisfaction on quality of life: mediating roles of depression and anxiety among cardiovascular disease patients</article-title>. <source>Clin. Nurs. Res.</source> <volume>30</volume>, <fpage>215</fpage>&#x2013;<lpage>224</lpage>. doi: <pub-id pub-id-type="doi">10.1177/1054773820947984</pub-id>, PMID: <pub-id pub-id-type="pmid">32757768</pub-id></citation></ref>
<ref id="ref54"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Morssinkhof</surname> <given-names>M.</given-names></name> <name><surname>Van Wylick</surname> <given-names>D.</given-names></name> <name><surname>Priester-Vink</surname> <given-names>S.</given-names></name> <name><surname>Van Der Werf</surname> <given-names>Y.</given-names></name> <name><surname>Den Heijer</surname> <given-names>M.</given-names></name> <name><surname>Van Den Heuvel</surname> <given-names>O.</given-names></name> <etal/></person-group>. (<year>2020</year>). <article-title>Associations between sex hormones, sleep problems and depression: a systematic review</article-title>. <source>Neurosci. Biobehav. Rev.</source> <volume>118</volume>, <fpage>669</fpage>&#x2013;<lpage>680</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.neubiorev.2020.08.006</pub-id>, PMID: <pub-id pub-id-type="pmid">32882313</pub-id></citation></ref>
<ref id="ref55"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ouimet</surname> <given-names>A. J.</given-names></name> <name><surname>Kane</surname> <given-names>L.</given-names></name> <name><surname>Tutino</surname> <given-names>J. S.</given-names></name></person-group> (<year>2016</year>). <article-title>Fear of anxiety or fear of emotions? Anxiety sensitivity is indirectly related to anxiety and depressive symptoms via emotion regulation</article-title>. <source>Cogent Psychol.</source> <volume>3</volume>:<fpage>1249132</fpage>. doi: <pub-id pub-id-type="doi">10.1080/23311908.2016.1249132</pub-id></citation></ref>
<ref id="ref56"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Pan</surname> <given-names>L.</given-names></name> <name><surname>Qiu</surname> <given-names>W.</given-names></name> <name><surname>Hu</surname> <given-names>Z.</given-names></name> <name><surname>Li</surname> <given-names>J.</given-names></name></person-group> (<year>2024</year>). <article-title>Intolerance of uncertainty and internet addiction among college students in China post-pandemic era: the mediating role of future anxiety</article-title>. <source>Sci. Rep.</source> <volume>14</volume>:<fpage>20098</fpage>. doi: <pub-id pub-id-type="doi">10.1038/s41598-024-70988-1</pub-id>, PMID: <pub-id pub-id-type="pmid">39209922</pub-id></citation></ref>
<ref id="ref57"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Paulus</surname> <given-names>D. J.</given-names></name> <name><surname>Vujanovic</surname> <given-names>A. A.</given-names></name> <name><surname>Wardle</surname> <given-names>M. C.</given-names></name></person-group> (<year>2016</year>). <article-title>Anxiety sensitivity and alcohol use among acute-care psychiatric inpatients: the mediating role of emotion regulation difficulties</article-title>. <source>Cogn. Ther. Res.</source> <volume>40</volume>, <fpage>813</fpage>&#x2013;<lpage>823</lpage>. doi: <pub-id pub-id-type="doi">10.1007/s10608-016-9792-y</pub-id></citation></ref>
<ref id="ref58"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Preece</surname> <given-names>D. A.</given-names></name> <name><surname>Petrova</surname> <given-names>K.</given-names></name> <name><surname>Mehta</surname> <given-names>A.</given-names></name> <name><surname>Gross</surname> <given-names>J. J.</given-names></name></person-group> (<year>2023</year>). <article-title>The emotion regulation questionnaire-short form (ERQ-S): a 6-item measure of cognitive reappraisal and expressive suppression</article-title>. <source>J. Affect. Disord.</source> <volume>340</volume>, <fpage>855</fpage>&#x2013;<lpage>861</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.jad.2023.08.076</pub-id>, PMID: <pub-id pub-id-type="pmid">37597776</pub-id></citation></ref>
<ref id="ref59"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Prince</surname> <given-names>M.</given-names></name> <name><surname>Patel</surname> <given-names>V.</given-names></name> <name><surname>Saxena</surname> <given-names>S.</given-names></name> <name><surname>Maj</surname> <given-names>M.</given-names></name> <name><surname>Maselko</surname> <given-names>J.</given-names></name> <name><surname>Phillips</surname> <given-names>M. R.</given-names></name> <etal/></person-group>. (<year>2007</year>). <article-title>No health without mental health</article-title>. <source>Lancet</source> <volume>370</volume>, <fpage>859</fpage>&#x2013;<lpage>877</lpage>. doi: <pub-id pub-id-type="doi">10.1016/S0140-6736(07)61238-0</pub-id></citation></ref>
<ref id="ref60"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Puolakanaho</surname> <given-names>A.</given-names></name> <name><surname>Muotka</surname> <given-names>J. S.</given-names></name> <name><surname>Lappalainen</surname> <given-names>R.</given-names></name> <name><surname>Hirvonen</surname> <given-names>R.</given-names></name> <name><surname>Lappalainen</surname> <given-names>P.</given-names></name> <name><surname>Kiuru</surname> <given-names>N.</given-names></name></person-group> (<year>2023</year>). <article-title>Temperament and symptoms of stress and depression among adolescents: the mediating role of psychological flexibility</article-title>. <source>J. Affective Disord. Rep.</source> <volume>12</volume>:<fpage>100493</fpage>. doi: <pub-id pub-id-type="doi">10.1016/j.jadr.2023.100493</pub-id></citation></ref>
<ref id="ref61"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Rabei</surname> <given-names>S.</given-names></name> <name><surname>Ramadan</surname> <given-names>S.</given-names></name> <name><surname>Abdallah</surname> <given-names>N.</given-names></name></person-group> (<year>2020</year>). <article-title>Self-efficacy and future anxiety among students of nursing and education colleges of Helwan University</article-title>. <source>Middle East Curr. Psychiatry</source> <volume>27</volume>, <fpage>1</fpage>&#x2013;<lpage>5</lpage>. doi: <pub-id pub-id-type="doi">10.1186/s43045-020-00049-6</pub-id>, PMID: <pub-id pub-id-type="pmid">39825265</pub-id></citation></ref>
<ref id="ref62"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Rashid</surname> <given-names>S.</given-names></name> <name><surname>Qureshi</surname> <given-names>A. G.</given-names></name> <name><surname>Noor</surname> <given-names>T. A.</given-names></name> <name><surname>Yaseen</surname> <given-names>K.</given-names></name> <name><surname>Sheikh</surname> <given-names>M. A. A.</given-names></name> <name><surname>Malik</surname> <given-names>M.</given-names></name> <etal/></person-group>. (<year>2023</year>). <article-title>Anxiety and depression in heart failure: an updated review</article-title>. <source>Curr. Probl. Cardiol.</source> <volume>48</volume>:<fpage>101987</fpage>. doi: <pub-id pub-id-type="doi">10.1016/j.cpcardiol.2023.101987</pub-id></citation></ref>
<ref id="ref63"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Regnoli</surname> <given-names>G. M.</given-names></name> <name><surname>Tiano</surname> <given-names>G.</given-names></name> <name><surname>De Rosa</surname> <given-names>B.</given-names></name></person-group> (<year>2024a</year>). <article-title>How is the fear of war impacting Italian young adults&#x2019; mental health? The mediating role of future anxiety and intolerance of uncertainty</article-title>. <source>Eur. J. Invest. Health Psychol. Educ.</source> <volume>14</volume>, <fpage>838</fpage>&#x2013;<lpage>855</lpage>. doi: <pub-id pub-id-type="doi">10.3390/ejihpe14040054</pub-id>, PMID: <pub-id pub-id-type="pmid">38667809</pub-id></citation></ref>
<ref id="ref64"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Regnoli</surname> <given-names>G. M.</given-names></name> <name><surname>Tiano</surname> <given-names>G.</given-names></name> <name><surname>De Rosa</surname> <given-names>B.</given-names></name></person-group> (<year>2024b</year>). <article-title>Is climate change worry fostering young Italian adults&#x2019; psychological distress? An Italian exploratory study on the mediation role of intolerance of uncertainty and future anxiety</article-title>. <source>Climate</source> <volume>12</volume>:<fpage>118</fpage>. doi: <pub-id pub-id-type="doi">10.3390/cli12080118</pub-id></citation></ref>
<ref id="ref65"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Richardson</surname> <given-names>C. M.</given-names></name> <name><surname>Jost</surname> <given-names>S. A.</given-names></name></person-group> (<year>2019</year>). <article-title>Psychological flexibility as a mediator of the association between early life trauma and psychological symptoms</article-title>. <source>Personal. Individ. Differ.</source> <volume>141</volume>, <fpage>101</fpage>&#x2013;<lpage>106</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.paid.2018.12.029</pub-id></citation></ref>
<ref id="ref66"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Sander</surname> <given-names>J.</given-names></name> <name><surname>Moessner</surname> <given-names>M.</given-names></name> <name><surname>Bauer</surname> <given-names>S.</given-names></name></person-group> (<year>2021</year>). <article-title>Depression, anxiety and eating disorder-related impairment: moderators in female adolescents and young adults</article-title>. <source>Int. J. Environ. Res. Public Health</source> <volume>18</volume>:<fpage>2779</fpage>. doi: <pub-id pub-id-type="doi">10.3390/ijerph18052779</pub-id>, PMID: <pub-id pub-id-type="pmid">33803367</pub-id></citation></ref>
<ref id="ref67"><citation citation-type="book"><person-group person-group-type="author"><name><surname>Scheier</surname> <given-names>M. F.</given-names></name> <name><surname>Carver</surname> <given-names>C. S.</given-names></name> <name><surname>Bridges</surname> <given-names>M. W.</given-names></name></person-group> (<year>2001</year>). &#x201C;<article-title>Optimism, pessimism, and psychological well-being</article-title>&#x201D; in <source>Optimism &#x0026; pessimism: implications for theory, research, and practice</source>. ed. <person-group person-group-type="editor"><name><surname>Chang</surname> <given-names>E. C.</given-names></name></person-group> (<publisher-loc>Washington, DC</publisher-loc>: <publisher-name>American Psychological Association</publisher-name>), <fpage>189</fpage>&#x2013;<lpage>216</lpage>.</citation></ref>
<ref id="ref68"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Seligowski</surname> <given-names>A. V.</given-names></name> <name><surname>Lee</surname> <given-names>D. J.</given-names></name> <name><surname>Bardeen</surname> <given-names>J. R.</given-names></name> <name><surname>Orcutt</surname> <given-names>H. K.</given-names></name></person-group> (<year>2015</year>). <article-title>Emotion regulation and posttraumatic stress symptoms: a meta-analysis</article-title>. <source>Cogn. Behav. Ther.</source> <volume>44</volume>, <fpage>87</fpage>&#x2013;<lpage>102</lpage>. doi: <pub-id pub-id-type="doi">10.1080/16506073.2014.980753</pub-id>, PMID: <pub-id pub-id-type="pmid">25421727</pub-id></citation></ref>
<ref id="ref69"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Sertba&#x015F;</surname> <given-names>K.</given-names></name> <name><surname>&#x00C7;utuk</surname> <given-names>S.</given-names></name> <name><surname>Soyer</surname> <given-names>F.</given-names></name> <name><surname>&#x00C7;utuk</surname> <given-names>Z. A.</given-names></name> <name><surname>Aydo&#x011F;an</surname> <given-names>R.</given-names></name></person-group> (<year>2020</year>). <article-title>Mediating role of emotion regulation difficulties in the relationship between social anxiety and problematic internet use</article-title>. <source>Psihologija</source> <volume>53</volume>, <fpage>291</fpage>&#x2013;<lpage>305</lpage>. doi: <pub-id pub-id-type="doi">10.2298/PSI190730013S</pub-id></citation></ref>
<ref id="ref70"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Shangguan</surname> <given-names>C.</given-names></name> <name><surname>Wang</surname> <given-names>Y.</given-names></name> <name><surname>Wang</surname> <given-names>X.</given-names></name> <name><surname>Zhang</surname> <given-names>L.</given-names></name> <name><surname>Zhou</surname> <given-names>B.</given-names></name></person-group> (<year>2024</year>). <article-title>The more anxious, the less flexible? Association of trait anxiety with expressive flexibility and the mediating role of emotion regulation strategies</article-title>. <source>Curr. Psychol.</source> <volume>43</volume>, <fpage>26121</fpage>&#x2013;<lpage>26133</lpage>. doi: <pub-id pub-id-type="doi">10.1007/s12144-024-06291-z</pub-id>, PMID: <pub-id pub-id-type="pmid">39831055</pub-id></citation></ref>
<ref id="ref71"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Strauss</surname> <given-names>G. P.</given-names></name> <name><surname>Sandt</surname> <given-names>A. R.</given-names></name> <name><surname>Catalano</surname> <given-names>L. T.</given-names></name> <name><surname>Allen</surname> <given-names>D. N.</given-names></name></person-group> (<year>2012</year>). <article-title>Negative symptoms and depression predict lower psychological well-being in individuals with schizophrenia</article-title>. <source>Compr. Psychiatry</source> <volume>53</volume>, <fpage>1137</fpage>&#x2013;<lpage>1144</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.comppsych.2012.05.009</pub-id>, PMID: <pub-id pub-id-type="pmid">22770716</pub-id></citation></ref>
<ref id="ref72"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Szota</surname> <given-names>M.</given-names></name> <name><surname>Rogowska</surname> <given-names>A. M.</given-names></name> <name><surname>Kwa&#x015B;nicka</surname> <given-names>A.</given-names></name> <name><surname>Chilicka-Hebel</surname> <given-names>K.</given-names></name></person-group> (<year>2024</year>). <article-title>The indirect effect of future anxiety on the relationship between self-efficacy and depression in a convenience sample of adults: revisiting social cognitive theory</article-title>. <source>J. Clin. Med.</source> <volume>13</volume>:<fpage>4897</fpage>. doi: <pub-id pub-id-type="doi">10.3390/jcm13164897</pub-id>, PMID: <pub-id pub-id-type="pmid">39201038</pub-id></citation></ref>
<ref id="ref73"><citation citation-type="book"><person-group person-group-type="author"><name><surname>Tabachnick</surname> <given-names>B. G.</given-names></name> <name><surname>Fidell</surname> <given-names>L. S.</given-names></name> <name><surname>Ullman</surname> <given-names>J. B.</given-names></name></person-group> (<year>2013</year>). <source>Using multivariate statistics</source>, vol. <volume>6</volume>. <publisher-loc>Boston, MA</publisher-loc>: <publisher-name>Pearson</publisher-name>.</citation></ref>
<ref id="ref74"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Tanhan</surname> <given-names>F.</given-names></name> <name><surname>&#x00D6;zok</surname> <given-names>H. &#x0130;.</given-names></name> <name><surname>Kaya</surname> <given-names>A.</given-names></name> <name><surname>Y&#x0131;ld&#x0131;r&#x0131;m</surname> <given-names>M.</given-names></name></person-group> (<year>2024</year>). <article-title>Mediating and moderating effects of cognitive flexibility in the relationship between social media addiction and phubbing</article-title>. <source>Curr. Psychol.</source> <volume>43</volume>, <fpage>192</fpage>&#x2013;<lpage>203</lpage>. doi: <pub-id pub-id-type="doi">10.1007/s12144-023-04242-8</pub-id>, PMID: <pub-id pub-id-type="pmid">36713623</pub-id></citation></ref>
<ref id="ref75"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Tindle</surname> <given-names>R.</given-names></name> <name><surname>Hemi</surname> <given-names>A.</given-names></name> <name><surname>Moustafa</surname> <given-names>A. A.</given-names></name></person-group> (<year>2022</year>). <article-title>Social support, psychological flexibility and coping mediate the association between COVID-19 related stress exposure and psychological distress</article-title>. <source>Sci. Rep.</source> <volume>12</volume>:<fpage>8688</fpage>. doi: <pub-id pub-id-type="doi">10.1038/s41598-022-12262-w</pub-id>, PMID: <pub-id pub-id-type="pmid">35606392</pub-id></citation></ref>
<ref id="ref76"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Wersebe</surname> <given-names>H.</given-names></name> <name><surname>Lieb</surname> <given-names>R.</given-names></name> <name><surname>Meyer</surname> <given-names>A. H.</given-names></name> <name><surname>Hofer</surname> <given-names>P.</given-names></name> <name><surname>Gloster</surname> <given-names>A. T.</given-names></name></person-group> (<year>2018</year>). <article-title>The link between stress, well-being, and psychological flexibility during an acceptance and commitment therapy self-help intervention</article-title>. <source>Int. J. Clin. Health Psychol.</source> <volume>18</volume>, <fpage>60</fpage>&#x2013;<lpage>68</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.ijchp.2017.09.002</pub-id>, PMID: <pub-id pub-id-type="pmid">30487911</pub-id></citation></ref>
<ref id="ref77"><citation citation-type="confproc"><person-group person-group-type="author"><name><surname>Y&#x0131;ld&#x0131;r&#x0131;m</surname> <given-names>M.</given-names></name></person-group> (<year>2020</year>). <article-title>Optimism as a predictor of flourishing over and above the big five among youth</article-title>. <source>Paper presented at the international academic studies conference</source>, <conf-loc>Turkey</conf-loc>.</citation></ref>
<ref id="ref78"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Y&#x0131;ld&#x0131;r&#x0131;m</surname> <given-names>M.</given-names></name> <name><surname>Aziz</surname> <given-names>I. A.</given-names></name></person-group> (<year>2023</year>). <article-title>Turkish validation of the Psy-flex scale and its association with resilience and social support</article-title>. <source>Environ. Soc. Psychol.</source> <volume>8</volume>:<fpage>1513</fpage>. doi: <pub-id pub-id-type="doi">10.18063/esp.v8.i1.1513</pub-id></citation></ref>
<ref id="ref79"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Y&#x0131;ld&#x0131;r&#x0131;m</surname> <given-names>M.</given-names></name> <name><surname>&#x00C7;a&#x011F;&#x0131;&#x015F;</surname> <given-names>Z. G.</given-names></name> <name><surname>Williams</surname> <given-names>G.</given-names></name></person-group> (<year>2023a</year>). <article-title>Fear of COVID-19, intolerance of uncertainty, psychological capital, and positive future expectations: tests of mediating relationships with healthcare workers</article-title>. <source>Arch. Psychiatr. Nurs.</source> <volume>45</volume>, <fpage>158</fpage>&#x2013;<lpage>163</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.apnu.2023.06.016</pub-id>, PMID: <pub-id pub-id-type="pmid">37544692</pub-id></citation></ref>
<ref id="ref80"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Y&#x0131;ld&#x0131;r&#x0131;m</surname> <given-names>M.</given-names></name> <name><surname>Cengiz</surname> <given-names>S.</given-names></name> <name><surname>Aziz</surname> <given-names>I. A.</given-names></name> <name><surname>Ziapour</surname> <given-names>A.</given-names></name> <name><surname>Turan</surname> <given-names>M. E.</given-names></name></person-group> (<year>2024b</year>). <article-title>Posttraumatic stress disorder (PTSD), psychological flexibility and psychological adjustment problems: Turkish validation of the PTSD checklist for short form DSM-5 (PCL-5-S)</article-title>. <source>Eur. J. Trauma Dissoc.</source> <volume>8</volume>:<fpage>100381</fpage>. doi: <pub-id pub-id-type="doi">10.1016/j.ejtd.2024.100381</pub-id></citation></ref>
<ref id="ref81"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Y&#x0131;ld&#x0131;r&#x0131;m</surname> <given-names>M.</given-names></name> <name><surname>Dilek&#x00E7;i</surname> <given-names>&#x00DC;.</given-names></name> <name><surname>Manap</surname> <given-names>A.</given-names></name></person-group> (<year>2024a</year>). <article-title>Mediating roles of meaning in life and psychological flexibility in the relationships between occupational stress and job satisfaction, job performance, and psychological distress in teachers</article-title>. <source>Front. Psychol.</source> <volume>15</volume>:<fpage>1349726</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fpsyg.2024.1349726</pub-id>, PMID: <pub-id pub-id-type="pmid">38765825</pub-id></citation></ref>
<ref id="ref82"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Y&#x0131;ld&#x0131;r&#x0131;m</surname> <given-names>M.</given-names></name> <name><surname>Kaynar</surname> <given-names>&#x00D6;.</given-names></name> <name><surname>Arslan</surname> <given-names>G.</given-names></name> <name><surname>Chirico</surname> <given-names>F.</given-names></name></person-group> (<year>2023b</year>). <article-title>Fear of COVID-19, resilience, and future anxiety: psychometric properties of the Turkish version of the dark future scale</article-title>. <source>J. Pers. Med.</source> <volume>13</volume>:<fpage>597</fpage>. doi: <pub-id pub-id-type="doi">10.3390/jpm13040597</pub-id>, PMID: <pub-id pub-id-type="pmid">37108983</pub-id></citation></ref>
<ref id="ref83"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Y&#x0131;ld&#x0131;r&#x0131;m</surname> <given-names>M.</given-names></name> <name><surname>&#x00D6;zaslan</surname> <given-names>A.</given-names></name></person-group> (<year>2022</year>). <article-title>Worry, severity, controllability, and preventive behaviours of COVID-19 and their associations with mental health of Turkish healthcare workers working at a pandemic hospital</article-title>. <source>Int. J. Ment. Heal. Addict.</source> <volume>20</volume>, <fpage>2306</fpage>&#x2013;<lpage>2320</lpage>. doi: <pub-id pub-id-type="doi">10.1007/s11469-021-00515-0</pub-id>, PMID: <pub-id pub-id-type="pmid">33686345</pub-id></citation></ref>
<ref id="ref84"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Y&#x0131;lmaz</surname> <given-names>&#x00D6;.</given-names></name> <name><surname>Boz</surname> <given-names>H.</given-names></name> <name><surname>Arslan</surname> <given-names>A.</given-names></name></person-group> (<year>2017</year>). <article-title>Depresyon Anksiyete Stres &#x00D6;l&#x00E7;e&#x011F;inin (DASS 21) T&#x00FC;rk&#x00E7;e kisa formunun ge&#x00E7;erlilik-g&#x00FC;venilirlik &#x00E7;ali&#x015F;masi</article-title>. <source>Finans Ekonomi ve Sosyal Ara&#x015F;t&#x0131;rmalar Dergisi</source> <volume>2</volume>, <fpage>78</fpage>&#x2013;<lpage>91</lpage>.</citation></ref>
<ref id="ref85"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Yin</surname> <given-names>H.</given-names></name> <name><surname>Cheng</surname> <given-names>X.</given-names></name> <name><surname>Liang</surname> <given-names>Y.</given-names></name> <name><surname>Liu</surname> <given-names>A.</given-names></name> <name><surname>Wang</surname> <given-names>H.</given-names></name> <name><surname>Liu</surname> <given-names>F.</given-names></name> <etal/></person-group>. (<year>2021</year>). <article-title>High perceived stress may shorten activated partial thromboplastin time and lead to worse clinical outcomes in patients with coronary heart disease</article-title>. <source>Front. Cardiovasc. Med.</source> <volume>8</volume>:<fpage>769857</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fcvm.2021.769857</pub-id>, PMID: <pub-id pub-id-type="pmid">34912866</pub-id></citation></ref>
<ref id="ref86"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Zaleski</surname> <given-names>Z.</given-names></name></person-group> (<year>1996</year>). <article-title>Future anxiety: concept, measurement, and preliminary research</article-title>. <source>Personal. Individ. Differ.</source> <volume>21</volume>, <fpage>165</fpage>&#x2013;<lpage>174</lpage>. doi: <pub-id pub-id-type="doi">10.1016/0191-8869(96)00070-0</pub-id></citation></ref>
<ref id="ref87"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Zaleski</surname> <given-names>Z.</given-names></name> <name><surname>Sobol-Kwapinska</surname> <given-names>M.</given-names></name> <name><surname>Przepiorka</surname> <given-names>A.</given-names></name> <name><surname>Meisner</surname> <given-names>M.</given-names></name></person-group> (<year>2019</year>). <article-title>Development and validation of the dark future scale</article-title>. <source>Time Soc.</source> <volume>28</volume>, <fpage>107</fpage>&#x2013;<lpage>123</lpage>. doi: <pub-id pub-id-type="doi">10.1177/0961463X16678257</pub-id></citation></ref>
</ref-list>
</back>
</article>