Understanding climate anxiety: What decision-makers, health care providers, and the mental health community need to know to promote adaptative coping

Exploring the relationship between eco-anxiety and suicide risk in adolescents with mental health disorders: insights from a cross-sectional observational study

Introduction

A limited number of studies have explored the connection between eco-anxiety, anxiety, and depression in adolescents. However, the relation between eco-anxiety and suicide remains unexamined. This cross-sectional observational study aims to bridge this gap by investigating the correlation between eco-anxiety intensity and suicide risk severity in adolescents.

Methods

We used validated French versions of the Climate Anxiety Scale (CAS) and its two key dimensions (cognitive and emotional and functional impairments), alongside the Columbia Suicide Severity Rating Scale (C-SSRS) and the Hospital Anxiety and Depression scale (HAD).

Results

Our study involved 87 hospitalized adolescent patients, aged 12-16. Although, the univariate model indicated a significant association between the CAS and the C-SSRS (β = 2.58; p = 0.049), the cognitive/emotional difficulties and functional impairment dimensions of eco-anxiety, considering different confounding factors, did not show statistical associations with the severity of suicide risk (respectively, p = 0.81 and p = 0.76).

Discussion

In an expansive literature, these results show for the first time that eco-anxiety may not be the priority of adolescents seen by adolescent psychiatrists. Such an observation would imply not overmedicalizing a dimension of life which perhaps does not fall solely within the field of medicine, but which concerns environmental issues broader than medical field. However, an ethical and prudent approach in mental health care for this particularly fragile population remains necessary. This intersection of eco-anxiety and suicide in youth opens up new avenues of research in the realm of environmental and mental health studies.

Limited consensus on what climate anxiety is: Insights from content overlap analysis on 12 questionnaires

Climate anxiety is a phenomenon that is gaining importance due to the general public's increased awareness of the worsening climate crisis. At present, climate anxiety is not operationalized consistently across the existing literature. It is important to gain more consensus on the definition and operationalization of climate anxiety to facilitate reliable and generalizable research and to further develop interventions. Content analysis can contribute to this by providing insight into the overlap in the content of climate anxiety measures. With a systematic search, this study identified and analyzed 12 distinct scales measuring climate anxiety. The 119 items covered a total of 57 disparate symptoms. Jaccard indices showed that the mean overlap between symptoms of different climate anxiety scales was generally very low, as was the overlap between pairwise comparisons of climate anxiety scales. These results highlight the lack of uniformity in assessing climate anxiety and the need to properly define and operationalize this concept. The potential reasons for low overlap and how this might impact the reliability and validity of existing measures are discussed. It is critical that future work aims at finding consensus on the definition of climate anxiety (e.g., through a Delphi study) and psychometrically comparing the different questionnaires.

Understanding coping with the climate crisis: an experimental study with young people on agency and mental health

Background: While the impact of climate change on mental health, especially in young people, has been acknowledged, underlying mechanisms of this relation remain elusive. Based on research on active coping, we explored effects of agency on anxiety and coping in an experimental design. We further examined the relation between mental health (i.e., psychopathology, depressiveness, trait anxiety), trait factors (i.e., climate distress, intolerance of uncertainty, trait coping), state anxiety and coping with climate distress.Methods: 244 participants (15-25 years) watched a climate anxiety inducing video, followed by an agency manipulation (high agency vs. low agency vs. control). Trait mental health, intolerance of uncertainty, and climate distress and coping were examined as predictors of state anxiety and coping.Results: State anxiety decreased in the high agency and control conditions, but not in the low agency condition. High agency led to increased meaning-focused coping and low agency to decreased meaning- and problem-focused coping. Trait mental health, problem-focused, and meaning-focused coping strategies each predicted their respective state counterparts. Emotion-focused coping was further predicted by all trait measures.Conclusion: The findings suggest a risk of low agency communication due to the lack of arousal decrease and lack of using functional coping in young people.

Detecting and classifying eco-anxiety: development of clinical cut-off scores for the climate change anxiety scale

BACKGROUND

Climate change anxiety, that is worry and fear in relation to the awareness of the impacts of climate change, is widely observed around the world. Some evidence suggests that while climate change anxiety can, at times, be adaptive, a growing body of research has reported that climate change anxiety is also related to a range of negative mental health outcomes and psychological distress. Currently, however, there is limited ability to assess for elevated levels of climate change anxiety and to identify those who may need support. The present study, therefore, aimed to develop clinical cut-off scores on a measure of climate change anxiety.

METHODS

A largely representative sample of Australian young adults (aged 16-25 years) completed measures of psychological distress (Depression, Anxiety and Stress Scale-21) and the Climate Change Anxiety Scale. Markers of clinically meaningful psychological distress - elevated depression, anxiety, and stress symptoms-were used to classify cases. Receiver Operating Characteristics analyses were performed to assess the predictive ability of the indicators of psychological distress (mild, moderate, severe, and extremely severe thresholds of anxiety, depression, and stress symptoms) for detecting climate change anxiety and to ascertain optimal cut-off scores.

RESULTS

The Area Under the Curve was acceptable to moderate for detecting climate change anxiety across all analyses. Across symptom severity thresholds and markers of psychological distress, based on consideration of balancing sensitivity and specificity, results consistently suggested that a cut-score of 21 was indicative of mild-moderate climate change anxiety, with a cut-off score of 23 indicating severe-extremely severe climate change anxiety.

CONCLUSIONS

The proposed cut-offs can feasibly be used to identify those with elevated climate change anxiety. Use of these cut-off scores can inform research as well as be used to guide screening, assessment, and inform clinical practice. Results also highlight a high rate of climate change anxiety in young adults.

Climate worry: associations with functional impairment, pro-environmental behaviors and perceived need for support

BACKGROUND

A large proportion of individuals experience functional impairment in everyday life due to climate worry. However, the current understanding of this functional impairment is limited by the use of suboptimal measures. Furthermore, it is not known whether functional impairment due to climate worry affects pro-environmental behaviors (PEBs) or whether individuals who experience such impairment perceive a need for support. The aims of the current study were (1) to extend previous research using an established measure of functional impairment (the Work and Social Adjustment Scale, WSAS), (2) to explore the associations between climate worry, functional impairment, and PEBs, and (3) to describe the characteristics and the perceived need for support of individuals with functional impairment due to climate worry.

METHODS

A cross-sectional survey targeting adult individuals who experience climate worry. Participants were recruited nationally in Sweden between September and October 2022. The survey included measures of climate worry severity, climate worry frequency, functional impairment, PEBs, depressive symptoms, sleep problems, and questions related to perceived need for support.

RESULTS

A total of 1221 adults (75% women, mean age 46.3 years) were included in the analyses. Multivariate structural equation modeling revealed that climate worry severity and frequency were significantly associated with PEBs (β = 0.34 and β = 0.45, respectively). Climate worry frequency was associated with functional impairment (β = 0.41). Functional impairment was only marginally associated with PEBs (β = 0.05). Approximately 40% of the sample (n = 484) reported a high frequency and high severity of climate worry. Among these, one-third (n = 153) scored above the cutoff for significant impairment on the WSAS. Individuals in this group (high severity and frequency of climate worry as well as significant functional impairment) were more likely to experience depressed mood and sleep problems and were more interested in receiving support, specifically concerning strategies for worry management and sustainable behavior change.

CONCLUSIONS

Using an established measure of functional impairment, we found an association of climate worry with functional impairment and PEBs. Importantly, as there is a perceived need for support in individuals with impairment due to climate worry, interventions targeting this specific subgroup should be developed.

The relationship between climate change and mental health: a systematic review of the association between eco-anxiety, psychological distress, and symptoms of major affective disorders

BACKGROUND AND OBJECTIVES

The adverse impacts of climate change on mental health is a burgeoning area, although findings are inconsistent. The emerging concept of eco-anxiety represents distress in relation to climate change and may be related to mental health. The aim of this study was to explore the relationship between eco-anxiety with validated mental health outcomes, specifically psychological distress and symptoms of major affective disorders.

DESIGN

Systematic review.

METHODS

EBSCO, ProQuest, and Web of Science databases were searched to February 2024 for studies of adult samples quantifying eco-anxiety (exposure, i.e. fear, worry or anxiety in relation to climate change) and symptoms of psychological distress and major affective disorders (outcomes), as assessed by validated measures.

RESULTS

Full text review of 83 studies was performed, and k = 35 studies were included in the review (N = 45 667, 61% female, Mage 31.2 years). Consistently, eco-anxiety showed small to large positive correlations with mental health outcomes of psychological distress, depression symptoms, anxiety symptoms, and stress symptoms. However, results regarding post-traumatic stress disorder symptoms and pathological worry were mixed. Stronger associations were observed where eco-anxiety was operationalised as 'anxiety' rather than 'worry'.

CONCLUSIONS

Findings underscore that eco-anxiety is related to psychological burden. Greater consideration of eco-anxiety in assessment and treatment is needed in clinical practice and further policy development is warranted at the intersection of climate and health to address the mental health challenges posed by climate change.

Climate Anxiety: Current Evidence and Future Directions

PURPOSE OF REVIEW

Challenging cognitive, somatic, and behavioral responses to climate change are often conceptualized as climate anxiety (CA). Due to the increased recognition of the impacts of climate change on mental health, a growing body of scientific literature is developing. The purpose of this manuscript is to review the current evidence base for CA and propose future research needs for this emerging construct.

RECENT FINDINGS

Early evidence supports underlying psychological mechanisms in the development and maintenance of CA, which are similar to other anxiety-related conditions. However, the study of CA poses unique challenges to researchers. The psychological impacts that occur in the context of climate change may be adaptive depending on the imminent threat of natural disasters, forced migration, or other climate-related challenges. Due to the potentially adaptive nature of CA and limited current evidence, a coordinated research program of climate-related distress is necessary. A review of the extant literature identified current gaps in understanding the epidemiology and individual differences that promote CA. Current evidence supports the prominent role of neuroticism, intolerance of uncertainty, and rumination. The development of evidence-based models of climate-related distress may provide a more valid and comprehensive depiction of the impacts of climate change on mental health. Transdiagnostic treatment methods are likely the most appropriate intervention for climate-related distress. As models, measures, and treatments of climate-related distress are developed, it is crucial to incorporate studies of populations most at risk for climate change-related mental health effects.

From negative feelings to impairments: A longitudinal study on the development of climate change anxiety

People may experience anxiety and related distress when they come in contact with climate change (i.e., climate change anxiety). Climate change anxiety can be conceptualized as either emotional-based response (the experience of anxiety-related emotions) or impairment-based response (the experience of impairment in daily functioning). To date, it remains uncertain how these distinct manifestations of climate change anxiety are related. Conceptually, the experience of climate change anxiety may transform from an adaptive and healthy emotional response to an impairment in daily functioning. We conducted two two-wave longitudinal studies to examine the possible bidirectional relationships between three manifestations of climate change anxiety. We recruited 942 adults (mean age = 43.1) and 683 parents (mean age = 46.2) in Studies 1 and 2, respectively. We found that Time 1 emotion-based response was positively linked to Time 2 cognitive-emotional impairment, while Time 1 cognitive-emotional impairment was positively related to Time 2 functional impairment. In Study 2, we also found a bidirectional positive relationship between generalized anxiety and emotion-based climate change anxiety over time. Overall, our findings provide initial support to the temporal relationships between different manifestations of climate change anxiety, corroborating that climate change anxiety may develop from emotional responses to impairment in functioning.

Bolstering health systems to cope with the impacts of climate change events: A review of the evidence on workforce planning, upskilling, and capacity building

BACKGROUND

As global CO2 emissions continue to rise and the 'era of global boiling' takes hold, the health workforce must cope with the challenge of providing care to increasing numbers of patients affected by climate change-related events (e.g., hurricanes, wildfires, floods). In this review, we describe the impacts of these events on the health workforce, and strategies responding to these challenges.

METHODS

This rapid systematic review was guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses and a registered protocol (PROSPERO CRD42023433610). Eight databases were searched in May 2022 and again in June 2023. Empirical studies discussing climate change and workforce policy, planning, preparedness, and capacity were included. Inductive thematic analysis of extracted data was conducted.

RESULTS

From the 60 included studies, two categories emerged: the impacts of climate events on the health workforce (n = 39), and workforce responses to and preparations for climate events (n = 58). Thirty-seven studies reported on both categories. Four impact themes were identified: absenteeism, psychological impacts, system breakdown, and unsafe working conditions; and six responses and preparations themes: training/skill development, workforce capacity planning, interdisciplinary collaboration, role flexibility, role incentivisation, and psychological support.

CONCLUSION

This review provides an overview of some of the deleterious impacts of climate events on the health workforce, as well as potential strategies for the health workforce to prepare or respond to climate events. Future studies should assess the implementation and effectiveness of these strategies to ensure a continuously improving healthcare system, and a well-supported health workforce.

Taking a trauma and adversity perspective to climate change mental health

The European Journal of Psychotraumatology has had a long interest in advancing the science around climate change and traumatic stress. In this special issue, we include papers that responded to a special call in this area. Six major themes emerge from these papers and together they contribute to trauma and adversity model of the mental health impacts of climate change. We argue that, in addition to individual vulnerability factors, we must consider the (i) cumulative trauma burden that is associated with exposure to ongoing climate change-related impacts; (ii) impact of both direct and indirect stressors; (iii) individual and community protective factors. These factors can then guide intervention models of recovery and ongoing resilience.

The challenge of eco-generativity. Embracing a positive mindset beyond eco-anxiety: a research agenda

Climate change has emerged as a tough challenge affecting the world's society and economy in the twenty-first century. Furthermore, it has been determined that global warming and climate change have detrimental effects on human health both physical and psychological. In this framework, eco-anxiety has emerged as a new construct to assess the distress in relation to climate change and its effects. In the current article, after a study of the literature regarding both eco-anxiety and generativity related to environmental issues, in the search for a healthy response to eco-anxiety, we propose the construct of eco-generativity as a sustainable development-related concept for the health of planet earth and people in the present and in the future. Accordingly, we explore the definitions of generativity in relation to the ecological environment, examining the development of the concept in accordance with the most recent research. Subsequently, according to the lens of psychology of sustainability and sustainable development, we propose key elements of eco-generativity in terms of construct and measures. Finally, a research agenda for future research and intervention on eco-generativity is provided.

Climate change on the brain: Neural correlates of climate anxiety

Climate change is a global crisis impacting individuals' mental health. Climate anxiety is an emerging area of interest within popular culture and the scientific community. Yet, little is known about the mechanisms underlying climate anxiety. We provide evidence that climate anxiety is related to gray matter volume in the midcingulate cortex as well as its level of functional connectivity with the insula cortex. These neuroanatomical and neurofunctional features of climate anxiety are involved in identifying and anticipating potential threats within the environment and preparing an appropriate action response to such threats. These neural correlates align with those observed in anxiety disorders. Yet, climate anxiety itself as well as the neural correlates of climate anxiety were related to pro-environmental behavior. This may suggest that the midcingulate and insula are part of a network linked to an adaptive aspect of climate anxiety in motivating behavioral engagement.

When eco-anger (but not eco-anxiety nor eco-sadness) makes you change! A temporal network approach to the emotional experience of climate change

Research on the emotional experience of climate change has become a hot topic. Yet uncertainties remain regarding the interplay between climate change-related emotions (i.e., eco-anxiety, eco-anger, eco-sadness), general emotions (i.e., regardless of climate change), and pro-environmental behaviors. Most previous research has focused on cross-sectional studies, and eco-emotions in everyday life have seldom been considered. In this preregistered study, 102 participants from the general population rated their eco-emotions (i.e., eco-anxiety, eco-anger, eco-sadness), general emotions (i.e., anxiety, anger, sadness), and pro-environmental intentions and behaviors daily over a 60-day period. Using a multilevel vector autoregressive approach, we computed three network models representing temporal (i.e., from one time-point to the next), contemporaneous (i.e., during the same time-frame), and between-subject (i.e., similar to cross-sectional approach) associations between variables. Results show that eco-anger was the only predictor of pro-environmental intentions and behaviors over time. At the contemporaneous level, the momentary experience of each eco-emotion was associated with the momentary emotional experience of the corresponding general emotion, indicating the distinctiveness of each eco-emotion and the correspondence between its experience and that of its general, non-climate-related emotion. Overall, our findings 1) emphasize the driving role of eco-anger in prompting pro-environmental behaviors over time, 2) suggest a functional and experiential distinction between eco-emotions, and 3) provide data-driven clues for the field's larger quest to establish the scientific foundations of eco-emotions.

Climate change anxiety positively predicts antenatal distress in expectant female parents

Clinical and subclinical levels of anxiety and depression are common experiences during pregnancy for expectant women; however, despite rising awareness of significant climate change anxiety around the world, the extent to which this particular type of anxiety may be contributing to overall antenatal psychological distress is currently unknown. Furthermore, the content of concerns that expectant women may have for their existing or future children remains unexplored. To address this gap in knowledge, 103 expectant Australian women completed standardised assessments of antenatal worry and depression, climate change anxiety, and perceived distance to climate change, and responded to several open-ended questions on concerns they had for their children. Results indicated that climate change anxiety accounted for significant percentages of variance in both antenatal worry and depression scores and, unexpectedly, neither child number nor perceived distance to climate change moderated these relationships. Content analysis of qualitative data highlighted the significant health-related anxieties for participants' children related to climate change (e.g., disease, exposure to extreme weather events, food/water insecurity). Given the escalating nature of climate change, further investigation of this relatively new stressor contributing to the experience of anxiety and distress, particularly in uniquely vulnerable groups such as expectant women, is urgently needed.

The influence of environmental crisis perception and trait anxiety on the level of eco-worry and climate anxiety

Eco-anxiety, which refers to the anxiety experienced in response to worsening environmental conditions, is a growing global phenomenon. Climate change anxiety, due to the escalating impact of ongoing climate change, stands out as the most commonly recognized form of eco-anxiety. Nevertheless, numerous uncertainties persist regarding the relationship of this eco-anxiety response to pro-environmental behaviors, as well as its connection with trait anxiety and the perception of the environmental crisis. In this study, we conducted an analysis with a sample size of 431 participants to elucidate the respective implications of these factors, delving into the different facets of the eco-anxiety response: worry and anxiety-related impairments. We measured eco-worry using a brief 5-item scale and assessed climate anxiety-related impairments using the Climate Change Anxiety Scale (CCAS). Our findings reveal that eco-worry acts as a mediator between the perception of the environmental crisis and the manifestation of climate anxiety-related impairments. Furthermore, eco-worry plays a constructive role in relation to the commitment to pro-environmental behaviors, with no additional contribution from the climate anxiety reaction involving impairments. In summary, our findings underscore the existence of distinct constructs within the anxiety response to climate change and environmental issues, each with different contributing factors.

Ecological anxiety and pro-environmental behaviour: The role of attention

Climate change is a serious threat to human health and the awareness of this threat can elicit ecological anxiety (eco-anxiety), which could be considered a rational and potentially adaptive response. However, the experience of eco-anxiety does not always lead to adaptive behaviour. The present study investigated whether differential patterns of selective attention towards climate-related information, and variability in this attention, might explain this inconsistent relationship. Participants completed a dot-probe assessment of attentional bias to images of both climate change mitigation strategies and of climate change causes and consequences, and measures of eco-anxiety, climate change belief, environmental self-efficacy, and general psychological symptoms. Engagement in pro-environmental behaviours was measured using a daily behavioural diary. Eco-anxiety and attentional bias independently predicted behaviour, but did not interact. However, attentional bias variability moderated the relationship between eco-anxiety and behaviour, such that higher eco-anxiety predicted greater behavioural engagement, but only when attentional bias variability was low. This was the first known study to examine the potential moderating effect of attentional bias on the relationship between eco-anxiety and pro-environmental behaviours. This growing field of research can help in identifying how the rational response of eco-anxiety can be better harnessed to motivate an adaptive response to the climate crisis.

The Eco-Generativity Scale (EGS): A New Resource to Protect the Environment and Promote Health

(1) Background: Environmental issues are among society's most pressing concerns as they can significantly impact the environment and human health. The Eco Generativity Scale (EGS), a 28-item four-factor scale has been introduced to promote a constructive outlook on the matter. It encompasses two types of generativity, namely ecological and social generativity, as well as environmental identity and agency/pathways. The aim of the current study was to examine the EGS's psychometric properties among 375 Italian university students. (2) Methods: To evaluate the scale's factor structure, both exploratory and confirmatory factor analyses were conducted. Internal consistency was evaluated via Cronbach's alphas and McDonald's omega. Concurrent validity was analyzed with the Positive and Negative Affect Scale (PANAS), Satisfaction with life Scale (SWLS), Meaningful Life Measure (MLM), and Flourishing Scale (FS). (3) Results: The exploratory factor analysis showed the best fit for a four-factor solution. Confirmatory factor analysis revealed that a four-factor higher-order model provided the best fit to the data with good internal consistency. Furthermore, each factor and the total score showed a good concurrent validity with the PANAS, SWLS, MLM, and FS. (4) Conclusions: The Eco-Generativity Scale (EGS) showed good psychometric properties for its use in research and intervention as a promising tool to measure eco-generativity.

Measuring negative emotional responses to climate change among young people in survey research: A systematic review

BACKGROUND

Climate change is a threat to the mental and emotional wellbeing of all humans, but young people are particularly vulnerable. Emerging evidence has found that young people's awareness of climate change and the danger it poses to the planet can lead to negative emotions. To increase our understanding about this, survey instruments are needed that measure the negative emotions young people experience about climate change.

RESEARCH QUESTIONS

(1) What survey instruments are used to measure negative emotional responses to climate change in young people? (2) Do survey instruments measuring young people's negative emotional responses to climate change have evidence of reliability and validity? (3) What factors are associated with young people's negative emotional responses to climate change?

METHODS

A systematic review was conducted by searching seven academic databases on November 30, 2021, with an update on March 31, 2022. The search strategy was structured to capture three elements through various keywords and search terms: (1) negative emotions, (2) climate change, and (3) surveys.

RESULTS

A total of 43 manuscripts met the study inclusion criteria. Among the 43 manuscripts, 28% focused specifically on young people, while the other studies included young people in the sample but did not focus exclusively on this population. The number of studies using surveys to examine negative emotional responses to climate change among young people has increased substantially since 2020. Survey instruments that examined worry or concern about climate change were the most common.

CONCLUSION

Despite growing interest in climate change emotions among young people, there is a lack of research on the validity of measures of such emotions. Further efforts to develop survey instruments geared to operationalize the emotions that young people are experiencing in relation to climate change are needed.