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Chinese children and adolescents have higher levels of anxiety than those in other countries. However, research that has examined psychological correlates among children and adolescents with a clinical level of anxiety or at risk of developing anxiety disorders in Hong Kong is extremely scarce. Studies on emotion regulation (ER) strategies as a psychological correlate have yielded inconsistent results, suggesting that while maladaptive ER strategies generally contribute to psychopathology, adaptive ER strategies show surprisingly weak or no influence on psychopathology. The present study aims to examine different effects of adaptive and maladaptive ER strategies on anxiety symptoms in two groups of Chinese adolescents with clinical anxiety or at risk of developing anxiety disorders. One hundred and thirty-six adolescents who met the clinical or at-risk levels of anxiety indicated by the Spence Child Anxiety Scale participated in the study, to whom a battery of standardized questionnaires was administered. Multiple-group Structural Equation Modeling (SEM) analysis found only two maladaptive ER strategies, self-blame and rumination, that were significantly associated with anxiety among the clinical group, while only the adaptive ER strategy of reappraisal was associated with anxiety among the at-risk group. When compared to a Western sample of adolescents with internalizing problems, adolescents in our sample reported higher levels of self-blame, other blame and catastrophizing. The findings shed light on how differently maladaptive and adaptive ER strategies function among adolescents with different levels of anxiety. Practical implications for the development of intervention programmes for different levels of adolescent anxiety are discussed. Highlights: Only maladaptive ER strategies are associated with anxiety among the clinical group of adolescents. Only adaptive ER strategies are associated with anxiety among the at-risk group of adolescents. Differences exist in levels of ER strategies between Chinese and Western adolescents. [ABSTRACT FROM AUTHOR]