Cognitive emotion regulation: characteristics and effect on quality of life in women with breast cancer

BACKGROUND In recent decades, researchers and clinicians have sought to determine how to improve the quality of life (QOL) of women with breast cancer. Previous research has shown that many women have particular behavioral coping styles, which are important determinants of QOL. As behavior is closely associated with cognition, these patients may also have particular cognitive coping styles. However, the cognitive coping characteristics and their effects on QOL in women with breast cancer remain unclear. Thus, this study aimed to characterize cognitive coping styles among women with breast cancer and explore the effects of cognitive emotion regulation strategies on QOL. METHODS The Chinese version of the Cognitive Emotion Regulation Questionnaire was used to assess cognitive coping strategies in 665 women newly diagnosed with breast cancer and 662 healthy women. QOL of patients was assessed using the Functional Assessment of Cancer Therapy for Breast Cancer Scale. Independent-samples t-tests were performed to investigate group differences in reporting of cognitive coping strategies. Multiple regression analyses were performed to examine the effects of cognitive coping strategies on QOL in patients after controlling for sociodemographic and medical variables. RESULTS Compared with control subjects, patients reported less frequent use of self-blame, rumination, positive refocusing, refocusing on planning, positive reappraisal, and blaming others, and more frequent use of acceptance and catastrophizing (all p < 0.01). The three strongest predictors of group membership were catastrophizing (B = -0.35), acceptance (B = -0.29), and positive reappraisal (B = 0.23). All nine coping strategies were significantly correlated with QOL in patients (all p < 0.05). After controlling for sociodemographic and medical variables, self-blame, rumination, and catastrophizing negatively affected QOL (all p < 0.05), whereas acceptance and positive reappraisal had positive effects (all p < 0.01). CONCLUSIONS Compared with healthy women, women newly diagnosed with breast cancer use catastrophizing and acceptance more frequently, and positive reappraisal, self-blame, rumination, positive refocusing, refocusing on planning, and blaming others less frequently. Catastrophizing, rumination, and self-blame may be not conducive to QOL of women with breast cancer and acceptance and positive reappraisal may be useful.