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The role of cognitive emotion regulation strategies in depression, anxiety and stress of coronary heart disease patients

Zahra Solg, Parisa Yaseminejad




Introduction: This study aims to examine the role of cognitive emotion regulation strategies in the degree of depression, anxiety, and stress of coronary heart disease patients by using predictive correlation method.


Materials and Methods: In this research population consisted of all coronary heart disease patients who referred to Cardiovascular Specialized Hospital in Kermanshah city among whom 130 were selected as participants using available sampling method. Subsequently, they asked to complete Cognitive Emotion Regulation Questionnaire (CERQ) and Depression, Anxiety and Stress Scale (DASS-21). Collected data were analyzed using correlation matrix, multivariate analysis of variance (MANOVA) and hierarchical multiple regression analysis.


Results: The MANOVA results showed that there was a significant difference between male and female patients (p< 0.05) in the strategies of rumination, positive refocusing, planning and positive reappraisal and blaming others. The results of correlation matrix showed that there was positive and significant relationship between inefficient components of self-blame, other-blame, rumination, and catastrophizing, and negative relationship between components of putting into perspective, positive refocusing, planning, and positive reappraisal with patients’ depression. In addition, the results of hierarchical multiple regression analysis indicated that among cognitive emotion regulation components, independent of gender, four components of self-blame, rumination, catastrophizing, and low positive reappraisal have great ability to predict depression, three components of self-blame, rumination, catastrophizing and planning are strong significant predictors of anxiety, and three components of self-blame, rumination and low positive reappraisal, respectively have the high ability to predict stress in coronary heart patients disease(p<0.05).

Conclusion: According to the research results, the role of inefficient cognitive emotion regulation strategies in the degree of depression, anxiety, and stress of coronary heart disease patients have been demonstrated. Thus, teaching efficient cognitive strategies in setting up emotions to enhance the physical, psychological, and social health of coronary heart disease patients seems necessary.


Cognitive emotion regulation;Depression; Anxiety; Stress; Coronary heart disease


Davison G, Neal J, Kring A. Abnormal psychology. New York: Wiley. 2007.

Kashi A, Saha S. Ethics in biomaterials research. Journal of Long Term Eff Med Implants 2009; 19(1): 19-30.

Hamid N. The study of correlation between personality trait and coronary heart diseases. Journal of Ahvaz Jondy University 2006; 6(2): 41-35.[In Persian]

Kafman MS, Concha-Parra R, Das S. Radiation therapy for pain management in pancreatitis: a meta analysis. Pancreas 2009; 38(8): 1014.

Takashi H, Fukunishi I. Development of a “Type C” inventory: cross-cultural applications . J Psychiatr Behav Sci 1997; 42(2): 73-76.

Alloy LB, Riskind JH. Cognitive vulnerability to emotional disorders. New Jersey: Lawrence Erlbaum Associates 2006.

Duarte AC, Matos AP, Marques C. Cognitive emotion regulation strategies and depressive symptoms: gender's moderating effect. Social and Behavioral Sciences 2015; 165: 275-283.

Chen H. A theoretic Review of emotion regulation. Journal of Social Sciences 2016; 4: 147-153.

Garnefski N, Kraaij v, Spinhoven P. CERQ: Manual for the use of the Cognitive Emotion Regulation Questionnaire: Datec, Leiderdorp, TheNetherlands, 2002.

Roberton T, Daffern M, Bucks RS. Emotion regulation and aggression. Aggression and Violent Behavior 2011, In Press.

Ongen DE. Cognitive emotion regulation in the prediction of depression and submissive behavior: Gender and grade level differences in Turkish adolescents. Procedia Social and Behavioral Sciences 2010; 9: 1516–1523.

Pourfaraji Omran M. Relationships between cognitive emotion regulation strategies with depression and anxiety. Journal of Psychiatry 2011; 1: 106-109. [In Persian]

Ryan C, Martin CM, Dahlen ER. cognitive emotion regulation in the prediction of depression, anxiety, stress and anger. personality and Individual Differences 2005; 39: 1249-1260.

Suls J, Bunde J. Anger, anxiety and depression as risk factors for cardiovascular disease: the problems and implicatins of overlapping affective dispositions . J Psychol Bull 2005;131(2): 260-300.

Fridman HS, Both Kewley S. The disease –pron personality. J Pers Indiv Differ 1987; 42:539-555.

Day RC, Freedland KE, Carney RM. Effects of anxiety and depression on heart disease attributions. International Journal of Behavioral Medicine 2005; 12(1): 24-29.

Samani S, Sadeghi L. Adequate psychometric indices of cognitive emotion regulation questionnaire. Journal of Psychological Methods and Models 2010; 1(1):51-62.[In Persian]

Lovibond PF, Lovibond SH. The structure of negative emotional sates: comparison of the Depression Anxiety Stress Scales(DASS) with the Beck Depression and Anxiety Inventories. Behavior Research and Therapy 1995; 33: 335-343.

Sahebi A, Asghari MJ, Salari RS. Validation of depression, anxiety and stress(DASS_21) for the Iranian population.Iranian Psychological Journal 2008; 4:299.[ In Persian]

Marroquín B. Interpersonal emotion regulation as a mechanism of social support in depression. Clinical Psychology Review 2011; 31: 1276–1290 .

Wolgast M, Lundh LG, Viborg G. Cognitive reappraisal and acceptance: An experimental comparison of two emotion regulation strategies. Behavior Research and Therapy 2011; 49: 858-866.

Aldao A, Nolen-Hoeksema S. Specificity of cognitive emotion regulation strategies: A transdiagnostic examination. Behavior Research and Therapy 2010; 48: 974-983.

Tortella-Feliu M, Balle M, Sese A. Relationships between negative affectivity, emotion egulation, anxiety, and depressive symptoms in adolescents as examined through structural equation modeling. Journal of Anxiety Disorders 2010; 24: 686–693.

Zlomke KR, Hahn KS. Cognitive emotion regulation strategies: Gender differences and associations to worry. Personality and Individual Differences 2010; 48:408–413.

Garnefski N, Kraaij v. Relationships between cognitive emotion regulation strategies and depressive symptoms: a comparative study of five specific samples. Personality and Individual Differences 2006; 40:1659-1669.

Szczygie D, Buczny J, Bazinska R. Emotion regulation and emotional information processing: The moderating effect of emotional awareness. Personality and Individual Differences 2012; 52: 433–437.

Gross JJ. (Ed.). Handbook of emotion regulation. New York: Guilford Press, 2007.

Campbell-Sills L, Barlow DH. Incorporating emotion regulation into conceptualizations and treatments of anxiety and mood disorders. In JJ. Gross (Ed.), Handbook of emotion regulation . New York: Guilford Press. 2007; pp: 542-559, [ On Line].

Barlow DH, Allen LB, Choate ML. Toward a unified treatment for emotional disorders. Behavior Therapy 2004; 35: 205–230.

Garnefski N, Kraaij V, van Etten M. Specificity of relations between adolescents’ cognitive emotion regulation strategies and internalizing and externalizing psychopathology. Journal of Adolescence 2005; 28:619-631.

Garnefski N, Kraaij V, Spinhoven, P. Negative life events, cognitiveemotion regulation, and emotional problems. Personality and Individual Differences 2001; 30:1311-132


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