Relationships among emotion regulation, depression, anxiety, stress, and physical health-related quality of life in coronary heart disease patients

Abstract

Coronary heart disease (CHD) is the third leading cause of death in Singapore. Although emotion regulation is a significant determinant of CHD patient’s quality of life, not many studies have assessed the impact of change in emotion regulation on physical functioning over time. The present study examined if emotion dysregulation and its changes predicted deterioration in physical HRQoL in CHD patients over 6 months. Additionally, depression, anxiety, and perceived stress were examined as mediators of this relationship. Questionnaires on emotion dysregulation, physical HRQoL, depression, anxiety, and perceived stress were administered to 255 participants from a cardiac rehabilitation program in Singapore, over a period of 6 months. Hierarchical regression analyses were performed to investigate the potential relationships. Results indicated that baseline physical HRQoL predicted physical HRQoL 6 months later. Even though baseline emotion dysregulation levels were not found to predict change in physical HRQoL, negative change in emotion dysregulating predicted further deterioration in physical HQRoL in 6 months. This relationship was mediated by depression, anxiety, and perceived stress. Findings highlighted the importance for healthcare workers to continuously evaluate emotion dysregulation and psychological distress variables in CHD patients over time, to enhance their physical functioning.