Psychiatry Investig.  2025 Mar;22(3):330-339. 10.30773/pi.2024.0349.

Cognitive Emotion Regulation and Its Impact on Sexual Function, Body Image, and Depression in Breast Cancer Survivors

Affiliations
  • 1Department of Psychiatry, University of Health Sciences, Erenköy Mental Health and Neurological Diseases Training and Research Hospital, Istanbul, Türkiye
  • 2Department of Radiation Oncology, Hitit University Çorum Erol Olçok Training and Research Hospital, Çorum, Türkiye
  • 3Department of Radiation Oncology, Kartal Dr Lutfi Kırdar City Hospital, Istanbul, Türkiye
  • 4Department of Psychiatry, Kartal Dr Lutfi Kırdar City Hospital, Istanbul, Türkiye

Abstract


Objective
This study explored the differences in cognitive emotion regulation strategies, body image, and sexual functioning between women with breast cancer and healthy controls. It also investigated the relationships among these variables in breast cancer patients, considering the role of depression and anxiety.
Methods
This cross-sectional case-control study included 112 participants (56 breast cancer patients and 56 healthy controls). Participants were assessed using the Cognitive Emotion Regulation Questionnaire, Body Cathexis Scale, Female Sexual Function Index (FSFI), and Golombok Rust Inventory of Sexual Satisfaction (GRISS). Depression and anxiety levels were evaluated using the Hamilton Depression Rating Scale and Hamilton Anxiety Scale. Statistical analyses included group comparisons and partial correlation analyses.
Results
Breast cancer patients exhibited significantly higher scores on the depression scale, reflecting greater depressive symptoms, poorer body image, and greater impairments in sexual functioning compared to healthy controls. GRISS subscales indicated higher dissatisfaction, avoidance, nonsensuality, vaginismus, and anorgasmia in breast cancer patients, while FSFI subscales showed reduced desire, arousal, lubrication, satisfaction, and orgasm. Positive reappraisal, an adaptive cognitive emotion regulation strategy, was negatively associated with sexual dissatisfaction after controlling for depression and anxiety.
Conclusion
Breast cancer significantly impacts mental health, body image, and sexual functioning. The findings underscore the importance of integrating psychiatric screening and care into oncology. Interventions enhancing cognitive emotion regulation, particularly positive reappraisal, may improve psychological and sexual well-being in breast cancer survivors.

Keyword

Breast cancer; Body image; Emotional regulation; Depression; Sexual dysfunction, psychological.
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