Emotion regulation in chronic diseases: A review on cardiovascular system diseases, cancer, migraine, psoriasis and fibromyalgia

Emotion regulation (ER) involves conscious and automatic regulation of the occurrence, type, intensity, timing, and expression of emotions. Previous studies indicate that ER not only affects individuals' mental health outcomes, but also plays a critical role in physical health as well. Especially in chronic diseases, how emotions are regulated shapes many patient variables including self-care, treatment adherence, and stress management; affecting both physical and psychological well-being. Furthermore, there is evidence that ER plays a role in initiation and prognosis of some chronic diseases. The aim of this review article was to summarize evidence regarding the association between chronic diseases and ER, and describe limitations in the existing studies in order to guide future research. To reach this aim, after a brief discussion of the mechanisms between emotions and health, we discussed research findings on ER in cardiovascular disease (CVD), cancer, migraine, fibromyalgia, and psoriasis, respectively. Findings indicate that emotion and ER play a role in the etiology of CVD; yet there are mixed findings regarding their role in the etiology of cancer. Research on migraine, psoriasis and fibromyalgia are rather correlational. Findings generally suggest that individuals with a chronic disease report more problems in ER as compared to healthy individuals. Frequent use of less adaptive strategies among patients have been related to less favorable outcomes such as psychopathology symptoms, bodily symptoms, and lower quality of life. Understanding ER in chronic diseases could guide the development of prevention and intervention programs aimed at increasing patients' quality of life. The article ends with an evaluation of the literature and suggestions for clinical practice.