Emotional Regulation as a Predictor of Psychological Adjustment in Chronic Illness: A Narrative Review

Chronic illnesses impose substantial psychological and physical burdens, with emotional dysregulation contributing to poorer psychological adjustment, reduced treatment adherence, and adverse health outcomes. This structured narrative review examined emotion regulation (ER) as a transdiagnostic predictor of psychological adjustment among individuals living with chronic illnesses.
A structured literature search was conducted using PubMed, Scopus, PsycINFO, Web of Science, and Google Scholar to identify peer-reviewed studies published between 2008 and 2026. Evidence from longitudinal, cross-sectional, observational, randomized controlled, and systematic review studies was synthesized narratively across major chronic illness populations, including cancer, diabetes, cardiovascular disease, chronic pain, and autoimmune disorders.
Findings consistently demonstrated that adaptive ER strategies, particularly cognitive reappraisal, acceptance, mindfulness, and problem-focused coping, were associated with lower anxiety and depression, greater resilience, improved treatment adherence, and enhanced health-related quality of life. In contrast, maladaptive strategies, including expressive suppression, rumination, catastrophizing, and experiential avoidance, were associated with greater psychological distress, poorer self-management, increased inflammatory activity, elevated glycosylated hemoglobin (HbA1c), and adverse cardiovascular outcomes. Emerging evidence also indicates that fluctuations in physical symptoms may temporarily impair emotion regulation, highlighting a reciprocal relationship between emotional and physical functioning.
Clinical evidence supports integrating evidence-based psychological interventions, including Acceptance and Commitment Therapy (ACT), Mindfulness-Based Stress Reduction (MBSR), Cognitive Behavioural Therapy (CBT), and Dialectical Behaviour Therapy (DBT), into chronic illness care. Overall, emotion regulation represents a modifiable mechanism that can enhance psychological well-being, treatment adherence, and overall quality of life, supporting its routine assessment and integration into multidisciplinary healthcare.

Emotional Regulation, Chronic Illness, Psychological Adjustment, Coping, Mental Health, Quality of Life

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