Cognitive Emotion Regulation Moderates the Relationship Between Anxiety, Depression and Cancer-Related Fatigue in Cancer Patients

The link between anxiety, depression, and cancer-related fatigue (CRF) in cancer patients is currently gaining attention, yet no research to date, have investigated the cognitive coping strategies moderating this link. This study evaluated the moderating role of cognitive emotion regulation (CER) in the association between anxiety, depression, and CRF in cancer patients. Participants included 372 cancer patients (female = 57%) recruited from the oncology unit of a University Teaching Hospital, South-east Nigeria. They completed the Multidimensional Fatigue Inventory, Hospital Anxiety and Depression Scale, and Cognitive Emotion Regulatory Questionnaires. The results of the moderation analysis showed that the adaptive CER (ACER) and maladaptive (MCER) total scores moderated the relationship between anxiety and CRF, but not for depression. ACER resulted in lower CRF when combined with lower anxiety while the use of MCER resulted in higher CRF when combined with higher anxiety. Further probe into the nine dimensions of CER (five ACER and four MCER) showed positive refocusing, putting into perspective, refocusing on planning, positive reappraisal, catastrophizing and others blame moderated the association between anxiety and CRF. But for depression, self-blame moderated the relationship between depression and CRF, particularly at higher level of self-blame. These findings highlighted the importance of cognitive emotion regulation strategies in the management of CRF in cancer patients. Interventions aimed at improving better cognitive coping strategies could help to ameliorate higher level of psychological distress among cancer patients.