The Mediating Role of Cognitive Flexibility in the Relationship between Cognitive Emotion Regulation Strategies and Mindfulness in Patients with Type 2 Diabetes

Given the importance of mental health in self-care of patients with type 2 diabetes and the relationship between cognitive flexibility and emotion regulation with mindfulness, the present study aimed to investigate the mediating role of cognitive flexibility in the relationship between cognitive emotion regulation strategies and mindfulness in patients with type 2 diabetes. The present study was conducted using correlation method and structural equation modeling. The statistical population of the study consisted of all men and women with type 2 diabetes referred to Imam Khomeini Hospital in Tehran. 253 participants were selected using convenience sampling. Participants completed the Garnefski & Kraaij (2006) Cognitive Emotion Regulation Questionnaire, the Kentucky Inventory of Mindfulness Skills (Baer, Smith & Allen, 2004), and the Cognitive Flexibility Inventory (Dennis & Vander Wal, 2010). The results showed a positive overall path coefficient between adaptive cognitive emotion regulation strategies and mindfulness (P = 0.005, β = 0.243) and a negative overall path coefficient between maladaptive cognitive emotion regulation strategies and mindfulness (P = 0.001, β = -0.453). The path coefficient between cognitive flexibility and mindfulness was positive and significant (P = 0.009, β = 0.273). The indirect path coefficient between adaptive cognitive emotion regulation strategies and mindfulness was positive (P = 0.007, β = 0.094) and the indirect path coefficient between maladaptive cognitive emotion regulation strategies and mindfulness was negative and significant (P = 0.009, β = -0.117). With an increase in emotion regulation skills, cognitive flexibility and mindfulness also increase in patients with type 2 diabetes.