Health and Medical Psychology Health and Medical Humanities

Structural Modeling of Symptom Severity in Patients with Multiple Sclerosis Based on Executive Functions and Cognitive Bias: The Mediating Role of Emotion Regulation

https://doi.org/10.61838/ijbmc.v13i6.1207
Multiple sclerosis symptom severity executive functions cognitive bias emotion regulation

Authors

  • Ali Arian Darestani Department of Health Psychology, Ki.C., Islamic Azad University, Kish, Iran.
  • Amin Rafiepoor
    rafiepoor@pnu.ac.ir
    Department of Psychology, Payame Noor University, Tehran, Iran.
  • Mehrdad Sabet Department of Psychology, Ro.c, Islamic Azad University, Roudehen, Iran.
  • Mansoor Alimahdi Department of Psychology, TeMS.C., Islamic Azad University, Tehran, Iran.
In Press
Quantitative Study(ies)

Background: Multiple sclerosis (MS) is a chronic neurological disorder associated not only with physical disability but also with substantial cognitive and emotional difficulties. Executive dysfunction, maladaptive cognitive bias, and impaired emotion regulation may contribute to the severity of symptoms experienced by patients with MS. The present study aimed to examine a structural model of symptom severity in patients with MS based on executive functions and cognitive bias, with emotion regulation as a mediating variable.

Methods: This descriptive-correlational study was conducted using structural equation modeling (SEM). A total of 384 patients with MS were selected through convenience sampling from the Iran MS Society in Tehran. Data were collected using the Expanded Disability Status Scale (EDSS), the Wisconsin Card Sorting Test (WCST), the Focus of Attention Questionnaire, and the Emotion Regulation Questionnaire (ERQ). Descriptive statistics, assumption testing, and SEM were performed to evaluate the proposed model.

Results: The proposed model showed a good fit to the data (χ²/df = 2.10, RMSEA = 0.05, CFI = 0.94, NFI = 0.91, GFI = 0.96, AGFI = 0.94). Executive functions had a significant direct effect on symptom severity (β = -0.22, p = .001). Cognitive bias also had a significant direct effect on symptom severity (β = -0.24, p = .001). In addition, emotion regulation had a significant direct effect on symptom severity (β = -0.47, p = .001) and significantly mediated the relationships of executive functions (β = -0.29, p = .001) and cognitive bias (β = 0.26, p = .001) with symptom severity.

Conclusion: The findings support a multidimensional model in which executive functions and cognitive bias influence symptom severity in MS both directly and indirectly through emotion regulation. Interventions targeting executive functioning, maladaptive cognitive bias, and emotion regulation may help reduce symptom burden in patients with MS.

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