Brain–Behavioral Systems and Executive Functions in Women with Multiple Sclerosis: The Mediating Role of Cognitive Emotion Regulation
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Objective: This study examined a structural model predicting executive functions in women with multiple sclerosis based on brain–behavioral systems, with cognitive emotion regulation as a mediating variable.
Methods and Materials: This descriptive-correlational study used structural equation modeling. The study population included women with relapsing–remitting multiple sclerosis who were members of the Iran MS Society in Tehran during 2024–2025. A total of 306 women were selected through purposive sampling. Data were collected using the Executive Functions Questionnaire, Cognitive Emotion Regulation Questionnaire, and Behavioral Inhibition/Behavioral Activation Systems Questionnaire. Data were analyzed using SPSS-26 and AMOS-24 with bootstrap testing.
Findings: The final model showed good fit: χ² = 92.14, χ²/df = 1.66, GFI = 0.99, AGFI = 0.96, CFI = 0.99, IFI = 0.99, TLI = 0.98, and RMSEA = 0.05. Executive functions were significantly correlated with behavioral inhibition (r = 0.49, p < 0.01), behavioral activation (r = −0.50, p < 0.01), positive cognitive emotion regulation (r = −0.54, p < 0.01), and negative cognitive emotion regulation (r = 0.55, p < 0.01). Bootstrap results showed significant indirect effects through positive cognitive emotion regulation for behavioral activation (β = 0.22, p = 0.001) and behavioral inhibition (β = −0.20, p = 0.001), and through negative cognitive emotion regulation for behavioral activation (β = 0.24, p = 0.001) and behavioral inhibition (β = −0.23, p = 0.001).
Conclusion: Cognitive emotion regulation mediated the relationship between brain–behavioral systems and executive functions in women with multiple sclerosis. Emotion regulation–focused interventions may help improve cognitive functioning in this population.
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