Introduction: Coronary artery disease (CAD) is one of the leading causes of global mortality, significantly impacting the physical and psychological health of patients. Emotion regulation is considered a key psychological variable in helping cardiac patients adapt to stressful conditions. This study aimed to investigate the relationship between psychological distress and changes in interleukin-6 (IL-6) levels with emotion regulation, considering the mediating role of metacognitive beliefs.
Materials and Methods: This correlational study employed structural equation modeling. The sample consisted of 217 CAD patients referred to Shahid Chamran Hospital in Isfahan. Data were collected using the Kessler Psychological Distress Scale, the Gross and John Emotion Regulation Questionnaire, the Wells Metacognitive Beliefs Questionnaire, and blood tests to measure IL-6 levels.
Results: Psychological distress and IL-6 had a significant negative direct effect on emotion regulation (β = -0.436, p < 0.001 and (β = -0.276, p < 0.01, respectively). Metacognitive beliefs showed a significant positive direct effect on emotion regulation (β = 0.490, p < 0.001) and played a positive mediating role between psychological distress, IL-6, and emotion regulation
Conclusion: The findings indicated that psychological distress and elevated IL-6 levels reduce emotion regulation, while metacognitive beliefs can mitigate these negative effects. These results underscore the importance of psychological and biological interventions to enhance psychological well-being and emotion regulation in cardiac patients.
Keywords: Psychological distress, Interleukin-6, Emotion regulation, Metacognitive beliefs, Coronary artery disease