Association Between Maladaptive Cognitive Emotion Regulation and Fear of Cancer Recurrence in Breast Cancer Patients With a History of Suicide Attempts: A Cross‐Sectional Study

OBJECTIVE: To investigate the relationship between maladaptive cognitive-emotional regulation and fear of cancer recurrence in breast cancer patients with a history of suicide attempts. METHODS: A cross-sectional study was conducted on 289 breast cancer patients from January to April 2025. The cognitive-emotional regulation questionnaire was used to assess maladaptive cognitive-emotional regulation, and the cancer recurrence fear scale was used to assess fear of cancer recurrence. Demographic, clinical, and psychosocial data were collected. Univariate and multivariate analyses were conducted, and smooth curve fitting was used to explore nonlinear relationships. RESULTS: The women in this group were aged 20-79 years. Non-adaptive cognitive-emotional regulation was associated with cancer recurrence fear in a non-linear positive association with a mid-range convexity relationship (p < 0.001). Fear of cancer recurrence increased with higher scores on non-adaptive cognitive-emotional regulation until reaching a plateau around 69 points (β = 0.45, 95% CI: 0.38-0.52, p < 0.001 below the threshold; β = 0.08, 95% CI: 0.01-0.15, p = 0.03 above the threshold). Age, educational level, and time since diagnosis significantly moderated this relationship (all interaction terms p < 0.05). CONCLUSION: This study identified a non-linear positive association with a mid-range convexity correlation between adaptive and maladaptive cognitive-emotional regulation and fear of cancer recurrence, highlighting a threshold effect. These findings emphasize the importance of addressing maladaptive cognitive-emotional regulation processes in psychological interventions targeting this vulnerable population.