Everyday and task-based cognition shape emotion regulation effectiveness in Parkinson's disease

Cognitive dysfunction and emotional symptoms frequently co-occur in Parkinson's disease (PD), yet the processes linking these domains remain unclear. One proposed pathway involves differences in emotion regulation (ER) strategy use, which may vary as a function of cognitive functioning.

This study examined whether task-based executive functioning (EF) and self-reported functional cognitive impairment (FCI) are associated with anxiety, depression, and mental wellbeing in PD, and whether these relationships are moderated by ER strategies. One hundred and three individuals with PD completed EF tasks, and self-report measures of FCI, ER strategy use, and mental health. Principal component analysis was used to derive task-based EF components. Moderation analyses tested whether self-reported and task-based cognitive functioning interacted with ER strategy use in relation to mental health outcomes.

Greater FCI was associated with stronger negative relationships between Seeking Distractions and Ignoring and mental wellbeing, and with higher anxiety and depression when Ignoring was used. Among those with better functional cognition, Withdrawal and Catastrophizing were more strongly related to poorer mental wellbeing, while Putting into Perspective was associated with lower depressive symptoms. Stronger task-based Executive and Inhibitory Control were associated with weaker relationships between Ignoring and anxiety and depression, respectively, whereas greater Acceptance was associated with higher anxiety among those with stronger Executive Control.

Cognitive functioning moderates the relationship between ER strategies and mental health outcomes in PD. Functional cognition showed more consistent associations, whereas task-based EF exerted more limited effects. These findings contribute to understanding variability in affective symptoms in PD.