Illness Perception, Psychological Distress and Cognitive Emotion Regulation in Women with Polycystic Ovary Syndrome

Abstract

The present study investigated the relationship between cognitive emotion regulation, illness perception, and psychological distress among women with Polycystic Ovary Syndrome (PCOS). In South Asia, particularly Pakistan, the cultural context around PCOS is frequently misinterpreted, leading to delays in diagnosis and treatment, and is accompanied by considerable stigma, especially about fertility and physical appearance.  These cultural elements have the power to intensify emotional suffering and influence how women perceive sickness in certain ways. A total of 300 women (150 with PCOS and 150 without), aged 18 to 45 years, were recruited through convenience sampling from hospitals and clinics in Haripur, Abbottabad, and Wah Cantt. Participants completed the Brief Illness Perception Questionnaire (BIPQ), the Cognitive Emotion Regulation Questionnaire (CERQ), the Depression, Anxiety, and Stress Scale-21 (DASS-21), and a demographic information sheet. Results from multiple linear regression analysis indicated that cognitive emotion regulation strategies—specifically self-blame, refocus on planning, catastrophizing, and other-blame—positively predicted psychological distress. In contrast, acceptance, positive refocusing, and positive reappraisal negatively predicted symptoms of depression, anxiety, and stress. Additionally, illness perception dimensions such as perceived consequences, timeline, and emotional response emerged as positive predictors of distress, whereas treatment control and identity were significant negative predictors. Women with PCOS exhibited significantly higher levels of psychological distress and more negative illness perceptions compared to women without the condition. These findings underscore the importance of addressing maladaptive cognitive and perceptual patterns in psychological interventions for women with PCOS, particularly in culturally relevant healthcare settings.