Examining the Correlation Between Cognitive Emotion Regulation and the Mediating Role of Self-Care on Quality of Life in Patients with Diabulimia

Introduction: Diabulimia, characterized by the intentional omission of insulin to prevent weight gain, is associated with serious physical and psychological complications. This study examined the correlations between cognitive emotion regulation strategies and quality of life, with self-care as a mediating variable, among patients with diabulimia. Methods: In this cross-sectional study, ۱۶۱ patients with diabulimia attending diabetes clinics in Shiraz between July and October ۲۰۲۵ were recruited using convenience sampling. Participants completed the CERQ, DSQ, and WHO-QOL-BREF questionnaires. Data were analyzed using correlation analysis and partial least squares structural equation modeling, with no causal inference. Results: Self-care showed a significant positive correlation with quality of life (β = ۰.۳۸۰, P < ۰.۰۰۱). Acceptance demonstrated a negative indirect association with quality of life through self-care (β = –۰.۰۹۸, P = ۰.۰۱۱), while positive refocus indicated a positive indirect association (β = ۰.۱۱۵, P = ۰.۰۰۱). Rumination and blaming others exhibited negative indirect associations with quality of life (β = –۰.۱۹۱, P = ۰.۰۰۱; β = –۰.۱۱۰, P = ۰.۰۰۴, respectively). Conclusion: The findings indicate significant associations between cognitive emotion regulation strategies, self-care behaviors, and quality of life in patients with diabulimia. These results highlight the importance of addressing emotional regulation patterns alongside self-care behaviors in clinical practice. However, causal interpretations should be avoided due to the cross-sectional design.