Emotion Regulation in Breast Cancer Patients: A Scoping Review from a Contextual Behavioral Perspective

Breast cancer (BC) exposes patients to long-term physical and emotional stressors that may increase the risk of common mental disorders development (CMDs). Across the disease trajectory, patients experience changing contexts in which emotion regulation strategies (ERS) may serve different behavioral functions and lead to distinct psychiatric outcomes. This study aimed to map how ERS have been conceptualized, assessed and associated with CMDs in BC populations. Methods: A scoping review was conducted, following PRISMA-ScR guidelines in electronic databases (MEDLINE, Web of Science, Scopus and PsycInfo) in May, 2024. Results: Eight studies met inclusion criteria for data extraction and content analysis. ERS were not intrinsically adaptive or maladaptive; rather, their associations with psychiatric outcomes depended on their functional use and contextual conditions. Disengagement strategies showed mixed effects: suppression and rigid avoidance were linked to worse outcomes, whereas positive refocusing and distraction improved psychological well-being, when not tied to emotional avoidance. Engagement-oriented strategies, such as psychoeducational actions, emotional approach and mindfulness-based interventions were generally associated with CMDs symptomatology reduction. In contrast, emotional expression without cognitive processing showed inconsistent outcomes. Finally, the perseveration of distorted cognitions were associated with higher CMDs symptomatology. Conclusions: This review highlights that ERS in BC patients should be understood through a functional, context-sensitive, and process-based perspective; rather than categorizing strategies as adaptive or maladaptive. Findings support the relevance of process-based formulations that consider the function of ER across illness contexts. From this standpoint, a contextual behavioral lens may improve health-related predictions and patient-based tailored interventions.