JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

eISSN: 2636-8579
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Submit Manuscript

Index
Original Article
The mediating role of cognitive flexibility in the relationship between emotional self-awareness and self-regulation among medical students
Abstract
Aims: The aim of this study was to examine the relationship between emotional self-awareness and self-regulation among medical students and to evaluate the mediating role of cognitive flexibility in this relationship.
Methods: This cross-sectional study included 151 medical students aged 18 years and older. Data were collected via an online survey using the Emotional Self-Awareness Scale (ESAS), the Cognitive Flexibility Inventory (CFI), and the Self-Regulation Scale (SRS). Relationships among variables were examined using correlation analyses, and the mediating role of cognitive flexibility was tested. Age and gender were controlled as covariates in the analyses.
Results: Significant and positive relationships were found among emotional self-awareness, cognitive flexibility, and self-regulation. Mediation analysis revealed that cognitive flexibility played a partial mediating role in the effect of emotional self-awareness on self-regulation. The model explained approximately 50% of the variance in self-regulation, and the magnitude of the mediating effect of cognitive flexibility was large (K²=0.246). Subdimension analyses indicated that the control dimension of cognitive flexibility exhibited a stronger mediating effect compared to the alternatives dimension.
Conclusion: The findings indicate that self-regulation among medical students is strengthened not only by emotional awareness itself but also by the cognitively flexible processing of this awareness. Cognitive flexibility, particularly through perceived control, can be considered a critical mechanism in transforming emotional self-awareness into functional self-regulatory behaviors.

Keywords : Emotional self-awareness, self-regulation, cognitive flexibility

Download Article


1. Agyapong-Opoku N, Agyapong-Opoku F, Agyapong B, Greenshaw AJ. Anxiety and depressive symptoms among medical students: a scoping review of systematic reviews and meta-analyses. Front Public Health. 2026;13:1710333. doi:10.3389/fpubh.2025.1710333
2. Wright RN, Adcock RA, LaBar KS. Learning emotion regulation: an integrative framework. Psychol Rev. 2025;132(1):173-203. doi:10.1037/rev0000506
3. Van Beveren ML, Goossens L, Volkaert B, et al. How do I feel right now? Emotional awareness, emotion regulation, and depressive symptoms in youth. Eur Child Adolesc Psychiatry. 2019;28(3):389-398. doi:10.1007/s00787-018-1203-3
4. Colonnello V, Castellano P, Mazzetti M, Russo PM. Specific emotion regulation difficulties mediate the relationship between personal distress and depressive symptoms in medical students. Front Psychol. 2024;15:1432318. doi:10.3389/fpsyg.2024.1432318
5. Baumeister RF, Tice DM, Vohs KD. The strength model of self-regulation: conclusions from the second decade of willpower research. Perspect Psychol Sci. 2018;13(2):141-145. doi:10.1177/1745691617716946
6. Dennis JP, Vander Wal JS. The Cognitive Flexibility Inventory: instrument development and estimates of reliability and validity. Cognit Ther Res. 2010;34(3):241-253. doi:10.1007/s10608-009-9276-4
7. Kiye S, Çiçek Habeş E. The mediating role of cognitive emotion regulation in the relationship between cognitive flexibility and psychological well-being. İnönü Üniv Eğit Fak Derg. 2024;25(3):1292-1310. doi:10.17679/inuefd.1481952
8. Kimhy D, Vakhrusheva J, Jobson-Ahmed L, Tarrier N, Malaspina D, Gross JJ. Emotion awareness and regulation in individuals with schizophrenia: implications for social functioning. Psychiatry Res. 2012;200(2-3):193-201. doi:10.1016/j.psychres.2012.05.029
9. Tatar A, Bekiroğlu B, Çelikbaş B, et al. Translation of Emotional Self-Awareness Scale into Turkish and examination of its psychometric properties. Int J Soc Humanit Sci Res. 2017;4:1484-1493.
10. Gülüm IV, Dağ İ. Tekrarlayıcı Düşünme Ölçeği ve Bilişsel Esneklik Envanteri’nin Türkçe’ye uyarlanması, geçerliliği ve güvenilirliği. Anad Psikiyatr Derg. 2012;13(3):216-223.
11. Carey KB, Neal DJ, Collins SE. A psychometric analysis of the Self-Regulation Questionnaire. Addict Behav. 2004;29(2):253-260. doi:10.1016/j.addbeh.2003.08.001
12. Ay İ. Öz Düzenleme Ölçeğinin Türkçe uyarlaması: geçerlik ve güvenirlik çalışması. J Psychometr Res. 2023;1(1):28-40.
13. Hayes AF, Rockwood NJ. Regression-based statistical mediation and moderation analysis in clinical research: observations, recommendations, and implementation. Behav Res Ther. 2017;98:39-57. doi:10.1016/j.brat.2016.11.001
14. Gürbüz S. Aracı, Düzenleyici ve Durumsal Etki Analizleri. Seçkin Yayıncılık; 2019.
15. Dixon-Gordon KL, Aldao A, De Los Reyes A. Emotion regulation in context: examining the spontaneous use of strategies across emotional intensity and type of emotion. Pers Individ Dif. 2015;86:271-276. doi:10.1016/j.paid.2015.06.011
16. Qu D, Liu D, Cai C, et al. Process model of emotion regulation-based digital intervention for emotional problems. Digit Health. 2023;9:205520 76231187476. doi:10.1177/20552076231187476
17. Brockbank RB, Feldon DF. Cognitive reappraisal: the bridge between cognitive load and emotion. Educ Sci. 2024;14(8):870. doi:10.3390/educsci14080870
18. Wang X, Shao S, Cheng H, Blain SD, Tan Y, Jia L. Effects of cognitive flexibility on dynamics of emotion regulation and negative affect in daily life. Anxiety Stress Coping. 2025;38(3):365-378. doi:10.1080/10615806.2024.2423154
19. Rudnik A, Sobczak K, Sawicki A, Zdun-Ryzewska A. Exploring the interplay of stress, fatigue, and empathy: the mediating role of cognitive flexibility in enhancing the well-being of university students in medical and social disciplines. PLoS One. 2025;20(4):e0321946. doi:10.1371/journal.pone.0321946
20. Gu C, Guo M, Cui Y, et al. Cognitive flexibility mediates the impact of emotion regulation strategies on negative emotions in preschool teachers. Front Psychol. 2025;16:1609872. doi:10. 3389/fpsyg.2025.1609872
21. Kaynak H, Denizci Nazlıgül M, Cengil BB. Your need for cognition, cognitive flexibility, and cognitive emotion regulation strategies matter! The path beyond a satisfied life. J Psychol. 2024;158:1-16. doi:10.1080/00223980.2024.2352730
22. Motevalli S, Salahshour HM, Bailey RP. The mediating role of cognitive flexibility in the relationship between cognitive emotion regulation strategies and mindfulness in patients with type 2 diabetes. J Affect Disord. 2023;339:676-682. doi:10.1016/j.jad.2023.07.043
23. Aldao A, Sheppes G, Gross JJ. Emotion regulation flexibility. Cognit Ther Res. 2015;39(3):263-278. doi:10.1007/s10608-014-9662-4
24. Nakhostin-Khayyat M, Borjali M, Zeinali M, Fardi D, Montazeri A. The relationship between self-regulation, cognitive flexibility, and resilience among students: a structural equation modeling. BMC Psychol. 2024;12(1):337. doi:10.1186/s40359-024-01843-1
Article available in :
Volume 9, Issue 3, 2026
Page : 603-607
https://doi.org/10.32322/jhsm.1854364
Article Information
Received : 09 Oca 2026
Accepted : 08 May 2026
Published : 19 May 2026
Corresponding Author :

Pelin Göksel: Department of Psychiatry, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkiye

[email protected]
Citation : Göksel P, Korkmaz U. The mediating role of cognitive flexibility in the relationship between emotional self-awareness and self-regulation among medical students. J Health Sci Med. 2026;9(3):603-607. doi:10.32322/jhsm.1854364

Read: 260
Download : 88
Cited: 0
_Footer