Structural modeling in the relationship between intellectual-practical obsessions and cognitive-emotional regulation with regard to the mediating role of mental resilience in dentists

Sadri Damirchi, Esmaeil; Taheri, Hasan; Fathy Karkaragh, Farshid

doi:10.22054/jcps.2026.85895.3228

Structural modeling in the relationship between intellectual-practical obsessions and cognitive-emotional regulation with regard to the mediating role of mental resilience in dentists

Document Type : Research Paper

Authors

¹ Professor, Department of Counseling, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.

² MSc Student in Clinical Psychology, Faculty of Psychology and Educational Sciences, Allameh Tabataba'i University, Tehran, Iran.

³ Ph.D. Student in Health Psychology, Department of Psychology, University of Tehran, Tehran, Iran.

10.22054/jcps.2026.85895.3228

Abstract

Introduction and Objective: Obsessive behaviors in dentists impair professional performance and mental health, while strengthening emotion regulation and stress tolerance can help prevent these risks. Therefore, this study aimed to predict obsessive thoughts and behaviors based on emotional regulation, considering the mediating role of psychological resilience among dentists.
Research Methodology: The present study is applied in terms of its purpose and descriptive-correlational in terms of data collection methods, utilizing structural equation modeling. The statistical population consisted of all dentists in Ardabil in 2024, from which 120 individuals were selected as respondents using convenience sampling. Data were collected using three questionnaires: the Connor-Davidson Psychological Resilience Questionnaire, the Garnefski et al. Cognitive Emotion Regulation Questionnaire, and the Maudsley Obsessional-Compulsive Questionnaire. Data analysis was conducted using SPSS.16 and R software, employing Pearson correlation, multiple regression analysis, structural equation modeling, and path analysis.
Findings: Statistical analysis results indicated a significant and inverse relationship between obsessive thoughts and behaviors with emotional regulation (p < 0.01), mediated by resilience. It was also found that resilience had a significant positive relationship with cognitive emotion regulation (p < 0.01). This research found that cognitive emotion regulation explained 54% of the variance in obsessive thoughts and behaviors, with resilience influencing approximately 81% of obsessive behaviors, and cognitive emotion regulation impacting resilience by about 32% (p < 0.01).
Conclusion: The findings indicated that resilience plays a significant and inverse mediating role in the relationship between obsessive thoughts and behaviors and cognitive emotion regulation among dentists. In other words, both cognitive emotion regulation and resilience can significantly predict obsessive-compulsive tendencies. Therefore, identifying obsessive behaviors and the factors influencing them should become a priority for health psychologists, as enhancing resilience and emotional competence can improve dentists' professional functioning and support targeted therapeutic interventions.

Keywords

References

Abramowitz, J. S., & Jacoby, R. J. (2022). Obsessive-compulsive disorder in the context of emotional processing. Clinical Psychology Review, 92, 102125. https://doi.org/10.1016/j.cpr.2021.102125

Aldao, A., & Dixon-Gordon, K. L. (2020). Broadening the scope of emotion regulation: Implications for psychopathology. Emotion Review, 12(3), 176–185. https://doi.org/10.1080/16506073.2013.816769

Almutairi, A., Albesher, M., & Alqahtani, N. (2021). The behavior of patients with obsessive-compulsive disorder in dental clinics: A systematic review. International Journal of Dentistry, 2021, Article ID 9873091. https://doi.org/10.1155/2021/9873091

Asli-Azad, M., Manshaee, G., & Ghamarani, A. (2019). Effectiveness of acceptance and commitment therapy on cognitive emotion regulation and ambiguity tolerance in students with obsessive-compulsive disorder. Journal of Exceptional Psychology, 9(36), 33–53. (In Persian) [Link ]

Atkinson, B. J. (2015). Relationships and the neurobiology of resilience. In Couple resilience: Emerging perspectives (pp. 107–120). https://doi.org/10.1007/978-94-017-9909-6_6

Azoulay, E., Pochard, F., Argaud, L., Cariou, A., Clere-Jehl, R., Guisset, O., et al. (2024). Resilience and mental-health symptoms in ICU healthcare professionals facing repeated COVID-19 waves. American Journal of Respiratory and Critical Care Medicine, 209(5), 573–583. https://doi.org/10.1164/rccm.202305-0806OC

Baghban, A. A., Shakeri, M., & Mousavi, S. J. (2023). Investigating the effect of obsessive-compulsive disorder on clinical symptoms of temporomandibular joint disorders. Clinical and Experimental Dental Research, 9(4), 654–662. https://doi.org/10.1002/cre2.734

Behzadpoor, S., Sohrabi, F., & Borjali, A. (2016). The role of attentional control and resilience in predicting the rumination in patients with obsessive-compulsive disorder. Zahedan Journal of Research in Medical Sciences, 18(3), e6249. [Link ]

Berking, M., & Wupperman, P. (2012). Emotion regulation and mental health: Recent findings, current challenges, and future directions. Current Opinion in Psychiatry, 25(2), 128–134. [Link ]

Besharat, M. A., Dehghani, S., Masoudi, M., Pourkhaghan, F., & Motahari, S. (2015). Predicting obsessive-compulsive disorder symptoms based on difficulties in emotion regulation, impulsivity, and anger. Applied Psychological Research Quarterly, 5(4), 29–49. (In Persian) [Link ]

Bischof, C., Hohensee, N., Dietel, F. A., Doebler, P., Klein, N., & Buhlmann, U. (2024). Emotion regulation in obsessive-compulsive disorder: An ecological momentary assessment study. Behavior Therapy, 5(35), 935–949. https://doi.org/10.1016/j.beth.2024.01.011

Bonanno, G. A. (2021). The resilience paradox: How adaptive processes can mitigate psychopathology. American Psychologist, 76(3), 417–429. https://doi.org/10.1037/amp0000774

Bonanno, G., Westphal, M., & Mancini, A. (2011). Resilience to loss and potential trauma. Annual Review of Clinical Psychology, 7(1), 511–535. [Link ]

Borbour, N. (2022). The effectiveness of analytical cognitive therapy on cognitive emotion regulation and repetitive negative thoughts in individuals with obsessive-compulsive disorder. Eighth Scientific-Research Conference on Educational and Psychological Sciences of Iran, Tehran. (In Persian) [Link ]

Brown, L., Haines, S., Amonoo, H. L., Jones, C., Woods, J., Huffman, J. C., & Morris, M. E. (2021). Sources of resilience in frontline health professionals during COVID-19. Healthcare (Basel), 9(12), 1699. https://doi.org/10.3390/healthcare9121699

Çalıkkasap, B., Karaaziz, M., & İskender, C. (2023). Relationship of obsessive-compulsive disorder with social anxiety and psychological resilience in adults. International Journal of Disability Sports and Health Sciences, 6(2), 238–250. [Link ]

Calkins, A. W., Berman, N. C., & Wilhelm, S. (2013). Recent advances in research on cognition and emotion in OCD: A review. Current Psychiatry Reports, 15, 357. [Link ]

Chen, S., & Bonanno, G. A. (2023). Resilience as a mediator in emotion regulation and obsessive-compulsive symptoms: Evidence from high-stress occupations. Journal of Anxiety Disorders, 95, 102678. https://doi.org/10.1016/j.janxdis.2023.102678

Connor, K. M., & Davidson, J. R. (2003). Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety, 18, 76–82. [Link ]

De Ruiter, N., Van der Heijden, P., & O'Connor, K. (2024). Resilience as a mediator between stress, emotion regulation, and obsessive-compulsive symptoms in high-risk professions. Psychiatry Research, 333, 115723. https://doi.org/10.1016/j.psychres.2023.115723

Emmelkamp, P. M. G., Hoekstra, R. J., & Visser, S. (1985). The behavioral treatment of OCD: Prediction of outcome at 3.5 years follow-up. In P. Pichot, P. Berner, R. Wolf, & K. Thau (Eds.), Psychiatry: The state of the art (pp. 265–270). Plenum Press. https://doi.org/10.1007/978-1-4684-4697-5_45

Ferrández-Mas, J., Moreno-Amador, B., & Piqueras, J. A. (2023). Relationship between cognitive strategies of emotion regulation and dimensions of obsessive-compulsive symptomatology in adolescents. Children, 10(5), 803. https://doi.org/10.3390/children10050803

Ferreira, S., Couto, B., Sousa, M., et al. (2021). Stress influences the effect of obsessive-compulsive symptoms on emotion regulation. Frontiers in Psychiatry, 11, 594541. https://doi.org/10.3389/fpsyt.2020.594541

Ferreira, S., Pêgo, J. M., & Morgado, P. (2020). A systematic review of behavioral, physiological, and neurobiological cognitive regulation alterations in obsessive-compulsive disorder. Brain Sciences, 10(11), 797. [Link ]

Fineberg, N. A., Apergis-Schoute, A. M., Vaghi, M. M., et al. (2018). Mapping compulsivity in the DSM-5 obsessive compulsive and related disorders: Cognitive domains, neural circuitry, and treatment. International Journal of Neuropsychopharmacology, 21(1), 42–58. [Link ]

Fineberg, N. A., Pellegrini, L., Clarke, A., & Perera, U. (2020). Clinical advances in obsessive-compulsive disorder: A position statement by the International College of Obsessive-Compulsive Spectrum Disorders. International Clinical Psychopharmacology, 35(4), 173–193. https://doi.org/10.1097/YIC.0000000000000314

Fisher, P. L. (2009). Obsessive–compulsive disorder: A comparison of CBT and the metacognitive approach. International Journal of Cognitive Therapy, 2(2), 107–122. [Link ]

Fletcher, D., & Sarkar, M. (2020). Psychological resilience: A review and critique of definitions, concepts, and theory. European Psychologist, 25(4), 275–288. https://doi.org/10.1027/1016-9040/a000417

Gallagher, J. E., Colonio-Salazar, F., & White, S. (2021). Supporting dentists' health and wellbeing—A qualitative study of coping strategies in ‘normal times’. British Dental Journal. [epub ahead of print 20 Jul 2021]. In press.

García-Soriano, G., Martínez-Lorca, M., & Roncero, M. (2020). Stress influences the effect of obsessive-compulsive symptoms on emotion regulation. Frontiers in Psychiatry, 11, 594541. https://doi.org/10.3389/fpsyt.2020.594541

Garnefski, N., & Kraaij, V. (2021). Cognitive emotion regulation questionnaire: Development and validation of a short form. European Journal of Psychological Assessment, 37(5), 345–353. https://doi.org/10.1027/1015-5759/a000657

Garnefski, N., Kraaij, V., & Spinhoven, P. (2007). The cognitive emotion regulation questionnaire: Psychometric features and prospective relationships with depression and anxiety in adults. European Journal of Psychological Assessment, 17(2), 141–149. [Link ]

Garnefski, N., Kraaij, V., & Spinhoven, P. (2019). Cognitive emotion regulation and psychopathology: A longitudinal study in health professionals. Journal of Clinical Psychology, 75(10), 1845–1857. https://doi.org/10.1002/jclp.22834

Ghassemzadeh, H., Khamseh, A., & Ebrahimkhani, N. (2005). Demographic variables and clinical features of obsessive-compulsive disorder in Iranian patients (Second report). In B. E. Ling (Ed.), Obsessive-compulsive disorder research (pp. 243–271). Nova Science Publishers, Inc.

Ghassemzadeh, H., Mojtabai, R., Khamseh, A., Ebrahimkhani, N., Issazadegan, A. A., & Saif-Nobakht, Z. (2002). Symptoms of OCD in a sample of Iranian patients. International Journal of Social Psychiatry, 1, 20–28.

Gorelik, M., Szepsenwol, O., & Doron, G. (2023). Promoting couples' resilience to relationship obsessive-compulsive disorder (ROCD) symptoms using a CBT-based mobile application: A randomized controlled trial. Heliyon, 9(11), e21673. [Link ]

Hakanen, J., Schaufeli, W. B., & Ahola, K. (2008). The job demands-resources model: A three-year cross-lagged study of burnout, depression, commitment, and work engagement. Work & Stress, 22(3), 224–241.

Harrington, K. A., Kennedy, D. S., Tang, B., et al. (2018). Computed tomographic evaluation of the thymus—Does obesity affect thymic fatty involution in a healthy young adult population? British Journal of Radiology, 91(1089), 20170609. [Link ]

Hasani, J. (2011). The psychometric properties of the cognitive emotion regulation questionnaire (CERQ). Journal of Clinical Psychology, 2(8), 38–78.

Hezel, D. M., & McNally, R. J. (2016). A theoretical review of cognitive biases and deficits in obsessive–compulsive disorder. Biological Psychology, 121(Part B), 221–232. [Link ]

Hilt, L. M., & Pollak, S. D. (2021). Resilience and emotion regulation: Mediating pathways to obsessive-compulsive disorder. Developmental Psychology, 57(6), 912–925. https://doi.org/10.1037/dev0001178

Hodgson, R. J., & Rachman, S. (1977). Obsessional-compulsive complaints. Behaviour Research and Therapy, 15(5), 389–395.

Jafari-Fard, Y., Sohrabi, F., Borjali, A., Khanjani, M., & Farkhi, N. (2019). Developing a training program to improve quality of life and its effectiveness on emotion regulation in individuals with obsessive-compulsive disorder. Thoughts and Behavior in Clinical Psychology, 14(53), 27–36. (In Persian) [Link ]

Jalal, B., Chamberlain, S. R., & Sahakian, B. J. (2023). Obsessive-compulsive disorder: Etiology, neuropathology, and cognitive dysfunction. Brain and Behavior, 13(6), e3000. https://doi.org/10.1002/brb3.3000

Keyhani, M., Taghvaei, D., Rajabi, A., & Amirpour, B. (2015). Internal consistency and confirmatory factor analysis of the Connor-Davidson Resilience Scale (CD-RISC) among nursing female. Iranian Journal of Medical Education, 14(10), 857–865. (In Persian) [Link ]

Khajeh, F., Mohammadi, N., & Zahrakar, K. (2022). The mediating role of psychological resilience in the relationship between emotion regulation and obsessive-compulsive symptoms among healthcare workers. Journal of Health Psychology, 27(10), 2345–2358. https://doi.org/10.1177/13591053211068932

Kökönyei, G., Kovács, L. N., Szabó, J., & Urbán, R. (2024). Emotion regulation predicts depressive symptoms in adolescents: A prospective study. Journal of Youth and Adolescence, 53(1), 142–158. [Link ]

Labrague, L. J. (2021). Psychological resilience, coping behaviours and social support among health care workers during the COVID‐19 pandemic: A systematic review of quantitative studies. Journal of Nursing Management, 29(7), 1893–1905. https://doi.org/10.1111/jonm.13336

Layne, C. M., Greeson, J. K., Ostrowski, S. A., et al. (2014). Cumulative trauma exposure and high-risk behavior in adolescence: Findings from the National Child Traumatic Stress Network Core Data Set. Psychological Trauma: Theory, Research, Practice, and Policy, 6(S1), S40–S49. [Link ]

Maragha, T., Atanackovic, J., Adams, T., Brondani, M., & Bourgeault, I. (2025). Dentists' Mental Health: Challenges, Supports, and Promising Practices. JDR clinical and translational research, 10(2), 100–111. https://doi.org/10.1177/23800844241271664

McKenzie, R., Dowling, N., & Yap, K. (2022). The interplay of resilience and emotion regulation in obsessive-compulsive disorder: A longitudinal study. Clinical Psychology & Psychotherapy, 29(4), 1321–1333. https://doi.org/10.1002/cpp.2678

Mohammadi-Ahmadabadi, N., & Dolatabadi, F. (2021). Investigating the relationship between resilience and obsessive beliefs among women. Iranian Journal of Psychology and Behavioral Sciences, 25, 21–30. (In Persian) [Link ]

Mohammadzadeh, A., Rezaei, A., & Amini, M. H. (2023). The prediction of resiliency based on childhood trauma, psychological distress, and emotion regulation difficulty in individuals with substance use. Etiadpajohi, 17(69), 67–86. (In Persian) [Link ]

Nangle, M. R., Henry, J. D., von Hippel, C., & Kjelsaas, K. (2019). An empirical study of how emotion dysregulation and social cognition relate to occupational burnout in dentistry. British Dental Journal, 227(4), 285–290. https://doi.org/10.1038/s41415-019-0620-0

Rahmani, M., Zanjani, Z., & Omidi, A. (2022). The mediating role of cognitive emotion regulation and mindfulness in the relationship between worry and generalized anxiety. Journal of Arak University of Medical Sciences, 25(1), 142–155.

Robbins, T. W., Vaghi, M. M., & Banca, P. (2022). Obsessive-compulsive disorder: Puzzles and prospects. Neuron, 110(7), 1123–1136. https://doi.org/10.1016/j.neuron.2022.01.021

Robinson, L. J., & Freeston, M. H. (2014). Emotion and internal experience in obsessive-compulsive disorder: Reviewing the role of alexithymia, anxiety sensitivity and distress tolerance. Clinical Psychology Review, 34, 256–271. [Link ]

Salamon, N., Augsburger, N., & Dan-Glauser, E. (2023). Benefits of planning as an emotion regulation strategy in obsessions and compulsions (OC): Implication of the perfectionism level in the planning-OC relationship. Journal of Affective Disorders Reports, 14, 100667. [Link ]

Salek Ebrahimi, L., Mousavi, S. E., Gharraee, B., Mohammadi Bytamar, J., & Saberi Isfeedvajani, M. (2019). Cognitive errors and psychological resilience in patients with social anxiety and obsessive-compulsive disorder: A cross-sectional study. Hospital Practices and Research, 4(1), 25–30. [Link ]

Salkovskis, P. M. (1999). Understanding and treating obsessive-compulsive disorder. Behaviour Research and Therapy, 37(1), 529–552. [Link ]

See, C. C. H., Tan, J. M., & Sündermann, O. (2022). A systematic review on the links between emotion regulation difficulties and obsessive-compulsive disorder. Journal of Psychiatric Research, 154, 341–353. https://doi.org/10.1016/j.jpsychires.2022.07.023

Shafi’i-Kahani, T., Hasani, J., & Shakeri, M. (2021). Role of self-efficacy, resilience, and cognitive emotion regulation in predicting obsessive-compulsive symptoms in the general population. Psychological Science Journal, 20(107), 2095–2106. (In Persian) [Link ]

Shams, G., Karam Ghadiri, N., Esmaili Torkanbori, Y., Amini, H., Ebrahim Khani, N., Naseri Beferoni, A., et al. (2008). Prevalence of obsessive-compulsive symptoms and its comorbidity with psychiatric symptoms in adolescents. Advances in Cognitive Sciences, 9(4), 50–59. http://icssjournal.ir/article-1-402-en.html

Sheppes, G., Suri, G., & Gross, J. J. (2022). Emotion regulation and occupational stress: A dynamic perspective. Annual Review of Organizational Psychology and Organizational Behavior, 9, 241–265. https://doi.org/10.1146/annurev-orgpsych-012420-091022

Smith, J., Taylor, R., & Adams, K. (2023). Occupational stress and obsessive-compulsive symptoms in dental professionals: A cross-sectional study. Journal of Occupational Health Psychology, 28(5), 312–320. https://doi.org/10.1037/ocp0000345

Solis, N. (2024). Making peace with imperfection. American Nurse Journal, 19(6), 57–59. https://doi.org/10.51256/anj062457

Southwick, S. M., & Charney, D. S. (2022). Resilience: The science of mastering life’s greatest challenges (3rd ed.). Cambridge University Press.

Stern, E., Müller, K., & Braun, S. (2023). Resilience as a mediator between stress and obsessive-compulsive symptoms in dentistry professionals. Psychology & Health, 38(6), 789–803. https://doi.org/10.1080/08870446.2023.2194321

Thompson, R. A., & Waltz, J. A. (2021). Adaptive cognitive emotion regulation in high-stress professions: Implications for mental health. Journal of Occupational Health Psychology, 26(4), 321–334. https://doi.org/10.1037/ocp0000278

Wu, G., Feder, A., & Cohen, H. (2022). Resilience as a buffer: Linking cognitive emotion regulation to obsessive-compulsive tendencies. Psychological Medicine, 52(8), 1456–1465. https://doi.org/10.1017/S0033291721002345

Yap, K., Gibbs, A., & Moulding, R. (2023). Emotion regulation difficulties and resilience: Predictors of obsessive-compulsive disorder severity in clinical samples. Journal of Anxiety Disorders, 95, 102698. https://doi.org/10.1016/j.janxdis.2023.102698

Yazdi-Ravandi, S., Shamsaei, F., Matinnia, N., et al. (2018). Cognitive process in patients with obsessive-compulsive disorder: A cross-sectional analytic study. Basic and Clinical Neuroscience, 9(6), 448–457. [Link ]

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Structural modeling in the relationship between intellectual-practical obsessions and cognitive-emotional regulation with regard to the mediating role of mental resilience in dentists

References

Abramowitz, J. S., & Jacoby, R. J. (2022). Obsessive-compulsive disorder in the context of emotional processing. Clinical Psychology Review, 92, 102125. https://doi.org/10.1016/j.cpr.2021.102125

Aldao, A., & Dixon-Gordon, K. L. (2020). Broadening the scope of emotion regulation: Implications for psychopathology. Emotion Review, 12(3), 176–185. https://doi.org/10.1080/16506073.2013.816769

Almutairi, A., Albesher, M., & Alqahtani, N. (2021). The behavior of patients with obsessive-compulsive disorder in dental clinics: A systematic review. International Journal of Dentistry, 2021, Article ID 9873091. https://doi.org/10.1155/2021/9873091

Asli-Azad, M., Manshaee, G., & Ghamarani, A. (2019). Effectiveness of acceptance and commitment therapy on cognitive emotion regulation and ambiguity tolerance in students with obsessive-compulsive disorder. Journal of Exceptional Psychology, 9(36), 33–53. (In Persian) [Link]

Atkinson, B. J. (2015). Relationships and the neurobiology of resilience. In Couple resilience: Emerging perspectives (pp. 107–120). https://doi.org/10.1007/978-94-017-9909-6_6

Baghban, A. A., Shakeri, M., & Mousavi, S. J. (2023). Investigating the effect of obsessive-compulsive disorder on clinical symptoms of temporomandibular joint disorders. Clinical and Experimental Dental Research, 9(4), 654–662. https://doi.org/10.1002/cre2.734

Behzadpoor, S., Sohrabi, F., & Borjali, A. (2016). The role of attentional control and resilience in predicting the rumination in patients with obsessive-compulsive disorder. Zahedan Journal of Research in Medical Sciences, 18(3), e6249. [Link]

Berking, M., & Wupperman, P. (2012). Emotion regulation and mental health: Recent findings, current challenges, and future directions. Current Opinion in Psychiatry, 25(2), 128–134. [Link]

Besharat, M. A., Dehghani, S., Masoudi, M., Pourkhaghan, F., & Motahari, S. (2015). Predicting obsessive-compulsive disorder symptoms based on difficulties in emotion regulation, impulsivity, and anger. Applied Psychological Research Quarterly, 5(4), 29–49. (In Persian) [Link]

Bischof, C., Hohensee, N., Dietel, F. A., Doebler, P., Klein, N., & Buhlmann, U. (2024). Emotion regulation in obsessive-compulsive disorder: An ecological momentary assessment study. Behavior Therapy, 5(35), 935–949. https://doi.org/10.1016/j.beth.2024.01.011

Bonanno, G. A. (2021). The resilience paradox: How adaptive processes can mitigate psychopathology. American Psychologist, 76(3), 417–429. https://doi.org/10.1037/amp0000774

Bonanno, G., Westphal, M., & Mancini, A. (2011). Resilience to loss and potential trauma. Annual Review of Clinical Psychology, 7(1), 511–535. [Link]

Brown, L., Haines, S., Amonoo, H. L., Jones, C., Woods, J., Huffman, J. C., & Morris, M. E. (2021). Sources of resilience in frontline health professionals during COVID-19. Healthcare (Basel), 9(12), 1699. https://doi.org/10.3390/healthcare9121699

Çalıkkasap, B., Karaaziz, M., & İskender, C. (2023). Relationship of obsessive-compulsive disorder with social anxiety and psychological resilience in adults. International Journal of Disability Sports and Health Sciences, 6(2), 238–250. [Link]

Calkins, A. W., Berman, N. C., & Wilhelm, S. (2013). Recent advances in research on cognition and emotion in OCD: A review. Current Psychiatry Reports, 15, 357. [Link]

Chen, S., & Bonanno, G. A. (2023). Resilience as a mediator in emotion regulation and obsessive-compulsive symptoms: Evidence from high-stress occupations. Journal of Anxiety Disorders, 95, 102678. https://doi.org/10.1016/j.janxdis.2023.102678

Connor, K. M., & Davidson, J. R. (2003). Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety, 18, 76–82. [Link]

De Ruiter, N., Van der Heijden, P., & O'Connor, K. (2024). Resilience as a mediator between stress, emotion regulation, and obsessive-compulsive symptoms in high-risk professions. Psychiatry Research, 333, 115723. https://doi.org/10.1016/j.psychres.2023.115723

Emmelkamp, P. M. G., Hoekstra, R. J., & Visser, S. (1985). The behavioral treatment of OCD: Prediction of outcome at 3.5 years follow-up. In P. Pichot, P. Berner, R. Wolf, & K. Thau (Eds.), Psychiatry: The state of the art (pp. 265–270). Plenum Press. https://doi.org/10.1007/978-1-4684-4697-5_45

Ferrández-Mas, J., Moreno-Amador, B., & Piqueras, J. A. (2023). Relationship between cognitive strategies of emotion regulation and dimensions of obsessive-compulsive symptomatology in adolescents. Children, 10(5), 803. https://doi.org/10.3390/children10050803

Ferreira, S., Couto, B., Sousa, M., et al. (2021). Stress influences the effect of obsessive-compulsive symptoms on emotion regulation. Frontiers in Psychiatry, 11, 594541. https://doi.org/10.3389/fpsyt.2020.594541

Ferreira, S., Pêgo, J. M., & Morgado, P. (2020). A systematic review of behavioral, physiological, and neurobiological cognitive regulation alterations in obsessive-compulsive disorder. Brain Sciences, 10(11), 797. [Link]

Fineberg, N. A., Apergis-Schoute, A. M., Vaghi, M. M., et al. (2018). Mapping compulsivity in the DSM-5 obsessive compulsive and related disorders: Cognitive domains, neural circuitry, and treatment. International Journal of Neuropsychopharmacology, 21(1), 42–58. [Link]

Fisher, P. L. (2009). Obsessive–compulsive disorder: A comparison of CBT and the metacognitive approach. International Journal of Cognitive Therapy, 2(2), 107–122. [Link]

Fletcher, D., & Sarkar, M. (2020). Psychological resilience: A review and critique of definitions, concepts, and theory. European Psychologist, 25(4), 275–288. https://doi.org/10.1027/1016-9040/a000417

Gallagher, J. E., Colonio-Salazar, F., & White, S. (2021). Supporting dentists' health and wellbeing—A qualitative study of coping strategies in ‘normal times’. British Dental Journal. [epub ahead of print 20 Jul 2021]. In press.

García-Soriano, G., Martínez-Lorca, M., & Roncero, M. (2020). Stress influences the effect of obsessive-compulsive symptoms on emotion regulation. Frontiers in Psychiatry, 11, 594541. https://doi.org/10.3389/fpsyt.2020.594541

Garnefski, N., & Kraaij, V. (2021). Cognitive emotion regulation questionnaire: Development and validation of a short form. European Journal of Psychological Assessment, 37(5), 345–353. https://doi.org/10.1027/1015-5759/a000657

Garnefski, N., Kraaij, V., & Spinhoven, P. (2007). The cognitive emotion regulation questionnaire: Psychometric features and prospective relationships with depression and anxiety in adults. European Journal of Psychological Assessment, 17(2), 141–149. [Link]

Garnefski, N., Kraaij, V., & Spinhoven, P. (2019). Cognitive emotion regulation and psychopathology: A longitudinal study in health professionals. Journal of Clinical Psychology, 75(10), 1845–1857. https://doi.org/10.1002/jclp.22834

Ghassemzadeh, H., Khamseh, A., & Ebrahimkhani, N. (2005). Demographic variables and clinical features of obsessive-compulsive disorder in Iranian patients (Second report). In B. E. Ling (Ed.), Obsessive-compulsive disorder research (pp. 243–271). Nova Science Publishers, Inc.

Ghassemzadeh, H., Mojtabai, R., Khamseh, A., Ebrahimkhani, N., Issazadegan, A. A., & Saif-Nobakht, Z. (2002). Symptoms of OCD in a sample of Iranian patients. International Journal of Social Psychiatry, 1, 20–28.

Gorelik, M., Szepsenwol, O., & Doron, G. (2023). Promoting couples' resilience to relationship obsessive-compulsive disorder (ROCD) symptoms using a CBT-based mobile application: A randomized controlled trial. Heliyon, 9(11), e21673. [Link]

Hakanen, J., Schaufeli, W. B., & Ahola, K. (2008). The job demands-resources model: A three-year cross-lagged study of burnout, depression, commitment, and work engagement. Work & Stress, 22(3), 224–241.

Harrington, K. A., Kennedy, D. S., Tang, B., et al. (2018). Computed tomographic evaluation of the thymus—Does obesity affect thymic fatty involution in a healthy young adult population? British Journal of Radiology, 91(1089), 20170609. [Link]

Hasani, J. (2011). The psychometric properties of the cognitive emotion regulation questionnaire (CERQ). Journal of Clinical Psychology, 2(8), 38–78.

Hezel, D. M., & McNally, R. J. (2016). A theoretical review of cognitive biases and deficits in obsessive–compulsive disorder. Biological Psychology, 121(Part B), 221–232. [Link]

Hilt, L. M., & Pollak, S. D. (2021). Resilience and emotion regulation: Mediating pathways to obsessive-compulsive disorder. Developmental Psychology, 57(6), 912–925. https://doi.org/10.1037/dev0001178

Hodgson, R. J., & Rachman, S. (1977). Obsessional-compulsive complaints. Behaviour Research and Therapy, 15(5), 389–395.

Jalal, B., Chamberlain, S. R., & Sahakian, B. J. (2023). Obsessive-compulsive disorder: Etiology, neuropathology, and cognitive dysfunction. Brain and Behavior, 13(6), e3000. https://doi.org/10.1002/brb3.3000

Keyhani, M., Taghvaei, D., Rajabi, A., & Amirpour, B. (2015). Internal consistency and confirmatory factor analysis of the Connor-Davidson Resilience Scale (CD-RISC) among nursing female. Iranian Journal of Medical Education, 14(10), 857–865. (In Persian) [Link]

Khajeh, F., Mohammadi, N., & Zahrakar, K. (2022). The mediating role of psychological resilience in the relationship between emotion regulation and obsessive-compulsive symptoms among healthcare workers. Journal of Health Psychology, 27(10), 2345–2358. https://doi.org/10.1177/13591053211068932

Kökönyei, G., Kovács, L. N., Szabó, J., & Urbán, R. (2024). Emotion regulation predicts depressive symptoms in adolescents: A prospective study. Journal of Youth and Adolescence, 53(1), 142–158. [Link]

Labrague, L. J. (2021). Psychological resilience, coping behaviours and social support among health care workers during the COVID‐19 pandemic: A systematic review of quantitative studies. Journal of Nursing Management, 29(7), 1893–1905. https://doi.org/10.1111/jonm.13336

Layne, C. M., Greeson, J. K., Ostrowski, S. A., et al. (2014). Cumulative trauma exposure and high-risk behavior in adolescence: Findings from the National Child Traumatic Stress Network Core Data Set. Psychological Trauma: Theory, Research, Practice, and Policy, 6(S1), S40–S49. [Link]

Maragha, T., Atanackovic, J., Adams, T., Brondani, M., & Bourgeault, I. (2025). Dentists' Mental Health: Challenges, Supports, and Promising Practices. JDR clinical and translational research, 10(2), 100–111. https://doi.org/10.1177/23800844241271664

McKenzie, R., Dowling, N., & Yap, K. (2022). The interplay of resilience and emotion regulation in obsessive-compulsive disorder: A longitudinal study. Clinical Psychology & Psychotherapy, 29(4), 1321–1333. https://doi.org/10.1002/cpp.2678

Mohammadi-Ahmadabadi, N., & Dolatabadi, F. (2021). Investigating the relationship between resilience and obsessive beliefs among women. Iranian Journal of Psychology and Behavioral Sciences, 25, 21–30. (In Persian) [Link]

Mohammadzadeh, A., Rezaei, A., & Amini, M. H. (2023). The prediction of resiliency based on childhood trauma, psychological distress, and emotion regulation difficulty in individuals with substance use. Etiadpajohi, 17(69), 67–86. (In Persian) [Link]

Nangle, M. R., Henry, J. D., von Hippel, C., & Kjelsaas, K. (2019). An empirical study of how emotion dysregulation and social cognition relate to occupational burnout in dentistry. British Dental Journal, 227(4), 285–290. https://doi.org/10.1038/s41415-019-0620-0

Rahmani, M., Zanjani, Z., & Omidi, A. (2022). The mediating role of cognitive emotion regulation and mindfulness in the relationship between worry and generalized anxiety. Journal of Arak University of Medical Sciences, 25(1), 142–155.

Robbins, T. W., Vaghi, M. M., & Banca, P. (2022). Obsessive-compulsive disorder: Puzzles and prospects. Neuron, 110(7), 1123–1136. https://doi.org/10.1016/j.neuron.2022.01.021

Robinson, L. J., & Freeston, M. H. (2014). Emotion and internal experience in obsessive-compulsive disorder: Reviewing the role of alexithymia, anxiety sensitivity and distress tolerance. Clinical Psychology Review, 34, 256–271. [Link]

Salamon, N., Augsburger, N., & Dan-Glauser, E. (2023). Benefits of planning as an emotion regulation strategy in obsessions and compulsions (OC): Implication of the perfectionism level in the planning-OC relationship. Journal of Affective Disorders Reports, 14, 100667. [Link]

Salek Ebrahimi, L., Mousavi, S. E., Gharraee, B., Mohammadi Bytamar, J., & Saberi Isfeedvajani, M. (2019). Cognitive errors and psychological resilience in patients with social anxiety and obsessive-compulsive disorder: A cross-sectional study. Hospital Practices and Research, 4(1), 25–30. [Link]

Salkovskis, P. M. (1999). Understanding and treating obsessive-compulsive disorder. Behaviour Research and Therapy, 37(1), 529–552. [Link]

See, C. C. H., Tan, J. M., & Sündermann, O. (2022). A systematic review on the links between emotion regulation difficulties and obsessive-compulsive disorder. Journal of Psychiatric Research, 154, 341–353. https://doi.org/10.1016/j.jpsychires.2022.07.023

Shafi’i-Kahani, T., Hasani, J., & Shakeri, M. (2021). Role of self-efficacy, resilience, and cognitive emotion regulation in predicting obsessive-compulsive symptoms in the general population. Psychological Science Journal, 20(107), 2095–2106. (In Persian) [Link]

Sheppes, G., Suri, G., & Gross, J. J. (2022). Emotion regulation and occupational stress: A dynamic perspective. Annual Review of Organizational Psychology and Organizational Behavior, 9, 241–265. https://doi.org/10.1146/annurev-orgpsych-012420-091022

Smith, J., Taylor, R., & Adams, K. (2023). Occupational stress and obsessive-compulsive symptoms in dental professionals: A cross-sectional study. Journal of Occupational Health Psychology, 28(5), 312–320. https://doi.org/10.1037/ocp0000345

Solis, N. (2024). Making peace with imperfection. American Nurse Journal, 19(6), 57–59. https://doi.org/10.51256/anj062457

Southwick, S. M., & Charney, D. S. (2022). Resilience: The science of mastering life’s greatest challenges (3rd ed.). Cambridge University Press.

Stern, E., Müller, K., & Braun, S. (2023). Resilience as a mediator between stress and obsessive-compulsive symptoms in dentistry professionals. Psychology & Health, 38(6), 789–803. https://doi.org/10.1080/08870446.2023.2194321

Thompson, R. A., & Waltz, J. A. (2021). Adaptive cognitive emotion regulation in high-stress professions: Implications for mental health. Journal of Occupational Health Psychology, 26(4), 321–334. https://doi.org/10.1037/ocp0000278

Wu, G., Feder, A., & Cohen, H. (2022). Resilience as a buffer: Linking cognitive emotion regulation to obsessive-compulsive tendencies. Psychological Medicine, 52(8), 1456–1465. https://doi.org/10.1017/S0033291721002345

Yap, K., Gibbs, A., & Moulding, R. (2023). Emotion regulation difficulties and resilience: Predictors of obsessive-compulsive disorder severity in clinical samples. Journal of Anxiety Disorders, 95, 102698. https://doi.org/10.1016/j.janxdis.2023.102698

Yazdi-Ravandi, S., Shamsaei, F., Matinnia, N., et al. (2018). Cognitive process in patients with obsessive-compulsive disorder: A cross-sectional analytic study. Basic and Clinical Neuroscience, 9(6), 448–457. [Link]

Volume 17, Issue 62March 2026Pages 35-48

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Asli-Azad, M., Manshaee, G., & Ghamarani, A. (2019). Effectiveness of acceptance and commitment therapy on cognitive emotion regulation and ambiguity tolerance in students with obsessive-compulsive disorder. Journal of Exceptional Psychology, 9(36), 33–53. (In Persian) [Link ]

Behzadpoor, S., Sohrabi, F., & Borjali, A. (2016). The role of attentional control and resilience in predicting the rumination in patients with obsessive-compulsive disorder. Zahedan Journal of Research in Medical Sciences, 18(3), e6249. [Link ]

Berking, M., & Wupperman, P. (2012). Emotion regulation and mental health: Recent findings, current challenges, and future directions. Current Opinion in Psychiatry, 25(2), 128–134. [Link ]

Besharat, M. A., Dehghani, S., Masoudi, M., Pourkhaghan, F., & Motahari, S. (2015). Predicting obsessive-compulsive disorder symptoms based on difficulties in emotion regulation, impulsivity, and anger. Applied Psychological Research Quarterly, 5(4), 29–49. (In Persian) [Link ]

Bonanno, G., Westphal, M., & Mancini, A. (2011). Resilience to loss and potential trauma. Annual Review of Clinical Psychology, 7(1), 511–535. [Link ]

Çalıkkasap, B., Karaaziz, M., & İskender, C. (2023). Relationship of obsessive-compulsive disorder with social anxiety and psychological resilience in adults. International Journal of Disability Sports and Health Sciences, 6(2), 238–250. [Link ]

Calkins, A. W., Berman, N. C., & Wilhelm, S. (2013). Recent advances in research on cognition and emotion in OCD: A review. Current Psychiatry Reports, 15, 357. [Link ]

Connor, K. M., & Davidson, J. R. (2003). Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety, 18, 76–82. [Link ]

Ferreira, S., Pêgo, J. M., & Morgado, P. (2020). A systematic review of behavioral, physiological, and neurobiological cognitive regulation alterations in obsessive-compulsive disorder. Brain Sciences, 10(11), 797. [Link ]

Fineberg, N. A., Apergis-Schoute, A. M., Vaghi, M. M., et al. (2018). Mapping compulsivity in the DSM-5 obsessive compulsive and related disorders: Cognitive domains, neural circuitry, and treatment. International Journal of Neuropsychopharmacology, 21(1), 42–58. [Link ]

Fisher, P. L. (2009). Obsessive–compulsive disorder: A comparison of CBT and the metacognitive approach. International Journal of Cognitive Therapy, 2(2), 107–122. [Link ]

Garnefski, N., Kraaij, V., & Spinhoven, P. (2007). The cognitive emotion regulation questionnaire: Psychometric features and prospective relationships with depression and anxiety in adults. European Journal of Psychological Assessment, 17(2), 141–149. [Link ]

Gorelik, M., Szepsenwol, O., & Doron, G. (2023). Promoting couples' resilience to relationship obsessive-compulsive disorder (ROCD) symptoms using a CBT-based mobile application: A randomized controlled trial. Heliyon, 9(11), e21673. [Link ]

Harrington, K. A., Kennedy, D. S., Tang, B., et al. (2018). Computed tomographic evaluation of the thymus—Does obesity affect thymic fatty involution in a healthy young adult population? British Journal of Radiology, 91(1089), 20170609. [Link ]

Hezel, D. M., & McNally, R. J. (2016). A theoretical review of cognitive biases and deficits in obsessive–compulsive disorder. Biological Psychology, 121(Part B), 221–232. [Link ]

Keyhani, M., Taghvaei, D., Rajabi, A., & Amirpour, B. (2015). Internal consistency and confirmatory factor analysis of the Connor-Davidson Resilience Scale (CD-RISC) among nursing female. Iranian Journal of Medical Education, 14(10), 857–865. (In Persian) [Link ]

Kökönyei, G., Kovács, L. N., Szabó, J., & Urbán, R. (2024). Emotion regulation predicts depressive symptoms in adolescents: A prospective study. Journal of Youth and Adolescence, 53(1), 142–158. [Link ]

Layne, C. M., Greeson, J. K., Ostrowski, S. A., et al. (2014). Cumulative trauma exposure and high-risk behavior in adolescence: Findings from the National Child Traumatic Stress Network Core Data Set. Psychological Trauma: Theory, Research, Practice, and Policy, 6(S1), S40–S49. [Link ]

Mohammadi-Ahmadabadi, N., & Dolatabadi, F. (2021). Investigating the relationship between resilience and obsessive beliefs among women. Iranian Journal of Psychology and Behavioral Sciences, 25, 21–30. (In Persian) [Link ]

Mohammadzadeh, A., Rezaei, A., & Amini, M. H. (2023). The prediction of resiliency based on childhood trauma, psychological distress, and emotion regulation difficulty in individuals with substance use. Etiadpajohi, 17(69), 67–86. (In Persian) [Link ]

Robinson, L. J., & Freeston, M. H. (2014). Emotion and internal experience in obsessive-compulsive disorder: Reviewing the role of alexithymia, anxiety sensitivity and distress tolerance. Clinical Psychology Review, 34, 256–271. [Link ]

Salamon, N., Augsburger, N., & Dan-Glauser, E. (2023). Benefits of planning as an emotion regulation strategy in obsessions and compulsions (OC): Implication of the perfectionism level in the planning-OC relationship. Journal of Affective Disorders Reports, 14, 100667. [Link ]

Salkovskis, P. M. (1999). Understanding and treating obsessive-compulsive disorder. Behaviour Research and Therapy, 37(1), 529–552. [Link ]

Shafi’i-Kahani, T., Hasani, J., & Shakeri, M. (2021). Role of self-efficacy, resilience, and cognitive emotion regulation in predicting obsessive-compulsive symptoms in the general population. Psychological Science Journal, 20(107), 2095–2106. (In Persian) [Link ]

Yazdi-Ravandi, S., Shamsaei, F., Matinnia, N., et al. (2018). Cognitive process in patients with obsessive-compulsive disorder: A cross-sectional analytic study. Basic and Clinical Neuroscience, 9(6), 448–457. [Link ]

Volume 17, Issue 62
March 2026
Pages 35-48