Predicting Quality of Life Based on Social Cognition with the Mediating Role of Emotion Regulation in Patients with Traumatic Brain Injury

Hadis  Jafari; Afsaneh Taheri; Hamidreza  Khayat Kashani

Authors

Hadis Jafari Department of psychology, Ro.C., Islamic Azad University, Roudehen, Iran. Author https://orcid.org/0009-0007-9516-4532
Afsaneh Taheri Department of psychology,Ro.C., Islamic Azad University, Roudehen, Iran. Author https://orcid.org/0000-0003-3711-6763
Hamidreza Khayat Kashani Department of Neurosurgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Author https://orcid.org/0000-0003-3711-6763

Keywords:

Traumatic brain injury, Quality of life, Social cognition, Cognitive Emotion Regulation, Structural equation modeling, Mediation

Abstract

The present study aimed to predict quality of life based on social cognition and to examine the mediating role of emotion regulation in patients with traumatic brain injury. This descriptive-correlational study was conducted using structural equation modeling. The statistical population consisted of patients with traumatic brain injury referred to Imam Hossein Hospital in Tehran, Iran, during 2024–2025. A total of 300 patients were selected through convenience sampling. Data were collected using the World Health Organization Quality of Life-BREF questionnaire, the Reading the Mind in the Eyes Test, and the Emotion Regulation Questionnaire. Data were analyzed using Pearson correlation coefficients and structural equation modeling. Model fit was evaluated using χ²/df, IFI, CFI, NFI, GFI, RMSEA, and SRMR indices, and the significance of indirect effects was examined using bootstrap analysis. Social cognition was significantly and positively correlated with emotion regulation (r = 0.560, p < 0.01) and quality of life (r = 0.550, p < 0.01), and emotion regulation was significantly and positively correlated with quality of life (r = 0.583, p < 0.01). The structural model showed acceptable fit (χ²/df = 3.042, IFI = 0.922, CFI = 0.921, NFI = 0.908, GFI = 0.917, RMSEA = 0.071, SRMR = 0.059). Social cognition had a significant direct effect on quality of life (B = 0.123, β = 0.279, t = 4.213, p < 0.01). The indirect effect of social cognition on quality of life through emotion regulation was also significant (B = 0.049, β = 0.110, p < 0.01), indicating partial mediation. The findings indicate that social cognition is associated with better quality of life in patients with traumatic brain injury both directly and indirectly through emotion regulation. These results highlight emotion regulation as an important explanatory mechanism linking social-cognitive functioning to quality of life and support the inclusion of social-cognitive and emotion-regulation interventions in rehabilitation programs for patients with traumatic brain injury.

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