The Role of Cognitive Flexibility in Coping with Chronic Illness

Abstract

Cognitive flexibility—the ability to shift mental sets, generate alternative perspectives, and adapt strategies when task demands change—is a core executive function implicated in psychological adaptation. In chronic illness, patients face recurrent stressors (symptom flare-ups, treatment routines, social/occupational disruptions) that require continual adjustment. This paper reviews empirical evidence and theory linking cognitive flexibility to coping and adaptation in chronic illness, presents a synthesis of representative quantitative findings, and discusses clinical implications and directions for research. Evidence from neuropsychological testing, self-report indices and intervention studies shows that (a) higher cognitive/psychological flexibility correlates with better functional outcomes and lower sick-leave, (b) flexibility sometimes mediates the relationship between coping strategies and well-being in populations with diabetes and chronic pain, and (c) psychological (ACT-style) flexibility interventions yield modest but clinically meaningful improvements in functioning. We conclude that cognitive flexibility is a promising target for integrative interventions in chronic illness, but highlight measurement heterogeneity, small-to-moderate effect sizes, and the need for longitudinal and mechanistic studies.