Psychophysiological correlates of emotion regulation training in adolescent anxiety: Evidence from the novel PIER task

BACKGROUND

Anxiety disorders are the leading cause of mental illness in adolescence. While anxious adolescents show impairments in emotion processing and deficits in emotion regulation, few studies have attempted to improve emotion regulation within these populations.

METHOD

This study used a multi-method design to test a newly developed emotion regulation training aimed at improving insight into emotions and instructing cognitive reappraisal. The efficacy of cognitive reappraisal was investigated in 27 clinically anxious youth (Age: M=12.36, SD=2.59) and 43 healthy controls (Age: M=13.07, SD=2.19) using psychophysiological measures. Specifically, heart rate variability, pupil dilation, and visual fixations were recorded while youth had to up- or downregulate their emotions in response to affective pictures in the Psychophysiological Indicators of Emotion Regulation (PIER) task.

RESULTS

The novel training effectively improved self-reported emotion regulation and momentary anxiety in both groups. Moreover, initial group differences in emotional reactivity mostly disappeared when participants were instructed to apply emotion regulation in the task. However, pupil dilation data suggested that participants with anxiety disorders required more cognitive resources for the upregulation of negative affect to counteract this effect.

LIMITATIONS

The relatively small sample size and large age range could hamper detection of additional group differences that may exist.

CONCLUSIONS

The current study provides evidence that anxious youth can apply cognitive reappraisal to a similar extent as healthy adolescents after emotion regulation training but may need to exert more effort to do so. This training could be a valuable addition to current treatment programs.

Cognitive Costs of Reappraisal Depend on Both Emotional Stimulus Intensity and Individual Differences in Habitual Reappraisal

Recent models of emotion regulation suggest that the cognitive costs of reappraisal depend on stimulus intensity and habitual reappraisal. In the current experiment, we tested these hypotheses by manipulating the intensity of unpleasant and pleasant images, which participants reappraised, viewed, or suppressed their emotions to. To assess cognitive costs, we measured participants’ performance on a concurrent simple reaction time task. Participants also reported on their everyday use of reappraisal and suppression. Higher intensity stimuli were associated with greater cognitive costs of reappraisal, for unpleasant, but not pleasant pictures. Also, greater habitual reappraisal predicted lower cognitive costs of reappraisal and greater reductions in subjective feelings. Results support the role of stimulus intensity and habitual use of reappraisal in predicting the cognitive costs of reappraisal.

Emotion regulation in adolescents with mental health problems

INTRODUCTION

Current literature points to a clear and consistent association between poor emotion control and psychopathology in adolescence, a critical developmental period during which most adult mental health problems emerge. However, nearly all of the studies in this literature have assessed emotion regulation in nonclinical cohorts, or indexed this construct using only self-report methodology.

METHOD

The present study compared adolescents with a mental illness (n = 41) to demographically matched controls (n = 45) on an experimental task that required them to either suppress or amplify their emotion expressive behavior in response to images that were either negative or positive in affective valence.

RESULTS

Clinical participants (like controls) showed evidence of being able to regulate their behavioral expression of emotion, indicating that the presence of mental health problems in adolescence does not prevent a basic level of control being exercised over the emotions that are expressed to others. However, the capacity to amplify expressive behavior was reduced, particularly for negative emotions. In addition, poorer emotion regulation in the clinical group was associated with reduced quality of life.

CONCLUSIONS

These data indicate that specific aspects of emotion expressive behavior are disrupted in adolescents with mental illness and are discussed in the context of theoretical models that regard emotion dysregulation as a core, transdiagnostic feature of mental illness.