Emotional intensity influences pre-implementation and implementation of distraction and reappraisal

The Use of Rumination and Reappraisal in Adolescents Daily Life: Links to Affect and Emotion Regulation Style

This study explored the association between temperament-i.e., positive affect (PA) and negative affect (NA)-and emotion regulation (ER), and what momentary factors influence the selection of rumination or reappraisal during adolescents' daily life. The type of social situation in which negative events occurred, the self-rated degrees of discomfort, the types of predominant emotions experienced, and the use of reappraisal and rumination were assessed at 24 different times with an ecological momentary assessment approach given to 71 adolescents. PA, NA, and ER style were evaluated using self-reports. Bivariate Pearson correlations analysis revealed that NA and negative ER style correlated positively with the rumination use whereas PA correlated negatively with the rumination use. Negative ER style moderated the relationship between NA and the frequency with which rumination was used. The moderated function of positive ER style could not be tested due to its lack of association with the rumination use. Adolescents selected rumination more often during family-related events and when experiencing depression-like emotions. No interaction effects were shown between negative ER style and the momentary factors related with the type of social situation and the type of prevailing emotion during negative event. No associations between study variables and reappraisal were found. This study provides a better understanding of ER patterns in adolescence.

Flexible emotion regulatory selection when coping with COVID-19-related threats during quarantine

The COVID-19 pandemic poses significant emotional challenges that individuals need to select how to regulate. The present study directly examined how during the pandemic, healthy individuals select between regulatory strategies to cope with varying COVID-19-related threats, and whether an adaptive flexible regulatory selection pattern will emerge in this unique threatening global context. Accordingly, this two-study investigation tested how healthy individuals during a strict state issued quarantine, behaviorally select to regulate COVID-19-related threats varying in their intensity. Study 1 created and validated an ecologically relevant set of low and high intensity sentences covering major COVID-19 facets that include experiencing physical symptoms, infection threats, and social and economic consequences. Study 2 examined the influence of the intensity of these COVID-19-related threats, on behavioral regulatory selection choices between disengagement via attentional distraction and engagement via reappraisal. Confirming a flexible regulatory selection conception, healthy individuals showed strong choice preference for engagement reappraisal when regulating low intensity COVID-19-related threats, but showed strong choice preference for disengagement distraction when regulating high intensity COVID-19-related threats. These findings support the importance of regulatory selection flexibility for psychological resilience during a major global crisis.

Dissociation and emotion regulation strategies: A meta-analytic review

OBJECTIVE

Clinical and neurobiological models posited that dissociative mechanisms might affect processes involved in emotional generation and regulation. However, there is a lack of a comprehensive theoretical framework that systematically includes dissociation within emotional functioning.

METHODS

The current study aims at conducting a meta-analytic review on the relationship between dissociation and emotion regulation in order to empirically estimate to what extent dissociation is related to emotion regulation processes. The meta-analysis was based on r coefficient as effect size measure, using a random-effect approach.

RESULTS

The meta-analysis included 57 independent studies for a total of 11596 individuals. Findings showed an overall moderate relationship between dissociation and emotion regulation (r_w = .32; p < .05). The association between dissociation and emotion regulation was the same among clinical samples than non-clinical ones. Furthermore, dissociation showed moderate to large relationships with maladaptive domains of emotion regulation, namely disengagement (r_w = 0.34; p < .01) (i.e., behavioral avoidance, experiential avoidance, thought and emotional suppression) and aversive cognitive perseveration (r_w = 0.38; p < .001) (i.e., rumination, worry and nonacceptance). The analysis did not find significant relationship between dissociation and adaptive domain of emotional regulation (i.e., problem solving, mindfulness).

CONCLUSION

Dissociation in the context of emotion regulation might be viewed as a basic neuro-mental mechanism that automatically contribute to the over-modulation of emotional states through avoidance reactions from internal and external reality. Future longitudinal studies are needed to clarify the causal relationships between dissociation and emotion regulation.

Development of emotion processing and regulation: Insights from event-related potentials and implications for internalizing disorders

Emotionally-salient stimuli receive selective attention and elicit complex neural responses that evolve considerably across development. Event-related potentials (ERPs) optimally capture the dynamics of emotion processing and regulation, with sensitivity to detect changes in magnitude, latency, and maximal location across development. In this selective qualitative review, we summarize evidence of developmental changes in neural reactivity to emotional stimuli and modulation of neural responses during emotion regulation indexed by ERPs across infancy, childhood, and adolescence. The cumulative ERP literature suggests the transition from childhood to adulthood is characterized by a gradual decrease in neural reactivity to emotional stimuli and increased efficiency in attentional allocation towards emotional stimuli. Some studies show sensitivity to emotional stimuli peaks in adolescence, but the evidence is mixed. While both early (<300 ms) and late (>300 ms) ERPs demonstrate sensitivity to emotional stimuli, emotional modulation is more consistently observed in relatively later ERPs across development. The literature additionally shows improvements in regulation abilities across development, though ERP research on developmental changes in emotion regulation is still relatively limited, highlighting a critical direction for future research. Finally, we briefly discuss changes in emotion-related ERPs relevant to the emergence of depression and anxiety. Findings from this review indicate that ERPs provide abundant information about the development of emotion processing and regulation, with potential clinical utility for detecting early-emerging vulnerabilities for internalizing forms of psychopathology.

The Effects of Mindfulness-Based Stress Reduction on the Association Between Autonomic Interoceptive Signals and Emotion Regulation Selection

OBJECTIVE

The ability to select the most adaptive regulatory strategy as a function of the emotional context plays a pivotal role in psychological health. Recently, we showed that mindfulness-based interventions (MBIs) can improve the sensitivity of regulatory strategy selection to emotional intensity. However, the mechanisms underlying this improvement are unclear. In this study, we tested the hypothesis that MBIs support adaptive regulatory selection by increasing sensitivity to interoceptive signals associated with the emotional stimuli.

METHODS

Participants (n = 84, mean [standard deviation {SD}] age = 30.9 [8.3] years; 54% women) were randomized to either a mindfulness-based stress reduction (MBSR) program or a wait-list control condition. Before and after the MBSR program, physiological measures for autonomic nervous system activity were obtained, and participants performed a task examining emotion regulation selections (reappraisal versus distraction) when confronted with low or high negative intensity images. They also completed a battery of mindfulness, interoception, and well-being self-report measures. A cross-classified model was used for the main analyses.

RESULTS

The participants assigned to the MBSR were overall more likely to choose reappraisal than distraction (b = 0.26, posterior SD = 0.13, 95confidence interval = 0.02-0.52) after the program. Interoceptive signals in response to negative images were associated with subsequent regulatory selections (b = 0.02, posterior SD = 0.01, 95% confidence interval = 0.01-0.03) in the MBSR group. Specifically, lower cardiac reactivity was associated with the choice to reappraise, whereas higher cardiac reactivity was related to the choice to distract. Greater differences in cardiac reactivity between states that prompt reappraisal and states that prompt distraction were associated with higher well-being (Satisfaction With Life Scale, Pearson r (29) = 0.527, p = .003).

CONCLUSIONS

Mindfulness seems to increase the sensitivity of regulatory selections to interoceptive signals, and this is associated with subjective well-being. This may be a central pathway through which MBIs exert their positive effects on mental health and resilience.

The Impact of the Aussie Optimism Program on the Emotional Coping of 5- to 6-Year-Old Children

Research indicates that mental health disorders can occur in children as young as 4 years of age, prompting the need for prevention programs for young children. The ability to use healthy strategies to cope with emotions is a protective factor against mental health disorders that can be effectively taught to children from an early age. The current study used a pre-test post-test cluster randomized controlled trial to test the efficacy of the new Aussie Optimism: I Spy Feelings Program. The aim of the study was to investigate the effects of the program on children’s emotional coping. The program included content on emotion regulation strategies, focusing on the emotions of happiness, sadness, anger, fear, and worry. The participants were 73 children (intervention = 33; control = 40) from pre-primary classes. Four schools were cluster randomized to the intervention or control group, resulting in two schools in each condition. Parents completed measures of their children’s emotional coping with sadness, anger and worry. Children in the intervention group participated in ten sessions of the I Spy Feelings Program, spread over 5 weeks. The results indicated a significant, small to moderate intervention effect for coping with anger. Children in the control group decreased in their ability to cope with anger, while children in the intervention group remained stable. No intervention effects were found for coping with sadness or worry, with results for these emotions staying stable across time for both groups. This pilot study will inform the further development of the program. The effects of the program on coping with anger provide support for the use of emotion regulation strategies in intervention programs to maintain healthy emotional coping, which is a protective factor against internalizing and externalizing disorders in childhood.

Acting against your own interests: The tension between emotion regulation preference and efficacy and its implications for individuals with depressive symptoms

The aim of this study was twofold: first, to compare individuals' strategy choices in low and high intensity conditions and the actual efficacy of these strategies; second, to assess whether and how perceived intensity levels of aversive situations moderate the relationship between depressive symptoms and a strategies' efficacy. In Experiment 1A (N = 58), we replicated previous results, showing that individuals prefer distraction in high- and reappraisal in low-intensity conditions, irrespective of depressive symptom levels. Experiment 1B (N = 50) assessed the efficacy of distraction and reappraisal strategies in aversive conditions with low and high intensity. Contrary to our prediction, reappraisal was more effective than distraction, independent of the intensity of the aversive conditions. In Experiment 2 (N = 113), we tested the interactive relationship between perceived intensity levels and depression on the relative effectiveness of reappraisal and distraction. We found that while in perceived low-intensity situations the advantage of distraction over reappraisal increased as depressive symptoms increased, no such relationship was found in high-intensity situations. The results suggest that while all individuals prefer to apply reappraisal in both low- and high-intensity conditions, for those with high level of depressive symptoms, such a preference acts against their own interests. The study highlights the need to distinguish between emotion regulation preferences and their actual efficacy, while illuminating possible implications for individuals with depressive symptoms.

Identifying the determinants of emotion regulation choice: a systematic review with meta-analysis

Day-to-day life is inundated with attempts to control emotions and a wealth of research has examined what strategies people use and how effective these strategies are. However, until more recently, research has often neglected more basic questions such as whether and how people choose to regulate their emotions (i.e. emotion regulation choice). In an effort to identify what we know and what we need to know, we systematically reviewed studies that examined potential determinants of whether and how people choose to regulate their emotions. Eighteen determinants were identified across 219 studies and were categorised as being affective, cognitive, motivational, individual or social-cultural in nature. Where there were sufficient primary studies, meta-analysis was used to quantify the size of the associations between potential determinants and measures of whether and how people choose to regulate their emotions. Based on the findings, we propose that people's decisions about whether and how to regulate their emotions are determined by factors relating to the individual doing the regulating, the emotion that is being regulated, and both the immediate situation and the broader social context in which the regulation is taking place.

Combined effects of tDCS over the left DLPFC and gaze-contingent training on attention mechanisms of emotion regulation in low-resilient individuals

Low resilience is characterized by impairments in attention and emotion regulation mechanisms that depend on prefrontal cortical activity. The aim of this study was to test whether transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (DLPFC) can augment the effectiveness of a new computerized mouse-based (gaze)contingent training (MCAT) to improve attention and emotion regulation processes (improved reappraisal, reduced rumination) in individuals reporting low resilience levels. The study used a full-factorial between-subject design combining active and sham MCAT and tDCS interventions. One hundred participants reporting low resilience levels were randomly assigned to receive either a single session of: tDCS with sham MCAT treatment (tDCS group), MCAT with sham tDCS (MCAT group), a combination of tDCS and MCAT (combined group), or sham tDCS and sham MCAT (control group). Transfer to attention regulation, reappraisal success, and state rumination was evaluated using an eye-tracking disengagement task and an emotion regulation paradigm, respectively. MCAT, either alone or combined with tDCS, resulted in improved attention regulation. Furthermore, the group receiving combined MCAT and tDCS also showed some evidence of increased reappraisal ability and reduced rumination. MCAT in combination with left DLPFC neuromodulation has potential to maximize transfer to emotion regulation capacities and to promote resilience.

Cognitive emotion regulation withstands the stress test: An fMRI study on the effect of acute stress on distraction and reappraisal

Cognitive emotion regulation is a key mechanism for the maintenance of mental health, but may fail, when individuals are exposed to acute stress. To date, it is not well understood whether and to what extent acute stress effects contribute to impairments in emotion regulation capacities as the sparse existing studies have yielded heterogeneous results, indicating that stress timing might be a crucial factor. In the present study, 81 healthy participants underwent either an acute stress task (ScanSTRESS-C; n = 40) or a control condition (n = 41) while lying in the MRI scanner. In the subsequent Cognitive Emotion Regulation Task (CERT), participants were confronted with neutral or negative pictures and instructed to either view them, or regulate their upcoming emotions using either distraction or reappraisal. Subjective ratings of affective state as well as functional brain imaging data served to indicate emotion regulation. The results showed a successful stress manipulation as indicated by group differences in subjective wellbeing, saliva cortisol concentrations, heart rate, and functional brain activity in regions implicated in stress processing. With respect to emotion regulation, CERT data revealed a significant regulation effect at the neural and behavioral level (less negative emotional ratings after reappraisal and distraction trials compared to view trials) in both groups. However, no significant group differences were observed, neither in BOLD responses to the CERT, nor in behavioral ratings. Contrary to previous studies, our study did not reveal further evidence of stress-related effects on emotion regulation, potentially being related to differences between studies in experimental setting, timing, and procedures. This study therefore underlines the need of future studies that disentangle the complex interplay of stress and emotion regulation and identify different factors influencing their bidirectional relationship.

Influence of suppression and reappraisal on eating-related symptoms and ruminative thinking in anorexia nervosa and bulimia nervosa

The goal of the present study was to investigate the influence of expressive suppression and cognitive reappraisal on eating-related symptomatology in anorexia nervosa (AN) and bulimia nervosa (BN). Secondly, on the background of theoretical models proposing a reciprocal relationship between suppression and rumination, we sought to understand whether inhibition of emotional expression also affects ruminative thinking in eating disorders. Women with AN (n = 39), BN (n = 37) and a control group (CG, n = 41) were randomly assigned to either engage in suppression or reappraisal during a sadness-eliciting film clip. Levels of drive to eat, anticipated loss of control over eating and ruminative thoughts were rated before and after the induction of emotion regulation. Induced expressive suppression led to a decrease of reported drive to eat in AN and an increase of anticipated loss of control over eating in BN. All groups responded to suppression with greater rumination, whereas no significant changes were found for reappraisal. Mediation analyses on trait questionnaires pointed to rumination as a partial mediator of the correlation between suppression and eating disorder pathology. Results are discussed in line with recent empirical research and current emotion regulation theories.

Regulating Road Rage

Road rage has been a problem since the advent of cars. Given the ubiquity of road rage, and its potentially devastating consequences, understanding road rage and developing interventions to curb it are important priorities. Emerging theoretical and empirical advances in the study of emotion and emotion regulation have provided new insights into why people develop road rage and how it can be prevented and treated. In the current article, we suggest an integrative conceptual framework for understanding road rage, based upon a psychological analysis of emotion and emotion regulation. We begin by defining road rage and other key constructs. We then consider the interplay between road rage generation and road rage regulation. Using an emotion regulation framework, we describe key points at which emotion-regulation difficulties can lead to road rage, followed by strategies that may alleviate these difficulties. We suggest that this framework usefully organizes existing research on road rage, while exposing key directions for future research.

Savor the moment: Willful increase in positive emotion and the persistence of this effect across time

Savoring is an emotion regulation technique that aims to increase, sustain, and deepen positive emotion. It has been incorporated into several novel, "positive affect" interventions for anxiety, depression, and chronic pain, but has not been studied in a laboratory setting. As such, it is unknown whether savoring can modulate subjective and neural correlates of emotion-processing and whether savoring might exert a persistent effect on stimulus processing (i.e., modulating response at subsequent encounter). Here, 49 participants savored or viewed positive and neutral pictures, before seeing the same pictures again approximately 20 min later without instructions to savor (or view) pictures. Subjective valence and arousal ratings and the picture-elicited late positive potential (LPP) were assessed during both tasks. Results showed that savoring increased participant ratings of picture pleasantness and arousal as well as a picture-elicited LPP. Moreover, pictures that had previously been savored continued to elicit higher ratings during the subsequent picture viewing task. A larger LPP was observed for previously savored positive and neutral pictures during an early portion of picture viewing; later on during picture viewing, this effect was limited to positive pictures only (i.e., it was not evident for neutral pictures). Results validate savoring as an effective and durable means of increasing positive emotion and are discussed in the context of a broader emotion regulation literature, which has primarily examined the downregulation of negative picture processing.

The VLPFC versus the DLPFC in Downregulating Social Pain Using Reappraisal and Distraction Strategies

The dorsolateral prefrontal cortex (DLPFC) and ventrolateral PFC (VLPFC) are both crucial structures involved in voluntary emotional regulation. However, it remains unclear whether the functions of these two cortical regions that are involved in emotional regulation, which are usually active in non-social situations, could be generalized to the regulation of social pain as well.

The dorsolateral prefrontal cortex (DLPFC) and ventrolateral PFC (VLPFC) are both crucial structures involved in voluntary emotional regulation. However, it remains unclear whether the functions of these two cortical regions that are involved in emotional regulation, which are usually active in non-social situations, could be generalized to the regulation of social pain as well. This study employed transcranial magnetic stimulation (TMS) to examine the causal relationship between the DLPFC/VLPFC and the emotional regulation of social pain via distraction and reappraisal. Ninety human participants (45 males and 45 females) initially underwent either active (DLPFC/VLPFC, n = 30/30) or sham (vertex, n = 30) TMS sessions. Participants were then instructed to use both distraction and reappraisal strategies to downregulate any negative emotions evoked by social exclusion pictures. Convergent results of the subjective emotional rating and electrophysiological indices demonstrated that: (1) both the DLPFC and VLPFC highly facilitate the downregulation of affective responses caused by social exclusion, revealing a causal role of these lateral PFCs in voluntary emotional regulation of both non-social and social pain; and (2) these two cortical regions showed relative functional specificity for distraction (DLPFC) and reappraisal (VLPFC) strategies, which helps to refine the cortical targeting of therapeutic protocols. In addition, the TMS effect was sustainable for at least 1 h, showcasing the potential feasibility of using this method in clinical practice. Together, these findings provide cognitive and neural evidence for the targeting of the VLPFC and/or the DLPFC to improve emotional regulation abilities, especially in social contexts.

SIGNIFICANCE STATEMENT This study aimed to examine the role of the dorsolateral prefrontal cortex (DLPFC) and ventrolateral PFC (VLPFC) in emotional regulation, particularly in response to social pain through the use of distraction and reappraisal strategies, as this is a relatively underexplored area of inquiry. This study makes a significant contribution to the literature because our results provide novel empirical information on the role of these cortical structures in the processing of negative emotions elicited within certain social contexts. As such, our findings have potential clinical implications, paving the way for future clinicians to be able to accurately target specific brain regions among patients struggling with impaired social cognition abilities, including those diagnosed with posttraumatic stress disorder, autism spectrum disorder, social anxiety disorder, and depression.

The effectiveness of emotion cognitive reappraisal as measured by self-reported response and its link to EEG alpha asymmetry

Cognitive reappraisal is an important emotion regulation skill for psychological health and well-being, however, some people cannot use this strategy effectively. We investigated EEG alpha asymmetry by calculating lateral index (LI) when twenty-six healthy participants were instructed to complete the emotion cognitive reappraisal task of viewing neutral pictures, watching negative pictures and reappraising negative pictures. According to self-reported valence and arousal, the participants were divided into effective and ineffective groups. Habitual use of rumination was also assessed using the Cognitive Emotion Regulation Questionnaire (CERQ). EEG alpha asymmetry results demonstrated that, ineffective group showed greater relative right temporal activity than effective group in the early stage of reappraisal, indicating higher subjective arousal. Both groups showed greater relative left frontal alpha activity in the late stages of reappraisal compared with watching negative images, indicating the recruitment of corresponding functions in prefrontal regulatory circuitry during the effort of reappraisal. CERQ analysis results showed that, ineffective group got significantly higher score than effective group in habitual use of rumination. Partial correlation revealed that, in male participants, temporal LI change (negative-reappraisal minus negative-watch) was negatively correlated with self-reported arousal and habitual use of rumination. In addition, by using K-means cluster analysis, temporal LI combined with CERQ-rumination score achieved a classification accuracy of 84.6 %. These findings suggested that, EEG alpha asymmetry as well as the habitual use of rumination accounted for the reappraisal effectiveness.

Distraction and expressive suppression strategies in down-regulation of high- and low-intensity positive emotions

Emotion intensity is important for emotional regulation process. The studies in this literature, however, have generally focused on the down-regulation of negative emotions. Few studies have examined the down-regulation of positive emotions. Distraction and expressive suppression belong to disengagement strategies, which direct coping efforts away from emotions. Participants are more likely to select distraction and expressive suppression when motivated to down-regulate their emotions. Therefore, this study aimed to assess the impact of emotional intensity on down-regulating positive emotions via distraction and expressive suppression. The event-related potentials (ERPs) of college students were recorded while they were instructed to down-regulate positive emotions using expressive suppression or distraction versus free viewing when exposed to high- and low-intensity pleasant stimuli. Subsequently, participants were instructed to rate their positive experience using a 9-point scale. Supporting our predictions, behavioral results showed that both strategies could dramatically reduce high-intensity positive experience relative to viewing, and distraction led to a larger reduction of high-intensity positive experience than expressive suppression. Both strategies could not decrease low-intensity positive experience relative to viewing. ERP results showed that distraction successfully attenuated the early (500-700 ms) and late (700-1500 ms) stage of late positive potential (LPP) in high-intensity, and in low-intensity it modulated the early (but not late) LPP relative to viewing. Unexpectedly, expressive suppression effectively attenuated the early and late LPP in high- and low-intensity relative to viewing. The findings suggest that expressive suppression and distraction can effectively down-regulate positive emotions; however, distraction is more susceptible to emotional intensity and time.

Rest a while and run a mile: Relationship between distraction and negative emotions among college students in China

Previous experimental studies have regarded distraction, an emotional regulation strategy, as an attentional disengagement strategy and considered it to be maladaptive in the long term. This study intends to further examine the relationship between distraction and negative emotions by using a questionnaire and a multiple mediation model. A total of 723 college students completed the distraction, cognitive reappraisal and problem-solving subscales of the Measurement of Affect Regulation Styles, the Needs Satisfaction Questionnaire, the Meaningful Life Measure, and the Emotional Experience Questionnaire of Well-being. Structural equation modeling (SEM) was performed, and mediation effects were tested. The results showed that (1) distraction was used significantly more frequently than problem-solving and cognitive reappraisal, with a large effect size (partial η² = 0.321 > 0.138), and (2) distraction had an effect on negative emotions through two multiple mediation paths, i.e., positive emotion—cognitive reappraisal—meaning in life, and positive emotion—problem-solving—needs satisfaction. Distraction reduces negative emotions by enhancing positive emotions and facilitating cognitive reappraisal, problem-solving, meaning in life and needs satisfaction. It is not a kind of avoidance but a temporary rest to strive for a better life.

Subjective ratings of fear are associated with frontal late positive potential asymmetry, but not with early brain activity over the occipital and centro-parietal cortices

The human frontal cortex is asymmetrically involved in motivational and affective processing. Several studies have shown that the left-frontal hemisphere is related to positive and approach-related affect, whereas the right-frontal hemisphere is related to negative and withdrawal-related affect. The present study aimed to investigate whether evolutionarily threatening stimuli modulate asymmetrical frontal activity. We examined hemispheric differences in frontal late positive potentials (f-LPP asymmetry) and frontal alpha power activation (frontal alpha asymmetry, FAA) in response to images depicting snakes, spiders, butterflies, and birds. Results showed that the late component of f-LPP asymmetry, but not FAA, was modulated by the category of stimuli. Specifically, threatening stimuli (snakes and spiders) evoked a relatively large late f-LPP over the right-frontal hemisphere than non-threatening stimuli (birds and butterflies). Moreover, this relatively great right-frontal activity was positively associated with the subjective ratings of fear. Importantly, the subjective ratings of fear were not associated with early brain activity over the occipital or centro-parietal cortices. These results suggest that late f-LPP asymmetry may reflect higher order affective processes, specifically the subjective appraisal of threatening stimuli and the subjective experience of fear, that are independent of the fast and automatic processing of evolutionarily significant and affectively arousing stimuli.

Monitoring in emotion regulation: behavioral decisions and neural consequences

Monitoring and deciding how to adjust an active regulatory strategy in order to maximize adaptive outcomes is an integral element of emotion regulation, yet existing evidence remains scarce. Filling this gap, the present study examined core factors that determine behavioral regulatory monitoring decisions and the neuro-affective consequences of these decisions. Using a novel paradigm, the initial implementation of central downregulation strategies (distraction, reappraisal) and the emotional intensity (high, low) were manipulated, prior to making a behavioral decision to maintain the initial implemented strategy or switch from it. Neuro-affective consequences of these behavioral decisions were evaluated using the Late Positive Potential (LPP), an electro-cortical measure of regulatory success. Confirming predictions, initial implementation of reappraisal in high intensity and distraction in low intensity (Strategy × Intensity combinations that were established in prior studies as non-preferred by individuals), resulted in increased behavioral switching frequency. Neurally, we expected and found that in high (but not low) emotional intensity, where distraction was more effective than reappraisal, maintaining distraction (relative to switching to reappraisal) and switching to distraction (relative to maintaining reappraisal) resulted in larger LPP modulation. These findings suggest that monitoring decisions are consistent with previously established regulatory preferences and are associated with adaptive short-term neural consequences.

Neural characteristics of cognitive reappraisal success and failure: An ERP study

INTRODUCTION

Cognitive reappraisal, an important strategy of emotion regulation, can change emotional experience and attention to emotional information. However, not all individuals can deploy reappraisal strategies successfully. In the current study, we investigated event-related potential (ERP) characteristics of reappraisal success and of reappraisal failure.

METHODS

Twenty-six participants were divided into the success group or the failure group based on self-report ratings of how successful they were in reducing their response to negative images using cognitive reappraisal strategy. All participants viewed 30 neutral images and 30 negative images which they were asked to just watch, and 30 negative stimuli that they were asked to reappraise, while electroencephalogram (EEG) was recorded.

RESULTS

The success group reported a significant reduction in the unpleasantness of negative images than the failure group in the negative-reappraisal condition. The ERP data indicated that two time windows differentiated between the success and failure groups. In 200-300 ms, P200 was significantly more positive to the negative-watch condition relative to both negative-reappraisal and neutral conditions in the failure group, while no difference was observed in the success group. In 300-5,000 ms, cognitive reappraisal led to increased late positive potential (LPP) relative to negative-watch in the early and middle latency windows (300-3,100 ms) in both groups; in the late latency window (3,100-5,000 ms), the reappraisal success group showed the LPP amplitude to the negative-reappraisal stimuli to be more positive than to the negative-watch stimuli, while no difference was found in the reappraisal failure group.

CONCLUSION

Our study provided direct evidence that different neurophysiological features were associated with reappraisal success and failure while engaging in the reappraisal of negative stimuli. This result will contribute to better understanding of the neural mechanism of emotion regulation in emotional disorders (i.e., depression and anxiety).

Keep calm and carry on: electrophysiological evaluation of emotional anticipation in the second language

Investigations of the so-called ‘foreign language effect’ have shown that emotional experience is language-dependent in bilingual individuals. Response to negative experiences, in particular, appears attenuated in the second language (L2). However, the human brain is not only reactive, but it also builds on past experiences to anticipate future events. Here, we investigated affective anticipation in immersed Polish–English bilinguals using a priming paradigm in which a verbal cue of controlled affective valence allowed making predictions about a subsequent picture target. As expected, native word cues with a negative valence increased the amplitude of the stimulus preceding negativity, an electrophysiological marker of affective anticipation, as compared with neutral ones. This effect was observed in Polish–English bilinguals and English monolinguals alike. The contrast was non-significant when Polish participants were tested in English, suggesting a possible reduction in affective sensitivity in L2. However, this reduction was not validated by a critical language × valence interaction in the bilingual group, possibly because they were highly fluent in English and because the affective stimuli used in the present study were particularly mild. These results, which are neither fully consistent nor inconsistent with the foreign language effect, provide initial insights into the electrophysiology of affective anticipation in bilingualism.

Automatic self-focused and situation-focused reappraisal of disgusting emotion by implementation intention: an ERP study

Detachment (self-focused) and positive reinterpretation (situation-focused) are two important forms of cognitive reappraisal during emotion regulation. Previous research shows situation-focused reappraisal to be more effective than self-focused reappraisal for intentional emotion regulation. How the two differ in emotional consequences as components of automatic emotion regulation is however unclear. In the current study, event-related potentials were recorded to clarify this problem, while participants passively viewed disgusting or neutral scenes or formed implementation intentions based on self-focused or situation-focused reappraisal. Behavioural results showed fewer negative emotions during self-focused reappraisal than during either situation-focused reappraisal or free viewing (which had similar emotion ratings). In addition, self-reported cognitive cost was not enhanced during the two forms of reappraisal compared to passive viewing. Late positive potential (LPP) amplitudes for disgusting stimuli were larger than those elicited for neutral stimuli, at both frontal and posterior-parietal regions. This amplitude enhancement effect, irrespective of whether frontal or parietal LPP were involved, was found to be weaker during self-focused reappraisal than when participants were engaged in situation-focused reappraisal or passive viewing. The latter two conditions showed similar amplitude enhancement. These findings suggest that automatic self-focused reappraisal by implementation intention produces more favourable emotion regulation than situation-focused reappraisal, without enhancing cognitive cost.

The regulation of recurrent negative emotion in the aftermath of a lost election

For some American voters, the news of Mr. Trump's victory in the 2016 presidential election caused recurrent emotions that were negative, persistent, and intense enough to elicit repeated attempts at emotion regulation. This afforded a rare opportunity to analyse the regulation of recurrent emotions in a natural, non-laboratory context. The regulation of recurrent emotion involves additional considerations relative to single-instance emotion, such as representations of past and future encounters with the emotion-eliciting variables, ongoing consequences of each regulatory episode, and a tendency to repeatedly deploy emotion regulation strategies that one is most familiar with in the context of the particular recurrent emotion. Despite the ubiquitous nature of recurrent emotions, its associated regulatory processes have been infrequently examined and are not well-understood. Over eight days (11/10/16-11/18/16), we administered four surveys to 202 participants who voted against Mr. Trump. We examined the determinants and outcomes of regulatory strategies in the context of recurrent emotion. We found that (1) reappraisal (compared to distraction and acceptance) was associated with greater decline in emotion intensity, (2) high-intensity emotions were more likely to be distracted, whereas low-intensity emotions were more likely to be reappraised, and (3) strategy variability was associated with greater affective adaptation.

Choose change: Situation modification, distraction, and reappraisal in mild versus intense negative situations

Despite the theoretical importance and applied potential of situation modification as an emotion regulation strategy, empirical research on how people change situations to regulate their emotions is scarce. Meanwhile, existing paradigms typically allowed participants to avoid the entire situation, thus confounding situation modification with situation selection. In our current experiments, participants could choose between partially modifying their negative emotional environment without avoiding it entirely and two well-established emotion regulation strategies (reappraisal and distraction). Participants did choose situation modification (Experiments 1–2) and they did so more often for intense than for mild stimuli in Experiment 2. In addition, modifying the stimulus display effectively helped downregulating negative affect (Experiments 1–2). Finally, in both experiments, participants opted more for distraction for intense compared to mild stimuli, while they opted more for reappraisal for mild compared to intense stimuli. Presenting a first step in developing a paradigm that allows people to exert control over but to not avoid emotion-provoking situations, we thus show that changing one’s environment helps regulating one’s emotions. More generally, our findings indicate that people prefer to regulate their emotions using disengagement strategies (situation modification and distraction) with high-intensity relative to low-intensity negative situations, while they prefer engagement strategies (reappraisal) with low-intensity relative to high-intensity negative situations.

The Limits of Cognitive Reappraisal: Changing Pain Valence, but not Persistence, during a Resistance Exercise Task

Physiological discomfort is commonly cited as a barrier for initiating and persisting with exercise. Although individuals may think of physiological discomfort as determined by physical sensations, it can also be influenced by cognitive and emotional factors. We explored the impacts of interpreting the purpose of pain as a sign of muscle building (helpful) vs. a sign of muscle tearing and possible injury (harmful) and tested the effect of cognitive reappraisals, or shifting interpretations of pain, on exercise persistence and the subjective experience of discomfort during exercise. Seventy-eight participants were randomized to listen to voice recordings that framed exercise-related pain as helpful vs. harmful before participating in a standard muscular endurance test using the YMCA protocol. Although the two experimental groups did not differ in the overall number of resistance training repetitions achieved, participants who were asked to think about the benefits (rather than the negative consequences) of pain reported less negative pain valence during exercise. Thus, the experience of pain was influenced by appraisals of the meaning of pain, but differences in pain valence did not impact exercise persistence. Theoretical implications and applications for affect-based exercise interventions are discussed.

Linguistic Shifts: A Relatively Effortless Route to Emotion Regulation?

Prior research indicates that psychological distance facilitates emotion regulation. Here, we propose that the ability to transcend one’s immersed perspective may be hidden in plain sight, within the very structure of language. We review evidence regarding two linguistic mechanisms, distanced self-talk and generic “you,” that promote emotion regulation by allowing speakers to shift from an immersed to a more distanced perspective through the words they use to reflect on the self (e.g., shifting from “I” to their own name or other non-first-person-singular pronouns). We conclude by suggesting that these linguistic shifts occur relatively seamlessly and thus may provide a less effortful route to emotion regulation.

Seeing emotions, reading emotions: Behavioral and ERPs evidence of the regulation of pictures and words

Background

Whilst there has been extensive study of the mechanisms underlying the regulation for pictures, the ability and the mechanisms beyond the regulation of words remains to be clarified. Similarly, the effect of strategy when applying a regulatory process is still poorly explored. The present study seeks to elucidate these issues comparing the effect of regulation and of strategy to both neutral and emotional words and pictures.

Methodology/Principal findings

Thirty young adults applied the strategy of distancing to the emotions elicited by unpleasant and neutral pictures and words while their subjective ratings and ERPs were recorded. At a behavioral level, participants successfully regulated the arousal and the valence of both pictures and words. At a neural level, unpleasant pictures produced an increase in the late positive potential modulated during the regulate condition. Unpleasant linguistic stimuli elicited a posterior negativity as compared to neutral stimuli, but no effect of regulation on ERP was detectable. More importantly, the effect of strategy independently of stimulus type, produced a significant larger Stimulus Preceding Negativity. Dipole reconstruction localized this effect in the middle frontal areas of the brain.

Conclusions

As such, these new psychophysiological findings might help to understand how pictures and words can be regulated by distancing in daily life and clinical contexts, and the neural bases of the effect of strategy for which we suggest an integrative model.

Characteristics of the regulation of the surprise emotion

This study aimed to assess the characteristics of the regulation of the emotion of surprise. Event-related potentials (ERPs) of college students when using cognitive reappraisal and expressive suppression to regulate their surprise level were recorded. Different contexts were presented to participants, followed by the image of surprised facial expression; subsequently, using a 9-point scale, participants were asked to rate the intensity of their emotional experience. The behavioral results suggest that individuals’ surprise level could be reduced by using both expressive suppression and cognitive reappraisal, in basic and complex conditions. The ERP results showed that (1) the N170 amplitudes were larger in complex than basic contexts, and those elicited by using expressive suppression and cognitive reappraisal showed no significant differences, suggesting that emotion regulation did not occur at this stage; (2) the LPC amplitudes elicited by using cognitive reappraisal and expressive suppression were smaller than those elicited by free viewing in both context conditions, suggesting that the late stage of individuals’ processing of surprised faces was influenced by emotion regulation. This study found that conscious emotional regulation occurred in the late stages when individuals processed surprise, and the regulation effects of cognitive reappraisal and expressive suppression were equivalent.

Joint Modulation of Facial Expression Processing by Contextual Congruency and Task Demands

Faces showing expressions of happiness or anger were presented together with sentences that described happiness-inducing or anger-inducing situations. Two main variables were manipulated: (i) congruency between contexts and expressions (congruent/incongruent) and (ii) the task assigned to the participant, discriminating the emotion shown by the target face (emotion task) or judging whether the expression shown by the face was congruent or not with the context (congruency task). Behavioral and electrophysiological results (event-related potentials (ERP)) showed that processing facial expressions was jointly influenced by congruency and task demands. ERP results revealed task effects at frontal sites, with larger positive amplitudes between 250–450 ms in the congruency task, reflecting the higher cognitive effort required by this task. Effects of congruency appeared at latencies and locations corresponding to the early posterior negativity (EPN) and late positive potential (LPP) components that have previously been found to be sensitive to emotion and affective congruency. The magnitude and spatial distribution of the congruency effects varied depending on the task and the target expression. These results are discussed in terms of the modulatory role of context on facial expression processing and the different mechanisms underlying the processing of expressions of positive and negative emotions.

Subjective emotional arousal: an explorative study on the role of gender, age, intensity, emotion regulation difficulties, depression and anxiety symptoms, and meta-emotion

Subjective emotional arousal in typically developing adults was investigated in an explorative study. 177 participants (20-70 years) rated facial expressions and words for self-experienced arousal and perceived intensity, and completed the Difficulties in Emotion Regulation scale and the Hospital Anxiety and Depression scale (HADS-D). Exclusion criteria were psychiatric or neurological diseases, or clinically relevant scores in the HADS-D. Arousal regarding faces and words was significantly predicted by emotional clarity. Separate analyses showed following significant results: arousal regarding faces and arousal regarding words constantly predicted each other; negative faces were predicted by age and intensity; neutral faces by gender and impulse control; positive faces by gender and intensity; negative words by emotional clarity; and neutral words by gender. Males showed higher arousal scores than females regarding neutral faces and neutral words; for the other arousal scores, no explicit group differences were shown. Cluster analysis yielded three distinguished emotional characteristics groups: "emotional difficulties disposition group" (mainly females; highest emotion regulation difficulties, depression and anxiety scores; by trend highest arousal), "low emotional awareness group" (exclusively males; lowest awareness regarding currently experienced emotions; by trend intermediate arousal), and a "low emotional difficulties group" (exclusively females; lowest values throughout). No age effect was shown. Results suggest that arousal elicited by facial expressions and words are specialized parts of a greater emotional processing system and that typically developing adults show some kind of stable, modality-unspecific dispositional baseline of emotional arousal. Emotional awareness and clarity, and impulse control probably are trait aspects of emotion regulation that influence emotional arousal in typically developing adults and can be regarded as aspects of meta-emotion. Different emotional personality styles were shown between as well as within gender groups.

Age Differences in Emotion Regulation Choice: Older Adults Use Distraction Less Than Younger Adults in High-Intensity Positive Contexts

Objectives

Previous research demonstrates that younger and older adults prefer distraction over engagement (reappraisal) when regulating high-intensity negative emotion. Older adults also demonstrate a greater bias for positive over negative information in attention and memory compared with younger adults. In this study, we investigated whether emotion regulation choice preferences may differ as a function of stimulus valence with age.

Method

The effect of stimulus intensity on negative and positive emotion regulation strategy preferences was investigated in younger and older men. Participants indicated whether they favored distraction or reappraisal to attenuate emotional reactions to negative and positive images that varied in intensity.

Results

Men in both age-groups preferred distraction over reappraisal when regulating high-intensity emotion. As no age-related strategic differences were found in negative emotion regulation preferences, older men chose to distract less from high-intensity positive images than did younger men.

Discussion

Older men demonstrated greater engagement with highly positive emotional contexts than did younger men. Thus, age differences in emotion regulation goals when faced with intense emotional stimuli depend on the valence of the emotional stimuli.

Emotion regulation choice: a broad examination of external factors

Emotion regulation choices are known to be profoundly consequential across affective, cognitive, and social domains. Prior studies have identified two important external factors of emotion regulation choice: stimulus intensity and reappraisal affordances. However, whether there are other external factors of emotion regulation choice and how these factors contribute to emotion regulation choice when considered simultaneously is not yet clear. The current studies addressed these gaps by examining the relations between emotion regulation choice (distraction vs. reappraisal) and self-reported stimulus intensity, reappraisal affordances, and several other factors including discrete emotions and distraction affordances. Across three studies using different databases of standardised images to enhance generalizability, our results showed that in the context of our experiments, reappraisal affordances were strongly associated with emotion regulation choice (greater reappraisal affordances predicted higher use of reappraisal). Further, stimulus intensity was independently associated with emotion regulation choice in each study. Our results also demonstrated that the discrete emotion of disgust (but not other discrete emotions) is a previously unidentified external factor of emotion regulation choice. We discuss the implications of the current findings.

Higher trait reappraisal predicts stronger HPA axis habituation to repeated stress

Undergoing stress can be advantageous when it leads to adaptation and growth; however, failure of the hypothalamic-pituitary-adrenal (HPA) axis to habituate (i.e., nonhabituation) involves continuing to become highly activated in response to repeated exposure of the same stimulus and is considered maladaptive. Although 50-75% of individuals assessed in a laboratory exhibit adaptive habituation to repeated stress, variability in habituation suggests psychological processes used in response to stress may play a role, such as emotion regulation (ER). Nonetheless, no research to date has investigated whether ER strategies affect HPA axis habituation. We investigated whether tendency to use two ER strategies, reappraisal and suppression, influenced HPA axis habituation among 84 healthy young adults (60.7% female; M_age = 24.8 years, SD = 6.0) exposed to a standardized experimental stress paradigm on two consecutive days. HPA axis stress responses were assessed using salivary cortisol concentrations. We also examined whether non-manipulated state ER strategies (i.e., those used by the participant during and following the stressor on the first day) modulated HPA axis habituation over and above trait-use in a subsample (N = 60). Trait, but not state, reappraisal was associated with stronger HPA axis habituation. Neither trait nor state suppression were significantly associated with HPA axis habituation. These findings expand our current understanding of how ER can affect stress-related health outcomes and suggest habitual reappraisal plays an important role in adaption of the HPA axis to stress.

Understanding Emotion Inflexibility in Risk for Affective Disease: Integrating Current Research and Finding a Path Forward

Emotion-related disorders (e.g., depression, anxiety, stress, eating, substance and some personality disorders) include some of the most common, burdensome, and costly diseases worldwide. Central to many, if not all of these disorders, may be patterns of rigid or inflexible emotion responses. Indeed, theorists point to emotion in-flexibility as a potential cause or maintaining factor in emotion-related diseases. Despite the increasing prominence of emotion inflexibility in theories of affective disease, a comprehensive review of the developing empirical literature has not yet been conducted. Accordingly, this review will examine the three dominant lines of inquiry assessing emotion flexibility. These include: (1) the capacity to use and vary deliberate emotion regulation strategies, (2) the context sensitivity of spontaneous emotional responses, and (3) flexibility in the appraisal of emotional events and experiences. Moreover, current evidence suggests that each of these three lines of research may converge to suggest the interplay of two key biological dimensions in emotion inflexibility, threat sensitivity, and cognitive control, known to be impaired in patients with affective disorders. In short, this developing body of work suggests a path by which future research could explicate and even exploit the ties between emotion inflexibility and affective disease, contributing to the development of improved models of risk, assessment, and intervention, with broad implications for psychological health.

Reducing socioeconomic disparities in the STEM pipeline through student emotion regulation

Increasing access to Science, Technology, Engineering, and Math (STEM) fields can create career opportunities. Yet many students, especially those from lower-income backgrounds, find the high-stakes exams in courses necessary for STEM success to be stressful and anxiety provoking. Such experiences of stress can lead to underperformance and compromise students’ ability to advance in STEM. We show that lower-income students given the opportunity to emotionally regulate their worries and reinterpret their arousal go on to perform better on their high school science exams and endorse a more adaptive interpretation of stress. Critically, emotion regulation interventions cut in half the course failure rate for lower-income students. For many students, success is based on more than STEM knowledge—their ability to regulate emotions is important too.

Educational attainment is one lever that can increase opportunity for economically disadvantaged families—especially in Science, Technology, Engineering, and Math (STEM). Unfortunately, students from lower-income backgrounds often perform poorly and fail high school STEM courses, which are a necessary step in pursuing fast-growing and lucrative STEM careers, graduating high school, and matriculating to college. We reasoned that, because high school STEM courses often use high-stakes tests to gauge performance, and such tests can be especially stressful for lower-income students, interventions that help students regulate their negative emotions during tests should reduce the achievement gap between higher- and lower-income students. In a large-scale (n = 1,175) field experiment conducted in ninth grade science classrooms, students were asked to complete a control exercise, or they were given the opportunity to complete an exercise to help them regulate their worries and reinterpret their anxious arousal before their tests. We found significant benefits of emotion regulation activities for lower-income students in terms of their science examination scores, science course passing rate, and students’ attitudes toward examination stress, suggesting that students’ emotions are one factor that impacts performance. For example, 39% of lower-income students failed the course in the control group compared with only 18% of students failing the course if they participated in the emotion regulation interventions—a reduction in course failure rate by half. Our work underscores the crucial importance of targeting students’ emotions during impactful points in their academic trajectories for improving STEM preparedness and enhancing overall academic success.

CISDA: Changes in Integration for Social Decisions in Aging

The aging of our population has been accompanied by increasing concerns about older adults' vulnerability to violations of trust and a growing interest in normative age-related changes to decision making involving social partners. This intersection has spurred research on age-related neurocognitive and affective changes underlying social decision making. Based on our review and synthesis of this literature, we propose a specification that targets social decision making in aging to the recently proposed Affect-Integration-Motivation (AIM) framework. Our framework specification, Changes in Integration for Social Decisions in Aging (CISDA), emphasizes three key components of value integration with particular relevance for social decisions in aging: theory of mind, emotion regulation, and memory for past experience. CISDA builds on converging research from economic decision making, cognitive neuroscience, and lifespan development to outline how age-related changes to neurocognition and behavior impact social decision making. We conclude with recommendations for future research based on CISDA's predictions, including implications for the development of interventions to enhance social decision outcomes in older adults. This article is categorized under: Economics > Individual Decision Making Psychology > Reasoning and Decision Making Psychology > Development and Aging Neuroscience > Cognition.

Sequential effects of reappraisal and rumination on anger during recall of an anger-provoking event

In everyday life, people often combine strategies to regulate their emotions. However, to date, most research has investigated emotion regulation strategies as if they occur independently from one another. The current study aims to better understand the sequential interplay between strategies by investigating how reappraisal and rumination interact to affect anger experience. After participants (N = 156) recalled a recent anger-provoking event, they were instructed to either a) reappraise the event twice, b) reappraise the event, and then ruminate about the event, c) ruminate about the event, and then reappraise the event, or d) ruminate twice about the event. The effects of the first strategy used replicated a large body of research: reappraisal was associated with a decrease in anger, but rumination was associated with no change in anger. There was a small interactive effect of the combination of the two strategies, such that those who ruminated and then reappraised showed a larger decrease in anger than those who reappraised and then ruminated. There were no other differences between groups. This suggests that the second strategy does have an effect over and beyond the first strategy, but this effect is small in size, highlighting the importance of the initial emotion regulation strategy used.

Regulating for a reason: Emotion regulation goals are linked to spontaneous strategy use

OBJECTIVE

We investigated how individual differences in emotion regulation goals predict emotion regulation strategy use in daily life.

METHOD

Across three studies, we assessed two common types of emotion regulation goals (hedonic, social) and strategies spanning the entire process model of emotion regulation. We conducted two studies using global measures with undergraduates (N = 394; 18-25 years; 69% female; 56% European American) and community members (N = 302; 19-74 years; 50% female; 75% European American), and a nine-day daily diary study with another community sample (N = 272; 23-85 years; 50% female; 84% European American).

RESULTS

Globally and in daily life, pro-hedonic goals were positively associated with all antecedent-focused strategies (situation selection, situation modification, distraction, and reappraisal), pro-social goals were positively linked to reappraisal, and impression management goals positively predicted suppression. Contra-hedonic goals were negatively associated with reappraisal and positively associated with suppression in some studies.

CONCLUSIONS

The reasons why people regulate their emotions are predictive of the strategies they use in daily life. These links may be functional, such that people typically use strategies that are suitable for their goals. These findings demonstrate the value of an individual difference approach and highlight the motivational component of emotion regulation.

When is experiential avoidance harmful in the moment? Examining global experiential avoidance as a moderator

BACKGROUND AND OBJECTIVES

Although experiential avoidance has been shown to predict a wide range of mental health problems, there has been minimal research to-date on the more immediate effects of engaging in experiential avoidance in the moment or the moderators that predict when it is more or less harmful.

METHODS

An ecological momentary assessment (EMA) study was conducted with 70 undergraduate students who completed assessments three times a day, over 7 day as well as a baseline assessment of global questionnaires.

RESULTS

Both greater global experiential avoidance and momentary experiential avoidance independently predicted greater momentary negative affect, lower positive affect, and lower valued action. Global experiential avoidance was also a significant moderator of momentary experiential avoidance such that experiential avoidance in the moment was more strongly related to negative effects among those high in global experiential avoidance.

LIMITATIONS

Study limitations include a non-clinical student sample and use of unvalidated EMA items.

CONCLUSIONS

Overall, these results suggest engaging in experiential avoidance in the moment has more negative, immediate effects particularly among those who engage in global, inflexible patterns of experiential avoidance.

Emotion dysregulation in patients with psychogenic nonepileptic seizures: A systematic review based on the extended process model

Psychogenic nonepileptic seizures (PNES) are characterized by paroxysmal alterations in motor and sensory functions resembling epileptic seizures, but are not caused by epileptiform activity. In recent years, there has been increasing scientific interest in emotion dysregulation in patients with PNES (pwPNES), but the literature has not yet been interpreted within a broader model of emotion dysregulation. The aim of this review was therefore to synthesize the existing literature on emotion dysregulation in pwPNES within the extended process model (EPM) of emotion regulation.

METHODS

PubMed and Web of Science were searched for studies relevant to emotion dysregulation as defined by the EPM. These studies were subjected to a bespoke quality appraisal tool. Studies of acceptable quality were categorized to the different stages of the EPM and critically appraised.

RESULTS

Studies of emotion regulation in pwPNES were generally of low quality - a finding largely driven by small sample sizes. However, there was evidence of emotion dysregulation characterized by deficits in the identification of patients' own emotional states, as well as the selection and implementation of maladaptive regulatory strategies, and altered exteroceptive emotional processing. However, heterogeneity in findings suggests that emotion dysregulation is likely linked to other psychological factors and not common to all pwPNES.

SIGNIFICANCE

This review suggests that while pwPNES are likely to experience emotion dysregulation as defined by the EPM, there is variability in the distribution of regulatory deficits in this patient population, and a person-centered approach should be taken when working with these patients. There is a need for more high quality and better-powered studies in this area.

Exploring deficient emotion regulation in adult ADHD: electrophysiological evidence

Emotional dysregulation (ED) is being increasingly recognized as a core feature of attention-deficit/hyperactivity disorder (ADHD), but the pathophysiological underpinnings remain unclear. In this study, we provide meaningful electrophysiological evidence of ED in adult patients with ADHD (n = 39) compared to healthy controls (n = 40) by exploring the electrophysiological correlates of the emotion regulation strategies reappraisal, distraction, and expressive suppression. Event-related potentials (ERPs) were recorded during passive viewing of neutral and negative images, as well as during emotion regulation. The patients with ADHD exhibited increased frontal late positive potential (LPP) amplitudes during passive viewing of the aversive images and during emotion regulation. Compared with the healthy controls, a subgroup of medication-naïve patients with ADHD (n = 25) also exhibited larger centroparietal LPP amplitudes and provided more negative ratings of the aversive and neutral images. Both the frontal and centroparietal LPP amplitudes were associated with ADHD symptom severity. However, no significant deficit in LPP modulation during emotion regulation was found. These findings strongly support the clinical observation of increased emotional responsivity toward negative stimuli and difficulty during the implementation of emotion regulation strategies and thus encourage the implementation of emotion regulation modules in the treatment of adult patients with ADHD.