Age differences in emotion regulation effort: Pupil response distinguishes reappraisal and distraction for older but not younger adults

Neurobehavioral meaning of pupil size

Pupil size is a widely used metric of brain state. It is one of the few signals originating from the brain that can be readily monitored with low-cost devices in basic science, clinical, and home settings. It is, therefore, important to investigate and generate well-defined theories related to specific interpretations of this metric. What exactly does it tell us about the brain? Pupils constrict in response to light and dilate during darkness, but the brain also controls pupil size irrespective of luminosity. Pupil size fluctuations resulting from ongoing "brain states" are used as a metric of arousal, but what is pupil-linked arousal and how should it be interpreted in neural, cognitive, and computational terms? Here, we discuss some recent findings related to these issues. We identify open questions and propose how to answer them through a combination of well-defined tasks, neurocomputational models, and neurophysiological probing of the interconnected loops of causes and consequences of pupil size.

Emotion regulation unveiled through the categorical lens of attachment

BACKGROUND

Emotion regulation, the process by which individuals manage and modify their emotional experiences, expressions, and responses to adaptively navigate and cope with various situations, plays a crucial role in daily life. Our study investigates the variations in emotion regulation strategies among individuals with different attachment styles (AS). Specifically, we examine how individuals with secure, anxious, avoidant, and fearful attachment styles effectively utilize cognitive reappraisal and expressive suppression to regulate their emotions.

METHODS

A total of n = 98 adults were instructed to attend, reappraise, or suppress their emotions while viewing negative and neutral images from the International Affective Picture System (IAPS) in an experimental emotion regulation task. After completing the task, participants rated the valence and arousal elicited by the images. Attachment styles were measured using the ECR-12 questionnaire and then categorized into four AS.

RESULTS

Our study revealed that individuals with secure AS (n = 39) effectively reduced displeasure through cognitive reappraisal but experienced levels of displeasure with expressive suppression. Anxious AS (n = 16) individuals successfully reduced displeasure using cognitive reappraisal but struggled to regulate arousal and effectively use expressive suppression. Avoidant AS (n = 24) individuals could reduce displeasure with both strategies but experienced high arousal during suppression attempts. Fearful AS (n = 19) individuals effectively regulated both displeasure and arousal using either strategy. However, Secure AS individuals showed superior reappraisal efficacy, significantly reducing arousal levels compared to the Fearful AS group. Both Secure and Avoidant AS groups experienced higher valence during reappraisal relative to a baseline, indicating a decrease in displeasure.

CONCLUSIONS

Individuals with different AS exhibit variations in the effectiveness of their use of emotion regulation strategies. Our findings reinforce the significance of AS in shaping emotion regulation processes and emphasize the need for tailored approaches to support individuals with different attachment orientations.

The Role of Autobiographical Resilience Memories in Emotion Regulation: An Account of Age Differences in Mnemonic and Positive Reappraisal

A lifetime of resilience through emotionally challenging experiences may benefit older adults, lending to emotion regulation mastery with time. Yet the influence of autobiographical experiences on momentary reappraisal, the reinterpretation of negative stimuli as more positive, has never been empirically tested. This online study examined the extent to which associating life memories of resilience with novel negative scenarios enhanced reappraisal efficacy and reduced difficulty to reappraise. Younger and older adults reappraised negative images by associating reappraisals to freely selected autobiographical resilience memories, cued autobiographical resilience memories, or by finding situational silver linings without mnemonic association (control). Changes in image emotional intensity ratings revealed no difference across reappraisal conditions for younger adults, while older adults most effectively down-regulated emotional intensity using the control reappraisal strategy. Older adults found autobiographical memories more helpful for mood regulation and less difficult to implement, and identified greater similarities between novel negative scenarios and their memories than younger adults. Surprisingly, greater similarity between resilience memories and negative images was associated with lower reappraisal efficacy for both age groups. Findings demonstrate the age-equivalent benefits of utilizing reappraisals associated with past narratives of resilience and suggest a sacrifice of immediate hedonic benefit for disproportionately greater subjective benefits with age.

Using connectome-based models of working memory to predict emotion regulation in older adults

Older adulthood is characterized by enhanced emotional well-being potentially resulting from greater reliance on adaptive emotion regulation strategies. However, not all older adults demonstrate an increase in emotional well-being and instead rely on maladaptive emotion regulation strategies. An important moderator of age-related shifts in strategy preferences is working memory (WM) and its underlying neural circuitry. As such, individual differences in the neural integrity underlying WM may predict older adults' emotion regulation strategy preferences. Our study used whole-brain WM networks-derived from young adults using connectome-based predictive modeling-to predict WM performance and acceptance strategy use in healthy older adults. Older adults (N = 110) completed baseline assessments as part of a randomized controlled trial examining the impact of mind-body interventions on healthy aging. Our results revealed that the WM networks predicted WM accuracy but not acceptance use or difficulties in emotion regulation in older adults. Individual differences in WM performance, but not WM networks, moderated relationships between image intensity and acceptance use. These findings highlight that robust neural markers of WM generalize to an independent sample of healthy older adults but may not generalize beyond cognitive domains to predict emotion-based behaviors.

Low mental health literacy and its association with depression, anxiety and poor sleep quality in Chinese elderly

BACKGROUND

Mental health literacy (MHL) is rarely reported in the Chinese elderly. This study explored the pattern of MHL in the Chinese elderly in relation to depression, anxiety and poor sleep quality.

METHODS

A cross-sectional study was conducted among older adults in Guangzhou, south China. Participants were investigated face-to-face using the Chinese National Mental Health Literacy Scale, the Patient Health Questionnaire-9 item (PHQ-9), the 7-item Generalized Anxiety Disorder (GAD-7) and the Pittsburgh Sleep Quality Index (PSQI). Mental Health Literacy Scale contains three dimensions: mental health knowledge, mental health skills (such as social support, cognitive reappraisal and attentional distraction) and mental health awareness. Multivariate logistic regression was used for examining the association between MHL and mental health.

RESULTS

A total of 506 older adults were recruited. The percentage of depression, anxiety, and poor sleep quality were 16.6%, 7.9% and 40.9%, respectively. MHL dimensions independently associated with depression included cognitive reappraisal (OR = 1.95, p < .001), attentional distraction (OR = 0.61, p = 0.044) and awareness (OR = 0.56, p = 0.027). MHL dimensions independently associated with anxiety symptoms included cognitive reappraisal (OR = 1.90, p = 0.011) and attentional distraction (OR = 0.44, p = 0.016). MHL dimensions independently associated with poor sleep quality included social support (OR = 0.75, p = 0.022), cognitive reappraisal (OR = 1.55, p = 0.003) and attentional distraction (OR = 0.65, p = 0.016).

CONCLUSION

Given the low MHL and its association with poor mental health in the Chinese elderly, policymakers and health professionals should improve the older adults' MHL, which could be conducive to the prevention and control of their mental health problems.

Successful implementation of cognitive reappraisal: effects of habit and situational factors

Reappraisal is an adaptive emotion regulation strategy associated with favourable mental health outcomes. It is unclear whether the adaptive outcomes of habitual reappraisal are associated with better implementation of reappraisal when faced with negative affective situations. The current study aimed to examine whether habitual reappraisal predicts the implementation of instructed reappraisal and to evaluate the potential moderating effects of situational factors, namely - emotional intensity and reappraisal affordance. To address this question, 100 participants reported their habitual reappraisal tendency and were asked to imagine themselves in different hypothetical interpersonal situations. Participants rated emotional intensity levels and reappraisal affordance for each situation, followed by instructions to implement reappraisal. Implementation success was measured by self-reported affect pre-and-post-implementation. Results indicated that habitual reappraisal was associated with greater reappraisal implementation success. While higher intensity scores predicted greater reappraisal implementation success, intensity did not moderate the association between habitual reappraisal and reappraisal implementation success. Reappraisal affordance did not predict reappraisal implementation success, nor did it moderate the association between habitual reappraisal and reappraisal implementation success. Our findings suggest that individual-centred factors play a significant role in reappraisal implementation success, while the effects of situation-centred factors demand further investigation.

Remembering past challenges to feel better today: Role of neural dedifferentiation and autobiographical integration in late-life reappraisal

Socioemotional theories suggest that surviving a lifetime of life experiences enhances older adult emotional resilience, yet the role of past emotional challenges in current models of emotion regulation is overlooked. In this paper, we propose how integration of memories and hippocampal dedifferentiation may together benefit the reappraisal of novel stressors across the lifespan. First, we review mood benefits of generating positive narratives, and more integrated memories of adverse life events with age. Second, we review neural mechanisms of narrative integration and meaning-making. We propose a framework in which narrative integration and neural dedifferentiation of hippocampal memory representations may facilitate late-life reappraisal via shared positive meaning-making in ventromedial prefrontal cortex (vmPFC). While current evidence supporting this model is limited, we conclude by discussing future directions for testing its components in multivariate neuroimaging studies, and briefly review clinical implications of the proposed model.

Advancing the Understanding of the Role of Responsible AI in the Continued Use of IoMT in Healthcare

This paper examines the continuous intention by healthcare professionals to use the Internet of Medical Things (IoMT) in combination with responsible artificial intelligence (AI). Using the theory of Diffusion of Innovation (DOI), a model was developed to determine the continuous intention to use IoMT taking into account the risks and complexity involved in using AI. Data was gathered from 276 healthcare professionals through a survey questionnaire across hospitals in Bahrain. Empirical outcomes reveal nine significant relationships amongst the constructs. The findings show that despite contradictions associated with AI, continuous intention to use behaviour can be predicted during the diffusion of IoMT. This study advances the understanding of the role of responsible AI in the continued use of IoMT in healthcare and extends DOI to address the diffusion of two innovations concurrently.

Reappraising fear: is up-regulation more efficient than down-regulation?

Catastrophizing thoughts may contribute to the development of anxiety, but functional emotion regulation may help to improve treatment. No study so far directly compared up- and down-regulation of fear by cognitive reappraisal. Here, healthy individuals took part in a cued fear experiment, in which multiple pictures of faces were paired twice with an unpleasant scream or presented as safety stimuli. Participants (N = 47) were asked (within-subjects) to down-regulate, to up-regulate and to maintain their natural emotional response. Valence and arousal ratings indicated successful up- and down-regulation of the emotional experience, while heart rate and pupil dilation increased during up-regulation, but showed no reduction in down-regulation. State and trait anxiety correlated with evaluations of safety but not threat stimuli, which supports the role of deficient safety learning in anxiety. Reappraisal did not modulate this effect. In conclusion, this study reveals evidence for up-regulation effects in fear, which might be even more efficient than down-regulation on a physiological level and highlights the importance of catastrophizing thoughts for the maintenance of fear and anxiety.

Age Differences in Reappraisal of Negative Autobiographical Memories

Background: Past studies have been equivocal regarding age differences in reappraisal efficacy. Moreover, the use of laboratory-generated stimuli (e.g., images, film clips) may overestimate age differences. Instead, the use of self-relevant stimuli (e.g., autobiographical memory) may better represent the day-to-day implementation of reappraisal. Method: Younger and older adults generated 50 negative memories and provided negativity, positivity, and vividness ratings. One to two weeks later, participants underwent a reappraisal task during which physiological data were collected. Participants implemented one of the three instructions for 30 seconds: remember naturally, increase negative reactions, or decrease negative reactions via a "positivizing" tactic. Results: Prior to the regulation session, older adults rated all memories more positively than younger adults. No age differences in negativity or vividness ratings emerged. After regulation, older adults rated memories more positively, negatively, and vividly than younger adults. Physiological data suggest that reappraisal demands may have been more cognitively demanding for older adults. However, older adults reported higher negativity and positivity than younger adults. Conclusion: This challenges the existing theory regarding age and emotion regulation. We contend that reappraisal was achieved by younger and older adults; however, achievement may have emerged in slightly different ways.

Effects and mechanisms of information saliency in enhancing value-based decision-making in younger and older adults

Aging attenuates frontostriatal network functioning, which could lead to deficits in value computation when decision-making involves uncertainty. Although it has been shown that visually enhancing information saliency of outcome probability can improve decision-making in old age, mechanisms of this effect are still unclear. In the present study, the saliency of outcome probability was increased using a color-coding scheme as a decision aid in a mixed lottery choice task, and spontaneous eye-blink rate and pupillary responses were assessed in younger and older adults. Older adults showed lower value sensitivity than younger adults; however, increasing information saliency benefitted choice behaviors in both age groups. Furthermore, the decision aid reduced pupil size during decision-making in both age groups, suggesting that enhancing information saliency decreases cognitive demands of value computation. Baseline value sensitivity was negatively correlated with benefit of enhancing information saliency only in older adults. As value representations in older decision makers are less distinctive at baseline, they may have required more environmental compensation than younger adults.

"Calm Down," "Cheer Up": How Age Influences the Way We Manage Emotion in Social Partners

This study examines how individuals (regulators) manage emotion in their social partners (targets) and whether the age of the regulator or the age of the target influences extrinsic emotion regulation strategy preference. An online questionnaire was used to assess extrinsic emotion regulation among 580 participants aged 18-87 years (M = 50.04, SD = 18.13). Participants (regulators) indicated the extent to which they would be likely to use different strategies when interacting with a younger or older target who was upset. Results of multi-level modeling showed that older regulators endorsed less use of situation modification than younger regulators, but age differences in regulators' use of other strategies were not significant. After adjustment for relationship-specific covariates, regulators endorsed less use of attentional deployment and cognitive change, for older targets than younger targets. Results are discussed in the context of lifespan perspectives on social behavior and emotion regulation.

Positive and Detached Reappraisal of Threatening Music in Younger and Older Adults

Past empirical studies have suggested that older adults preferentially use gaze-based mood regulation to lessen their negative experiences while watching an emotional scene. This preference for a low cognitively demanding regulatory strategy leaves open the question of whether the effortful processing of a more cognitively demanding reappraisal task is really spared from the general age-related decline. Because it does not allow perceptual attention to be redirected away from the emotional source, music provides an ideal way to address this question. The goal of our study was to examine the affective, behavioral, physiological, and cognitive outcomes of positive and detached reappraisal in response to negative musical emotion in younger and older adults. Participants first simply listened to a series of threatening musical excerpts and were then instructed to either positively reappraise or to detach themselves from the emotion elicited by music. Findings showed that, when instructed to simply listen to threatening music, older adults reported a more positive feeling associated with a smaller SCL in comparison with their younger counterparts. When implementing positive and detached reappraisal, participants showed more positive and more aroused emotional experiences, whatever the age group. We also found that the instruction to intentionally reappraise negative emotions results in a lesser cognitive cost for older adults in comparison with younger adults. Taken together, these data suggest that, compared to younger adults, older adults engage in spontaneous downregulation of negative affect and successfully implement downregulation instructions. This extends previous findings and brings compelling evidence that, even when auditory attention cannot be redirected away from the emotional source, older adults are still more effective at regulating emotions. Taking into account the age-associated decline in executive functioning, our results suggest that the working memory task could have distracted older adults from the reminiscences of the threat-evoking music, thus resulting in an emotional downregulation. Hence, even if they were instructed to implement reappraisal strategies, older adults might prefer distraction over engagement in reappraisal. This is congruent with the idea that, although getting older, people are more likely to be distracted from a negative source of emotion to maintain their well-being.

Age-related variability in decision-making: Insights from neurochemistry

Despite dopamine's significant role in models of value-based decision-making and findings demonstrating loss of dopamine function in aging, evidence of systematic changes in decision-making over the life span remains elusive. Previous studies attempting to resolve the neural basis of age-related alteration in decision-making have typically focused on physical age, which can be a poor proxy for age-related effects on neural systems. There is growing appreciation that aging has heterogeneous effects on distinct components of the dopamine system within subject in addition to substantial variability between subjects. We propose that some of the conflicting findings in age-related effects on decision-making may be reconciled if we can observe the underlying dopamine components within individuals. This can be achieved by incorporating in vivo imaging techniques including positron emission tomography (PET) and neuromelanin-sensitive MR. Further, we discuss how affective factors may contribute to individual differences in decision-making performance among older adults. Specifically, we propose that age-related shifts in affective attention ("positivity effect") can, in some cases, counteract the impact of altered dopamine function on specific decision-making processes, contributing to variability in findings. In an effort to provide clarity to the field and advance productive hypothesis testing, we propose ways in which in vivo dopamine imaging can be leveraged to disambiguate dopaminergic influences on decision-making, and suggest strategies for assessing individual differences in the contribution of affective attentional focus.

Psychophysiological Effects of Downregulating Negative Emotions: Insights From a Meta-Analysis of Healthy Adults

Assessing psychophysiological responses of emotion regulation is a cost-efficient way to quantify emotion regulation and to complement subjective report that may be biased. Previous studies have revealed inconsistent results complicating a sound interpretation of these findings. In the present study, we summarized the existing literature through a systematic search of articles. Meta-analyses were used to evaluate effect sizes of instructed downregulation strategies on common autonomic (electrodermal, respiratory, cardiovascular, and pupillometric) and electromyographic (corrugator activity, emotion-modulated startle) measures. Moderator analyses were conducted, with moderators including study design, emotion induction, control instruction and trial duration. We identified k = 78 studies each contributing multiple sub-samples and performed 23 meta-analyses for combinations of emotion regulation strategy and psychophysiological measure. Overall, results showed that effects of reappraisal and suppression on autonomic measures were highly inconsistent across studies with rather small mean effect sizes. Electromyography (startle and corrugator activity) showed medium effect sizes that were consistent across studies. Our findings highlight the diversity as well as the low level of standardization and comparability of research in this area. Significant moderation of effects by study design, trial duration, and control condition emphasizes the need for better standardization of methods. In addition, the small mean effect sizes resulting from our analyses on autonomic measures should be interpreted with caution. Findings corroborate the importance of multi-channel approaches.