A systematic review and meta-analysis of the association between expressive suppression and positive affect

Emotion regulation and mental health across cultures: a systematic review and meta-analysis

Emotion regulation (ER) plays a central role in mental health, but the effect differs across cultures. Here, expanding from extant literature's focus on Western-Eastern dichotomy or individualism-collectivism, this meta-analysis synthesized evidence on the associations between the two most-studied ER strategies (cognitive reappraisal and expressive suppression) and two mental health outcomes (psychopathology and positive functioning) and investigated the moderating roles of several cultural dimensions: Hofstede's national cultures dimensions, education, industrialization, richness and democracy (EIRDness), and sample demographics. A comprehensive literature search was conducted using electronic databases (CINAHL, Scopus, Web of Science, PsycINFO and MEDLINE) to identify eligible studies reporting relationships between ER and mental health outcomes (PROSPERO: CRD42021258190, 249 articles, n = 150,474, 861 effect sizes, 37 countries/regions). For Hofstede's national cultures and EIRDness, multimodel inference revealed that greater reappraisal propensity was more adaptive in more short-term-oriented, uncertainty-tolerant and competition-driven cultures, whereas greater suppression propensity was more maladaptive in more indulgent and competition-driven cultures. For demographics, greater reappraisal propensity was more adaptive for samples with more female (B = -0.19, 95% confidence interval (CI) -0.29 to -0.09) and more racial minority participants (B = -0.32, 95% CI -0.51 to -0.13), whereas greater suppression propensity was more maladaptive in younger samples (B = -0.004, 95% CI -0.005 to -0.002). These findings elucidate how cultures are associated with the function of ER and suggests ways in which future studies can integrate cultural characteristics when examining ER and psychological adjustment.

Association between stressful life events and sleep quality in Chinese university students: Mediating and moderating roles of emotion regulation

This study investigated whether emotion regulation mediates or modulates the relationship of SLEs with sleep quality and potential sex differences. A total of 1447 Chinese university students completed the Adolescent Self-Rating Life Events Checklist, the Pittsburgh Sleep Quality Index, and the Emotion Regulation Questionnaire. The results indicated that both cognitive reappraisal and expressive suppression significantly mediated and moderated the negative association between SLEs and sleep quality. Additionally, sex differences were found for the mediating role of cognitive reappraisal and for the modulating roles of cognitive reappraisal and expressive suppression in the relationship between SLEs and sleep quality. Although the present cross-sectional data does not allow us to test any causal relationships, these results help clarify the underlying emotion-regulation process between SLEs and sleep in university students and highlight the importance of considering sex differences in emotion regulation.

The impact of physical exercise on adolescent social anxiety: the serial mediating effects of sports self-efficacy and expressive suppression

OBJECTIVE

This study aims to investigate the impact of physical exercise on adolescent social anxiety and to elucidate the serial mediating roles of sports self-efficacy and expressive suppression within this context.

METHODS

Utilizing a convenience random cluster sampling technique, this study surveyed 2500 primary and secondary school students across Sichuan, Guangdong, Shandong, Henan, and Jiangxi provinces. The survey utilized validated scales to assess physical exercise, sports self-efficacy, expressive suppression, and social anxiety among adolescents.

RESULTS

The study revealed that: (1) Physical exercise has a significant negative correlation with social anxiety (r = -0.32, p < 0.01); (2) Sports self-efficacy significantly mediated the relationship between physical exercise and social anxiety, with an indirect effect of -0.15 (95% CI [-0.22, -0.09]); (3) Expressive suppression significantly mediated the relationship between physical exercise and social anxiety, with an indirect effect of -0.11 (95% CI [-0.17, -0.06]); (4) Sports self-efficacy and expressive suppression exerted a significant serial mediating effect on the relationship between physical exercise and social anxiety, with an indirect effect of -0.05 (95% CI [-0.08, -0.02]).

CONCLUSION

Physical exercise not only directly alleviates social anxiety in adolescents but also indirectly diminishes social anxiety through the enhancement of sports self-efficacy and the reduction of expressive suppression.

The impact of experimentally instructed suppression on cardiovascular habituation during repeated stress

Experimental research has shown instructed suppression is associated with heightened physiological responses during a single active stress exposure, with heightened responses to stress being a potential underlying mechanism linking suppression to cardiovascular disease (CVD). However, no research to date has examined instructed suppression with cardiovascular habituation to repeated stress. This study extends prior research by introducing a novel experimental paradigm, which incorporates a traditional suppression manipulation protocol within an active stress habituation framework. Between September 2022 and May 2023, participants (N = 244; mean (SD) age = 19.04 (1.9) years; 50.4 % women; 65.6 % White) completed a 10-min baseline, 5-min speech preparation, and 5-min speech delivery, which was repeated after a 10-min recovery. Participants were randomly assigned to either suppression or control instructions before the second speech prep. Heart rate (HR), systolic/diastolic blood pressures (SBP/DBP), and pre-ejection period (PEP) were measured throughout. State affect, perceived psychological stress, and state suppression were self-reported after each task. Habitual use of suppression was assessed using the Emotion Regulation Questionnaire. All participants exhibited significant cardiovascular habituation, irrespective of condition, suggesting instructed suppression did not hinder habituation. Instructed suppression was not associated with changes in perceived psychological stress or positive affect across tasks; however, instructed suppression was associated with greater habituation of negative affect. Neither state nor habitual suppression interacted with instructed suppression in influencing task responses. This is the first study to examine the relationship between experimentally instructed suppression and cardiovascular habituation, providing new perspective of the interplay between suppression and cardiovascular stress responding.

Emotional regulation mechanisms regarding posttraumatic and depressive symptoms in maltreated youth

Maltreated youth are a particularly vulnerable group that often contends with multifaceted mental health challenges, especially symptoms of posttraumatic stress and depression. Emotional dysregulation may have a central role in linking victimization to youth psychopathology in this population, but few have examined the effect of specific mechanisms such as expressive suppression and cognitive reappraisal in this regard. The present study examined these mechanisms vis-à-vis posttraumatic and depressive symptoms in a highly diverse sample of 133 youth aged 11-17 years who were removed from home following maltreatment. Expected positive relationships were found with respect to expressive suppression and total and cluster (i.e., intrusion, avoidance, alterations in cognition and mood, and alterations in arousal and reactivity) posttraumatic stress symptoms as well as depressive symptoms. Conversely, unexpected positive relationships were found with respect to cognitive reappraisal and these symptoms only for specific groups, notably males, younger youth, and those who had not experienced sexual maltreatment. The findings may have implications for tailoring clinical protocols for this vulnerable population, and may offer directions for integrating expressive suppression and cognitive reappraisal into transdiagnostic models of psychopathology in youth.

Examining the influence of two emotion regulation strategies on anxiety in Chinese college students: insights from cross-lagged and moderated network models

BACKGROUND

Anxiety, a prevalent and detrimental mental disorder, usually emerges in late adolescence and emerging adulthood. Emotion regulation strategies, namely expressive suppression and cognitive reappraisal, share a close relation with the onset and maintenance of anxiety. Yet the relation between anxiety and emotion regulation strategies remains controversial and warrants further clarification.

METHODS

The generalized anxiety disorder-7 (GAD-7) was used to measure the anxiety disorders and the emotion regulation questionnaire (ERQ) was utilized to assess the use of two emotion regulation strategies. In study 1, a total of 2201 college students completed two measurement waves (females = 1358, 61.70%, Mage = 18.37). The cross-lagged model was conducted to identify the directional relation between two emotion regulation strategies and anxiety. In study 2, 3150 college students (females = 1562, 49.59%, Mage = 19.73) completed the measurements. The moderated network model was utilized to clarify the influence of emotion regulation strategy on anxiety from the symptomatic perspective.

RESULTS

In study 1, the results of the cross-lagged model suggested that the level of anxiety in wave 2 could be negatively predicted by the cognitive reappraisal (b = -0.552, p < .01) but not by expressive suppression (b = 0.035, p = .174) in wave 1. In study 2, the results of the moderated network indicated that cognitive reappraisal could moderate the interaction between "Excessive worry"-"Irritability", "Nervousness" -"Uncontrollable worry", "Trouble relaxing"-"Nervousness" (GAD1) ,and "Restlessness" -"Irritability".

CONCLUSIONS

The current study confirmed cognitive reappraisal could serve as a protective factor for anxiety by diminishing the positive relation between "Excessive worry"-"Irritability" and "Nervousness" -"Uncontrollable worry". This finding may guide clinical workers to develop more targeted interventions using cognitive reappraisal to alleviate anxiety symptoms.

Latent Structure and Profiles of Emotion Regulation: Reappraisal and Suppression Patterns with the Polish Version of the Emotion Regulation Questionnaire

Background/Objectives: The Emotion Regulation Questionnaire (ERQ) is a 10-item self-report measure of two emotion regulation strategies, cognitive reappraisal (CR) and expressive suppression (ES). This study aimed to (1) examine the latent structure of the Polish version of the ERQ, and (2) use it to explore different profiles of emotion regulation strategy use and their links with mental health outcomes. Methods: Our sample was 1197 Polish-speaking adults from the general community in Poland. Results: A factor analysis showed that the ERQ had strong factorial validity, with an intended two-factor structure (CR and ES factors) that was invariant across gender, age, and education categories, as well as across different levels of psychopathology symptoms and alexithymia. Our latent profile analysis extracted four emotion regulation profiles (subtypes): a Mainly Reappraisal profile (high CR, low ES), a Mainly Suppression profile (low CR with high ES), a Generally Low Regulation profile (low CR, low ES), and a Generally High Regulation profile (high CR, high ES). People with the Mainly Reappraisal profile had the best mental health outcomes, whereas people with the Mainly Suppression profile had the poorest mental health outcomes. Conclusions: Conceptually, these findings support the process model of emotion regulation, illustrating the differential affective outcomes of various emotion regulation strategies. Our results highlight the importance of considering individual differences in strategy use patterns, including combinations of strategies within an emotion regulation profile. The Polish version of the ERQ appears to be a robust measure of these key emotion regulation processes across a variety of demographic groups. To facilitate its use, including score interpretations in clinical practice, we present Polish percentile rank norms for the ERQ.

Emotion regulation strategies explain associations of theta and Beta with positive affect

Maladaptive emotion regulation (ER) strategies are a transdiagnostic construct in psychopathology. ER depends on cognitive control, so brain activity associated with cognitive control, such as frontal theta and beta, may be a factor in ER. This study investigated the association of theta and beta power with positive affect and whether emotion regulation strategies explain this association. One hundred and twenty-one undergraduate students (mean age = 20.74, SD = 5.29; 73% women) completed self-report questionnaires, including the Emotion Regulation Questionnaire and the Positive and Negative Affect Schedule. Spectral analysis was performed on resting state frontal electroencephalogram activity that was collected for eight 1-min periods of alternating open and closed eyes. Relative beta and theta band power were extracted relative to global field power at frontal channels. Regression analysis revealed that positive affect is significantly predicted by theta power (β = 0.24, p = .007) and beta power (β = -0.33, p < .0001). There was an indirect effect of beta power on positive affect via reappraisal, but not suppression. Additionally, theta power significantly predicted suppression, but no indirect effect was observed between theta power and positive affect. These findings are consistent with a prior study reporting a positive and negative relationship between theta and beta power, respectively, and positive affect induction. This study elucidates how modulation of theta and beta bands link to ER strategies.

Emotion Regulation Frequency and Self-Efficacy: Differential Associations with Affective Symptoms

Successful emotion regulation is a critical component of mental health, and difficulties with emotion regulation have been associated with a wide range of disorders, including anxiety and depressive disorders. However, although much is known about commonly used forms of emotion regulation such as cognitive reappraisal and expressive suppression, the relative contribution of two important facets of emotion regulation-frequency and self-efficacy-is not yet clearly established. To address this issue, we conducted two studies. Study 1 employed a community sample (cross-sectional N = 431; 4- to 5-month longitudinal N = 182). Study 2 employed a clinical sample (cross-sectional N = 132). Both assessed emotion regulation frequency and self-efficacy, as well as affective outcomes (anxiety and depressive symptoms). Findings indicated cognitive reappraisal self-efficacy appears to be a relevant variable understanding negative affect outcomes, cross-sectionally, longitudinally and in the clinical sample. Our findings support the process model of emotion regulation in affective symptomatology. Implications for theory and treatment are discussed.

Association between personality traits and symptoms of depression and anxiety via emotional regulation and distress tolerance

The Big Five personality traits have shown associations with symptoms of depression and anxiety among college students, but it is unclear which factors mediate these relationships. Past research suggests that psychological distress is closely related to difficulties in affect regulation (e.g., low distress tolerance). Therefore, the present study examined the associations between personality traits and depression and anxiety via emotion regulation and distress tolerance. Participants were 694 (81.4% females; Mean age = 23.12 [SD 2.75]) Argentinian college students who completed an online survey examining mental health and personality variables. A sizeable percentage of students endorsed moderate to severe symptoms of depression (45.1%) or anxiety (25.9%). Utilizing path analyses, we found that appraisal, a dimension of distress tolerance, atemporally mediated the association between emotional stability and symptoms of depression/anxiety (i.e., higher levels of emotional stability → higher appraisal distress tolerance → fewer symptoms of depression/anxiety). Further, expressive suppression (a dimension of emotion regulation) significantly mediated the associations between personality traits (i.e., agreeableness and extraversion) and symptoms of depression (higher levels of agreeableness/extraversion → lower use of expressive suppression → fewer symptoms of depression). Taken together, the results suggest that higher levels of emotional stability, extraversion and agreeableness could protect students from the development of symptoms of depression/anxiety via lower maladaptive emotion regulation strategies and higher distress tolerance (particularly appraisal). These findings highlight the relevance of intervention strategies specifically tailored to improve distress tolerance and emotion regulation for those students undergoing mental health problems.

The role of objective sleep in implicit and explicit affect regulation: A comprehensive review

Impairments in sleep and affect regulation are evident across a wide range of mental disorders. Understanding the sleep factors that relate to affect regulatory difficulties will inform mechanistic understanding and aid in treatment. Despite rising interest, some research challenges in this area include integrating across different clinical and non-clinical literatures investigating the role of sleep architecture (measured with polysomnography) and experimentally manipulated sleep, as well as integrating more explicit versus implicit affect regulation processes. In this comprehensive review, we use a unifying framework to examine sleep's relationship with implicit-automatic regulation and explicit-controlled regulation, both of which are relevant to mental health (e.g., PTSD and depression). Many studies of implicit-automatic regulation (e.g., fear extinction and safety learning) demonstrate the importance of sleep, and REM sleep specifically. Studies of explicit-controlled regulation (e.g., cognitive reappraisal and expressive suppression) are less consistent in their findings, with results differing depending on the type of affect regulation and/or way that sleep was measured or manipulated. There is a clear relationship between objective sleep and affect regulation processes. However, there is a need for 1) more studies focusing on sleep and explicit-controlled affect regulation; 2) replication with the same types of regulation strategies; 3) more studies experimentally manipulating sleep to examine its impact on affect regulation and vice versa in order to infer cause and effect; and 4) more studies looking at sleep's impact on next-day affect regulation (not just overnight change in affect reactivity).

Contexts Matter in 'a Distress Shared Is a Distress Halved': A Meta-Analysis of Distress Sharing-Psychological Distress Relations

Can 'a distress shared is a distress halved' be universally applied? The relationship between sharing distress with others and individuals' psychological health may oscillate depending on how and where it is shared. This meta-analysis aimed to examine (1) whether the relationship between sharing distress and psychological distress is moderated by the manner of sharing (i.e. general tendency to share distress with others [general distress sharing] vs. ruminatively fixating on the negatives during the sharing [co-rumination]) and (2) cultural context (Eastern vs. Western). A total of 110 effect sizes from 105 studies (91 articles on general distress sharing and 84 articles on co-rumination) were included in the analysis with sharing manner as a moderator. For the cross-cultural analyses, 61 studies were included with 47 studies conducted in Western cultures and 15 studies conducted in Eastern cultures. Whereas generally sharing distress was negatively related to psychological distress, co-rumination showed a positive correlation with psychological distress. Culture significantly moderated co-rumination but not general distress sharing in relation to psychological distress. General distress sharing was consistently associated with decreased psychological distress across cultures. In contrast, co-rumination was related to deleterious psychological health only among Westerners, while Easterners showed a non-significant association with psychological distress. Our results align with the increasing importance of taking contextual factors into account in the field of emotion regulation literature.

Cognitive Reappraisal and Expressive Suppression Evoke Distinct Neural Connections during Interpersonal Emotion Regulation

Interpersonal emotion regulation is the dynamic process where the regulator aims to change the target's emotional state, which is presumed to engage three neural systems: cognitive control (i.e., dorsal and ventral lateral PFC, etc.), empathy/social cognition (i.e., dorsal premotor regions, temporal-parietal junction, etc.), and affective response (i.e., insula, amygdala, etc.). This study aimed to identify the underlying neural correlate (especially the interpersonal one), of interpersonal emotion regulation based on two typical strategies (cognitive appraisal, expressive suppression). Thirty-four female dyads (friends) were randomly assigned into two strategy groups, with one assigned as the target and the other as the regulator to downregulate the target's negative emotions using two strategies. A functional near-infrared spectroscopy system was used to simultaneously measure participants' neural activity. Results showed that these two strategies could successfully downregulate the targets' negative emotions. Both strategies evoked intrapersonal and interpersonal neural couplings between the cognitive control, social cognition, and mirror neuron systems (e.g., PFC, temporal-parietal junction, premotor cortex, etc.), whereas cognitive reappraisal (vs expressive suppression) evoked a broader pattern. Further, cognitive reappraisal involved increased interpersonal brain synchronization between the prefrontal and temporal areas at the sharing stage, whereas expressive suppression evoked increased interpersonal brain synchronization associated with the PFC at the regulation stage. These findings indicate that intrapersonal and interpersonal neural couplings associated with regions within the abovementioned systems, possibly involving mental processes, such as cognitive control, mentalizing, and observing, underlie interpersonal emotion regulation based on cognitive reappraisal or expressive suppression.SIGNIFICANCE STATEMENT As significant as intrapersonal emotion regulation, interpersonal emotion regulation subserves parent-child, couple, and leader-follower relationships. Despite enormous growth in research on intrapersonal emotion regulation, the field lacks insight into the neural correlates underpinning interpersonal emotion regulation. This study aimed to probe the underlying neural correlates of interpersonal emotion regulation using a multibrain neuroimaging (i.e., hyperscanning) based on functional near-infrared spectroscopy. Results showed that both cognitive reappraisal and expressive suppression strategies successfully downregulated the target's negative emotions. More importantly, they evoked intrapersonal and interpersonal neural couplings associated with regions within the cognitive control, social cognition, and mirror neuron systems, possibly involving mental processes, such as cognitive control, mentalizing, and observing. These findings deepen our understanding of the neural correlates underpinning interpersonal emotion regulation.

Habitual Expressive Suppression of Positive, but not Negative, Emotions Consistently Predicts Lower Well-being across Two Culturally Distinct Regions

Habitual expressive suppression (i.e., a tendency to inhibit the outward display of one's emotions; hereafter suppression) is often conceptualized as a maladaptive emotion regulation strategy. Yet, is this equally true for suppression of positive and of negative emotions? Across three studies and seven samples (total N > 1300 people) collected in two culturally distinct regions (i.e., Taiwan and the US), we examined the separability and distinct well-being effects of suppressing positive vs. negative emotions. Results consistently showed that (a) people suppressed their positive (vs. negative) emotions less, (b) the construct of suppression of positive (vs. negative) emotions was conceptually farther away from that of suppression of emotions in general, (c) suppression of positive and of negative emotions were only moderately correlated, and (d) only suppression of positive, but not negative, emotions, predicted lower well-being. An internal meta-analysis (k = 52 effect sizes) showed that these associations were robust to the inclusion of age, gender, and region as covariates. Future research may further probe the respective links between suppression of positive and of negative emotions and well-being across more cultural regions and across the life-span.

Perceived stress and affective experience in Italian teachers during the COVID-19 pandemic: correlation with coping and emotion regulation strategies

The COVID-19 pandemic has represented a source of stress for teachers by adding new challenges. The objective of this study was to assess the association between emotion regulation and coping strategies, on the one hand, and perceived stress and affective experience on the other among teachers during the COVID-19 pandemic. A sample of 1178 of Italian pre-primary, primary, and secondary school teachers completed an online survey. Three hierarchical linear regression analyses were run to evaluate teachers’ emotion regulation, coping strategies, years of teaching experience, perceived workload, and perceptions about online teaching in predicting their perceived stress and positive and negative affect. The findings showed that cognitive reappraisal and positive attitude were associated with a lower level of perceived stress and negative affect and a higher level of positive affect. Problem orientation strategies were also associated with a higher level of positive affect. By contrast, expressive suppression was correlated with a higher level of perceived stress. Avoidance coping strategies were associated with higher perceived stress and negative affect and a lower level of positive affect. The perceived burden of online teaching was positively related with perceived stress and negative affect. Confidence in using educational technologies predicted lower levels of perceived stress, and previous online teaching experience was positively correlated with positive affect. The findings of this study could be useful for implementing teacher training programmes on emotion regulation and coping strategies to reduce stress and promote positive affect.

Translation and Validation of the Malay Version of the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA)

The Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA) has been translated and adapted globally. This study aimed to examine the psychometric properties of the Malay version of the ERQ-CA. The ERQ-CA underwent forward and back translation twice and was tested in two separate studies, Study 1 and Study 2, with 296 and 359 students aged between 13 and 14 years old, respectively. Cronbach's alpha values were calculated, and confirmatory factor analysis was conducted. The results from Study 1 demonstrate good internal consistency for cognitive reappraisal and expressive suppression. The results indicate a good factor loading for most of the items, but only one value of the goodness-of-fit met the criteria for a good fit. The results from Study 2 show improvements in the values of the goodness-of-fit that are comparable to previous studies, but there was a decrease in the factor loading scores. Overall, the Malay version of the ERQ-CA possesses acceptable reliability and validity. Further studies are required in the near future to develop a Malay version of the ERQ-CA that reasonably represents Malaysian adolescents.

The neural bases of expressive suppression: A systematic review of functional neuroimaging studies

Expressive suppression refers to the inhibition of emotion-expressive behavior (e.g., facial expressions of emotion). Although it is a commonly used emotion regulation strategy with well-documented consequences for well-being, little is known about its underlying mechanisms. In this systematic review, we for the first time synthesize functional neuroimaging studies on the neural bases of expressive suppression in non-clinical populations. The 12 studies included in this review contrasted the use of expressive suppression to simply watching emotional stimuli. Results showed that expressive suppression consistently increased activation of frontoparietal regions, especially the dorsolateral and ventrolateral prefrontal cortices and inferior parietal cortex, but decreased activation in temporo-occipital areas. Results regarding the involvement of the insula and amygdala were inconsistent with studies showing increased, decreased, or no changes in activation. These mixed findings underscore the importance of distinguishing expressive suppression from other forms of suppression and highlight the need to pay more attention to experimental design and neuroimaging data analysis procedures. We discuss these conceptual and methodological issues and provide suggestions for future research.

Affect regulation as a moderator of intentions for breast cancer chemoprevention

Women at high risk for breast cancer (BC) may consider chemoprevention for risk reduction, but uptake is low. This study examined the role of affect regulation (the attempt to alter or control one's emotions) in decision-making about BC chemoprevention. A cross-sectional, single group design was used. High-risk women (N = 81) were surveyed. Moderation analyses specified cancer-specific distress as the independent variable, affect regulation (cognitive reappraisal or expressive suppression) as the moderator, and chemoprevention intentions (yes = 1, unsure = 0, no = -1) as the dependent variable. Cognitive reappraisal significantly moderated the relationship between cancer-specific distress and chemoprevention intentions (p = 0.03), but expressive suppression did not (p = 0.31). For the 44% of participants who were highest on reappraisal, higher cancer-specific distress was associated with greater intentions for chemoprevention. For the remaining 56%, there was no relationship between cancer-specific distress and chemoprevention intentions. Cognitive reappraisal may play an important role in decisions regarding uptake of chemoprevention.

Positive rumination can (also) interfere with sleep: A study in a non-clinical sample

It is postulated that negative ruminations perpetuate insomnia symptoms by increasing arousal. Less is known about the role of positive rumination. In this study, we set out to test the association between positive and negative ruminations and insomnia symptoms in a non-clinical sample, asking whether reappraisal and suppression moderate the relationship between rumination types and symptoms of insomnia.

METHODS

A convenience sample of 354 participants (59% women), ages 18-50, responded to online questionnaires regarding symptoms of insomnia (Insomnia Severity Index [ISI]), Emotion Regulation Questionnaire that provides separate scales for Reappraisal and Suppression, Negative Rumination (Ruminative Response Scale), Positive Rumination and Dampening (Responses to Positive Affect questionnaire), and general health and demographics.

RESULTS

About 30% of respondents had moderate to severe symptoms of insomnia according to the ISI. The primary hypothesis was tested using three moderation models, where rumination type, emotion regulation styles, and interaction terms were predictors, and ISI scores were the outcome variable. Negative rumination positively predicted ISI (β = 0.56, p < 0.001), while the interaction terms with Reappraisal (β = 0.02, p = 0.575) and Suppression (β = 0.07, p = 0.092) were not significant. Dampening also positively predicted ISI (β = 0.56, p < 0.001), with the interaction term with Reappraisal nearly significant (β = -0.09, p = 0.060), but not with Suppression (β = 0.08, p =0.098). Positive rumination negatively predicted ISI (β = -0.12, p = 0.021), this relationship was reversed with emotion regulation factors in the model (β = 0.11, p = 0.094), where the interaction with Reappraisal (β = 0.13, p = 0.020) and Suppression (β = -0.13, p = 0.024) were both significant.

DISCUSSION

Positive Rumination weakly and negatively correlated with ISI, but the combination with Reappraisal was associated with more insomnia symptoms. By contrast, Dampening was associated with more insomnia symptoms, with minimal to no moderating effects. These observations are interpreted in the context of the role of emotion regulation strategies and sleep, and their potential clinical implications.