Does Psychosocial Stress Impact Cognitive Reappraisal? Behavioral and Neural Evidence

The influence of acute stress exposure on cognitive reappraisal: a psychophysiological study

Successful and efficient emotion regulation (ER) is a key mechanism for mental health. However, acute stress may impact the ability to cognitively regulate negative emotions due to its immediate effects on executive functioning. Based on previous studies, we expected that the time at which ER is tested after a stressor might have a decisive influence, with impairments in ER being more pronounced immediately after stress as compared to a later post-stress phase. To investigate such a time-dependent effect of stress on ER, we investigated 50 healthy adults (26 female) who were exposed to either the Trier Social Stress Test (n = 25) or a control condition (n = 25). Afterwards subjects conducted a cognitive ER task during which they were instructed to either regulate (cognitive reappraisal) or passively view neutral and negative visual stimuli. The ER task was divided into an early (0-20 minutes) and a late post-stress phase (20-40 minutes). Salivary cortisol and α-amylase were assessed as markers of the neuroendocrine stress response. Self-reported emotional state, the mean activity of the late positive potential measured via electroencephalogram (EEG), and corrugator electromyographic activity (EMG) were used as indices of ER. While the groups did not differ in the early post-stress phase, our results suggest a stress-related impairment in ER in the late post-stress phase. This effect was evident in all ER outcome variables (subjective rating, EEG, and EMG data). These results suggest a time-specific stress effect on cognitive reappraisal, which would have implications for reappraisal as a possible stress management technique.

Unpacking reappraisal: a systematic review of fMRI studies of distancing and reinterpretation

In recent decades, a substantial volume of work has examined the neural mechanisms of cognitive reappraisal. Distancing and reinterpretation are two frequently used tactics through which reappraisal can be implemented. Theoretical frameworks and prior evidence have suggested that the specific tactic through which one employs reappraisal entails differential neural and psychological mechanisms. Thus, we were motivated to assess the neural mechanisms of this distinction by examining the overlap and differentiation exhibited by the neural correlates of distancing (specifically via objective appraisal) and reinterpretation. We analyzed 32 published functional magnetic resonance imaging (fMRI) studies in healthy adults using multilevel kernel density analysis. Results showed that distancing relative to reinterpretation uniquely recruited right bilateral dorsolateral PFC (DLPFC) and left posterior parietal cortex, previously associated with mentalizing, selective attention and working memory. Reinterpretation relative to distancing uniquely recruited left bilateral ventrolateral PFC (VLPFC), previously associated with response selection and inhibition. Further, distancing relative to reinterpretation was associated with greater prevalence of bilateral amygdala attenuation during reappraisal. Finally, a behavioral meta-analysis showed efficacy for both reappraisal tactics. These results are consistent with prior theoretical models for the functional neural architecture of reappraisal via distancing and reinterpretation and suggest potential future applications in region-of-interest specification and neural network analysis in studies focusing on specific reappraisal tactics.

What a difference timing makes: Cortisol effects on neural underpinnings of emotion regulation

The ability of emotion regulation under stress is of crucial importance to psychosocial health. Yet, the dynamic function of stress hormones for the cognitive control of emotions over time via non-genomic and genomic cortisol effects remains to be elucidated. In this randomized, double-blind, placebo-controlled neuroimaging experiment, 105 participants (54 men, 51 women) received 20 mg hydrocortisone (cortisol) or a placebo either 30min (rapid, non-genomic cortisol effects) or 90min (slow, genomic cortisol effects) prior to a cognitive reappraisal task including different regulatory goals (i.e., downregulate vs. upregulate negative emotions). On the behavioral level, cortisol rapidly reduced and slowly enhanced emotional responsivity to negative pictures. However, only slow cortisol effects improved downregulation of negative emotions. On the neural level, cortisol rapidly enhanced, but slowly reduced amygdala and dorsolateral prefrontal activation as well as functional connectivity between both structures in the down- minus upregulate contrast. This interaction speaks for an effortful but ineffective regulation of negative emotions during rapid cortisol effects and improved emotion regulation capacities during slow cortisol effects. Taken together, these results indicate a functional shift of cortisol effects on emotion regulation processes over time which may foster successful adaptation to and recovery from stressful life events.

The Stressed Brain: Neural Underpinnings of Social Stress Processing in Humans

As humans, we face a variety of social stressors on a regular basis. Given the established role of social stress in influencing physical and psychological functioning, researchers have focused immense efforts on understanding the psychological and physiological changes induced by exposure to acute social stressors. With the advancement of functional magnetic resonance imaging (fMRI), more recent work has sought to identify the neural correlates of processing acute social stress. In this review, we provide an overview of research on the neural underpinnings of social stress processing to date. Specifically, we summarize research that has examined the neural underpinnings of three types of social stressors commonly studied in the literature: social rejection, social evaluation, and racism-related stress. Within our discussion of each type of social stressor, we describe the methods used to induce stress, the brain regions commonly activated among studies investigating that type of stress, and recommendations for future work. This review of the current literature identifies activity in midline regions in both prefrontal and parietal cortices, as well as lateral prefrontal regions, as being associated with processing social rejection. Activity in the insula, thalamus, and inferior frontal gyrus is often found in studies using social evaluation tasks. Finally, racism-related stress is associated with activity in the ventrolateral prefrontal cortex and rostral anterior cingulate cortex. We conclude by taking a "30,000-foot view" of this area of research to provide suggestions for the future of research on the neuroscience of social stress.

Associations between brain activity and endogenous and exogenous cortisol - A systematic review

To arrive at a coherent understanding of the relation between glucocorticoids and the human brain, we systematically reviewed the literature for studies examining the associations between endogenous or exogenous cortisol and human brain function. Higher levels of endogenous cortisol during psychological stress were related to increased activity in the middle temporal gyrus and perigenual anterior cingulate cortex (ACC), decreased activity in the ventromedial prefrontal cortex, and altered function (i.e., mixed findings, increased or decreased) in the amygdala, hippocampus and inferior frontal gyrus. Moreover, endogenous cortisol response to psychological stress was related to increased activity in the inferior temporal gyrus and altered function in the amygdala during emotional tasks that followed psychological stress. Exogenous cortisol administration was related to increased activity in the postcentral gyrus, superior frontal gyrus and ACC, and altered function in the amygdala and hippocampus during conditioning, emotional and reward-processing tasks after cortisol administration. These findings were in line with those from animal studies on amygdala activity during and after stress.

Physiological arousal and visuocortical connectivity predict subsequent vividness of negative memories

Relative to neutral memories, negative and positive memories both exhibit an increase in memory longevity, subjective memory re-experiencing and amygdala activation. These memory enhancements are often attributed to shared influences of arousal on memory. Yet, prior work suggests the intriguing possibility that arousal affects memory networks in valence-specific ways. Psychophysics work has shown that arousal-related heart rate deceleration (HRD) responses are related to enhanced amygdala-visual functional connectivity (AVFC) and visual perception of negative stimuli. However, in the memory realm, it is not known whether the effect of AVFC influences subsequent negative memory outcomes as a function of the magnitude of physiological arousal during encoding. Using psycho-autonomic interaction analyses and trial-level measures of HRD as an objective measure of arousal during encoding of emotional stimuli, our findings suggest that the magnitude of the HRD modulates the effect of AVFC on subsequent negative memory vividness. Specifically, AVFC effects in early visual regions predicted negative memory vividness, not neutral or positive vividness, but only in the presence of heightened physiological arousal. This novel approach was grounded in a replication of prior working showing enhanced HRD effects in the insula for negative stimuli. These findings demonstrate that the effect of arousal on emotional memory networks depends on valence and provide further evidence that negative valence may enhance the incorporation of visuo-sensory regions into emotional memory networks.

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.

Increasing Deactivation of Limbic Structures Over Psychosocial Stress Exposure Time

BACKGROUND

Understanding the interplay between central nervous system and hypothalamic-pituitary-adrenal axis responses to stress in humans is assumed to be essential to contribute to the central question of stress research, namely how stress can increase disease risk. Therefore, the present study used a neuroimaging stress paradigm to investigate the interplay of 3 stress response domains. Furthermore, we asked if the brain's stress response changes over exposure time.

METHODS

In a functional magnetic resonance imaging study, changes in brain activation, cortisol levels, affect, and heart rate in response to an improved ScanSTRESS protocol were assessed in 67 young, healthy participants (31 females).

RESULTS

Stress exposure led to significant increases in cortisol levels, heart rate, and negative affect ratings as well as to activations and deactivations in (pre)limbic regions. When cortisol increase was used as a covariate, stronger responses in the hippocampus, amygdala, medial prefrontal cortex, and cingulate gyrus were observed. Responses within the same regions predicted negative affect ratings. Remarkably, an increasing deactivation over the two ScanSTRESS runs was found, again, in the same structures. A reanalysis of an independent sample confirmed this finding.

CONCLUSIONS

For the first time, reactions in a cluster of (pre)limbic structures was consistently found to be associated with changes in cortisol and negative affect. The same neural structures showed increasing deactivations over stress exposure time. We speculate that investigating possible associations between exposure-time effects in neural stress responses and stress-related interindividual differences (e.g., chronic stress) might be a promising new avenue in stress research.

Examining the Causal Effects of Sleep Deprivation on Emotion Regulation and Its Neural Mechanisms

Cognitive reappraisal (CR) is a strategy used to regulate emotions that is thought to be effective but effortful, relying on higher-order cognitive control systems to engage in active regulation. Sleep deprivation is believed to impair the functioning of these control systems, suggesting that it may impede the ability to implement CR effectively. This study tested the causal effects of sleep deprivation on emotional reactivity and the neurobiological systems underlying CR. We employed a within-subject crossover design in which participants underwent fMRI scanning twice, once when fully rested and once after a night of total sleep deprivation. During scans, participants passively viewed or used CR to down-regulate their emotional response to negative and neutral images. Contrary to hypotheses, both self-reported negative affect ratings and neural responses to the images indicated no difference in the way participants implemented CR when sleep deprived and when fully rested. Meanwhile, neural regions that showed distinct reactivity responses to negative relative to neutral images lost this specificity under deprived conditions. Negative affect ratings and heart rate deceleration, a physiological response typically evoked by aversive pictures, exhibited a similar blunting. Together, these results suggest that, although sleep deprivation may reduce the discrimination between emotional reactivity responses to negative and neutral stimuli, it does not impact CR the way it is presently studied.

Stress Influences the Effect of Obsessive-Compulsive Symptoms on Emotion Regulation

Obsessive-compulsive disorder (OCD) is associated with emotion regulation impairments, namely the frequent use of maladaptive strategies such as suppression and the decreased use of reappraisal strategies. Additionally, these patients exhibit elevated stress levels. Since stress exposure affects emotion regulation abilities, stress might influence the relationship between obsessive-compulsive symptoms and emotion regulation. In this study, we explored the effects of stress and obsessive-compulsive symptoms on emotion regulation in a sample of healthy and OCD individuals. We used self-reported psychometric scales to measure stress levels, obsessive-compulsive symptoms, and emotion reappraisal and suppression skills. We applied multiple regression and mediation analyses. Our results demonstrated that increased reappraisal scores were associated with higher suppression scores. Additionally, elevated stress values predicted increased scores for suppression and decreased scores for reappraisal. Furthermore, the reappraisal abilities resulted from a combination of a direct effect of obsessive-compulsive symptoms and an indirect effect of obsessive-compulsive symptoms mediated by stress. The reliance on suppression strategies and the difficulty in using reappraisal approaches are explained by stress levels and are not directly explained by obsessive-compulsive symptoms. This study highlights the necessity of targeting stress in current therapy-based treatments for OCD.

Cognitive reappraisal in an unpredictable world: Prior context matters

Cognitive reappraisal is a higher order emotion regulation strategy, the effects of which can be measured using the late positive potential (LPP), an event-related potential that is larger for emotional versus neutral stimuli. Whereas the lab provides a relatively predictable and calm environment in which to engage in reappraisal, outside of the lab, individuals may need to enact reappraisal in unpredictable and anxiety-provoking environments. In prior work, unpredictable auditory tones have been shown to increase threat-processing and induce anxiety. Here, forty-seven participants performed a reappraisal task while being exposed in a blockwise fashion to a "Random Tone" sequence or silence ("No Tone"), to determine the effects of an unpredictable auditory stimulus on the reappraisal of negative pictures. In addition, exploratory analyses assessed whether starting block (i.e., beginning the task in a Random Tone versus No Tone block) would moderate effects. Results showed that during an early time window, reappraisal LPPs were smallest for participants who started in a No Tone block and who performed reappraisal in a No Tone block. Therefore, reappraisal may be optimally performed when conditions are predictable/calm, by participants whose initial learning context was also predictable/calm. In addition, larger LPPs for negative versus neutral images were only observed throughout the later portion of picture presentation for participants who began in a Random Tone block, suggesting that unpredictability may increase sustained attention towards aversive stimuli. The results fit within a growing body of work aimed at understanding contextual and individual differences in emotion regulation.

Acute stress modifies oscillatory indices of affective processing: Insight on the pathophysiology of schizophrenia spectrum disorders

OBJECTIVE

The current study evaluated the differential impact of acute psychosocial stress exposure on oscillatory correlates of affective processing in control participants and patients with schizophrenia spectrum disorders (SCZ) to elucidate the stress-mediated pathway to psychopathology.

METHODS

EEG was recorded while 21 control participants and 21 patients with SCZ performed emotional framing tasks (assessing a key aspect of emotion regulation (ER)) before and after a laboratory stress challenge (Trier Social Stress Test). EEG spectral perturbations evoked in response to neutral and aversive stimuli (presented with positive or negative contextual cues) were extracted in theta (4-8 Hz) and beta (12-30 Hz) frequencies.

RESULTS

Patients demonstrated aberrant theta and beta oscillatory activity, with impaired frontal theta-mediated framing and beta-derived motivated attention processes relative to controls. Following stress exposure, controls exhibited impaired frontal theta-mediated emotional framing, similar to the oscillatory profile observed in patients before stress.

CONCLUSIONS

The acute stress-induced oscillatory changes observed in controls were persistently present in patients, indicating an inefficiency of fronto-limbic adaptation to stress exposure.

SIGNIFICANCE

Results provide novel insight on the electrophysiological correlates of arousal and affect regulation, which are core homogeneous symptom dimensions shared across neuropsychiatric disorders, and shed light on putative mechanisms in the translation of stress into psychopathology.

Emotion Reactivity and Regulation in Adolescent Girls Following an Interpersonal Rejection

Failures in emotion regulation, especially as a result of interpersonal stress, are implicated as transdiagnostic risk factors for psychopathology. This study examines the effects of an experimentally timed targeted interpersonal rejection on emotion reactivity and regulation in typically developing adolescent girls. Girls ( n = 33, ages 9-16 years, M = 12.47, SD = 2.20) underwent fMRI involving a widely used emotion regulation task. The emotion task involves looking at negative stimuli and using cognitive reappraisal strategies to decrease reactions to negative stimuli. Participants also engaged in a social evaluation task, which leads participants to believe a preselected peer was watching and evaluating the participant. We subsequently told participants they were rejected by this peer and examined emotion reactivity and regulation before and after this rejection. Adolescent girls evidence greater reactivity via higher self-reported emotional intensity and greater amygdala activation to negative stimuli immediately after (compared with before) the rejection. Self-reported emotional intensity differences before and after rejection were not observed during regulation trials. However, on regulation trials, girls exhibited increased prefrontal activation in areas supporting emotion regulation after compared with before the rejection. This study provides evidence that a targeted rejection increases self-report and neural markers of emotion reactivity and that girls increase prefrontal activation to regulate emotions after a targeted rejection.

Stress impacts the fidelity but not strength of emotional memories

Psychological stress during memory encoding influences resulting memory representations. However, open questions remain regarding how stress interacts with emotional memory. This interaction has mainly been studied by characterizing the correct identification of previously observed material (memory "hits"), with few studies investigating how stress influences the endorsement of unobserved material as remembered (memory "false alarms"). While hits can provide information about the presence or strength of a memory representation, false alarms provide insight into memory fidelity, indicating to what extent stored memories are confused with similar information presented at retrieval. This study examined the effects of stress on long-term memory for negative and neutral images, considering the separate contributions of hits and false alarms. Participants viewed images after repeated exposure to either a stress or a control manipulation. Stress impaired memory performance for negative pictures and enhanced memory performance for neutral pictures. These effects were driven by false alarms rather than hits: stressed participants false alarmed more often for negative and less often for neutral images. These data suggest that stress undermines the benefits of emotion on memory by changing individuals' susceptibility towards false alarms, and highlight the need to consider both memory strength and fidelity to characterize differences in memory performance.