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

Neural underpinnings of individual differences in emotion regulation: A systematic review

This review synthesises individual differences in neural processes related to emotion regulation (ER). It comprises individual differences in self-reported and physiological regulation success, self-reported ER-related traits, and demographic variables, to assess their correlation with brain activation during ER tasks. Considering region-of-interest (ROI) and whole-brain analyses, the review incorporated data from 52 functional magnetic resonance imaging studies. Results can be summarized as follows: (1) Self-reported regulation success (assessed by emotional state ratings after regulation) and self-reported ER-related traits (assessed by questionnaires) correlated with brain activity in the lateral prefrontal cortex. (2) Amygdala activation correlated with ER-related traits only in ROI analyses, while it was associated with regulation success in whole-brain analyses. (3) For demographic and physiological measures, there was no systematic overlap in effects reported across studies. In showing that individual differences in regulation success and ER-related traits can be traced back to differences in the neural activity of brain regions associated with emotional reactivity (amygdala) and cognitive control (lateral prefrontal cortex), our findings can inform prospective personalised intervention models.

Emotion suppression and acute physiological responses to stress in healthy populations: a quantitative review of experimental and correlational investigations

Emotion suppression may be linked to poor health outcomes through elevated stress-related physiology. The current meta-analyses investigate the magnitude of the association between suppression and physiological responses to active psychological stress tasks administered in the laboratory. Relevant articles were identified through Medline, PsychINFO, PubMed, and ProQuest. Studies were eligible if they (a) used a sample of healthy, human subjects; (b) assessed physiology during a resting baseline and active psychological stress task; and (c) measured self-report or experimentally manipulated suppression. Twenty-four studies were identified and grouped within two separate random effects meta-analyses based on study methodology, namely, manipulated suppression (k = 12) and/or self-report (k = 14). Experimentally manipulated suppression was associated with greater physiological stress reactivity compared to controls (Hg = 0.20, 95% CI [0.08, 0.33]), primarily driven by cardiac, hemodynamic, and neuroendocrine parameters. Self-report trait suppression was not associated with overall physiological stress reactivity but was associated with greater neuroendocrine reactivity (r = 0.08, 95% CI [0.01, 0.14]). Significant moderator variables were identified (i.e., type/duration of stress task, nature of control instructions, type of physiology, and gender). This review suggests that suppression may exacerbate stress-induced physiological arousal; however, this may differ based upon the chosen methodological assessment of suppression.

The effect of emotion regulation on the emotional modulation of pain and nociceptive flexion reflex

ABSTRACT

Positive emotions inhibit pain, whereas negative emotions facilitate pain. Thus, many psychosocial interventions capitalize on this emotion-pain relationship to improve patients' abilities to regulate emotion (ie, reduce negative emotion, increase positive emotion), influence nociception, and manage pain. This study extended the existing literature to examine whether emotion regulation procedures could influence emotional modulation of the nociceptive flexion reflex (NFR), a marker of spinal nociception. To elicit emotion, 2 blocks of pleasant, neutral, and unpleasant pictures were presented. In block 1, participants were asked to passively view pictures during which painful electric stimulations were delivered to evoke pain and the NFR. Valence, arousal, corrugator electromyogram, and skin conductance response were used to measure emotional responses to pictures. To manipulate emotion regulation, participants were randomized to either suppress (downregulate) or enhance (upregulate) their emotion during block 2 (other procedures same as block 1). Instructions to suppress decreased subjective and physiological responding to emotional pictures, reduced emotional modulation of pain, and generally decreased NFR magnitude (regardless of picture content). Instructions to enhance emotion increased subjective responding to emotional pictures but did not alter physiological responding to pictures or emotional modulation of pain/NFR in predictable ways. Results imply that downregulation/suppression of negative emotions may work best to reduce pain facilitation. Furthermore, this study contributes to the existing literature that shows that pain and pain signaling is tightly coupled with emotional states and that emotion regulation can impact pain perception.

Which emotion regulation strategy is efficient for whom? Reappraisal and suppression efficiency for adaptive and maladaptive personality profiles

OBJECTIVE

This study aimed to explore the efficiency of different emotion regulation strategies, specifically reappraisal and suppression, in relation to adaptive and maladaptive personality profiles.

BACKGROUND

Personality conditions emotions and influences emotion regulation. Of the available regulation strategies, reappraisal (reinterpreting the situation) is described as an efficient strategy, whereas suppression (not displaying the experienced emotion) carries higher physiological and cognitive costs. Little is known, however, about the influence of personality on these efficiencies.

METHOD

We tested the personality structure of 102 participants (Meanage = 20.75, SDage = 2.15), based on the Five-Factor Model and the Maladaptive Personality Trait Model. Experience, expressivity, and physiological arousal were recorded during the viewing of emotionally charged positive and negative images while participants reappraised, suppressed, or viewed the images without regulating their emotions.

RESULTS

We identified two clusters for adaptive personality ("Adaptive Resilient" and "Anti-resilient") and two for maladaptive personality ("Maladaptive Resilient" and "Under-controlled"). The major finding was for emotional experience in maladaptive personalities, where reappraisal was efficient in the Maladaptive Resilient profile, while none of the strategies brought relief in the Under-controlled profile.

CONCLUSION

This study, which systematically contrasts personality and efficiency of emotion regulation strategies, is one of the first attempts to refine the understanding of how personality influences the emotional regulation process.

Emotion beliefs, emotion regulation strategies, and test anxiety of Chinese adolescents in grade 8: Evidence from physiological recordings during an exam

Controllability beliefs and goodness beliefs about emotion are two fundamental emotion beliefs. The present study considered both controllability beliefs and goodness beliefs to examine whether and how the emotion beliefs of adolescents influence their test anxiety. Besides self-reported test anxiety (sr-TA), the present study measured heart rate (HR) and galvanic skin response (GSR) using custom-designed wristbands during an exam as indicators of state test anxiety. The GSR was further decomposed into the tonic skin conductance level and the transient skin conductance response. The results revealed that, after controlling the goodness beliefs about anxiety, the controllability beliefs about emotion were negatively related to sr-TA. This relationship was mediated by suppression. The controllability beliefs about emotion were directly related to the integration of transient skin conductance responses of 5 min before the exam. They were also indirectly related to the integration of transient skin conductance responses of the exam period, whether including the 5 min before the exam or not, and HR during certain periods through suppression. Therefore, adolescents' controllability beliefs about emotion may have important implications for their test anxiety.

Facing emotions: real-time fMRI-based neurofeedback using dynamic emotional faces to modulate amygdala activity

Introduction

Maladaptive functioning of the amygdala has been associated with impaired emotion regulation in affective disorders. Recent advances in real-time fMRI neurofeedback have successfully demonstrated the modulation of amygdala activity in healthy and psychiatric populations. In contrast to an abstract feedback representation applied in standard neurofeedback designs, we proposed a novel neurofeedback paradigm using naturalistic stimuli like human emotional faces as the feedback display where change in the facial expression intensity (from neutral to happy or from fearful to neutral) was coupled with the participant's ongoing bilateral amygdala activity.

Methods

The feasibility of this experimental approach was tested on 64 healthy participants who completed a single training session with four neurofeedback runs. Participants were assigned to one of the four experimental groups (n = 16 per group), i.e., happy-up, happy-down, fear-up, fear-down. Depending on the group assignment, they were either instructed to "try to make the face happier" by upregulating (happy-up) or downregulating (happy-down) the amygdala or to "try to make the face less fearful" by upregulating (fear-up) or downregulating (fear-down) the amygdala feedback signal.

Results

Linear mixed effect analyses revealed significant amygdala activity changes in the fear condition, specifically in the fear-down group with significant amygdala downregulation in the last two neurofeedback runs as compared to the first run. The happy-up and happy-down groups did not show significant amygdala activity changes over four runs. We did not observe significant improvement in the questionnaire scores and subsequent behavior. Furthermore, task-dependent effective connectivity changes between the amygdala, fusiform face area (FFA), and the medial orbitofrontal cortex (mOFC) were examined using dynamic causal modeling. The effective connectivity between FFA and the amygdala was significantly increased in the happy-up group (facilitatory effect) and decreased in the fear-down group. Notably, the amygdala was downregulated through an inhibitory mechanism mediated by mOFC during the first training run.

Discussion

In this feasibility study, we intended to address key neurofeedback processes like naturalistic facial stimuli, participant engagement in the task, bidirectional regulation, task congruence, and their influence on learning success. It demonstrated that such a versatile emotional face feedback paradigm can be tailored to target biased emotion processing in affective disorders.

The role of engagement and arousal in emotion regulation: an EEG study

Cognitive reappraisal and expressive suppression are well-studied strategies of emotion regulation (ER). However, the results on their physiological basis are controversial. While in some studies, ER was accompanied by the inhibition of the nervous system, others suggested that ER even might increase arousal and engagement. We calculated the inter-subject correlation (ISC) and indices of engagement, valence and arousal of EEG during suppression, reappraisal, or natural watching of neutral and negative videos. First, both suppression and reappraisal provoked a higher ISC in comparison with watching negative or neutral videos. We consider this as a marker of engagement to the task and feedback processing required for ER. Second, the engagement index was lower during ER compared to watching negative videos in central electrodes, whereas both strategies provoked a higher engagement in frontal electrodes. Third, the arousal index of EEG was higher during all negative conditions; therefore, regulation required a certain level of arousal. In summary, different EEG measures seem to be sensitive to different aspects of ER.

A unique neuropsychophysiological approach to objectify emotion (dys)regulation in healthy older adults during the COVID-19 pandemic

The response of older people to the COVID-19 pandemic has attracted much attention as they are at increased risk of adverse outcomes. A longitudinal study has shown that improvement in global cognitive, executive and language functioning in healthy older adults enrolled at the University of the Third Age appears to play a protective role against emotional dysregulation and mood changes during the pandemic. To date, no study has examined emotional dysregulation through COVID-19-related images using facial electromyographic recordings in healthy older adults. Therefore, we aimed to analyze the relationships between zygomaticus and corrugator reactivity, neuropsychological measures, and the affective dimensions of arousal, dominance, and valence. The results showed an unexpected association between higher zygomaticus activity and higher levels of apathy, depression, and anxiety. In contrast, increased contracture of the corrugator was associated with poorer performance on cognitive tests (global cognition, memory, executive functions) and physical status, i.e., walking speed. These results are consistent with the reappraisal of emotional stimuli in response to the challenges of the pandemic. Interestingly, COVID-19-related stimuli triggered the activation of bottom-up affectivity strategies associated with higher mood levels and interacted with top-down factors that play an important role in the dysregulation of cognitive control.

Emotion regulation tendencies and cardiovascular responses to repeated acute psychological stress

Poor emotion regulation has been associated with cardiovascular disease (CVD) through maladaptive cardiovascular responses to psychological stress. However, there has been scant research examining the relationship between emotion regulation and habituation of cardiovascular responses to recurrent stress, which may be more directly applicable to the experience of stress in everyday life. The aims of the current study were to examine the associations between emotion regulation tendencies and cardiovascular stress reactivity, as well as habituation of cardiovascular reactivity across repeated stressors. A sample of 453 participants (mean (SD) age = 19.5 (1.3) years; 62 % women) completed a repeated stress paradigm, which consisted of two 10-minute baselines and two identical 4-minute stress tasks, separated by a 10-minute recovery period. Heart rate (HR) was measured continuously; systolic/diastolic blood pressures (SBP/DBP) were measured every 2 min. At the end of the visit, participants completed the Emotion Regulation Questionnaire (ERQ) and Difficulties in Emotion Regulation Scale (DERS). Results indicate that impulse control difficulties when distressed (a DERS subscale) were significantly associated with blunted SBP, DBP, and HR reactivity to both stressors, as well as impaired HR habituation across the stressors. None of the ERQ subscales (cognitive reappraisal, expressive suppression) were found to be associated with cardiovascular stress reactivity or habituation. The outcomes of this study demonstrate a potential underlying physiological pathway through which impulse control difficulties when distressed may contribute to CVD risk. This study also reveals the importance of extending traditional cardiovascular stress reactivity protocols to include multiple exposures of the same stress task.

Boosting affective control with bifrontal transcranial direct current stimulation (tDCS): a proof-of-concept study in healthy individuals

Affective control refers to the ability to regulate emotions and is considered a marker of mental health. Transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique, holds promise to enhance affective control. In this between-subjects study in healthy individuals, we investigated the effects of bifrontal tDCS on core processes and higher-level markers of affective control. As such, we assessed direct tDCS effects on emotional interference during an affective control task and indirect effects on an instructed reappraisal task afterward. Results showed that the affective control task combined with active tDCS, compared to sham, resulted in enhanced cognitive emotion regulation. Specifically, participants in the active tDCS condition showed an increased propensity to use reappraisal and were more successful in doing so. Moreover, there was reduced vagally mediated heart rate variability indicative of attenuated emotion and self-regulation, in the sham, but not in the active condition. Surprisingly, there were no effects of tDCS on emotional interference during the affective control task, with Bayesian analyses showing extreme evidence against these effects. Nevertheless, there was a positive association between the emotional interference during the affective control task and participants' reappraisal success afterward for the active, but not the sham tDCS condition. The study offers valuable insights to guide future work on combined tDCS with affective control tasks or training on the ability to regulate emotions.

Autonomic nervous system flexibility for understanding brain aging

A recent call was made for autonomic nervous system (ANS) measures as digital health markers for early detection of Alzheimer's disease and related dementia (AD/ADRD). Nevertheless, contradictory or inconclusive findings exist. To help advance understanding of ANS' role in dementia, we draw upon aging and dementia-related literature, and propose a framework that centers on the role of ANS flexibility to guide future work on application of ANS function to differentiating the degree and type of dementia-related brain pathologies. We first provide a brief review of literature within the past 10 years on ANS and dementia-related brain pathologies. Next, we present an ANS flexibility model, describing how the model can be applied to understand these brain pathologies, as well as differentiate or even be leveraged to modify typical brain aging and dementia. Lastly, we briefly discuss the implication of the model for understanding resilience and vulnerability to dementia-related outcomes.

Estimating individual subjective values of emotion regulation strategies

Individuals have a repertoire of emotion regulation (ER) strategies at their disposal, which they can use more or less flexibly. In ER flexibility research, strategies that facilitate goal achievement are considered adaptive and therefore are subjectively valuable. Individuals are motivated to reduce their emotional arousal effectively and to avoid cognitive effort. Perceived costs of ER strategies in the form of effort, however, are highly subjective. Subjective values (SVs) should therefore represent a trade-off between effectiveness and subjectively required cognitive effort. However, SVs of ER strategies have not been determined so far. We present a new paradigm for quantifying individual SVs of ER strategies by offering monetary values for ER strategies in an iterative process. N = 120 participants first conducted an ER paradigm with the strategies distraction, distancing, and suppression. Afterwards, individual SVs were determined using the new CAD paradigm. SVs significantly predicted later choice for an ER strategy (χ2 (4, n = 119) = 115.40, p < 0.001, BF10 = 1.62 × 1021). Further, SVs were associated with Corrugator activity (t (5, 618.96) = 2.09, p = 0.037, f2 = 0.001), subjective effort (t (5, 618.96) = - 13.98, p < 0.001, f2 = 0.035), and self-reported utility (t (5, 618.96) = 29.49, p < 0.001, f2 = 0.155). SVs were further associated with self-control (t (97.97) = 2.04, p = 0.044, f2 = 0.002), but not with flexible ER. With our paradigm, we were able to determine subjective values. The trait character of the values will be discussed. PROTOCOL REGISTRATION: The stage 1 protocol for this Registered Report was accepted in principle on July 19, 2022. The protocol, as accepted by the journal, can be found at: https://doi.org/10.17605/OSF.IO/FN9BT .

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.

Effectiveness of emotion regulation strategies measured by self-report and EMG as a result of strategy used, negative emotion strength and participants' baseline HRV

We investigated how emotion regulation (ER) effectiveness-on both a self-reported rating as well as emotional expression (corrugator supercilii muscle activity) level-is affected by the characteristics of the situation (low vs. high negativity), the strategy used (reinterpretation, distraction, suppression, no regulation control condition) and individual dispositions (low vs. high baseline Heart Rate Variability) as well as their interaction. For this purpose, 54 adult women participated in a laboratory study. All the included factors significantly influenced both corrugator activity and appraisals of pictures' negativity (in specific experimental conditions). For example, for high HRV participants, (1) distraction, suppression and reinterpretation significantly decreased corrugator activity compared to the control condition, and (2) distraction decreased appraised picture negativity for high negativity photos. For low HRV participants, distraction and suppression were most effective in decreasing corrugator responses, while suppression was more effective than reinterpretation in decreasing perceived picture negativity in the high negativity condition. Subjectively reported effort and success in applying ER strategies were also dependent on manipulated and dispositional factors. Overall, our results lend support to the flexible emotion regulation framework, showing that emotion regulation effectiveness relies on situational context as well as individual dispositions and their interaction.

Enhancing emotion regulation

BACKGROUND

Emotion regulation (ER) refers to the process of modulating an affective experience or response. Objectives: This is a systematic review of the research on therapist methods to facilitate patient ER, including affect-focused, experiential methods that aim to enhance immediate patient emotion regulation, and structured psychoeducation, skills training in ER.

METHOD

A total of 10 studies of immediate and intermediate outcomes of emotion regulation methods were examined. A total of 38 studies were included in the meta-analysis of distal treatment effects on emotion regulation.

RESULTS

In eight studies with 84 clients and 33 therapists, we found evidence of positive intermediate outcomes for affect-focused therapist methods and interpretations. A meta-analysis of 26 studies showed that the average effect size of ER methods from pre- to post-treatment was large (g = 0.82).

CONCLUSIONS

Both affect-focused and structured skill training are associated with distal improvements in emotion regulation. When working with ER in psychotherapy, therapists must consider how patients' cultural backgrounds inform display rules, as well as what might be considered adaptive or maladaptive. The article concludes with training implications and therapeutic practices based on the research evidence.

Reappraising cognitive reappraisal: The taxing impact of emotion regulation on executive functioning in older adults

OBJECTIVE

Cognitive reappraisal (CR) and expressive suppression (ES) are two common emotion regulation strategies that share similar cognitive and neural underpinnings. Prior research has consistently shown that recent engagement in ES (both self-reported and experimentally manipulated) is associated with subsequent temporary decrements in executive functioning (EF). Thus far, only one study has examined the association between CR and EF, with null results. However, that study was limited by examining only zero-order correlations and by assessing only the speed, not accuracy, of EF performance. The present study examined multivariate relationships among recent CR, recent ES, and EF (both speed and accuracy), as well as the potential impacts of more chronic engagements in, and trait-level preferences between, the two emotion regulation strategies.

METHOD

Participants were 201 community-dwelling older adults aged 60 to 93 who had participated in three separate studies examining the relationship between self-reported emotion regulation and EF.

RESULTS

Recent CR was associated with EF performance accuracy above and beyond chronic CR. Both recent CR and ES contributed to EF performance accuracy uniquely beyond each other and beyond chronic and preferred emotion regulation.

CONCLUSIONS

Both recent ES and CR appear to have a deleterious impact on EF performance accuracy, potentially due to utilization of similar resources; both should be accounted for when assessing emotion regulation and its impacts on EF.

Multivariate Brain Activity while Viewing and Reappraising Affective Scenes Does Not Predict the Multiyear Progression of Preclinical Atherosclerosis in Otherwise Healthy Midlife Adults

Cognitive reappraisal is an emotion regulation strategy that is postulated to reduce risk for atherosclerotic cardiovascular disease (CVD), particularly the risk due to negative affect. At present, however, the brain systems and vascular pathways that may link reappraisal to CVD risk remain unclear. This study thus tested whether brain activity evoked by using reappraisal to reduce negative affect would predict the multiyear progression of a vascular marker of preclinical atherosclerosis and CVD risk: carotid artery intima-media thickness (CA-IMT). Participants were 176 otherwise healthy adults (50.6% women; aged 30-51 years) who completed a functional magnetic resonance imaging task involving the reappraisal of unpleasant scenes from the International Affective Picture System. Ultrasonography was used to compute CA-IMT at baseline and a median of 2.78 (interquartile range, 2.67 to 2.98) years later among 146 participants. As expected, reappraisal engaged brain systems implicated in emotion regulation. Reappraisal also reduced self-reported negative affect. On average, CA-IMT progressed over the follow-up period. However, multivariate and cross-validated machine-learning models demonstrated that brain activity during reappraisal failed to predict CA-IMT progression. Contrary to hypotheses, brain activity during cognitive reappraisal to reduce negative affect does not appear to forecast the progression of a vascular marker of CVD risk.

Supplementary Information

The online version contains supplementary material available at 10.1007/s42761-021-00098-y.

Affective Response Categories—Toward Personalized Reactions in Affect-Adaptive Tutoring Systems

Affect-adaptive tutoring systems detect the current emotional state of the learner and are capable of adequately responding by adapting the learning experience. Adaptations could be employed to manipulate the emotional state in a direction favorable to the learning process; for example, contextual help can be offered to mitigate frustration, or lesson plans can be accelerated to avoid boredom. Safety-critical situations, in which wrong decisions and behaviors can have fatal consequences, may particularly benefit from affect-adaptive tutoring systems, because accounting for affecting responses during training may help develop coping strategies and improve resilience. Effective adaptation, however, can only be accomplished when knowing which emotions benefit high learning performance in such systems. The results of preliminary studies indicate interindividual differences in the relationship between emotion and performance that require consideration by an affect-adaptive system. To that end, this article introduces the concept of Affective Response Categories (ARCs) that can be used to categorize learners based on their emotion-performance relationship. In an experimental study, N = 50 subjects (33% female, 19–57 years, M = 32.75, SD = 9.8) performed a simulated airspace surveillance task. Emotional valence was detected using facial expression analysis, and pupil diameters were used to indicate emotional arousal. A cluster analysis was performed to group subjects into ARCs based on their individual correlations of valence and performance as well as arousal and performance. Three different clusters were identified, one of which showed no correlations between emotion and performance. The performance of subjects in the other two clusters benefitted from negative arousal and differed only in the valence-performance correlation, which was positive or negative. Based on the identified clusters, the initial ARC model was revised. We then discuss the resulting model, outline future research, and derive implications for the larger context of the field of adaptive tutoring systems. Furthermore, potential benefits of the proposed concept are discussed and ethical issues are identified and addressed.

Reappraisal and empathic perspective-taking - More alike than meets the eyes

Emotion regulation and empathy represent highly intertwined psychological processes sharing common conceptual ground. Despite the wealth of research in these fields, the joint and distinct functional nature and topological features of these constructs have not yet been investigated using the same experimental approach. This study investigated the common and distinct neural correlates of emotion regulation and empathy using a meta-analytic approach. The regions that were jointly activated were then characterized using meta-analytic connectivity modeling and functional decoding of metadata terms. The results revealed convergent activity within the ventrolateral and dorsomedial prefrontal cortex as well as temporal regions. The functional decoding analysis demonstrated that emotion regulation and empathy were related to highly similar executive and internally oriented processes. This synthesis underlining strong functional and neuronal correspondence between emotion regulation and empathy could (i) facilitate greater integration of these two separate lines of literature, (ii) accelerate progress toward elucidating the neural mechanisms that support social cognition, and (iii) push forward the development of a common theoretical framework for these psychological processes essential to human social interactions.

Merging the exposome into an integrated framework for “omics” sciences

The exposome concept encourages holistic consideration of the non-genetic factors (environmental exposures including lifestyle) that influence an individual’s health over their life course. However, disconnect between the concept and practical application has promoted divergent interpretations of the exposome across disciplines and reinforced separation of the environmental (emphasizing exposures) and biological (emphasizing responses) research communities. In particular, while knowledge of biological responses can help to distinguish actual (i.e. experienced) from potential exposures, the inclusion of endogenous processes has generated confusion about the position of the exposome in a multi-omics systems biology context. We propose a reattribution of “exposome” to exclusively represent the totality of contact with external factors that a biological entity experiences, and introduce the term “functional exposomics” to denote the systematic study of exposure-phenotype interaction. This reoriented definition of the exposome allows a more readily integrable dataset for multi-omics and systems biology research.

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Reattribution of exposome concept to exclusively represent environmental exposures

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Generalized the exposome concept for all levels of biological organization

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Functional exposome presented as the totality of exposure-phenotype interaction

Acute stress influences strategy preference when dealing with high intensity emotions in men

Stress has been shown to initiate a shift from flexible to rigid, less demanding cognitive processes. Reappraisal and distraction are two emotion regulation strategies varying in their cognitive demands. Previous studies indicate that stress improves regulatory performances of high arousal stimuli. We thus investigated whether acute stress alters the preference for reappraisal or distraction when downregulating emotions of different intensities and further explored its influence on regulatory outcomes. Eighty males were either socially stressed (n=40) or exposed to a control condition (n=40) prior to an emotion regulation choice paradigm. Stress increased the probability to prefer distraction for downregulating high intensity emotions. Stressed (vs. control) participants reported to be generally more successful in regulating high intensity emotions, which was positively associated with cortisol but not alpha-amylase increases. Our findings provide initial evidence that stress fosters a preference for less demanding regulatory options, suggesting favorable strategy choices in response to acute stressors. DATA AVAILABILITY: The data that support the findings of this study are available at the Open Science Framework (OSF) under https://osf.io/b9ae3/.

Emotion regulation and peripheral psychophysiological correlates in the management of induced pain: A systematic review

Cognitive reappraisal and acceptance strategies have been shown to be effective in reducing pain experience and increasing pain tolerance. However, no systematic reviews have focused on the relationship between the use of these two strategies and peripheral physiological correlates when pain is experimentally induced. This systematic review aims to summarize the existing literature that explores the relationship between emotion regulation strategies (i.e., cognitive reappraisal and acceptance) and peripheral correlates of the autonomic nervous system and facial electromyography, such as affect-modulated responses and corrugator activity, on laboratory tasks where pain is induced. The systematic review identifies nine experimental studies that meet our inclusion criteria, none of which compare these strategies. Although cognitive reappraisal and acceptance strategies appear to be associated with decreased psychological responses, mixed results were found for the effects of the use of both strategies on all the physiological correlates. These inconsistencies between the studies might be explained by the high methodological heterogeneity in the task designs, as well as a lack of consistency between the instructions used in the different studies for cognitive reappraisal, acceptance, and the control conditions.

Expressive suppression versus cognitive reappraisal: Effects on self-report and peripheral psychophysiology

Effectiveness of various emotion regulation (ER) strategies have received much attention in recent research. Among the most studied ER strategies are cognitive reappraisal and expressive suppression. However, the evidence of their effectiveness is controversial and depends on the measures used. The aim of the present study was to compare the effectiveness of cognitive reappraisal and expressive suppression strategies of ER via different measures such as self-report, facial expressions (zygomaticus major and corrugator supercilii electromyography), and physiological assessment (skin conductance response and heart rate deceleration). Participants were presented with intensely unpleasant or neutral pictures and performed ER tasks. We expected that the implementation of ER strategies would reduce negative emotions, and cognitive reappraisal would produce greater reduction in negative emotions compared to expressive suppression. Self-report data showed that reappraisal had a greater effect on the reduction of negative emotions compared to suppression. There was no difference between reappraisal and suppression assessed with skin conductance response and electromyography. Curiously, heart rate deceleration increased while participants tried to suppress their emotional expressions, which could reflect efforts exerted in the attempt to suppress. The ER strategies reduced negative emotions during the presentation of unpleasant pictures partially in skin conductance response and heart rate deceleration. Overall, reappraisal is more effective in changing subjective experience, whereas the physiological reactions do not differ substantially between the two ER strategies explored. We therefore recommend that the assessment of ER strategies in the laboratory should accommodate more than one type of measures to come to more reliable conclusions.

Inferior Frontal Gyrus-Based Resting-State Functional Connectivity and Medium Dispositional Use of Reappraisal Strategy

The previous neuroimaging functional connectivity analyses have indicated that the association between the inferior frontal gyrus (IFG) and other brain regions results in better emotion regulation in reappraisal tasks. However, no study has explored the relationship between IFG-based resting-state functional connectivity (rsFC) and the dispositional use of reappraisal strategy. Therefore, the present study examined the potential associations between rsFC patterns of both left and right IFG and dispositional reappraisal use. One hundred healthy participants completed the Emotion Regulation Questionnaire (ERQ) and underwent a resting-state functional magnetic resonance imaging (fMRI) acquisition. An approach of the seed-based rsFC analysis was recruited to estimate the functional connectivity maps of bilateral IFG with other brain regions, and the reappraisal scores from the ERQ were then correlated with the functional maps. Our findings showed that IFG-based rsFC was positively correlated with dispositional reappraisal only in the range of 4 to 5.5 points [medium reappraisal group (MRG)]. Specifically, medium dispositional reappraisal was positively correlated with rsFC between left/right IFG and bilateral temporal gyrus. Besides, medium dispositional reappraisal was positively correlated with rsFC between left IFG and bilateral superior parietal lobe (SPL), middle cingulate cortex (MCC), and right insula, as well as between right IFG and dorsomedial prefrontal cortex (DMPFC) and anterior cingulate cortex (ACC). In conclusion, these results indicate that bilateral IFG plays an important role in the medium use of the reappraisal strategy.

Emotions, Emotion Management and Emotional Intelligence in the Workplace: Healthcare Professionals' Experience in Emotionally-Charged Situations

This perspective article is grounded in a cognitive and context-dependent view on emotions. By considering emotions as socially embedded and constructed, the different but related concepts of Emotion Management and Emotional Intelligence can be introduced. Yet, research juxtaposing and applying them within the healthcare sector to explain healthcare professionals' multifaceted emotional experiences at work is still scarce. Hence, this article contributes to the literature on emotions by offering an overarching perspective on how the juxtaposition of Emotion Management and Emotional Intelligence may help healthcare professionals to bridge the developmental transition between these two crucial abilities which, in turn, can help them overcome emotional difficulties in complex situations. Such integration would positively influence individuals' behavioral and mental health, as well as the overall quality of the healthcare system.

Covariate effects of resting heart rate variability on affective ratings and startle reflex during cognitive reappraisal of negative emotions

Heart Rate Variability (HRV) has been widely studied in laboratory settings due to its clinical implications, primarily as a potential biomarker of emotion regulation (ER). Studies have reported that individuals with higher resting HRV show more distinct startle reflexes to negative stimuli as compared to those with lower HRV. These responses have been associated with better defense system function when managing the context demands. There is, however, a lack of empirical evidence on the association between resting HRV and eyeblinks during laboratory tasks using instructed ER. This study explored the influence of tonic HRV on voluntary cognitive reappraisal through subjective and startle responses measured during an independent ER task. In total, 122 healthy participants completed a task consisting of attempts to upregulate, downregulate, or react naturally to emotions prompted by unpleasant pictures. Tonic HRV was measured for 5 minutes before the experiment began. Current results did not support the idea that self-reported and eyeblink responses were influenced by resting HRV. These findings suggest that, irrespective of resting HRV, individuals may benefit from strategies such as reappraisal that are useful for managing negative emotions. Experimental studies should further explore the role of individual differences when using ER strategies during laboratory tasks.

Cortisol promotes the cognitive regulation of high intensive emotions independent of timing

Failures to cognitively downregulate negative emotions are a crucial risk factor for mental disorders. Previous studies provide evidence for a stress-induced improvement of cognitive emotion regulation possibly mediated via glucocorticoid actions. Cortisol can initialize immediate non-genomic as well as delayed genomic effects on cognitive control functioning, but its distinct effects on emotion regulation processes remain to be shown. Here, we sought to characterize time-dependent effects of oral cortisol administration on cognitive emotion regulation outcomes. We expected cortisol to improve emotion regulation success. Possible interactions with the delay between cortisol treatment and emotion regulation, strategy use and intensity of the emotional stimuli were examined. Eighty-five healthy men received either 10 mg hydrocortisone or a placebo in a double-blind, randomized design 30 or 90 min prior to an emotion regulation paradigm, in which they were asked to downregulate their emotional responses towards low and high intensive negative pictures via reappraisal or distraction. Affective ratings and pupil dilation served as outcome measures. Reduced arousal, enhanced valence ratings as well as increases in pupil dilations indexing the cognitive regulatory effort indicated successful downregulation of negative emotions evoked by high intensive but not low intensive negative pictures. Cortisol significantly reduced arousal ratings when downregulating high intensive negative emotions via distraction and (at a trend level) via reappraisal, independent of timing, demonstrating a beneficial effect of cortisol on subjective regulatory outcomes. Taken together, this study provides initial evidence suggesting that cortisol promotes the cognitive control of high intensive negative emotions both, 30 and 90 min after treatment.

Delayed effects of acute stress on cognitive emotion regulation

Acute stress has been shown to modulate cognitive emotion regulation. Besides interactions with strategy use or sex, another critical modulating factor appears to be stress timing. Exposure to acute stress initiates immediate and delayed glucocorticoid effects on cognitive control functions. Previous studies indicated a delayed increase in prefrontal activity after stress and cortisol elevations, which might also improve the ability to cognitively regulate emotions when the acute stress state has subsided. In this study, we investigated the delayed impact of acute stress on the two emotion regulation strategies reappraisal and distraction. Eighty-one healthy males and free-cycling females were exposed to the Trier Social Stress Test or a control condition 90 min before they were tested in an emotion regulation paradigm, which required them to up- and downregulate their emotional responses towards negative pictures. Affective ratings served to measure emotion regulation success, whereas pupil dilation was included to additionally assess the cognitive effort required to deliberately regulate emotions. Stress affected neither arousal, valence or success ratings nor pupil dilation. However, cortisol increases were significantly associated with reduced arousal and enhanced valence ratings when regulating negative emotions via distraction. Exploratory mediation analyses revealed an indirect effect of stress on arousal and valence ratings for distraction that was mediated by cortisol increase. Our findings thereby provide further evidence that cortisol is positively related to emotion regulation success, which might be driven by a glucocorticoid-mediated mechanism facilitating attentional shifting.

Resting State Cortico-Limbic Functional Connectivity and Dispositional Use of Emotion Regulation Strategies: A Replication and Extension Study

Neuroimaging functional connectivity analyses have shown that the negative coupling between the amygdala and cortical regions is linked to better emotion regulation (ER) in experimental task settings. However, less is known about the neural correlates of ER traits or dispositions. The present study aimed to: (1) replicate the findings of differential cortico-limbic coupling during resting-state depending on the dispositional use of emotion regulation strategies. Furthermore, the study aimed to: (2) extend prior findings by examining whether differences in cortico-limbic coupling during resting-state predict experiential and neuronal ER success in a standard ER task. To this end, N = 107 healthy adults completed the Emotion Regulation Questionnaire (ERQ), underwent an 8-min resting-state fMRI acquisition, and completed a reappraisal task during fMRI. Functional connectivity maps of basolateral and centromedial amygdala nuclei were estimated with a seed-based approach regarding associations with regions of the prefrontal cortex and were then correlated with ERQ scores as well as experiential and neuronal ER success. All hypotheses and the analysis plan are preregistered at https://osf.io/8wsgu. Opposed to prior findings, we were not able to replicate a correlation of dispositional ER strategy use with functional connectivity between the amygdala and PFC regions (p > 0.05, FWE-corrected). Furthermore, there was no association of experiential and neuronal reappraisal success with functional connectivity between amygdala and insula as well as PFC (p > 0.05, FWE-corrected). The present preregistered study calls into question the reported association between individual differences in resting-state cortico-limbic connectivity and dispositional use of ER strategies. However, ongoing advances in functional brain imaging and distributed network approaches may leverage the identification of reliable functional connectivity patterns that underlie successful emotion regulation.

Acute stress improves the effectivity of cognitive emotion regulation in men

Emotion regulation is crucial for coping with stressors but in turn can also be influenced by stress. Initial studies provided mixed evidence showing either beneficial or impairing stress effects on cognitive emotion regulation depending on stress timing, sex or the regulatory strategy. Here, we investigated the impact of acute stress on different emotion regulation strategies in men and women. N = 118 healthy participants were subjected to the Trier Social Stress Test or a control condition after which they completed an emotion regulation paradigm, requiring them to regulate their emotions in response to negative pictures using reappraisal or distraction. Cortisol levels were repeatedly measured to quantify changes in HPA axis activity. Affective ratings and pupil dilation served to measure emotion regulation success and the cognitive effort to regulate emotions. Stress reduced arousal and increased valence and success ratings for reappraisal in men, whereas no significant stress effects were found in women. Moreover, stressed men displayed a significant expansion of pupil diameter during reappraisal suggesting enhanced cognitive regulatory engagement, which ultimately may have led to better emotion regulation outcomes. Cortisol secretion positively correlated with subjective reappraisal success in men, suggesting a glucocorticoid-driven mechanism that may promote emotion regulatory performance in the aftermath of stress.

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.