Specificity of emotion regulation difficulties related to anxiety in early adolescence

Etiological models identify difficulties in emotion regulation as potential contributors to the development and maintenance of anxiety. To date, studies with adolescents have not tested whether different types of anxiety symptoms are related to different emotion regulation difficulties. The current study aimed to examine specificity of associations between emotion regulation difficulties and symptoms of social and generalized anxiety in early adolescence. Ninety adolescents (ages 11–14 years) completed measures of emotion regulation and anxiety symptoms. Social and generalized anxiety symptoms showed similar bivariate correlations with emotion regulation. However, when controlling for generalized anxiety, social anxiety symptoms were uniquely related to emotion understanding, acceptance, evaluation, and reactivity. Generalized anxiety symptoms were uniquely related to emotion modification. The current study suggests that social and generalized anxiety symptoms have both common and unique associations with emotion regulation difficulties in early adolescence, and has implications for which emotion regulation skills to target in clinical interventions.     

The neural substrates of social emotion perception and regulation are modulated by adult attachment style

Adult attachment style (AAS) refers to individual differences in the way people experience and regulate their social relationships and corresponding emotions. Based on developmental and psychological research, it has been hypothesized that avoidant attachment style (AV) entails deactivating strategies in social contexts, whereas anxious attachment style (AX) involves hyper vigilance and up-regulation mechanisms. However, the neural substrates of differences in social emotion regulation associated with AAS have not been systematically investigated. Here we used fMRI in 19 healthy adults to investigate the effect of AAS on the processing of pleasant or unpleasant social and nonsocial scenes. Participants were asked either to naturally attend (NAT), cognitively reappraise (REAP), or behaviorally suppress (ESUP) their emotional responses. Avoidantly attached participants showed increased prefrontal and anterior cingulate activation to social negative scenes when making spontaneous emotion judgments. They also exhibited persistent increases in dorsolateral prefrontal cortex and left amygdala activity for the same stimuli during reappraisal, as well as additional activation in supplementary motor area and ventral caudate during the suppression of social positive emotions. These results suggest that AV may imply less efficient reappraisal strategies to regulate social negative emotions, and lead to higher conflict or effortful control when suppression cannot be employed. In contrast, anxiously attached participants showed differential increases in the right amygdala and left parahippocampal cortex for social negative and positive stimuli, respectively, but only when making spontaneous emotion judgments. No effect of AX was found during down-regulation conditions. This suggests heightened arousal to negative information without difficulty in down-regulating emotions through cognitive re-evaluation or suppression. Taken together, these findings reveal for the first time the neural underpinnings of attachment-related differences in social emotion regulation.     

Adaptive and maladaptive emotion regulation strategies: Interactive effects during CBT for social anxiety disorder

There has been a increasing interest in understanding emotion regulation deficits in social anxiety disorder (SAD; e.g., Hofmann, Sawyer, Fang, & Asnaani, 2012). However, much remains to be understood about the patterns of associations among regulation strategies in the repertoire. Doing so is important in light of the growing recognition that people's ability to flexibly implement strategies is associated with better mental health (e.g., Kashdan et al., 2014). Based on previous work (Aldao & Nolen-Hoeksema, 2012), we examined whether putatively adaptive and maladaptive emotion regulation strategies interacted with each other in the prediction of social anxiety symptoms in a sample of 71 participants undergoing CBT for SAD. We found that strategies interacted with each other and that this interaction was qualified by a three-way interaction with a contextual factor, namely treatment study phase. Consequently, these findings underscore the importance of modeling contextual factors when seeking to understand emotion regulation deficits in SAD.     

Parental reactions to children's negative emotions: Relationships with emotion regulation in children with an anxiety disorder

Research has demonstrated that parental reactions to children's emotions play a significant role in the development of children's emotion regulation (ER) and adjustment. This study compared parent reactions to children's negative emotions between families of anxious and non-anxious children (aged 7–12) and examined associations between parent reactions and children's ER. Results indicated that children diagnosed with an anxiety disorder had significantly greater difficulty regulating a range of negative emotions and were regarded as more emotionally negative and labile by their parents. Results also suggested that mothers of anxious children espoused less supportive parental emotional styles when responding to their children's negative emotions. Supportive and non-supportive parenting reactions to children's negative emotions related to children's emotion regulation skills, with father's non-supportive parenting showing a unique relationship to children's negativity/lability.     

The relation between emotion regulation strategies and physiological stress responses in middle childhood

The current study sought to examine whether children's spontaneous use of the emotion regulation strategies suppression and reappraisal during a psychosocial stress task was related to their cortisol and alpha-amylase responses to that task. Salivary cortisol and alpha-amylase responses to a psychosocial stress task were assessed in 158 10-year-old children (83 girls). The children completed a self-report questionnaire measuring use of reappraisal and suppression during the task. Results showed overall increases in cortisol and alpha-amylase in response to the stressor, with higher cortisol reactivity in girls than in boys. With regard to emotion regulation, more use of suppression was related to lower cortisol reactivity in girls, and lower alpha-amylase reactivity and quicker alpha-amylase recovery in all children. The use of reappraisal was not related to the children's cortisol or alpha-amylase responses. The current study is the first to investigate the relation between the spontaneous use of reappraisal and suppression, and physiological stress responses to a psychosocial stressor in children. Our results indicate that reappraisal and suppression are used and can be measured even in 10-year-olds. At this age reappraisal appears ineffective at down-regulating physiological responses, while suppression was related to lower physiological responses. For cortisol reactivity there was a sex difference in the relation with suppression, indicating the importance of including sex as a moderator variable in research studying stress reactivity and its correlates in this age group.     

Peer facilitation of emotion regulation in adolescence

Emotion regulation is particularly important for adolescents as they undergo normative developmental changes in affective systems and experience heightened risk for psychopathology. Despite a high need for emotion regulation during adolescence, commonly studied emotion regulation strategies like cognitive reappraisal are less beneficial for adolescents than adults because they rely on neural regions that are still developing during this period (i.e., lateral prefrontal cortex). However, adolescence is also marked by increased valuation of peer relationships and sensitivity to social information and cues. In the present review, we synthesize research examining emotion regulation and peer influence across development to suggest that sensitivity to peers during adolescence could be leveraged to improve emotion regulation for this population. We first discuss developmental trends related to emotion regulation at the level of behavior and brain in adolescents, using cognitive reappraisal as an exemplar emotion regulation strategy. Next, we discuss social influences on adolescent brain development, describing caregiver influence and increasing susceptibility to peer influence, to describe how adolescent sensitivity to social inputs represents both a window of vulnerability and opportunity. Finally, we conclude by describing the promise of social (i.e., peer-based) interventions for enhancing emotion regulation in adolescence.     

The effect of strategies,goals and stimulus material on the neural mechanisms of emotion regulation: A meta-analysis of fMRI studies

Emotion regulation comprises all extrinsic and intrinsic control processes whereby people monitor, evaluate and modify the occurrence, intensity and duration of emotional reactions. Here we sought to quantitatively summarize the existing neuroimaging literature to investigate a) whether different emotion regulation strategies are based on different or the same neural networks; b) which brain regions in particular support the up- and down-regulation of emotions, respectively; and c) to which degree the neural networks realising emotion regulation depend on the stimulus material used to elicit emotions. The left ventrolateral prefrontal cortex (VLPFC), the anterior insula and the supplementary motor area were consistently activated independent of the regulation strategy. VLPFC and posterior cingulate cortex were the main regions consistently found to be recruited during the up-regulation as well as the down-regulation of emotion. The down-regulation compared to the up-regulation of emotions was associated with more right-lateralized activity while up-regulating emotions more strongly modulated activity in the ventral striatum. Finally, the process of emotion regulation appeared to be unaffected by stimulus material.     

Socialization of emotion regulation strategies through friends

This study examines the effects of best friends' emotion regulation strategies (regarding the emotions anger, fear, and sadness) on the development of adolescents' emotion regulation strategies and subsequent depressive symptoms. Based on a two-wave longitudinal sample of 238 German adolescents, true change analyses showed positive effects of best friends' adaptive strategies (T1) on the change of adolescents' adaptive strategies (T2 − T1) for anger and fear. Best friends' adaptive strategies (T1) indirectly influence the development of maladaptive strategies (T2 − T1) through the change of adaptive strategies (T2 − T1) and, in turn, the development of depressive symptoms (T2 − T1; two-step mediation). Best friends' adaptive strategies for sadness did not have an effect on adolescents' adaptive strategies. In contrast to adaptive strategies, none of the friends' maladaptive strategies affected adolescents' maladaptive strategies. The results are discussed in terms of peer influences on the development of emotion regulation strategies and psychosocial adjustment.     

Regulating emotion during imaginal exposure to social anxiety: Impact of the specificity of information processing

The present study investigates the emotional impact of a specific vs. generic mode of information processing during imaginal exposure. Forty-nine socially anxious students mentally relived a personally experienced stressful social situation. Half of the participants were instructed to activate generic elements of the target event (i.e., elements repetitively experienced in similar social situations); the other half had to recall the specific features of the target event. Results showed that participants who focused on specific elements reported less distress than those who focused on generic features. Clinical implications are discussed.     

From psychological to physical health: Exploring temporal precedence throughout emotion regulation therapy

ObjectiveGeneralized anxiety disorder (GAD) is characterized, in part, by physical symptoms such as muscle tension and gastrointestinal (GI) distress. To date, little research has examined how changes in psychological symptoms associated with GAD may impact physical symptoms. This study investigated if reductions in worry, anxiety, and depression precede changes in muscle tension and GI distress throughout psychotherapy.MethodsParticipants with GAD (N = 85) completed 20 weeks of emotion regulation therapy (ERT) in addition to assessments pre, mid, and post treatment. They completed a physical symptom questionnaire, evaluating muscle tension and GI distress. Participants also completed psychological symptoms questionnaires, including the State Trait Anxiety Inventory (STAI-7), Penn State Worry Questionnaire (PSWQ), and Beck Depression Inventory (BDI-II). Control participants (N = 44) completed these measures at baseline.ResultsParticipants with GAD had significantly greater muscle tension (p < .001) and GI distress (p < .001) compared to control participants without GAD. Reductions in worry, depression, and trait anxiety did not precede changes in muscle tension (range of effect size (r): .05–.12). Reductions in both depression (p = 0.04) and trait anxiety (p < 0.01) preceded reductions in GI distress. Reductions in worry did not precede reductions in GI distress (p = 0.25).ConclusionThese data provide preliminary evidence for the temporal effect of reductions in psychological symptoms on reductions in GI distress in GAD, highlighting the potential of psychotherapy to improve physical outcomes.     

Emotion regulation and depressive symptoms: Examining the mediation effects of school connectedness in Chinese late adolescents

This study tested Gross's process model of emotion regulation in a Chinese adolescent sample. It hypothesized that emotion regulation strategies (cognitive reappraisal and expressive suppression) would predict adolescents' perception of school connectedness and depressive symptoms. It also posited that school connectedness may be a possible mediator between emotion regulation and depressive symptoms. Participants were 504 adolescents aged 16–18 from two Chinese public upper secondary schools. Structural equation modeling analyses indicated that reappraisal and suppression significantly associated with school connectedness and depressive symptoms, and school connectedness mediated the link between emotion regulation and depressive symptoms, even when the general emotion experiences were controlled. Although boys unexpectedly reported higher level depressive symptoms, the hypothesized model was invariant across gender except for the link between suppression and depressive symptoms. These findings demonstrate that it is meaningful to involve both emotion regulation processes and school connectedness in explaining adolescent depressive symptoms.     

Within the mind's eye: Negative mental imagery activates different emotion regulation strategies in high versus low socially anxious individuals

Background and objectivesThe link between social anxiety (SA) and maladaptive emotion regulation has been clearly established, but little is known about the spontaneous regulation strategies that may be activated during social stress by negative involuntary mental images and whether the nature of such strategies might distinguish individuals with high vs. low trait SA.MethodsParticipants with high (n = 33) or low (n = 33) trait SA performed an evaluative speech and reported whether they experienced an involuntary negative mental image during the task. They also rated their negative affect (NA) and positive affect (PA) and the extent to which they viewed their image as being controllable and malleable. Finally, they described the types of strategies they spontaneously used to try to control or change their image intrusions. Reported strategies were then subjected to a content analysis and categorized by blinded coders.ResultsAmong high SA participants, image controllability was both diminished overall and positively correlated with PA. Whereas 90% of low SA individuals reported that they spontaneously self-regulated by altering the content or perceptual features of their images, only about half of the high SA participants used this strategy, with the other 50% reporting that they either suppressed their images or succumbed passively to them in whatever form they took.Limitations and conclusionsAlthough these initial findings require replication in future experimental studies on clinical samples, they also help to enrich our understanding of the strategies that are commonly used by high and low SA individuals to manage their image intrusions during in-vivo stress and suggest potential avenues for future research on the role of imagery in adaptive and maladaptive emotion regulation.     

A model of BIS/BAS sensitivity,emotion regulation difficulties,and depression,anxiety, and stress symptoms in relation to sleep quality

Recent research has indicated that interactions between behavioral inhibition system (BIS)/behavioral activation system (BAS) sensitivity and emotion regulation (ER) difficulties increases risk for psychopathology. Considering sleep quality (SQ) has been linked to emotion regulation difficulties (ERD) and psychopathology, further investigation of a possible mechanism is needed. The current study examined associations between BIS/BAS sensitivity, ERD, and SQ to depression, anxiety, and stress symptoms in an undergraduate sample (n=459). Positive relationships between BIS sensitivity and both ERD and stress symptoms, and negative relationships between BAS-reward sensitivity and both ERD and depression symptoms were observed. Furthermore, ERD were positively related to depression, anxiety, and stress symptoms. Succeeding analyses revealed differential relationships between ERD and depression, anxiety, and stress symptoms among good quality and poor quality sleepers. The findings are discussed within the context of personality dimensions and self-regulatory mechanisms, along with implications for the treatment of depression, anxiety and sleep difficulties.     

Examining the effects of emotion regulation on the ERP response to highly negative social stigmas

In order to determine if highly negative stigma is a more salient cue than other negative emotional, non-stigmatized cues, participants underwent electroencephalography while passively viewing or actively regulating their emotional response to images of highly negative stigmatized (e.g., homeless individuals, substance abusers) or highly negative non-stigmatized (e.g., a man holding a gun, an injured person) individuals. Event-related potential (ERP) analyses focused on the N2 (associated with detecting novelty), the early positive potential (associated with processing emotion), and a sustained late positive potential (associated with modulating regulatory goals). A salience effect for highly negative stigma was revealed in the early positive potential, with higher magnitude ERP responses to images of highly negative stigmatized as compared to highly negative non-stigmatized individuals 355 ms poststimulus onset. Moreover, the amplitude of this effect was predicted by individual differences in implicit bias. Our results also demonstrated that the late positivity response was not modulated by regulatory goals (passively view versus to reappraise) for images of highly negative stigmatized individuals, but was for images of highly negative, non-stigmatized individuals (replicating previous findings). Our findings suggest that the neural response to highly negative stigma is salient and rigid.     

Dedifferentiation of emotion regulation strategies in the aging brain

Different emotion regulation strategies are distinctly represented in the brains of younger adults. Decreasing a reaction to a negative situation by reinterpreting it (reappraisal) relies on cognitive control regions in the prefrontal cortex, while distracting away from a stressor involves more posterior medial structures. In this study, we used Multi-Voxel pattern analyses (MVPA) to examine whether reappraisal and distraction strategies have distinct representations in the older adult brain, or whether emotion regulation strategies become more dedifferentiated in later life. MVPA better differentiated the two emotion regulation strategies for younger adults than for older adults, and revealed the greatest age-related differences in differentiation in the posterior medial cortex (PMC). Univariate analyses revealed equal PMC recruitment across strategies for older adults, but greater activity during distraction than reappraisal for younger adults. The PMC is central to self-focused processing, and thus our findings are consistent with the possibility that focusing on the self may be a default mechanism across emotion regulation strategies for older people.     

The associations of emotion regulation and dysregulation with the metabolic syndrome factor

OBJECTIVE: Emotion regulation has been associated with good, and dysregulation with poor subjective health; but it is unclear if emotion regulation is related to metabolic syndrome. METHODS: Associations between the metabolic syndrome factor (systolic and diastolic blood pressure, waist circumference, high-density lipoprotein, triglycerides, and glucose), emotion regulation (the strategies of repair and maintenance, self-perceived emotion regulation) and dysregulation (emotional ambivalence); and subjective health (self-rated health and psychosomatic symptoms) were studied using a structural equation modelling (SEM) approach. The participants (96 women, 85 men) were drawn from the Jyv?skyl? Longitudinal Study of Personality and Social Development (JYLS). RESULTS: High repair was associated directly to the low metabolic syndrome factor, while high maintenance, high self-perceived emotion regulation, and low emotional ambivalence were related indirectly to the low metabolic syndrome factor through good subjective health. CONCLUSIONS: Successful emotion regulation may have an association not only with the subjective experience of health, but also with physiological regulation systems, leading to a reduced risk for metabolic syndrome.     

The structural and functional connectivity of the amygdala: from normal emotion to pathological anxiety

The dynamic interactions between the amygdala and the medial prefrontal cortex (mPFC) are usefully conceptualized as a circuit that both allows us to react automatically to biologically relevant predictive stimuli as well as regulate these reactions when the situation calls for it. In this review, we will begin by discussing the role of this amygdala-mPFC circuitry in the conditioning and extinction of aversive learning in animals. We will then relate these data to emotional regulation paradigms in humans. Finally, we will consider how these processes are compromised in normal and pathological anxiety. We conclude that the capacity for efficient crosstalk between the amygdala and the mPFC, which is represented as the strength of the amygdala-mPFC circuitry, is crucial to beneficial outcomes in terms of reported anxiety.