Can Cognitive Reappraisal down-regulate emotional responses in an ecologically-valid fear induction paradigm?

Dr Christopher Maymon

Victoria University of Wellington

Emotion Regulation

It’s hard to find good images online about emotions, even with new AI tools. This one felt like it got the closest to what I was looking for.

Life is brimming with emotionally charged situations. Some are pleasant, others are not. Fortunately, we are not at the mercy of our emotions and humans have invented countless strategies aimed at regulating our emotions, whether to amplify positive ones or to minimize negative ones. And some emotion regulation strategies work better than others.

Emotional Stimuli & Emotional States

But, to do experimental research into the relative effectiveness of different Emotion Regulation strategies, what you have to do is induce a target emotion in the lab, and this is quite challenging. What most studies have done is presented participants with what I’ll call emotionally charged stimuli, images like this one of a dog displaying aggression.

These pictures carry emotional value and indeed results from these studies may have predictive potency when it comes to situations where we might need to regulate emotional responding on the internet or when we engage with particular media. But emotions as we experience them in the world can be much more intense than the kinds of responses that can be elicited when you are shown a photograph. So it’s difficult to know whether results from studies inducing emotions using stimuli can generalize to situations in we are in an intense emotional state, like when we are actually afraid for our safety.

Emotional State manipulation using Virtual Reality

In this study, we used virtual reality to immerse people in a situation that we have found repeatedly produces large effects consistent with fear.

And using this simulation, we aimed to induce an ecologically valid emotional State of fear, so that we can investigate whether and how specific emotion regulation strategies attenuate fear responses.

But before we talk about the specific strategies in question, let me first give you a visual breakdown of the VR procedure.

Fear Induction using Height Exposure in VR

Cognitive Reappraisal

Turning back to the emotion regulation strategies in question, what is on the screen is the Process Model of ER by James Gross, who categorizes different strategies in relation to when they intervene during an unfolding and repeating process of emotion generation. In the literature, special attention is given to strategies that involve cognitive change or reappraisal, and indeed this is the basis of how CBT Cognitive Behaviour Therapy works.

So the idea is that because our emotions are generated based upon an appraisal that we form about a given situation, if we deliberately update that appraisal, we can in turn modulate the intensity or the valence of whatever emotion we are experiencing.

Does Cognitive Reappraisal work?

• Cognitive Reappraisal associated with positive social, emotional, cognitive and physiological outcomes (Webb, Miles, & Sheeran, 2012)
• Studies into the effect of cognitive reappraisal are mixed (Zaehringer et al, 2020).
• May tax cognitive resources too heavily.

So, does Cognitive reappraisal really work? On the one hand, there are decades of work showing that cognitive reappraisal use is associated with better social, emotional, cognitive and physiological outcomes.

But, laboratory research into the effectiveness of cognitive reappraisal has reported mixed findings.

Some claim that cognitive reappraisal requires too much cognitive effort to be effective. So, we don’t know if it works, or what the necessary conditions are for Cognitive Reappraisal to be worth using.

Therefore, in this study, we endeavoured to provide Cognitive Reappraisal with the best chance possible to demonstrate its effectiveness for down-regulating intense negative emotions, in an emotional situation that better reflects a real-life emotional challenge.

Cognitive Reappraisal Training

We partnered with clinical psychologists to create a Training protocol where participants sit down with the experimenter immediately before the VR session and they learn about Cognitive Reappraisal and are guided through some practice about how they could reappraise during different emotionally challenging situations (like how they might try to control their fear when they are coming in for a landing in an airplane on a day with a lot of turbulence).

Experimental Conditions

1. Cognitive Reappraisal (verbally reappraise for 3-minutes)
2. Immersion (verbally report automatic thoughts and feelings for 3-minutes)
3. Distraction (complete a cognitive task for 3-minutes)

Of course, we need to compare emotional responses in the cognitive reappraisal condition to some condition where participants are un-regulated, and against whose responses we can ask “Did participants who used Cognitive Reappraisal fare better?”

Previous research has shown that there are some strategies that are actually counterproductive for down-regulating negative emotions. For example, when people immerse themselves in the negative emotions they are feeling, this amplifies those negative feelings.

Therefore, we decided that our unregulated condition would be a condition in which participants would be instructed to verbally immerse themselves in their automatic thoughts and feelings during the emotional challenge

We also decided to include a third condition, called the distraction condition, and in this condition people complete a cognitive task that pops up in front of their eyes for 3 minutes.

Condition: Distraction

And the rationale for including this condition is based on some of our resutls from other studies that have involved this plank simulation. In those studies, we have embed cognitive tasks into the virtual environment to examine the effects of fear on executive functioning like inhibitory control, attentional control, and conflict adaptation.

So what you see here is a depiction of a go/no-go task based on shapes that appear in front of you, and the participant responds by pressing a button on their controller.

Comparison Condition: Distraction

And we have repeatedly found that the act of doing a cognitive task during the emotional challenge functions as an excellent regulator.

This graph is from one of our recent studies into inhibitory control, and if you look at the red line (this is our height condition), you see that there is this considerable increase in Heart Rate once the emotional challenge begins (which is after the vertical dashed line). But, to our surprise and our annoyance really, while they were doing the task, their heart rates recovered back to baseline.

Therefore, we reasoned that our Emotion Regulation study would be enhanced by including a third condition in which participants complete a 3-minute cognitive task during the emotional challenge, which should distract them from the emotional situation and facilitate excellent emotional regulation.

General Predicted Pattern of responses

The experimental design has three conditions. The immersion condition and distraction condition should result in clear differences whereby those in the immersion condition should show the least regulated (or most intense, if you prefer) fear responses, relative to those in the distraction condition.

Then, the question we can ask is where does Cognitive Reappraisal fit between these two patterns of fear responding.

Measures & Predictions

If people are successfully regulating their fear, we will observe:

1. decreased fear ratings
2. decreased heart rate
   
3. decreased skin conductance level
4. increased heart rate variability
   
5. reaching the end of the plank faster

Emotion Ratings across all Time points

• Fear
• Excitement
• Relaxation

Emotion Ratings pre- vs. post-Strategy

• Fear
• Excitement
• Relaxation

F(2, 68) = 2.22, p = .116

F(2, 68) = 2.96, p = .059

F(2, 68) = 0.92, p = .403

Heart Rate

• Across Time
• During Task

F(2, 68) = 2.43, p = .096

Skin Conductance Level

• Across Time
• During Task

F(2, 59) = 1.82, p = .170

Heart Rate Variability (RMSSD)

• Across Time
• During Task

F(2, 68) = 0.19, p = .824

High-Frequency Heart Rate Variability

• Across Time
• During Task

F(2, 68) = 6.56, p = .002

Time to complete plank walk

F(2,62) = 2.11, p = .129

Conclusions

1. Emotion Regulation taking place for all conditions (Immersion failed).
2. Distraction condition worked as expected.
3. Distraction delays fear responses (a fickle regulator)
4. No evidence that cognitive reappraisal was associated with attenuated fear responses
5. Suggestive evidence that cognitive reappraisal leads to increase in positive high-arousal emotions (flipping the valence)

Thank you

All Ratings

Physiological Measures Contrasts

Dependent Variable	Comparison	df	t	p	d	95% CI
HR	Distraction - Immersion	68	-1.87	.066	-0.54	[-1.12, 0.12]
	Distraction - Reappraisal	68	-1.93	.057	-0.56	[-1.20, 0.06]
	Immersion - Reappraisal	68	-0.08	.934	-0.02	[-0.55, 0.55]
RMSSD	Distraction - Immersion	68	0.36	.722	0.10	[-0.57, 0.73]
	Distraction - Reappraisal	68	0.62	.538	0.18	[-0.29, 0.65]
	Immersion - Reappraisal	68	0.27	.791	0.08	[-0.57, 0.69]
HF_ms2	Distraction - Immersion	68	-0.21	.832	-0.06	[-0.71, 0.63]
	Distraction - Reappraisal	68	-0.70	.485	-0.20	[-0.65, 0.16]
	Immersion - Reappraisal	68	-0.49	.625	-0.14	[-0.67, 0.52]
HF_percent	Distraction - Immersion	68	2.21	.030*	0.64	[0.10, 1.18]
	Distraction - Reappraisal	68	1.24	.219	0.36	[-0.12, 0.87]
	Immersion - Reappraisal	68	-0.95	.347	-0.28	[-0.86, 0.37]
HF_nu	Distraction - Immersion	68	3.62	.001***	1.05	[0.42, 1.62]
	Distraction - Reappraisal	68	1.77	.080	0.52	[-0.03, 1.04]
	Immersion - Reappraisal	68	-1.81	.075	-0.53	[-1.17, 0.12]