Se hacoancs Emotion sanarey ~ pnecsoephottsneman INTRODUCTION Emotion Regulation Kateri McRae James J. Gross University of Denver Stanford University motion regulation (ER) refers to atempis to influence emotions in ourselves or obers. Over the past soveral decades, ER has become a popula topic across many subdiscipines within psychology. One framework tat has helped to ozunize work on ER isthe process model of ER, which distinguishes S Families of strategies defined by when they impact the emotion generation process. The process mse embeds these ER stratspes in stages in which a need foe relation is identified, a sitapy selec nd implemented, and monitoring occurs to track success. Much of the research fo dae has Focused on 8 sracgy called cognitive reappraisal, which involves changing how one thinks about a situation to influence one's emotional response. Reappraisal i thought be genealy effective and pve, but thre are important qualications. In his arc, we use reappraisal 36 an example to llusrate how we might consider 4 interelated issues: (2) the consequeaces of usiag ER, either when instructed of spontaneous: (b) how ER success and Frequency ae shaped by individual and environmental determi nants: (¢) the psychological and neurobiological mechanisms tht make ER possible: and ()inerven- tions tar migh improve how well aa how often people we ER, Keywonts emotion rpulation, cogitive eappeisal, process mods! of emotion epulaton, aeuescence, peas Supplemental materials: bp: de og! 105expe0000708 supp “The idea that we can change our emotions (rather than just broader in tha passively experience them) gocs buck thousands of years (Grube & Reeve, 1974). In the modern era this idea has been expressed in foundational theoretical and empirical work on psychological defenses (Freud, 1946) and stress and coping (Lazarus & Folkman, 1984). Then in the 1990s, the field of outside conscious awareness (Braunstein, Gross. & Ochsner, 2017 motion regulation (ER) began to emerge ws a distinc research Kole, Wel 5) To dae, aula of one's ow Se ee ee cre im oer swe Sedalia aca 2 1995: Izard, 1990; Thompson, 1994) ee jkolajczak, but encompasses 4 Soo, Za Wha 209 (Gustin. Hye. an Zones © Ore Sioa Fai an 20, ssune sepa enti sDont eect n weve anes wed. We tet evi poco an ofthis etc Conespondence concerning this tcl should be addressed to Kateri ally. We review interventions designed to improve individuals" ‘McRue, Deparment of Psychology, University of Denver, 2135 Sous emotional lives by increasing how well or how often reappraisal Race Sree, Denver, CO SO210, Ena: Ker morse ede is used. historical predecessors, ER is Fdior’s Note. "This isan itroduction wo the special issue “Pundmental (Qvestions in Emotion Repulaton.” Please see the Table of Contents here uppsyenet pa orpouralveme/20V1/—PRP Content may be shared a2 MeRAE AND GROSS What Is Emotion Regulation? ation cyele ereates a new aspect of the situation (the situation is ‘now sitting in a job interview while feeling afraid, being short of ~ EL ing to the emotion ge (ce Table I and Figure 1b), Table | outlines the five Famili gives nonexhaustive example strategies for each family, and hides specific tactics which might he implemented in the context of the job interview scenario. EER researchers seck to identity the diferent ways that individ A the frst level ofthis model ( is sequentially described as (2), the SITUATION ———* ATTENTION ———* APPRAISAL——* RESPONSE art SITUATION — SITUATION = ATTENTIONAL = COGNITIVE RESPONSE SELECTION MODIFICATION DEPLOYMENT CHANGE MODULATION IDENTIFICATION > SELECTION ———+_ IMPLEMENTATION MONITORING key NOTION REGULATION PROCESS MODEL Figures are modified fom Uusberg eta. 2018), Feedback aos i iterating cycles4 Content may be shared a EMOTION REGULATION 3 Table | The Five Families of ER Srategies, Strategy, and Tactic Examples From the Job Interview Context, Organized by the Stage in the Emotion Generation Cycle in Which They First Intervene Stategy famity Selected strategies Example tactics (inj interview context) uation selection Avoidance Situation miicakion Direct aguas “Tokingaeion to influence a situation once enpaped (ey aking 10 move stevie (0 a private location) Attentional deployment Disrastion Directing atention internal or external) away fom dhe emxiona situation towed nonematonal aspects of the situation or nonemetional situations (eg, plancng totes rather an the interviewers ac) Romination Recurenly directing sltetion toward cares and consuensss of emvaton (2, mentally replaying a moment in which the inerviewer appeared t fown a your response) | CCogniive change Cognitive reappraisal Reinterpeting or wevalating the emotional station andor your pols (e2. ing yours the inteviewer Was likely coached 10 nat ge overt pose Feack to pcs). Accopiance Welcoming emotions with nonevaluatve judgment (eg, noticing and calivaling curiosity about ‘manifestations of ankity inthe inlericu) Response movlation Expressive suppression Proveatng outward expression of intral emotional state (eg. kepiag fice acuta to avoid ‘expressing disappointment) Physiological intervention Diocly altering emotion relevant physiology using actions or substances (2, slowing one’s treating rate) Note. ER = emotion regulation, EY—Processes that con- (Aldao, Sheppes, & Gross, 2015; Bo- ‘anno & Burton, 2013; Pruessner, Barnow, Holt, Joormann, & Schulze, 2020). What Consequences Does Emotion Regulation Have? Most studies of emotion regulation have cither manipulated E or assessed typical patterns of ER use (McRae, 2013). The con sequences of manipulating ER (implementation stage) have typi ally ben the purview of basic affective science because strategies are trained and cued inthe laboratory, and the measured emotional ‘outcomes are temporally proximal (0 the re catcher often refer to this as (which we use here). Initial studies of ER success tested the ‘versus later repeating cycles, (Gross, 2001 Sheppes & Gross, 2011). By contrast, pattems of ER use (selection stage) have largely been studied within personality, developmen- tal, and clinical psychology, are most typically measured using questionnaires, and many of the presumed consequences are rela tively distal associates. Typical ER use is variously referred to as ER tendency, ER use, habitual ER, trait ER, oF ER frequency (which we use ere). Inthe Tast decade, ER frequency has increas ingly been operationalized as how often someone chooses {0 use & particular strategy inthe laboratory (Sheppes t al. 2011). Reappraisal is frequently successful, inasmuch as it often results in the desired changes in self-reported emotion (Gross, 1908; Jackson, Malmstar, Larson, & Davidson, 2000), peripheral phys Fology (Denson, Grisham, & Moulds, 2011; Dillon & LaBar, 2005; Ray, MeRac, Ochsner, & Gross, 2010), and neural measures of ‘emotion (Chang, Gianatos, Manuck, Krishnan, & Wager, 2015; Dirfel etal, 2014; Hajcak & Nieuwenhuis, 2006; Kalisch eta, 2005: Lohani & Issacowitz, 2014: Ochsner, Bunge, Gross, & Gabrieli, 2002; Schaefer etal. 2002; Shahane, Lopez, & Denny, 2019), Studies using experience sampling to examine reappraisal in more natural envieonments have been largely consistent with Inboratory findings (Colombo et al. 2020). (Goldin, McRae, rinos. Greenaway, & mann, Kress, & Stark, 2017; echert, Sheppes. Rydstrom, & Gross, 2011; for a meta-analysis, see Webb, Miles, & Sheeran, 2012). Factors that lessen reappraisal's success are discussed below in the determinants section (fora review, see Ford & Troy. 2019) is often associated with adaptive ‘outcomes st (Appleton, Buka, Loucks, Gilman, & Kubzansky, 2013: Appleton, Loucks, Buka, & Kubzan- sky, 2014, Davis & Levine, 2013; Iveevie & Brackett, 2014), (ing Tish, John, Srivastava, & Gross, ross & John, 2003), \da0, Nolen-Hocksema, & Schweizer, 2010: Cludins, nin, & Ehring, 2020), These associations contrast with greater suppression frequency, whichis often associated with lesser well- being, more symptoms of pyychopathology, and lesser relationship, satisfaction (Cameron & Overall, 2018; Chervonsky & Hunt,rent in part or whee must go through the American Paychologicl Assocla be shared at no cost, but any TeqUess fo reuse this 4 MeRAE AND GROSS 2017; English tal, 2012; English & Eldesouky, 2020; Gross & John, 2003). However, suppression seems 0 be a relatively adap- tive skill early in development, and more suppression use is associated with greater school readiness in preschoolers (Har ‘ington, Trevino. Lopez, & Giuliani, 2020). What Determines (Moderates) Emotion Regulation? (Shafi, Schwartz, Blechert, Sheppes, a 2015), (McRae, Misra, Prasad, Pereira, & Gross, 2011. Nelson Fitzgerald, Klumpp. Shannan, & Phan, 2015) and when there fe relatively rete sll mie cin Resibois, Vertuyn,& Kuppens, 2017: Sheppes & Meira, 2007). Th REST REEAMD tps oly when clan ote negative emot et ne nao, Se (Waugh. 2020) The engagement of peomal conce (PEC) ontol regions during reappraisal (Buble tal. 2013; Moravetz Bode, Demi & Heckeren, 2017; Ochsner Gross, 2008) sag. ests tha eppraisal may be ss susesfl unr coniton that impair PFC-dependent cognition. Inco. (Walker & van der Helin 2008), Mas Ty, LeBourgeois, 2013), SRBRRao. Orr, Paar : Phelps. 2013; Zhan eal 2017, PEC incgrity and funcioning (DeCicco, Solomon, & Denis, 2012; Mefae et a, 2012) a associated with ss succesful appa ‘What factors termine how often people wsereappsal? Re- appr reqency les erable and tore open to nonfa Cnvironmenal inences than emotion evant penn i trension suppression equeney (Mekace al 2017) Comtex tl fats that determine ER resuency incl Social relationship partnces, especially in childhood (Lindy, 2020, and personality factors (Hughes, Kratsiotis, Nive, &¢ Hol ‘man, 2020), Individuals select reappraisal more fequemy when thesia to be reputed ae of ser item (Doe, Weber, & Ochsner, 2017: Matin, Shepes, Gross Mather, 2016; Op Cavan, & Un, 2015) or contain more eapprs aerdances (Sur eal, 2017) and wsereapraal less Fequenty when they have anticipatory fafomation abou th conten (bt meng) ot tmetinlevant events (Shaft & Sheppes, 2020), When stil fico high intensity, distraction (Sheppes, Schebe, Suri & Gross 2011) oF suppesion (Dinon Gordon, Aldgo. & De Los Reyes 2015) are more likely to be wed. Infvidals om cultures ht Salue selection ‘amt insight tend Yo ake reaps moe Frequemly than average (Haga, Kraft & Corby. 2000), whereas inviuats fom cures that value open expression of emotion {End to use suppression les fequently (Matsumoto, Yoo. & Ne agawa, 2008: MeRae, Heller, John, & Grose 2011; St ota DTS). Furthermore there is evidence that» hisry oF having Shoretim succes ht ea to more Feet we of alae tual and i strategies such as self-injurious behavior (Swerdlow, Peatstein, Sandel, Mauss, & Johnson, 2020). What Are the Mechanisms (Mediators) of Emotion Regulation? What neurobiological and psychological mechanisms enable reappraisal? Neurobiologieal mechanisms of reappraisal imple- mentation include brain systems that support cognitive contol and linguistic elaboration, compared wit distraction, which uses more external attentional control systems, and suppression, which uses ‘more inhibitory systems (Goldin et al, 2008; Hayes et al, 2010; Kanske, Heissler, Schénfelder, Bongers, & Wessa, 2011; McRae 2010; Ohira etal. 2006: Vandechasselt, Kuhn, & De Raed. 2012). Engagement of reappraisal-related prefrontal and parietal cognitive control and linguistic elaboration systems can lead to cither diminished or enhanced emotional responding, in comrespon- dence with one's emotional goal (Ochsner et al, 2004; Kim & Hamann, 2007), Clarifying how reappraisal relates to affective versus cognitive contol may clarify the developmental trajectory fof ER during. adolescence (Schweizer, Gotlib, & Blakemore, 2020), Likewise, clarifying whether reappraisal can be driven by prosctive versus reactive control processes may help us determine the most effective and adaptive ER strategies (o use in adulthood and later in life (Martins-Kiein, Alves, & Chiew, 2020). Another potential mechanism is the (up-regulation of positive emotion ‘which may help ws better understand associations between ER and psychopathology (Silton et a, 2020) Psychological mechanisms governing the selection of reap: praisal include decision-making processes, in which the need for regulation is balanced with anticipated success, the estimated cognitive costs of implementing candidate strategies (Milyavsky et I, 2019), and the desire to engage with the emotional aspects of the situation to be regulated (Sheppes eta, 2014). The process of reappraisal sclection may engage a similar frontoparital network to that engaged during reappraisal implementation, but few studies are able fo separate mechanisms of selection from implementation (Cosme, Mobasser, Zeithamova, Berkman, & Pfeifer, 2018). Which Interventions Improve Emotion Regulation? Psychosocial interventions that target ER to treat psychopathol- ‘ogy are common (Berking ct al. 2008; Rottenberg & Gross, 2007) and have considerable empirical support (Butler, Chapman, For man, & Beck, 2006). Interventions can target neurobiological oF psychological mechanisms of ER sind mesure their proximal oF distal effects. Interventions for children often east a wide net by educating parents andior teachers about healthy ER and offering concrete steps for children to observe and practice ER cither through parent socialization at home (England-Mason & Gonzalez, 2020) or instruction about emotional intelligence (whieh includes ‘emotion regulation) at school (Hoffman, Brackett, Bailey. & Will ner, 2020), Less frequent use of largely adaptive strategies lke reappraisal and, to a greater extent, overuse of maladaptive strategies like rumination and suppression consistently characterize clinical groups ‘with mood disorders (Aldao ca, 2010; Compas etal, 2017; Pathot? ct al, 2016). The goal of many interventions is to decrease the Frequency with which maladaptive ER strategics are used and 14 Content may be shared a EMOTION REGULATION 5 increase the frequency ans success with which adapive ER strategies are use (Aldao,Jazaieri, Goklin, & Gross, 2014; Brozovich etal, 2015: Gilboa-Schechiman, Shachar, & Sahar, 2014). Cognitive ther ‘ies, including cogniive-behavioral therapy, directly target reap- prasad skills Beck & Dovois, 2011; Kazantzis et al. 2018), CCognitive-behavioral therapy improves selF-repored reappraisal sac~ cess (Goldin et al, 2014), and ether interventions that improve reap- praia success include direct reappraisal training using a pictire- based task (Denny, 2020), Neurobiological interventions such as Aanidepressant medication increase reappraisal frequency (McRae Rekshan, Williams, Cooper, & Gross, 2014) and suceess (Outhred et al, 2015), and noninvasive stimulation of neural regions engaged ring reappraisal increases reappraisal success (Peeser, Prehn, Ka- ‘zet, Mungee, & Bajo. 2014) and decreases symptoms of depres sion (Lan, Chetty, Ligon, Mann, & Dubin, 2016), Directions for Future Research ‘To round out this discussion, we will first briefly review re- scarch that falls outside the selection and implementation stages of the process model, We will then turn toa high-stakes example that demonstrates the importance of separating implementation from selection So far, we have facused on implementation success and selec- tion frequency in the context of reappraisal. What about the con- sequences, determinants, mechanisms, and interventions that in- fluence the identification and monitoring stages? The consequence of not identifying a nced to regulate is emotion regulation failure, and identification appears to be jointly determined by an individ ual’s emotion goals (which ean be hedonic or instrumental; Tami, Mitchell, & Gross, 2008) and their belief in the malleability of ‘emotion (Tamir, John, Srivastavs, & Gross, 2007). Mechanisms of ‘dentitication include processes that govern goal pursuit, including goal setting, goal striving (Tamir, Vishkin, & Gutentag, 2020), or the use of implementation intentions (Gallo & Gollwitesr, 2007) Interventions for identification target the valuation of specific emotional states (Crum, Jamieson, & Akinola, 2020) or beliefs about emotion malleability (Kneeland, Nolen-Hoeksema, Dovid, ‘& Gruber, 2016). Although monitoring isan important stage ofthe process model, few studies have examined consequences, deter ‘minants, mechanisms, and interventions related to monitoring of ER specifically (but see Koch, Mars, Toni, & Roclofs, 2018). One exciting exception is the suecessful extemalization of monitoring in functional magnetic resonance imaging-based neurofeedback (Paret & Hendler, 2020), In future research on emotion regulation, it will be important to examine the full range of stages in the {emotion regulation process ‘Throughout this discussion, we have distinguished between how well and how often people use reappraisal. Why is this important? In many circumstances, they are conflated, especially as research- cr, including ourselves, briefly summarize findings of previous studies of ER. This conflation is reasonable because the short-term success of reappraisal (eg. successfully reduced negative emo- tion) could logically lead to some of the long-term adaptive asso- ciates of reappraisal frequency. (e.g, lower levels of daily negative affect). However, there is reason t0 believe how well and how often reappraisal is used might be distinct constructs (MeRae, 2013; Silvers & Moreira, 2019), which is especially apparent in clinical contexts. (One of the most reliable Findings in the ER Titerature i that eater use of reappraisal is related to fewer symptoms of psycho- pathology (Aldao et al., 2010; Eftekhar, Zoellner & Vigil, 2000 Hu et al, 2014), but studies of how well reappraisal is used by clinical groups have reported weak or null differences from non- clinical groups. With few exceptions, it appears that members of clinical groups can successfully use reappraisal in a laboratory setting (Goldin, Manber, Hakimi, Canli, & Gross, 2009), Mets analyses indicate that members of clinical groups demonsirate reappraisal success that is indistinguishable from controls in 80% of published studies (Pic6-Pérez, Radua, Steward, Menchn, & Soriano-Mas, 2017: Zilverstand, Parvaz, & Goldstein, 2017). What is the source of this disconnect between reappraisal success and ‘One possibilty is that although individuals from clinical groups ‘ean use reappraisal sucessfully when cued, they fall to appropri ately identity moments at which ER would be helpful in everyday life. Alternatively, members of elinial groups may infact be able to identify moments at which ER would be helpful but for one reason of another choose not to use reappraisal very frequently in ‘everyday life (as implied by Dryman & Heimberg, 2018). Itis also possible that laboratory use measures capacity, which is an over= estimate of actual success everyday life. Finally, itis possible that this disconnect between reappraisal use and success is an artifact fof the way these constructs are measured (cumulative emotion ratings om laboratory task vs. self-report responses). The source of the disconnect eauld have important implications for ER intr ‘vention science, which would respectively focus on using remind: crs and encouragement to seloct and initiate roappraisal in every” day life, improving conditions for implementing reappraisal in ‘everyday life, oF developing, refining, or combining measures of reappraisal that most closely correspond to documented emotional difficulties in clinical groups. These suggestions for future research are, of course, small ‘sampling of the full set of possiblities currently evident inthis fast-growing field. Our goal is to show that research on ER has produced sharpened definitions and generative models of ER, ‘outlined different emotional consequences of engaging in different types of ER, identified moderating contextual and individual fac tors that impact ER, described psychological and neurobiological ‘mechanisms by which regulation influences emotion, and docu ‘mented the effect of ER interventions on short= and long- term ‘outcomes. Additional reading beyond the scope of our discussion can be found in online supplemental materials. In our view, when considering (or conducting) research on ER, its helpful to clarity which stage of the ER process (identification, sclection, imple ‘mentation, or monitoring) is being described, manipulated, oF ‘measured because this will help to make subsequent ER interven: tions more targeted and precise. 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