See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/41402532

Emotion Suppression: A Preliminary Experimental Investigation of Its

Immediate Effects and Role in Subsequent Reactivity to Novel Stimuli

Article in Cognitive Behaviour Therapy · June 2010

DOI: 10.1080/16506070903280491 · Source: PubMed

CITATIONS READS

19 308

3 authors:

Matthew T Tull Matthew Jakupcak

University of Toledo Lyra Health
242 PUBLICATIONS 10,713 CITATIONS 63 PUBLICATIONS 3,877 CITATIONS

SEE PROFILE SEE PROFILE

Lizabeth Roemer
University of Massachusetts Boston
127 PUBLICATIONS 16,806 CITATIONS

SEE PROFILE

Some of the authors of this publication are also working on these related projects:

Non-suicidal self-injury - characteristics, clinical correlates and interventions View project

Sexual Consent Among LGBTQ+ and Gender Diverse Young Adults View project

All content following this page was uploaded by Matthew T Tull on 06 January 2014.

The user has requested enhancement of the downloaded file.

This article was downloaded by: [Roemer, Lizabeth]
On: 7 May 2010
Access details: Access Details: [subscription number 922057239]
Publisher Routledge
Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-
41 Mortimer Street, London W1T 3JH, UK

Cognitive Behaviour Therapy

Publication details, including instructions for authors and subscription information:
http://www.informaworld.com/smpp/title~content=t713926011

Emotion Suppression: A Preliminary Experimental Investigation of Its

Immediate Effects and Role in Subsequent Reactivity to Novel Stimuli
Matthew T. Tull a; Matthew Jakupcak b;Lizabeth Roemer c
a
Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson,
MS, USA b Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care
System, and Department of Psychiatry and Behavioral Sciences, University of Washington School of
Medicine, Seattle, WA, USA c Department of Psychology, University of Massachusetts Boston, Boston,
MA, USA

First published on: 01 February 2010

To cite this Article Tull, Matthew T. , Jakupcak, Matthew andRoemer, Lizabeth(2010) 'Emotion Suppression: A Preliminary
Experimental Investigation of Its Immediate Effects and Role in Subsequent Reactivity to Novel Stimuli', Cognitive
Behaviour Therapy, 39: 2, 114 — 125, First published on: 01 February 2010 (iFirst)
To link to this Article: DOI: 10.1080/16506070903280491
URL: http://dx.doi.org/10.1080/16506070903280491

PLEASE SCROLL DOWN FOR ARTICLE

Full terms and conditions of use: http://www.informaworld.com/terms-and-conditions-of-access.pdf

This article may be used for research, teaching and private study purposes. Any substantial or
systematic reproduction, re-distribution, re-selling, loan or sub-licensing, systematic supply or
distribution in any form to anyone is expressly forbidden.

The publisher does not give any warranty express or implied or make any representation that the contents
will be complete or accurate or up to date. The accuracy of any instructions, formulae and drug doses
should be independently verified with primary sources. The publisher shall not be liable for any loss,
actions, claims, proceedings, demand or costs or damages whatsoever or howsoever caused arising directly
or indirectly in connection with or arising out of the use of this material.
 Cognitive Behaviour Therapy Vol. 39, No. 2, pp. 114–125, 2010

Emotion Suppression: A Preliminary Experimental

Investigation of Its Immediate Effects and Role in
Subsequent Reactivity to Novel Stimuli

Matthew T. Tull1, Matthew Jakupcak2 and Lizabeth Roemer3

1
Department of Psychiatry and Human Behavior, University of Mississippi Medical Center,
Jackson, MS, USA; 2Mental Illness Research, Education, and Clinical Center, VA Puget
Sound Health Care System, and Department of Psychiatry and Behavioral Sciences,
University of Washington School of Medicine, Seattle, WA, USA; 3Department of
Psychology, University of Massachusetts Boston, Boston, MA, USA
Abstract. This study details a preliminary investigation of the subjective and physiological effects of
emotion suppression, relative to the allowance of emotional experience, within one distressing
Downloaded By: [Roemer, Lizabeth] At: 20:06 7 May 2010

situation on responses to another, unrelated situation. Thirty-four men were instructed to suppress or
allow their emotional responses to a distressing film clip. Immediately following the film clip,
participants responded to a mildly emotionally evocative interpersonal scenario. There was evidence
of significantly different patterns of change in subjective distress and heart rate (HR) from one
situation to the next as a function of whether participants received instructions to suppress or allow
their emotional experience to the film clip. Specifically, allowance participants exhibited a significant
decrease in subjective distress, whereas suppression participants exhibited no change in distress.
Further, suppression participants’ distress was significantly higher than that of allowance
participants following the interpersonal scenario. Suppression participants also exhibited a
significant increase in mean HR from one situation to the next, whereas allowance participants
exhibited no change. Finally, allowance participants were significantly more likely to report being
willing to watch the film clip again than were suppression participants. Results are discussed in terms
of their implications for understanding the delayed negative consequences of emotion suppression.
Key words: acceptance; emotional avoidance; emotion regulation; emotion suppression; experiential
avoidance.

Received 18 August, 2009; Accepted 24 August, 2009

Correspondence address: Matthew T. Tull, PhD, Department of Psychiatry and Human Behavior,
University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA. Tel:
þ 601 815 6518. Fax: þ 601 984 4489. E-mail: mtull@psychiatry.umsmed.edu

Difficulties in emotion regulation have been
implicated as a common underlying vulner-
ability factor in the pathogenesis of diverse
clinical disorders (e.g. Baker, Holloway,
Thomas, Thomas, & Owens, 2004; Gratz,
Rosenthal, Tull, Lejuez, & Gunderson, 2006;
Mennin, Heimberg, Turk, & Fresco, 2005;
Tull, Barrett, McMillan, & Roemer, 2007;
Tull & Roemer, 2007). Emotion regulation
strategies that serve an experientially avoidant
function (i.e. altering the form or frequency of
unwanted internal experiences; Hayes,
Wilson, Gifford, Follette, & Strosahl, 1996)
have received particular attention, and a
substantial body of correlational research
has consistently supported the association
between the self-reported use of experientially
avoidant regulation strategies and many
negative outcomes (for a review, see Hayes,
Luoma, Bond, Masuda, & Lillis, 2006; Salters-
Pedneault, Tull, & Roemer, 2004). However,
results from experimental studies examining
the physiological and subjective impact of
experientially avoidant emotion regulation

q 2010 Taylor & Francis ISSN 1650-6073

DOI: 10.1080/16506070903280491
 VOL 39, NO 2, 2010
strategies, such as the active suppression of
emotional experience, have been more
variable.
For example, the instructed suppression of
emotional expression in response to negative
emotional film clips has been found to be
associated with increased physiological arou-
sal (Gross & Levenson, 1993, 1997). Similar
paradoxical effects of emotion suppression
have also been found (in regard to subjective
emotional response) among high experien-
tially avoidant individuals instructed to sup-
press their response to a carbon dioxide (CO2)
challenge (Feldner, Zvolensky, Eifert, & Spira,
2003). Feldner, Zvolensky, Stickle, Bonn-
Miller, and Leen-Feldner (2006) found that
instructed emotion suppression resulted in
elevated heart rate (HR) following a CO2
Downloaded By: [Roemer, Lizabeth] At: 20:06 7 May 2010
challenge and, among those low in anxiety
sensitivity, a significant increase in self-
reported negative valence of emotional
response. Studies that simply explore the
effect of trait experiential avoidance (as
opposed to instructed emotion suppression)
on emotional reactivity have demonstrated
that high (vs. low) experientially avoidant
individuals report greater negative and posi-
tive emotions and decreased HR in response
to unpleasant and pleasant film clips, respect-
ively (Sloan, 2004). On the other hand,
Karekla, Forsyth, and Kelly (2004) found
that high (vs. low) experientially avoidant
individuals reported a more severe subjective
emotional response and exhibited no differ-
ence in physiological arousal in response to a
CO2 challenge. Thus, results generally demon-
strate a paradoxical effect of trait experiential
avoidance or instructed suppression on sub-
jective emotional responding and, in some
cases, physiological responding across a
variety of emotion induction procedures.
Several laboratory studies have also exam-
ined the differential effects of the instructed
suppression versus acceptance of emotional
experience. For example, Campbell-Sills,
Barlow, Brown, and Hofmann (2006) com-
pared the effects of acceptance and suppres-
sion during a distressing film clip among mood
and anxiety disorder patients. They found that
instructed emotion suppression was associated
with a slower reduction in negative affect after
and greater physiological arousal during the
film clip. Levitt, Brown, Orsillo, and Barlow
(2004) compared the effects of acceptance,
Emotion suppression and reactivity 115
suppression, and neutral instructions among
panic disorder patients in response to a CO2
challenge task. Suppression participants
reported greater anxiety in response to the
CO2 challenge task as well as decreased
willingness to participate in a second CO2
trial compared with those instructed to accept
(with no differences between suppression and
neutral instruction conditions). Finally, Liver-
ant, Brown, Barlow, and Roemer (2008)
examined the effects of emotion suppression
relative to emotion acceptance in response to a
sadness-inducing film clip among individuals
with unipolar depression. Results demon-
strated that whereas participants instructed
to suppress their emotions reported signifi-
cantly less sadness in response to the film clip
than participants instructed to accept their
emotions, suppression was associated with a
marginally significant greater increase in
negative affect during the film clip compared
with acceptance. Findings of these studies
illustrate the negative, paradoxical conse-
quences of emotion suppression relative to
acceptance, at least in some aspects of
emotional responding.
Although the studies described previously
provide evidence for the potential negative
consequences of emotional avoidance on
emotional responding within the context of a
distressing situation, limited research has
examined how avoidance in one situation
may affect subsequent emotional responding
to another, unrelated situation. A small body
of research suggests that the suppression of
emotional experience and/or expression in one
context can negatively affect behavioral and
cognitive performance in another (Baumeis-
ter, Bratslavsky, Muraven, & Tice, 1998;
Muraven, Tice, & Baumeister, 1998; Richards
& Gross, 2000), and there is evidence that the
physiological effects of suppression may
persist after the termination of an aversive
stimulus (e.g. Campbell-Sills et al., 2006;
Feldner et al., 2006). Thus, emotion suppres-
sion may result in the maintenance and
intensification of an emotional experience
(e.g. Gross & Levenson, 1993, 1997; Hayes
et al., 1996; Levitt et al., 2004), thereby
increasing the extent to which it influences
responding to other situations. Indeed,
emotion suppression has been suggested to
interfere with functional exposure, prohibiting
the natural reduction in emotional intensity
 116 Tull, Jakupcak, and Roemer
that accompanies exposure (Foa & Kozak,
1986). Further, it has been suggested that the
avoidance of emotional experience, although
initially effective in reducing distress, may be
followed by a rebound in distress and arousal
(Hayes et al., 1996; Salters-Pedneault et al.,
2004), consistent with observations of the
effect of thought suppression (Wegner,
Schneider, Carter, & White, 1987). This
rebound of emotional arousal may contribute
to the misinterpretation of the emotional
salience of new situations, increasing emotion-
al responding to even mildly evocative
situations. Allowing one’s emotional experi-
ence, on the other hand, may initially be
associated with heightened distress but then be
followed by a reduction in the intensity of an
emotional response, facilitating a clear con-
Downloaded By: [Roemer, Lizabeth] At: 20:06 7 May 2010
nection between arousal and target and
preventing contamination of one situation
with emotional arousal from another.
The goal of this study was to examine the
differential effects of emotion suppression
versus allowance of emotional experience to
one emotionally evocative stimulus (a distres-
sing film clip) on emotional responding to a
mildly emotionally evocative, novel stimulus
(an interpersonal scenario). For this study, the
allowance of emotional experience was specifi-
cally chosen as the comparison condition
(rather than a no-instruction condition)
because it was expected that the use of
instructions that facilitate emotional approach
would heighten the contrast between the two
conditions. Indeed, there is evidence that
allowing emotional experience may serve a
function opposite that of emotion suppression
(Campbell-Sills et al., 2006; Levitt et al., 2004).
A no-instruction condition could reduce the
ability to make meaningful comparisons as a
result of uncertainty regarding what emotion
regulation strategies participants were actually
using, given evidence that participants who are
provided with no regulation instructions may
be naturally inclined to use strategies that
function to avoid internal experience in the
context of a distressing situation (Levitt et al.,
2004).
Hypotheses were as follows:
1. Despite the equivocal nature of past
findings concerning the immediate effects
of emotion suppression, theoretical litera-
ture suggests that emotion suppression has
COGNITIVE BEHAVIOUR THERAPY
an immediate beneficial effect, which
negatively reinforces the use of this
particular emotion regulatory strategy
(Hayes et al., 1996). Consequently, we
predicted that emotion suppression (vs.
allowance) instructions would be associ-
ated with lesser subjective and physiologi-
cal emotional reactivity in response to the
distressing film clip.
2. Suppression (vs. allowance) instructions
would be associated with greater subjective
and physiological emotional reactivity to
the interpersonal scenario following
exposure to the distressing film clip.
3. Regulation instructions would produce a
different pattern of change in emotional
responses across the study procedures.
Specifically, participants instructed to
suppress their emotions in response to a
distressing film clip would demonstrate a
significant increase in distress and physio-
logical arousal from that situation to the
next, whereas the opposite pattern would
emerge for participants who allowed their
emotional experience.
4. Participants instructed to suppress their
emotions, compared with those who
allowed their emotional experience,
would be less willing to view the film clip
again.
Method
Participants
As part of another study, 313 students,
faculty, and staff (225 men) at a large public
university completed questionnaire packets.
To minimize within-group variability resulting
from potential gender differences in emotion-
ality (e.g. McRae, Ochsner, Mauss, Gabrieli,
& Gross, 2008), only men were recruited for
this study. Forty men who provided written
consent to be contacted for future research
agreed to take part in this experiment.
Participants were randomly assigned to an
emotion suppression or an emotion allowance
condition. Six participants were excluded
because of missing data on one or more
dependent variables or covariates utilized in
analyses testing the hypotheses, resulting in a
final sample of 34 men (17 per condition). The
mean age of participants was 25.38 years
(SD ¼ 6.68) and 26.35 years (SD ¼ 7.19) for
the suppression and allowance conditions,
 VOL 39, NO 2, 2010
respectively. Among suppression partici-
pants,12 (70.6%) self-identified as White, one
(5.9%) as Black/African American, and two
(11.8%) as Asian/Pacific Islander; one (5.9%)
reported being from another, unspecified
racial/ethnic background, and one (5.9%)
did not provide this information. Among
allowance participants, 14 (82.4%) self-ident-
ified as White, two (11.8%) as Black/African
American, and one (5.9%) as Latino.
Materials
Preexperimental self-report assessment. Three
measures included in the initial questionnaire
packet assessed constructs expected to influ-
ence emotional responding to the presented
film clip (i.e. experiential avoidance, male
gender role stress, and history of sexual
Downloaded By: [Roemer, Lizabeth] At: 20:06 7 May 2010
assault). Conditions were matched on levels
of the first two phenomena. Sexual assault was
examined across groups to ensure equivalence.
The Acceptance and Action Questionnaire
(AAQ; Hayes et al., 2004) is a nine-item self-
report measure of experiential avoidance.
Evidence exists for the adequate convergent,
discriminant, and concurrent validity of the
AAQ as well as its reliability (Hayes et al.,
2004). Scores on the AAQ have been found to
be predictive of emotional responses to
emotionally evocative film clips (Sloan,
2004). Given that all participants were male
and our film clip depicted images that were
expected to violate traditional male gender
role norms (i.e. a male-on-male sexual assault;
see later discussion), participants were also
matched based on their responses to the Male
Gender Role Stress Scale (MGRS; Eisler &
Skidmore, 1987). The MGRS contains 40
items measuring the appraisal of circum-
stances judged to be more stressful for men
than women. There is evidence for the
construct validity and reliability of this
measure (see Eisler & Skidmore, 1987; Eisler,
Skidmore, & Ward, 1988). The MGRS has
been found to be associated with emotional
and physiological responses to emotionally
evocative stimuli among men (Moore &
Stuart, 2004). Finally, participants completed
the Life Events Checklist (Gray, Litz, Hsu, &
Lombardo, 2004), a measure assessing
whether or not participants have experienced
a number of potentially traumatic events. For
this study, the endorsement of a past sexual
assault was of particular interest. Considering
Emotion suppression and reactivity 117
the nature of the film clip presented, it was
expected that a history of sexual assault may
contribute to greater emotional reactivity to
the film clip.
Experiment self-report assessments. Following
baseline assessment periods and exposure to
stimuli, participants reported on their level of
emotional distress using a 5-point Likert scale
ranging from 1 (very slightly or not at all) to 5
(extremely).
Postexperiment self-report assessments. At the
end of the experiment, willingness to approach
a potentially distressing situation again was
assessed by asking, “Would you be willing to
watch the film clip again as part of a similar
study?” Participants responded with “Yes” or
“No.” Participants also answered seven ques-
tions using a 5-point Likert scale ranging from
1 (not at all) to 5 (very much) that retro-
spectively assessed the ways in which they
responded to their emotions during the
postmanipulation film clip (see Appendix).
Items were used for a manipulation check.
Physiological assessments. Physiological arou-
sal was measured via HR using standard
electrodes. HR electrodes were placed under
the left and right rib cage. Information was
relayed through a Biopac encoder unit. Data
were recorded online through Acknowledge 3.5
software using a sampling rate of 1,000
samples per second. HR data were recorded
during each baseline period, during each film
clip, and during a follow-up recovery period
(see Figure 1). Baseline and recovery periods
were 5 min long with a 20-s test period to
ensure that good physiological recordings
were obtained. The first film clip was 90 s
long and the second 3 min long. Consistent
with Salters-Pedneault, Gentes, and Roemer
(2007), data points two times greater than
mean HR for that assessment period were
smoothed using running mean replacement
through the Acknowledge program. Mean HR
for each period was calculated. Skin con-
ductance response (SCR) was also collected
and analyzed in a similar fashion as HR.
Apparent artifacts in the data were smoothed
using running mean replacement. Analyses
assessing the validity of these data demon-
strated that SCR during the distressing film
clip and after the second interpersonal
scenario was significantly associated with
room humidity ( p , .05). Consequently, the
decision was made to exclude this variable in
 118 Tull, Jakupcak, and Roemer
Baseline Baseline
ATSSP Film 1
1 2
1 (90 s)
(5 min) (5 min)
HR and SCR assessed during each period, except ATSSP 1 and 2.
Subjective emotional distress assessed after each period,
except Recovery.
Figure 1. Flow chart describing the study procedure. (ATSSP, Articulated Thoughts in Simulated
Situations Paradigm; HR, heart rate; SCR, skin conductance response.)
analyses. HR and subjective distress data were
not found to be affected by room humidity
( ps . .10). The units of measurement for HR
and SCR are beats per minute and microsie-
mens (mS), respectively.
Film stimuli. At two points during the
Downloaded By: [Roemer, Lizabeth] At: 20:06 7 May 2010
experiment, participants viewed a film clip of
a male-on-male sexual assault from the movie
Deliverance (Boorman, 1972), chosen because it
was expected to have a universal negative
emotional effect on men. In support of its
ability to induce distress, ratings of subjective
emotional distress in response to the premani-
pulation viewing of this film clip by the
participants in this study were compared with
ratings of emotional distress in response to a
nonemotionally evocative clip from the same
film (provided by 17 men recruited from the
larger questionnaire study but not included
in this study). Of note, these men were
comparable to those included in this study,
exhibiting no differences on age, t(49) ¼ 20.43,
p . .10, d ¼ 0.12, baseline subjective distress,
t(49) ¼ 0.33, p . .10, d ¼ 0.11, male gender role
stress, t(49) ¼ 0.81, p . .10, d ¼ 0.24, experien-
tial avoidance, t(49) ¼ 0.35, p . .10, d ¼ 0.27,
sexual assault exposure, x2(2, N ¼ 51) ¼ 0.74,
p . .10, r ¼ .12, or racial/ethnic background,
x2(5, N ¼ 51) ¼ 6.84, p ..10, r ¼ .35. HR data
were not available for these men. The sexual
assault scene was found to elicit significantly
greater levels of emotional distress, t(49) ¼ 2.96,
p , .01, d ¼ 0.85.
Interpersonal scenario following the postmani-
pulation film clip. The Articulated Thoughts in
Simulated Situations Paradigm (ATSSP;
Davison, Robins, & Johnson, 1983) asks
participants to listen to hypothetical situations
and imagine that they are an active member of
each situation. Each situation lasts 10 to 15 s
and is followed by a 30-s pause during which
participants talk out loud about what they
COGNITIVE BEHAVIOUR THERAPY
Baseline
Film 2 ATSSP Recovery
3
(3 min) 2 (5 min)
(5 min)
Emotion suppression or
allowance instructions provided
(manipulation)
would feel, think, or do if they were in that
situation. Participants are presented with eight
related situations in each ATSSP scenario.
The original ATSSP (Davison et al., 1983)
involved situations characterized by social-
evaluative stress that were particularly appli-
cable to undergraduate students (e.g. critical
evaluation of course work by a teaching
assistant). Given that this study included male
students, faculty, and staff, we decided to
modify the ATSSP to include scenarios that
would induce distress by evoking failures to
behave in accordance with male gender role
norms. As with the original ATSSP, situations
were characterized by social-evaluative stress.
In particular, participants were presented with
two scenarios: going to a movie or to a
restaurant with friends (presentation order
was counterbalanced within each condition).
To ensure that the scenarios evoked male
gender role stress-related distress, the events
included in these situations were based on
items included in the MGRS (e.g. “Having to
ask for directions when you are lost,” “Letting
a woman control the situation,” “Not making
enough money,” “Having people say that you
are indecisive,” and “Being compared unfa-
vorably to other men”).
Procedure
Before coming to the lab, participants were
randomly assigned to either the suppression or
the allowance group. Upon arrival, partici-
pants were told that the purpose of this study
was to examine how people process emotional
material. After providing written consent,
each participant was brought to a small
room connected to the main lab and was
seated in front of a computer monitor.
Physiological assessment electrodes were then
attached. The experimenter then left the
room, closed the door, and told the participant
 VOL 39, NO 2, 2010
to await further instructions. All communi-
cation during the experiment was done
through an intercom. A video camera allowed
the experimenter to observe the participant.
See Figure 1 for a flow chart describing the
study procedure. Participants were asked to sit
quietly for 5 min (Baseline 1) in order to obtain
a baseline measurement of their physiological
state. After this baseline assessment period,
participants rated their current level of
distress. Participants were then provided with
instructions on how to respond to the ATSSP.
Once participants indicated that they under-
stood the procedure, they were presented
with the first of two ATSSPs (ATSSP 1) to
assess baseline ATSSP reactivity. Upon
completing ATSSP 1, participants were again
asked to report on their current level of
Downloaded By: [Roemer, Lizabeth] At: 20:06 7 May 2010
distress. A second 5-min baseline physiological
assessment period (Baseline 2) then occurred.
After the second baseline assessment period
and subsequent reporting on their current level
of distress, a brief version of the film clip
(Film 1) was presented to assess baseline
reactivity to the film clip. Participants were not
provided with any instructions on how to
regulate their emotions in response to Film 1.
HR was recorded during Film 1. Because of
concerns that viewing Film 1 could result in a
habituation of emotional response to the
second viewing, participants only viewed the
first 90 s of the postmanipulation film clip.
Following presentation of Film 1, participants
reported their current level of distress. A 5-min
physiological assessment period (Baseline 3)
then occurred followed by another self-report
of current level of distress.
Suppression participants were then pro-
vided with the following instructions:
You will now be watching a film clip. It is
important that you watch the film very
carefully. This film may cause you to have
some distressing emotions as you view it. If you
do experience emotions during this clip, please
try your best to push these emotions away so
that you do not feel them. Do your best to
remain neutral during the film.
Allowance participants, on the other hand,
were provided with the following instructions:
You will now be watching a film clip. It is
important that you watch the film very
carefully. This film may cause you to have
some distressing emotions as you view it. Allow
Emotion suppression and reactivity 119
yourself to feel any emotions that you may have
as you are watching the film.
When participants indicated that they
understood the instructions, the second film
clip (Film 2) was started, lasting approxi-
mately 3 min. HR was recorded during Film 2.
Afterward, participants reported on their
current level of distress. Then the second
ATSSP (ATSSP 2) was presented to assess
emotional reactivity within a new context.
After the ATSSP 2, participants reported on
their current level of distress and took part in a
5-min physiological assessment period (recov-
ery). Participants were then given the post-
experiment questionnaire, debriefed, and
interviewed to ensure that there were no
prolonged negative effects of watching the film
clip. Monetary payment was provided ($20).
Results
Preliminary analyses
Manipulation and counterbalancing check. To
determine the effectiveness of the manipu-
lation, independent-sample t tests were con-
ducted to examine between-group differences
on the postexperiment questions, which
assessed how participants responded to their
emotional experience as a result of watching
Film 2. Compared with allowance partici-
pants, suppression participants were less likely
to report allowing themselves to feel whatever
they were feeling, t(32) ¼ 2 3.43, p , .01,
d ¼ 1.21, and more likely to report trying
not to feel distressed, t(32) ¼ 2.94, p , .01,
d ¼ 1.04, and trying to not show their feelings
on their face, t(32) ¼ 2.26, p , .05, d ¼ 0.80.
Within each group, no significant differences
between ATSSP 1 and 2 distress or HR were
found as a function of which ATSSP was
received first ( ps . .10), thus indicating that
counterbalancing was successful.
Examination of preexperimental individual
differences. Groups did not differ significantly
on age, t(32) ¼ 2 0.41, p . .10, d ¼ 0.15, or
racial/ethnic background (i.e. White vs. non-
White), x2(1, N ¼ 34) ¼ 0.65, p . .10, r ¼ .14.
Only one participant per group reported a past
sexual assault. No significant between-group
differences were found for Baseline 1 sub-
jective distress, t(32) ¼ 2 0.53, p . .10,
d ¼ 0.19, or HR, t(32) ¼ 0.71, p . .10,
d ¼ 0.25.
 120 Tull, Jakupcak, and Roemer COGNITIVE BEHAVIOUR THERAPY

Examination of baseline stimuli reactivity. In measures analyses of covariance (ANCO-

addition to simply examining baseline differ-
ences, analyses were conducted to ensure that
the film clip and ATSSP were effective in
evoking distress in our sample. In regard to
the ATSSP, a paired-samples t test examining
change in subjective distress from post-Base-
line 1 to post-ATSSP 1 was conducted.
Participants’ subjective distress significantly
increased from Baseline 1 (M ¼ 1.35, SD ¼
0.65) to ATSSP 1 (M ¼ 1.74, SD ¼ 0.75),
t(33) ¼ 2.61, p , .05, d ¼ 0.91. In regard to
the film clip, a paired-samples t test examining
change in subjective distress from Baseline 2 to
Film 1 was conducted. As with the ATSSP,
participants’ subjective distress significantly
increased from Baseline 2 (M ¼ 1.41,
SD ¼ 0.74) to Film 1 (M ¼ 2.00, SD ¼ .89),
Downloaded By: [Roemer, Lizabeth] At: 20:06 7 May 2010
VAs), utilizing subjective distress and HR as
dependent variables. Participants’ subjective
distress and HR in response to the first
presentations of the film clip and ATSSP were
used as covariates in analyses (depending on
the dependent variable being examined) to
control for baseline emotional and physio-
logical reactivity. Planned comparisons (using
adjusted means obtained with the repeated
measures ANCOVAs) were then conducted to
examine between-group differences in Film 2
(Hypothesis 1) and ATSSP 2 (Hypothesis 2)
responding. A paired-samples t test was also
used to examine within-group changes in
responding from Film 2 to ATSSP 2
(Hypothesis 3). Finally, a chi-square analysis
was conducted to examine between-group

t(33) ¼ 2.90, p , .01, d ¼ 1.10. Results differences in willingness (Hypothesis 4).

demonstrated that the ATSSP and film clip
were successful in evoking distress in our
sample. However, the ATSSP and film clip
were not associated with increases in HR at
baseline. HR from Baseline 1 (M ¼ 91.63,
SD ¼ 16.80) to Baseline 2 (post-ATSSP 1;
M ¼ 72.44, SD ¼ 12.96) actually decreased
significantly, t(33) ¼ 20.63, p , .001, d ¼ 7.18,
and HR from Baseline 2 (M ¼ 72.44,
SD ¼ 12.96) to Film 1 (M ¼ 71.58, SD ¼
11.92) did not change significantly, t(33) ¼
0.93, p . .10, d ¼ 0.32.
Primary analyses
Descriptive data are presented in Table 1. To
test our hypotheses, we conducted a series of 2
(condition) £ 2 (assessment period) repeated
The repeated measures ANCOVAs demon-
strated a significant Condition £ Assessment
Period interaction for subjective distress,
F(1, 32) ¼ 5.17, p , .05, h2p ¼ .15 (see
Figure 2) and HR, F(1, 32) ¼ 5.75, p , .05,
h2p ¼ .16 (see Figure 3).1
To explore the immediate effects of con-
dition instructions (Hypothesis 1), indepen-
dent-sample t tests were conducted to examine
between-group differences in subjective dis-
tress following Film 2 and mean HR during
Film 2.2 No significant between-group differ-
ences were found for Film 2 subjective distress,
t(32) ¼ 1.21, p . .10, d ¼ 0.43, or HR,
t(32) ¼ 1.88, p . .05, d ¼ 0.67.
To examine the carryover effects of the mani-
pulation (Hypothesis 2), independent-sample t

Table 1. Mean values of dependent variables for emotion allowance and suppression groups

Allowance Suppression
(N ¼ 17) (N ¼ 17)

Variable M SD M SD t(32) d
Subjective distress
Post-ATSSP 1 1.82 0.88 1.65 0.61 0.65 0.23
Post-Film 1 2.00 0.94 2.00 0.87 0.00 0.00
Post-Film 2 2.65 1.27 2.29 1.05 0.90 0.32
Post-ATSSP 2 1.76 0.83 2.12 0.99 1.15 0.41
Mean heart rate
Post-ATSSP 1 (Baseline 2) 71.24 15.17 73.64 10.64 0.53 0.19
During Film 1 70.88 12.58 72.29 11.57 0.34 0.12
During Film 2 71.70 13.30 71.22 10.44 0.12 0.04
Post-ATSSP 2 70.88 14.63 74.00 11.05 0.70 0.25
Note. ATSS ¼ Articulated Thoughts in Simulated Situations Paradigm.
 VOL 39, NO 2, 2010 Emotion suppression and reactivity 121

reported significantly greater distress following

2.75 Condition ATSSP 2, t(32) ¼ 2.10, p , .05, d ¼ 0.74.
Suppression
To examine the patterns of change in
Subjective emotional distress

Allowance
subjective distress and HR from Film 2 to
2.5
ATSSP 2 across groups (Hypothesis 3), a
paired-samples t test was conducted within
2.25 each group. Analyses demonstrated a signifi-
cant decrease in subjective distress across
assessment periods for allowance participants,
2
t(16) ¼ 2.31, p , .05, d ¼ 0.83, but no signifi-
cant change in distress for suppression partici-
1.75 pants, t(16) ¼ 0.72, p . .10, d ¼ 0.17. In regard
to HR, analyses demonstrated that suppression
participants exhibited a significant increase in
Post-Film 2 Post-ATSSP 2 mean HR during Film 2 to post-ATSSP 2,
Assessment Period t(16) ¼ 2 3.38, p , .01, d ¼ 0.26, whereas
allowance participants exhibited no significant
Figure 2. Condition (suppression, allowance) £ change, t(16) ¼ 0.67, p . .10, d ¼ 0.06.
Downloaded By: [Roemer, Lizabeth] At: 20:06 7 May 2010

Assessment Period (post-Film 2, post-ATSSP 2) Finally, to examine between-group differ-

interaction for subjective emotional distress.
(ATSSP, Articulated Thoughts in Simulated
Situations Paradigm.) Adjusted means are
presented.
tests were conducted to examine between-
group differences in subjective distress and HR
following ATSSP 2. No significant between-
group difference was found for post-ATSSP 2
HR, t(32) ¼ 0.89, p . .10, d ¼ 0.31. However,
suppression (vs. allowance) participants
73.00
72.50
72.00
Mean HR
ences in willingness, a chi-square analysis was
conducted. Results indicate that 23.5% of
suppression participants were not willing to
participate again compared with 0% of
allowance participants, x2(1, N ¼ 34) ¼ 4.53,
p , .05, r ¼ .34.
Discussion
Preliminary support for the differential effects
of emotion suppression versus allowance was
found, with findings providing some initial
evidence for varying patterns of emotional
responding across different domains (i.e.
subjective emotional distress and HR). How-
ever, before reviewing the findings of this
study, it is important to note that the sample
size was small, limiting power to find
significant differences. To illustrate this
point, in order to obtain power of 0.80 (with

71.50 a set at .05), we would have required an

71.00
70.50
70.00
During Film 2
Assessment Period
Figure 3. Condition (suppression, allowance) £
Assessment Period (during Film 2, post-ATSSP 2)
interaction for mean HR. (HR, heart rate; ATSSP,
Articulated Thoughts in Simulated Situations
Paradigm.) Adjusted means are presented.
additional 11 participants per group (for a
total sample size of 56; Erdfelder, Faul, &
Buchner, 1996). Consequently, null findings
Condition should be interpreted with caution. It is also
Suppression important to note, however, that nonsignifi-
Allowance
cant findings were generally associated with
small effect sizes, thus increasing confidence
Post-ATSSP 2
that Type II errors were not committed. The
exception to this was the absence of a
significant between-group difference on
Film 2 HR when taking into account
premanipulation responding. Specifically,
suppression participants’ adjusted mean HR
during Film 2 was lower than the adjusted
 122 Tull, Jakupcak, and Roemer
mean HR of allowance participants, and this
difference, although not significant, was
associated with a medium effect size
(d ¼ 0.67).
Although other studies examining the effect
of experientially avoidant regulation strategies
on emotional responding to a variety of
stimuli have found immediate consequences
of emotional suppression (e.g. Levitt et al.,
2004; Liverant et al., 2008), the procedures
utilized in this study did not reproduce these
results. Specifically, emotion suppression
(vs. allowance) was not found to have any
immediate effects on self-reported distress or
HR. However, although no between-group
differences in mean HR were found during the
post-ATSSP 2 recovery period, suppression
(vs. allowance) participants reported signifi-
Downloaded By: [Roemer, Lizabeth] At: 20:06 7 May 2010
cantly heightened distress immediately follow-
ing the ATSSP 2, partially consistent with
hypotheses. In addition, results indicated a
significantly different pattern of change in
subjective distress and HR from one situation
to the next as a function of the emotion
regulation instructions received. However, the
patterns of change were not entirely consistent
with what was expected. Specifically, suppres-
sion participants exhibited no significant
change in distress during this time (contrary
to predictions), whereas allowance partici-
pants exhibited a significant decrease in
subjective emotional distress from Film 2 to
ATSSP 2, consistent with predictions. In
addition, suppression participants exhibited a
significant increase in mean HR from the film
clip to the recovery period following ATSSP 2,
in line with what was expected. However,
inconsistent with hypotheses, allowance par-
ticipants exhibited no change in mean HR
across assessment periods.
Findings from this study suggest that the
immediate effects of emotion suppression
versus allowance may be similar. However,
the suppression of emotions appears to be
associated with a rebound effect for physio-
logical arousal following exposure to another,
novel situation (which is even more notable
given findings that the ATSSP was associated
with a reduction in HR levels premanipula-
tion). Further, no change in HR was observed
for allowance participants. In the context of
emotion allowance, it is possible that continu-
ous exposure to potentially distressing stimuli
may inhibit recovery of physiological arousal;
COGNITIVE BEHAVIOUR THERAPY
however, although emotion allowance was not
associated with a reduction in HR following
exposure to another situation, no increase in
HR was observed, suggesting that emotion
allowance may prevent a rebound or intensi-
fication effect. Suppressing one’s emotional
experience also appears to maintain subjective
distress. Allowing one’s emotional experience,
on the other hand, appears to have the benefit
of not interfering with recovery (at least in
regard to subjective distress) from exposure to
a distressing situation. Thus, even though
allowance participants experienced similar
HR levels from one situation to the next, it
appears as though they did not respond to or
interpret that maintained or consistent level of
arousal as an indication of emotional distress.
Finally, suppression participants were sig-
nificantly less likely to report future-oriented
approach behavior (i.e. willingness) at the end
of the study. Emotion suppression may have
hindered emotional engagement throughout
the course of exposure to the distressing
stimulus, thereby preventing habituation to
that stimulus (see Foa & Kozak, 1986) and
decreasing willingness to come into contact
with that situation in the future. Participants
who were instructed to suppress their
emotions also ended the study in a heightened
state of emotional distress compared with
allowance participants, likely influencing will-
ingness to participate again.
The current results contribute to the
growing evidence of negative consequences
of emotion suppression. However, findings are
preliminary and must be considered in the
context of limitations present. First, as
mentioned previously, the sample size was
small and may have limited our ability to find
significant between-group differences. None-
theless, it is important to note that most
nonsignificant findings were associated with
small effect sizes, thus limiting concerns about
Type II error. It will still be important for
future studies to replicate these findings in a
larger sample.
Second, this study examined the differential
effects of emotion suppression and allowance
among a sample of men. A different pattern of
findings may have emerged if hypotheses were
tested in a sample of women. However, given
research demonstrating that adult men report
less facial and verbal emotional expression
than women (Gross & John, 1998) and
 VOL 39, NO 2, 2010
naturally inhibit facial expressions of emotion
despite greater physiological reactivity (e.g.
Buck, Miller, & Caul, 1974), research on the
consequences of emotion suppression among
men may be particularly clinically relevant.
Third, the sample was predominantly White,
and the effect of racial/ethnic background was
not explored (primarily as a consequence of
the low number of racial/ethnic minority
participants across groups). Future research
should explore whether the effects of emotion
suppression versus allowance are comparable
or different across racial/ethnic groups.
In addition, this study did not include a no-
regulation instruction comparison group, only
comparing the effects of emotion suppression
versus allowance. Consequently, we cannot be
certain as to how the consequences of emotion
Downloaded By: [Roemer, Lizabeth] At: 20:06 7 May 2010
suppression or allowance compare with base-
line emotional responding (in the absence of
regulation attempts) or in regard to the
emotion regulation strategies that people
generally use in response to emotionally
significant events. Therefore, future studies
are needed that examine the effect of emotion
suppression, allowance, and no-regulation
instructions on emotional responding to
emotionally evocative stimuli as well as
subsequent reactivity to novel stimuli. Finally,
this study used participants from a nonclinical
setting who were not selected based on levels
of some clinical phenomenon. The use of
nonclinical participants was considered an
important and necessary “first step” research
approach in regard to our questions, given
that it allowed us to examine the effect of
emotional suppression not confounded by
psychopathology (see Tull, Bornovalova,
Patterson, Hopko, & Lejuez, 2008). Having
identified certain emotion regulation-based
processes that may contribute to elevations in
clinically relevant variables, the next step will
be to examine whether this study’s findings
can be replicated in clinical samples.
Despite limitations, findings offer prelimi-
nary evidence on the pattern of emotional
responding across situations and the will-
ingness to approach a distressing stimulus as a
function of the type of emotion regulation
strategy used. Inconsistencies between find-
ings from this study and past research suggest
that future studies may benefit from examin-
ing the differential effects of emotion suppres-
sion as a function of the type of stimulus
Emotion suppression and reactivity 123
presented (i.e. film clips, CO2 challenge) as well
as whether trait versus state suppression is
examined. Moreover, it may be advantageous to
use stimuli consistent with real-life situations so
as to promote participant engagement and
investment. The use of standardized emotion
regulation instructions may also be useful
(because all studies to date examining emotion
suppression have generally used different
instructions). By elucidating the specific effects
of different emotion regulation strategies, we
may improve our understanding of how specific
difficulties in emotion regulation may contrib-
ute to the development and maintenance of
various forms of psychopathology.
Acknowledgments
This study was conducted at the University of
Massachusetts Boston and was supported in
part by an internal grant from the University
of Massachusetts Boston to Lizabeth Roemer
and by two support grants through the
Department of Psychology at the University
of Massachusetts Boston to Matthew T. Tull
and Matthew Jakupcak. Portions of this study
were presented at the 37th annual meeting of
the Association for Advancement of Behavior
Therapy in Boston, Massachusetts (November
2003) by Matthew T. Tull. The authors wish to
thank Kim L. Gratz for her assistance with the
development of the ATSSP scenarios used in
this study and Winna Goldman for her help in
running participants.
Notes
1. As indicated previously, given that SCR during
Film 2 and post-ATSSP 2 was found to be
significantly associated with room humidity,
hypotheses pertaining to SCR were not
examined. However, it warrants mention that
there were no significant between-group differ-
ences in the pattern of change in SCR from
during Film 2 to post-ATSSP 2, F(1, 30) ¼ 0.03,
p . .10, h2p ¼ .00, as well as no significant
between-group differences in Film 2,
t(32) ¼ 1.62, p . .10, d ¼ 0.57, or ATSSP 2
SCR, t(32) ¼ 1.11, p . .10, d ¼ 0.39. Results
did not change when controlling for room
humidity.
2. As another approach to examining the immedi-
ate effect of instructed emotion suppression (vs.
allowance) on subjective distress and HR, we
conducted a 2 (condition) £ 2(assessment
period) repeated measures analysis of variance
to examine between-group differences in the
 124 Tull, Jakupcak, and Roemer
pattern of change in distress and HR from Film
1 to Film 2. Consistent with other analyses
testing Hypothesis 1, no significant between-
group differences were found for subjective
distress, F(1, 32) ¼ 1.24, p . .10, h2p ¼ .04, or
HR, F(1, 32) ¼ 1.91, p . .10, h2p ¼ .06.
References
Baker, R., Holloway, J., Thomas, P. W., Thomas,
S., & Owens, M. (2004). Emotional processing
and panic. Behaviour Research and Therapy, 42,
1271–1287.
Baumeister, R. F., Bratslavsky, E., Muraven, M., &
Tice, D. M. (1998). Ego-depletion: Is the active
self a limited resource? Journal of Personality
and Social Psychology, 74, 1252–1265.
Boorman, J. (Producer and Director). (1972).
Deliverance [Motion picture]. United States:
Warner Bros.
Downloaded By: [Roemer, Lizabeth] At: 20:06 7 May 2010
Buck, R. W., Miller, R. E., & Caul, W. F. (1974).
Sex, personality, and physiological variables in
the communication of affect via facial
expression. Journal of Personality and Social
Psychology, 30, 587– 596.
Campbell-Sills, L., Barlow, D. H., Brown, T. A., &
Hofmann, S. G. (2006). Effects of suppression
and acceptance on emotional responses of
individuals with anxiety and mood disorders.
Behaviour Research and Therapy, 44,
1251–1263.
Davison, G. C., Robins, C., & Johnson, M. K.
(1983). Articulated thoughts during simulation
situation: A paradigm for studying cognition in
emotion and behavior. Cognitive Therapy and
Research, 7, 17 – 39.
Eisler, R., & Skidmore, J. (1987). Masculine gender
role stress: Scale development and components
factors in the appraisal of stressful situations.
Behavior Modification, 11, 123– 136.
Eisler, R. M., Skidmore, J. R., & Ward, C. H.
(1988). Masculine gender-role stress: Predictor
of anger, anxiety and health-risk behaviors.
Journal of Personality Assessment, 52, 133– 141.
Erdfelder, E., Faul, F., & Buchner, A. (1996).
GPOWER: A general power analysis program.
Behavior Research Methods, Instruments, and
Computers, 28, 1 –11.
Feldner, M. T., Zvolensky, M. J., Eifert, G. H., &
Spira, A. P. (2003). Emotional avoidance: An
experimental test of individual differences and
response suppression using biological challenge.
Behaviour Research and Therapy, 40, 1– 9.
Feldner, M. T., Zvolensky, M. J., Stickle, T. R.,
Bonn-Miller, M. O., & Leen-Feldner, E. W.
(2006). Anxiety sensitivity-physical concerns as
a moderator of the emotional consequences of
emotion suppression during biological chal-
lenge: An experimental test using individual
growth curve modeling. Behaviour Research and
Therapy, 44, 249– 272.
Foa, E. B., & Kozak, M. J. (1986). Emotional
processing of fear: Exposure to corrective
information. Psychological Bulletin, 99, 20 – 35.
COGNITIVE BEHAVIOUR THERAPY
Gratz, K. L., Rosenthal, M. Z., Tull, M. T.,
Lejuez, C. W., & Gunderson, J. G. (2006).
An experimental investigation of emotion
dysregulation in borderline personality disorder.
Journal of Abnormal Psychology, 115, 850–855.
Gray, M. J., Litz, B. T., Hsu, J. L., & Lombardo,
T. W. (2004). Psychometrics properties of the
Life Events Checklist. Assessment, 11, 330– 341.
Gross, J., & John, O. (1998). Mapping the domain
of expressivity: Multimethod evidence for a
hierarchical model. Journal of Personality and
Social Psychology, 74, 170– 191.
Gross, J. J., & Levenson, R. W. (1993). Emotional
suppression: Physiology, self-report, and
expressive behavior. Journal of Personality and
Social Psychology, 64, 970– 986.
Gross, J. J., & Levenson, R. W. (1997). Hiding
feelings: The acute effects of inhibiting negative
and positive emotion. Journal of Abnormal
Psychology, 106, 95 – 103.
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda,
A., & Lillis, J. (2006). Acceptance and commit-
ment therapy: Model, processes, and outcomes.
Behaviour Research and Therapy, 44, 1 –25.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G.
(1999). Acceptance and commitment therapy: An
experiential approach to behavior change. New
York: Guilford Press.
Hayes, S. C., Strosahl, K. D., Wilson, K. G.,
Bissett, R. T., Pistorello, J., Toarmino, D., et al.
(2004). Measuring experiential avoidance:
A preliminary test of a working model. The
Psychological Record, 54, 553 –578.
Hayes, S. C., Wilson, K. G., Gifford, E. V.,
Follette, V. M., & Strosahl, K. (1996).
Experiential avoidance and behavioral dis-
orders: A functional dimensional approach to
diagnosis and treatment. Journal of Consulting
and Clinical Psychology, 64, 1152 –1168.
Karekla, M., Forsyth, J. P., & Kelly, M. M. (2004).
Emotional avoidance and panicogenic respond-
ing to a biological challenge procedure. Beha-
vior Therapy, 35, 725– 746.
Levitt, J. T., Brown, T. A., Orsillo, S. M., &
Barlow, D. H. (2004). The effects of acceptance
versus suppression of emotion on subjective and
psychophysiological response to carbon dioxide
challenge in patients with panic disorder.
Behavior Therapy, 35, 747– 766.
Liverant, G. I., Brown, T. A., Barlow, D. H., &
Roemer, L. (2008). Emotion regulation in
unipolar depression: The effects of acceptance
and suppression of subjective emotional experi-
ence on the intensity and duration of sadness
and negative affect. Behaviour Research and
Therapy, 46, 1201– 1209.
McRae, K., Ochsner, K. N., Mauss, I. B., Gabrieli,
J. J. D., & Gross, J. J. (2008). Gender
differences in emotion regulation: An fMRI
study of cognitive reappraisal. Group Processes
and Intergroup Relations, 11, 143– 162.
Mennin, D. S., Heimberg, R. G., Turk, C. L., &
Fresco, D. M. (2005). Preliminary evidence for
an emotion dysregulation model of generalized
 VOL 39, NO 2, 2010
anxiety disorder. Behaviour Research and
Therapy, 43, 1281 –1310.
Moore, T. M., & Stuart, G. L. (2004). Effects of
masculine gender role stress on men’s cognitive,
affective, physiological, and aggressive
responses to intimate conflict situations. Psy-
chology of Men and Masculinity, 5, 132– 142.
Muraven, M., Tice, D. M., & Baumeister, R. F.
(1998). Self-control as limited resource: Regu-
latory depletion patterns. Journal of Personality
and Social Psychology, 74, 774– 789.
Richards, J. M., & Gross, J. J. (2000). Emotion
regulation and memory: The cognitive costs of
keeping one’s cool. Journal of Personality and
Social Psychology, 79, 410– 424.
Salters-Pedneault, K., Gentes, E., & Roemer, L.
(2007). The role of fear of emotion in distress,
arousal, and cognitive interference following an
emotional stimulus. Cognitive Behaviour
Therapy, 36, 12 – 22.
Salters-Pedneault, K., Tull, M. T., & Roemer, L.
(2004). The role of avoidance of emotional
Downloaded By: [Roemer, Lizabeth] At: 20:06 7 May 2010
material in the anxiety disorders. Applied and
Preventive Psychology, 11, 95 – 114.
Sloan, D. M. (2004). Emotion regulation in action:
Emotional reactivity in experiential avoidance.
Behaviour Research and Therapy, 42,
1257– 1270.
Tull, M. T., Barrett, H. M., McMillan, E. S., &
Roemer, L. (2007). A preliminary investigation
of the relationship between emotion regulation
difficulties and posttraumatic stress symptoms.
Behavior Therapy, 38, 303– 313.
Tull, M. T., Bornovalova, M. A., Patterson, R.,
Hopko, D. R., & Lejuez, C. W. (2008).
View publication stats
Emotion suppression and reactivity 125
Analogue research. In D. McKay (Ed.), Hand-
book of research methods in abnormal and
clinical psychology (pp. 61 – 78). Thousand
Oaks, CA: Sage.
Tull, M. T., & Roemer, L. (2007). Emotion
regulation difficulties associated with the
experience of uncued panic attacks: Evidence
of experiential avoidance, emotional non-
acceptance, and decreased emotional clarity.
Behavior Therapy, 38, 378– 391.
Wegner, D. M., Schneider, D. J., Carter, S. R., &
White, T. L. (1987). Paradoxical effects of
thought suppression. Journal of Personality and
Social Psychology, 53, 5– 13.
Appendix
Items for the Retrospective (Postexperiment)
Assessment of Emotion Regulation during Film 2
Participants were asked to answer each item using a
5-point Likert scale ranging from 1 (not at all) to 5
(very much).
1. I let myself feel whatever I was feeling.
2. I tried to not feel distressed.
3. I tried to reduce the intensity of my feelings.
4. I tried to feel differently about the film.
5. I tried to think differently in order to change my
emotions about the film.
6. I tried to not show my feelings on my face.
7. I tried to see the events in a different way in
order to feel differently.