Should we suppress or reappraise our stress?: the moderating role of reappraisal on cortisol reactivity and recovery in healthy adults

Background: People differ in their ability to regulate their physiological stress response. Individual differences in emotion regulation strategies such as suppression and reappraisal may explain this differential response to stress.

Objective: The aim of the current study was to assess whether daily use of suppression and reappraisal as well as their interaction predicted physiological stress reactivity and/or recovery, as assessed by variations in cortisol levels.

Method: Thirty-eight healthy young adults (13 men) completed the Emotion Regulation Questionnaire and were exposed to a psychosocial stressor, throughout which salivary cortisol was measured.

Results: Linear regressions showed main effects of reappraisal and suppression on cortisol reactivity and a main effect of suppression on cortisol recovery, where both strategies were positively associated with stress phases. Moreover, results showed a significant interaction of suppression by reappraisal in predicting both cortisol reactivity and recovery. Simple slope tests revealed that reappraisal moderated the association between suppression and both phases of cortisol responsivity.

Conclusion: Our results suggest that reappraisal represents a protective factor against the deleterious effects of suppression on stress responsivity. This study underlines the importance of investigating emotion regulation strategies as a means to understand individual differences in vulnerability to stress-related psychopathologies such as anxiety and depression.     

The role of emotion control and emotional rumination in stress management training

The present paper reports on three outcome studies evaluating the effectiveness of a new stress management training program. In contrast to conventional stress management, which tends to emphasize life-events, the symptoms of stress and relaxation, the new program is based on emotional rumination, emotion control, and attention control. The training developed from a series of experimental studies on the role of emotional inhibition and rumination in prolonging physiological recovery from stress, and the findings reported here were obtained from a series of applied studies involving police officers from a police force in the North of England. The first two studies employed both self-reported and objective measures of change to demonstrate that the training produced significant increases in job satisfaction and reduced absenteeism, while the results of the final study showed that the benefits of the program were enhanced by follow-up training.     

Emotional responding in NSSI: examinations of appraisals of positive and negative emotional stimuli,with and without acute stress

Non-suicidal self-injury (NSSI) is commonly used by young adults to regulate emotional responses. Yet, experimental examination of how people who self-injure appraise and respond to emotional stimuli is limited. We examined appraisals of, and responses to, emotive images in young adults who did and did not self-injure, and assessed whether these were impacted by exposure to a stressor. Study 1 (N?=?51) examined whether participants differed in their appraisals of emotional images. Study 2 (N?=?78) assessed whether appraisals of images changed after exposure to the Trier Social Stress Test. Ratings of emotional valence and arousal were collected in both studies; skin conductance was measured as an indicator of physiological arousal in Study 2. In Study 1 participants reporting NSSI rated positively valenced images as less pleasant than participants not reporting NSSI. In Study 2, after acute stress, participants reporting NSSI displayed dampened physiological reactions to positive images whereas participants who did not self-injure displayed heightened physiological reactions to these and rated them as more pleasant. Individuals who self-injure seem less able to engage in strategic mood repair after exposure to stress compared to people who do not self-injure.     

Effects of emotional response on the Stroop‐like task in preschool children and young adults

This study investigated the effects of emotional response on an inhibitory task, the Stroop‐like day‐night task, in which participants are presented with two pictures. They are then requested to inhibit naming what the card shown to them represents and instead state what the other card represents. Specifically, 35 4‐ to 6‐year‐old children and 15 young adults were administered the emotion‐related happy‐sad task and the emotion‐unrelated up‐down task using the same stimulus set (happy and sad cartoon faces). The results suggested that vulnerability to errors in the happy‐sad task was not derived from increased inhibitory demand. The results also suggested that the happy‐sad task is more inhibitory‐demanding in terms of response time. These results suggested that the happy‐sad task elicits interference more than other variants of this task, not because the task involves emotional stimuli per se but because the task involves both emotional stimuli and emotional responses.     

Emotion recognition and emotional theory of mind in chronic fatigue syndrome

Background: Difficulties with social function have been reported in chronic fatigue syndrome (CFS), but underpinning factors are unknown. Emotion recognition, theory of mind (inference of another's mental state) and ‘emotional’ theory of mind (eToM) (inference of another's emotional state) are important social abilities, facilitating understanding of others. This study examined emotion recognition and eToM in CFS patients and their relationship to self-reported social function.

Methods: CFS patients (n?=?45) and healthy controls (HCs; n?=?50) completed tasks assessing emotion recognition, basic or advanced eToM (for self and other) and a self-report measure of social function.

Results: CFS participants were poorer than HCs at recognising emotion states in the faces of others and at inferring their own emotions. Lower scores on these tasks were associated with poorer self-reported daily and social function. CFS patients demonstrated good eToM and performance on these tasks did not relate to the level of social function.

Conclusions: CFS patients do not have poor eToM, nor does eToM appear to be associated with social functioning in CFS. However, this group of patients experience difficulties in emotion recognition and inferring emotions in themselves and this may impact upon social function.     

The effect of passive heat stress on distress andself-control in male smokers and non-smokers

In the current study, we tested the effects of core body temperature increases (e.g. heat stress) on affect, self-reported physical discomfort, and subsequent self-control in male smokers and nonsmokers using a novel passive heat stress paradigm, within a distress tolerance framework. Twenty-eight men (14 smokers), completed both heat stress and control sessions in randomized order. Results revealed that increases in core body temperature were associated with increased anxiety, irritability, and body discomfort as well as decreased happiness, with stronger effects for smokers. Smokers and nonsmokers both evidenced less self-control during the heat session and did not differ on this measure, nor on a measure of interoceptive sensitivity. The current study indicates that heat stress is a viable method for studying distress tolerance in men, and suggests the value in examining dynamic changes in self-control as a function of distress. Implications will be discussed for distress tolerance in general and smokers in specific.     

Gender gaps in cognitive and social‐emotional skills in early primary grades: Evidence from rural Indonesia

This paper examines the magnitude and source of gender gaps in cognitive and social‐emotional skills in early primary grades in rural Indonesia. Relative to boys, girls score more than 0.17 SD higher in tests of language and mathematics (cognitive skills) and between 0.18 and 0.27 SD higher in measures of social competence and emotional maturity (social‐emotional skills). We use Oaxaca–Blinder decomposition to investigate the extent to which gender differences in early schooling and parenting practices explain these gender gaps in skills. For cognitive skills, differences in early schooling between boys and girls explain between 9% and 11% of the gender gap whereas differences in parenting practices explain merely 3%–5% of the gender gap. This decomposition result is driven largely by children living in villages with high‐quality preschools. In contrast, for social‐emotional skills, differences in parenting styles toward boys and girls explain between 13% and 17% of the gender gap, while differences in early schooling explain only 0%–6% of the gender gap.     

Gender differences in emotional and overt/covert aggressive responses to stress

We examined the role of stress exposure on gender differences in hostile (emotional and behavioral) reactions within the context of a laboratory paradigm. Aggressive behavior was indexed via the intensity (overt) and the duration (covert) of putative shocks delivered to a confederate. Half of the participants were exposed to a chronic stressor (high stress) and half were not (low stress). Participants' emotional responses were measured via self-report mood ratings before and after the experiment. Men displayed higher aggression in both stress conditions, which corresponded to their ratings of state hostility. On the other hand, women in high stress delivered lower intensity shocks, and this decreased overt aggression was positively correlated with sadness ratings. However, women did not decrease their levels of shock duration (covert aggression) under high stress and showed equivalent shock duration compared with men in high stress. These findings are discussed in terms of differential overt manifestations of distress between men and women.     

Quantitative work demands,emotional demands,and cognitive stress symptoms in surgery nurses

In surgery, cognitive stress symptoms, including problems in concentrating, deciding, memorising, and reflecting are risks to patient safety. Recent evidence points to social stressors as antecedents of cognitive stress symptoms in surgery personnel. The current study tests whether cognitive stress symptoms are positively associated with emotional abuse, emotional- and task-related demands and resources in surgery work. Forty-eight surgery nurses from two hospitals filled out the Copenhagen Psychosocial Questionnaire in its German version. Task-related and emotional demands were positively related to cognitive stress symptoms. In a stepwise, multiple, linear regression of cognitive stress symptoms on task-related and emotional demands, emotional abuse and emotional demands were unique predictors (p < .05). Efforts to increase patient safety should address emotional abuse, emotional demands, and, therefore, communication and cooperation team climate in surgery personnel.     

Higher cortisol is associated with poorer executive functioning in preschool children: The role of parenting stress,parent coping and quality of daycare

Child executive functions (cognitive flexibility, inhibitory control, working memory) are key to success in school. Cortisol, the primary stress hormone, is known to affect cognition; however, there is limited information about how child cortisol levels, parenting factors and child care context relate to executive functions in young children. The aim of this study was to examine relationships between child cortisol, parenting stress, parent coping, and daycare quality in relation to executive functions in children aged 3–5 years. We hypothesized that (1) poorer executive functioning would be related to higher child cortisol and higher parenting stress, and (2) positive daycare quality and positive parent coping style would buffer the effects of child cortisol and parenting stress on executive functions. A total of 101 children (53 girls, 48 boys, mean age 4.24 years ±0.74) with complete data on all measures were included. Three saliva samples to measure cortisol were collected at the child’s daycare/preschool in one morning. Parents completed the Behavior Rating Inventory of Executive Function – Preschool Version (BRIEF-P), Parenting Stress Index (PSI), and Ways of Coping Questionnaire (WCQ). The Early Childhood Environment Rating Scale – Revised (ECERS-R) was used to measure the quality of daycare. It was found that children with poorer executive functioning had higher levels of salivary cortisol, and their parents reported higher parenting stress. However, parent coping style and quality of daycare did not modulate these relationships. Identifying ways to promote child executive functioning is an important direction for improving school readiness.     

Association between obesity and suicide in woman,but not in man: a population-based study of young adults

The relationship between obesity and suicide risk is still unclear with controversial research results. The aim of this study is to investigate the relationship between obesity and suicide risk for men and women in a population-based study of young adults. This is a cross-sectional population-based study that identified young adults between 18 and 35 years of age. Suicide risk was investigated through the structured clinical interview Mini. Weight and height were assessed, and participants were classified as normal-weight body mass index (BMI < 30) or obese (BMI > 30). The prevalence of obesity was of 19.9% of the total sample (n = 1953). Obesity was more prevalent among women and participants between 27 and 35 years of age. Suicide risk was present in 13.0% of the sample and more prevalent among women. In our study we found an association between obesity and suicide risk for women, but not for men. Obesity was associated with a higher prevalence of suicide risk in women. Given the strength of the relationship between BMI and suicide, identifying the mechanisms associated with obesity, especially for women, can lead to new insights into the prevention of suicide risk     

Treatment of chronic stress in employees: subjective, cognitive and neural correlates

This study reports the effect of an affect-focused intervention program, the Affect School, on stress, psychological symptoms, cognitive functioning and neural activity. Fifty employees in social service and education, with high levels of chronic stress, were randomly divided into a treatment (N=27) and control (N=23) group. Complete sets of data were available in 20 participants in the treatment group and 17 in the control group. The Perceived Stress Questionnaire assessed stress and the Symptom Check List-90 psychological symptoms before and after treatment. Episodic-memory functioning under focused and divided attention conditions was also assessed. Prior and after the Affect School, seven participants in the treatment group were studied with functional magnetic resonance imaging (fMRI) during episodic memory processing. After the Affect School there was a reduction in stress and psychological symptoms for the treatment group but not in the control group. The controls showed a reduction in episodic memory functioning whereas the performance of the treatment group remained intact. The fMRI scanning indicated a qualitative change in the neural network subserving episodic memory. These preliminary results suggest that the Affect School is effective on individuals with high stress.     

Eating styles in the morbidly obese: Restraint eating,but not emotional and external eating,predicts dietary behaviour

Objectives : The research explored (1) the relationships between self-reported eating style (restraint, emotional and external eating) and dietary intake and (2) emotional eater status as a moderator of food intake when emotional, in a morbidly obese population.

Design : A sample of 57 obese participants (BMI: M?=?51.84, SD?=?8.66) completed a five-day food diary together with a reflective diary, which assessed eating style and positive and negative affect daily.

Main outcome measures : A dietician-scored food pyramid analysis of intake.

Results : Restraint eating was the only predictor (negative) of overall food intake and the variable most strongly associated with the consumption of top-shelf foods. Emotional and external eating were unrelated to food intake. Emotional eater status did not moderate food intake in response to positive and negative mood states.

Conclusion : The findings indicated largely analogous relationships between eating style and dietary intake in this obese sample compared with previous results from healthy populations. The lack of predictive validity for emotional eating scales (when emotional) raises questions over people’s ability to adequately assess their eating style and consequently, the overall validity of emotional eater scales.     

Personal mastery predicts pain,stress, fatigue,and blood pressure in adults with rheumatoid arthritis

Among individuals with rheumatoid arthritis (RA), stress-associated disease flare can severely impact well-being. Psychological factors such as personal mastery may buffer an individual from the negative effects of those flares. We tested the hypothesis that a high sense of personal mastery would prospectively predict stress reactivity. Measures of pain, perceived stress, fatigue, and mean arterial pressure (MAP) were collected before, during, and after two interpersonal stressors conducted on 73 individuals with RA. Factor analysis of the personal mastery scale yielded two independent factors: a 5-item “fatalism” component and a 2-item “control” component. Individuals with high fatalism scores reported overall greater joint pain at baseline and those scoring high on control exhibited lower MAP, and reported less stress and fatigue at baseline. After controlling for baseline differences, those high in control exhibited greater MAP increase during stress, and less drop in pain when compared to those low in control. These results suggest that individuals high in control may be more susceptible to the effects of acute stress; however, the overall beneficial aspects of high control outweigh the acute negative effects. Personal mastery may play a role in the experience of pain, stress, and fatigue for people with RA.     

Distress tolerance but not impulsivity predicts outcome in concurrent treatment for posttraumatic stress disorder and substance use disorder

Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) commonly co-occur. Emerging research suggests that both distress tolerance and impulsivity may underlie this comorbidity. However, to our knowledge no studies have examined whether these 2 constructs predict outcome in PTSD-SUD treatment. The current study investigated whether pretreatment distress tolerance and impulsivity predicted posttreatment PTSD and cravings severity in a sample of 70 Veterans receiving concurrent treatment for PTSD and SUD in a residential day treatment program. Veterans completed measures of symptom severity before and after treatment. Results demonstrated that pretreatment distress tolerance predicted posttreatment PTSD severity while controlling for pretreatment PTSD. By contrast, pretreatment impulsivity was not predictive of posttreatment PTSD while controlling for pretreatment values. Neither distress tolerance nor impulsivity predicted posttreatment cravings severity. The findings support the notion that distress tolerance may help to explain the co-occurrence of PTSD and SUD and suggest that targeting this construct in PTSD-SUD treatment may be important for successful outcomes.     

Randomized trial of a meditation-based stress reduction program and cognitive behavior therapy in generalized social anxiety disorder

Mindfulness-based stress reduction (MBSR) has been reported to reduce anxiety in a broad range of clinical populations. However, its efficacy in alleviating core symptoms of specific anxiety disorders is not well established. We conducted a randomized trial to evaluate how well MBSR compared to a first-line psychological intervention for social anxiety disorder (SAD). Fifty-three patients with DSM-IV generalized SAD were randomized to an 8-week course of MBSR or 12 weekly sessions of cognitive-behavioral group therapy (CBGT). Although patients in both treatment groups improved, patients receiving CBGT had significantly lower scores on clinician- and patient-rated measures of social anxiety. Response and remission rates were also significantly greater with CBGT. Both interventions were comparable in improving mood, functionality and quality of life. The results confirm that CBGT is the treatment of choice of generalized SAD and suggest that MBSR may have some benefit in the treatment of generalized SAD.     

Hippocampal low-frequency stimulation and chronic mild stress similarly disrupt fear extinction memory in rats

Disruptions of fear extinction-related potentiation of synaptic efficacy in the connection between the hippocampus (HPC) and the medial prefrontal cortex (mPFC) have been shown to impair the recall of extinction memory. This study was undertaken to examine if chronic mild stress (CMS), which is known to alter induction of HPC–mPFC long-term potentiation, would also interfere with both extinction-related HPC–mPFC potentiation and extinction memory. Following fear conditioning (5 tone-shock pairings), rats were submitted to fear extinction (20 tone-alone presentations), which produced an increase in the amplitude of HPC–mPFC field potentials. HPC low-frequency stimulation (LFS), applied immediately after training, suppressed these changes and induced fear return during the retention test (5 tone-alone presentations). CMS, delivered before fear conditioning, did not interfere with fear extinction but blocked the development of extinction-related potentiation in the HPC–mPFC pathway and impaired the recall of extinction. These findings suggest that HPC LFS may provoke metaplastic changes in HPC outputs that may mimic alterations associated with a history of chronic stress.     

Gender differences in acute and chronic stress in Wistar Kyoto (WKY) rats

While females are considered more susceptible to depressive behavior, this assertion is not strongly supported by the experimental literature. Since stress contributes to depressive behavior, male and female Wistar Kyoto (WKY) rats were exposed to either one session (acute stress) or 5 sessions (chronic stress) of restraint plus cold in order to study depressive behavior in male and female rats. After their respective treatment exposure, rats were tested in the open field test (OFT) and for retention of a passive-avoidance (P-A) task. One stress session resulted in significant immobility in the OFT for males, whereas 5 sessions were required to produce similar immobility in female rats. Acute stress interfered with the retention of the P-A response for males, while both acute and chronic stress produced poor P-A responses in female rats. Food consumption decresed, progressively, as a function of stress sessions, in female rats, whereas feeding in males returned to control levels after five stress days. Both acute and chronic stress exacerbated the stress ulcer response in male rats, but not in female rats. Chronic, but not acute, stress resulted in an increase in serotonin transporter mRNA levels in the dorsal raphe nucleus of both male and, female rats. The general consensus from these data suggested that female rats were more vulnerable to chronic stress and consequently supported the notion that females may be more susceptible to stress induced behavioral depression.