How to handle anxiety: The effects of reappraisal, acceptance, and suppression strategies on anxious arousal. Behaviour Research and Therapy, 47, 389-394

Department of Psychology, Boston University, 648 Beacon Street, 6th Floor, Boston, MA 02215-2002, USA.
Behaviour Research and Therapy (Impact Factor: 3.85). 03/2009; 47(5):389-94. DOI: 10.1016/j.brat.2009.02.010
Source: PubMed


It has been suggested that reappraisal strategies are more effective than suppression strategies for regulating emotions. Recently, proponents of the acceptance-based behavior therapy movement have further emphasized the importance of acceptance-based emotion regulation techniques. In order to directly compare these different emotion regulation strategies, 202 volunteers were asked to give an impromptu speech in front of a video camera. Participants were randomly assigned to one of three groups. The Reappraisal group was instructed to regulate their anxious arousal by reappraising the situation; the Suppression group was asked to suppress their anxious behaviors; and the Acceptance group was instructed to accept their anxiety. As expected, the Suppression group showed a greater increase in heart rate from baseline than the Reappraisal and Acceptance groups. Moreover, the Suppression group reported more anxiety than the Reappraisal group. However, the Acceptance and Suppression groups did not differ in their subjective anxiety response. These results suggest that both reappraising and accepting anxiety is more effective for moderating the physiological arousal than suppressing anxiety. However, reappraising is more effective for moderating the subjective feeling of anxiety than attempts to suppress or accept it.

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Available from: Stefan G Hofmann, Oct 03, 2015
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    • "The lack of any active control condition is also a concern, as the inclusion of such a baseline may help to clarify the inconsistent findings from previous studies (Aldao & Mennin, 2012) and facilitate interpretations of effectiveness comparisons (Dunn et al., 2009). This is also reflected in the asymmetry that exists within the comparison of emotion outcomes; most studies focus on subjective experience and physiology (e.g., Campbell-Sills et al., 2006a; Wolgast et al., 2011; Szasz et al., 2011), but rarely on behavior (e.g., Hofmann et al., 2009). "
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    ABSTRACT: Background and objectives: Few studies related to the impact of different emotion regulation strategies on anxiety have used externally and ecologically valid emotion-eliciting stimuli or Eastern populations. The present study compares the effects of reappraisal, suppression, and acceptance on anxiety induced by a simulated job interview in a Chinese sample. Methods: Eighty-two subjects were randomly assigned to one of four instructions: reappraisal, suppression, acceptance, or no-regulation strategies during a simulated job interview. Anxiety was assessed with an observer-based behavior rating scale during the interview and the State Anxiety Inventory before, during, and after the interview. Results: A repeated-measures MANOVA indicated a significantly greater reduction in anxiety in the reappraisal and acceptance groups displayed a greater amount of anxiety reduction compared to the control group during the interview (reappraisal: d=1.42; acceptance: d=1.30; each p < .001), but not during the recovery stage. The suppression and control group did not differ in any stage. Suppression led to a higher (pmax < .04) anxiety than reappraisal/acceptance in the anticipation (d=0.65/0.68), interview (d=0.87/0.79), and recovery stages (d=0.94/1.03). No significant differences were found between reappraisal and acceptance. Conclusions: In Chinese students reappraisal and acceptance seem to be more effective anxiety regulation strategies than suppression.
    Anxiety Stress & Coping 05/2015; in press. DOI:10.1080/10615806.2015.1042462 · 1.97 Impact Factor
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    • "Null findings on behavioral outcomes, however, come from a study examining the use of reappraisal, acceptance, or suppression while giving a speech. Whereas participants instructed to use acceptance or suppression reported greater anxiety than those told to use reappraisal, they did not differ from one another in the length of their speeches (Hofmann, Heering, Sawyer, & Asnaani, 2009). "
    Psychological Inquiry 03/2015; 26:27-36. DOI:10.1080/1047840X.2015.962399 · 4.73 Impact Factor
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    • "Reappraisal and acceptance appear equivalent in promoting flexible physiological regulation among individuals with heightened anxiety (as indexed by heart rate variability; Cristea et al., 2012) and in reducing physiological arousal (Hofmann et al., 2009). However, acceptance may be less effective at regulating anxiety and anger than reappraisal (Hofmann et al., 2009; Szasz et al., 2011). Other studies have found equivalent decreases in subjective distress (Wolgast et al., 2011). "
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    ABSTRACT: Mood disorders are characterized by impaired emotion regulation abilities, reflected in alterations in frontolimbic brain functioning during regulation. However, little is known about differences in brain function when comparing regulatory strategies. Reappraisal and emotional acceptance are effective in downregulating negative affect, and are components of effective depression psychotherapies. Investigating neural mechanisms of reappraisal versus emotional acceptance in remitted major depressive disorder (rMDD) may yield novel mechanistic insights into depression risk and prevention. Thirty-seven individuals (18 rMDD, 19 controls) were assessed during an fMRI task requiring reappraisal, emotional acceptance, or no explicit regulation while viewing sad images. Lower negative affect was reported following reappraisal than acceptance, and was lower following acceptance than no explicit regulation. In controls, the acceptance > reappraisal contrast revealed greater activation in left insular cortex and right prefrontal gyrus, and less activation in several other prefrontal regions. Compared to controls, the rMDD group had greater paracingulate and right midfrontal gyrus (BA 8) activation during reappraisal relative to acceptance. Compared to reappraisal, acceptance is associated with activation in regions linked to somatic and emotion awareness, though this activation is associated with less reduction in negative affect. Additionally, a history of MDD moderated these effects. © The Author (2015). Published by Oxford University Press. For Permissions, please email:
    Social Cognitive and Affective Neuroscience 01/2015; 10(9). DOI:10.1093/scan/nsv003 · 7.37 Impact Factor
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