One of life's great challenges is successfully regulating emotions. Do some emotion regulation strategies have more to recommend them than others? According to Gross's (1998, Review of General Psychology, 2, 271-299) process model of emotion regulation, strategies that act early in the emotion-generative process should have a different profile of consequences than strategies that act later on. This review focuses on two commonly used strategies for down-regulating emotion. The first, reappraisal, comes early in the emotion-generative process. It consists of changing the way a situation is construed so as to decrease its emotional impact. The second, suppression, comes later in the emotion-generative process. It consists of inhibiting the outward signs of inner feelings. Experimental and individual-difference studies find reappraisal is often more effective than suppression. Reappraisal decreases emotion experience and behavioral expression, and has no impact on memory. By contrast, suppression decreases behavioral expression, but fails to decrease emotion experience, and actually impairs memory. Suppression also increases physiological responding for suppressors and their social partners. This review concludes with a consideration of five important directions for future research on emotion regulation processes.

https://onlinelibrary.wiley.com/doi/pdf/10.1017/S0048577201393198

Emotion regulation: Affective, cognitive, and social consequences

Individuals regulate their emotions in a wide variety of ways. Are some forms of emotion regulation healthier than others? We focus on two commonly used emotion regulation strategies: reappraisal (changing the way one thinks about a potentially emotion-eliciting event) and suppression (changing the way one responds behaviorally to an emotion-eliciting event). In the first section, we review experimental findings showing that reappraisal has a healthier profile of short-term affective, cognitive, and social consequences than suppression. In the second section, we review individual-difference findings, which show that using reappraisal to regulate emotions is associated with healthier patterns of affect, social functioning, and well-being than is using suppression. In the third section, we consider issues in the development of reappraisal and suppression and provide new evidence for a normative shift toward an increasingly healthy emotion regulation profile during adulthood (i.e., increases in the use of reappraisal and decreases in the use of suppression).

Healthy and Unhealthy Emotion Regulation: Personality Processes, Individual Differences, and Life Span Development

The ability of personality traits to predict im- portant life outcomes has traditionally been questioned because of the putative small effects of personality. In this article, we compare the predictive validity of personality traits with that of socioeconomic status (SES) and cogni- tive ability to test the relative contribution of personality traits to predictions of three critical outcomes: mortality, divorce, andoccupationalattainment.Onlyevidence from prospective longitudinal studies was considered. In addi- tion, an attempt was made to limit the review to studies that controlled for important background factors. Results showed that the magnitude of the effects of personality traits on mortality, divorce, and occupational attainment wasindistinguishablefrom the effectsofSES and cognitive ability on these outcomes. These results demonstrate the influence of personality traits on important life outcomes, highlight the need to more routinely incorporate measures of personality into quality of life surveys, and encourage further research about the developmental origins of per- sonality traits and the processes by which these traits in- fluence diverse life outcomes.

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The Power of Personality: The Comparative Validity of Personality Traits, Socioeconomic Status, and Cognitive Ability for Predicting Important Life Outcomes:

OBJECTIVE Type D personality-a joint tendency toward negative affectivity (NA) and social inhibition (SI)-is related to poor cardiac prognosis, but there is no standard for assessing Type D. This study reports on the Type D Scale-14 (DS14) as a standard measure of NA, SI, and Type D. METHODS The study included 3813 participants (2508 from the general population, 573 cardiac patients, 732 hypertension patients). They all filled out the DS14, containing 7-item NA and SI subscales; 275 subjects also completed the NEO-FFI, and 121 patients filled out the DS14 twice. RESULTS Factor analysis of the DS14 yielded 2 dominant traits; all of the NA and SI items loaded between 0.62 to 0.82 on their corresponding factor (N = 3678). The NA scale covered dysphoria, worry, and irritability; the SI scale covered discomfort in social interactions, reticence, and lack of social poise. The NA and SI scales were internally consistent (alpha = 0.88/0.86; N = 3678), stable over a 3-month period (test-retest r = 0.72/0.82) and not dependent on mood and health status (N = 121). NA correlated positively with neuroticism (r = 0.68); SI correlated negatively with extraversion (r = -0.59/-0.65). Scale-level factor analysis confirmed the construct validity of the DS14 against the NEO-FFI. Using a cutoff of 10 (NA > or =10 and SI > or =10), 1027 subjects (28%) were classified as Type D, 21% in the general population versus 28% in coronary heart disease and 53% in hypertension (p < or = .001). Age, sex, and Type D (odds ratio, 3.98; 95% confidence interval, 3.2-4.6; p <.0001) were independently associated with cardiovascular morbidity. CONCLUSION The DS14 is a brief, psychometrically sound measure of negative affectivity and social inhibition that could readily be incorporated in epidemiologic and clinical research.

DS14 : Standard assessment of negative affectivity, social inhibition, and Type D personality

Background Prospective studies on physically healthy subjects have shown an association between depression and the subsequent development of coronary heart disease (CHD). The relative risk in meta-analytic aggregation is 1.64 (confidence interval [CI], 1.29-2.08) for any CHD event. However, the adverse impact of depression on CHD patients has not yet been the subject of a meta-analysis. Objective To quantify the impact of depressive symptoms (eg, BDI, HADS) or depressive disorders (major depression) on cardiac or all-cause mortality. We analyzed the strength of the relationship, the time dependency, and the differences in studies using depressive symptoms or a clinical diagnosis as predictors of mortality. Method English and German language databases (Medline, PsycInfo, PSYNDEX) from 1980 to 2003 were searched for prospective cohort studies. Sixty-two publications were identified. The inclusion criteria were met by 29 publications reporting on 20 studies. A random model was used to estimate the combined overall effect as crude odds ratios (OR) or adjusted hazard ratios (HR [adj]). Results Depressive symptoms increase the risk of mortality in CHD patients. The risk of depressed patients dying in the 2 years after the initial assessment is two times higher than that of nondepressed patients (OR, 2.24; 1.37-3.60). This negative prognostic effect also remains in the long-term (OR, 1.78; 1.12-2.83) and after adjustment for other risk factors (HR [adj], 1.76; 1.27-2.43). The unfavorable impact of depressive disorders was reported for the most part in the form of crude odds ratios. Within the first 6 months, depressive disorders were found to have no significant effect on mortality (OR, 2.07; CI, 0.82-5.26). However, after 2 years, the risk is more than two times higher for CHD patients with clinical depression (OR, 2.61; 1.53-4.47). Only three studies reported adjusted hazard ratios for clinical depression and supported the results of the bivariate models. Conclusions Depressive symptoms and clinical depression have an unfavorable impact on mortality in CHD patients. The results are limited by heterogeneity of the results in the primary studies. There is no clear evidence whether self-report or clinical interview is the more precise predictor. Nevertheless, depression has to be considered a relevant risk factor in patients with CHD.

Depression as a risk factor for mortality in patients with coronary heart disease: a meta-analysis.

Personality as independent predictor of long-term mortality in patients with coronary heart disease

The examination of blood flow velocity (BFV) changes during the performance of mental tasks is one of the applications of transcranial Doppler (TCD) ultrasonography. The purpose of this review is to summarize the results of the functional TCD literature, to investigate the effects of methodological differences between studies, and to provide guidelines for future research. It is concluded that larger series of more homogeneous groups concerning age and handedness, and stricter criteria for subject selection and laboratory setting are required. The implication of quantitative and qualitative performance measures and psychological parameters (motivation, anxiety, and task anticipation) could also yield important information. We recommend future agreement upon a more standardized methodology. TCD promises to be a useful tool to provide further insight into the cerebral organization and temporal reactivity of the human brain.

Transcranial Doppler ultrasonography monitoring of cerebral hemodynamics during performance of cognitive tasks: a review.

Background and Purpose—Transcranial Doppler ultrasonography (TCD) permits the assessment of cognitively induced cerebral blood flow velocity (BFV) changes. We sought to investigate the lateralizati...

Lateralization of Cerebral Blood Flow Velocity Changes During Cognitive Tasks A Simultaneous Bilateral Transcranial Doppler Study

Relation between neurocognitive impairment, embolic load, and cerebrovascular reactivity following on- and off-pump coronary artery bypass grafting.

Objective: Neuropsychological dysfunctions are considered to be important complications of coronary artery bypass graft surgery (CABG). We examined the frequency of neuropsychological abnormalities occurring in patients undergoing CABG with (on-pump) and without (off-pump) cardiopulmonary bypass. Methods: Neuropsychological assessment with seven cognitive tasks was performed one day before, 6–7 days after (n ¼ 49) and 6 months after (n ¼ 35) surgery. The subgroup undergoing on-pump surgery (n ¼ 30 at 7 days and n ¼ 22 at 6 months) was demographically comparable to the off-pump subgroup. The on-pump group included more multiple vessel disease. Results: Repeated measures multivariate analysis of variance (using surgical group as a between-subjects factor) on the group data revealed no significant differences neither immediately after surgery nor at 6 months after surgery, compared with the preoperative performance. There were no significant differences between the on-pump and off-pump groups in post-operative neuropsychological performance soon after surgery. A significant difference was found between the two groups 6 months after surgery, with more favorable results for the off-pump group. Individual comparisons revealed that 59% of the patients of both groups undergoing CABG showed evidence of cognitive impairment soon after surgery. In 11% of the patients (all on-pump), the cognitive sequelae persisted at follow-up. Conclusion: This study showed no short-term difference between the on-pump and off-pump CABG groups. The long-term cognitive outcome revealed more favorable results for the off-pump group. Although a preference to operate multiple vessel disease with classical cardiopulmonary bypass (CPB) has to be considered, the present study shows evidence for a different pattern of early decline and late recovery of cognitive functions in patients undergoing CABG with and without CPB. q 2002 Elsevier Science B.V. All rights reserved.

Nathalie Stroobant

Papers

Personality as independent predictor of long-term mortality in patients with coronary heart disease

Transcranial Doppler ultrasonography monitoring of cerebral hemodynamics during performance of cognitive tasks: a review.

Lateralization of Cerebral Blood Flow Velocity Changes During Cognitive Tasks A Simultaneous Bilateral Transcranial Doppler Study

Relation between neurocognitive impairment, embolic load, and cerebrovascular reactivity following on- and off-pump coronary artery bypass grafting.

Short-term and long-term neurocognitive outcome in on-pump versus off-pump CABG.