Divergent associations of adaptive and maladaptive emotion regulation strategies with inflammation.

Abstract

Background Recent work suggests effective emotion regulation may protect against risk of developing coronary heart disease (CHD), but the mechanisms remain unknown. Strategies for regulating emotions vary in how effectively they mitigate potentially toxic effects of stressful life experiences, and therefore may be differentially associated with CHD risk. In this study we examined emotion regulation strategies of reappraisal and suppression in relation to inflammation, a biological state associated with both stress and CHD. We hypothesized that suppression would be associated with elevated inflammation and reappraisal would be associated with lower inflammation. Methods We studied n=379 adult offspring (mean age=42.2 years) of Collaborative Perinatal Project participants, a national cohort of pregnant women enrolled in 1959–1966. Validated measures of two emotion regulation strategies were examined: reappraisal and suppression. Inflammation was measured as plasma C-reactive protein (CRP) levels. We fit multiple linear regression models predicting CRP while controlling for demographic, socioeconomic and health factors, including depressive symptoms, measured across the life course. Results A one standard deviation increase in reappraisal was associated with significantly lower CRP (b = −0.18, se=0.06, p<0.01) controlling for demographics. This relation was somewhat attenuated in life course models, with adulthood body mass index partially explaining the association. A one standard deviation increase in suppression was associated with significantly higher CRP (b=0.21, se=0.05, p<0.001) and this association was not substantively attenuated with further covariate adjustment. Conclusion Adaptive emotion regulation was associated with lower levels of inflammation and maladaptive emotion regulation was associated with higher levels of inflammation. If these associations are confirmed by prospective and experimental studies, such evidence may provide insight into novel targets for interventions to promote health and reduce cardiovascular risk.

Divergent Associations of Antecedent- and Response-Focused Emotion Regulation Strategies with Midlife Cardiovascular Disease Risk

“…In contrast, because reappraisal is employed before an emotion occurs and involves changing cognitive appraisals about the situation, this strategy may help to prevent the occurrence or reduce the intensity of negative emotions [7–9], thereby avoiding activation of stress-related dysregulation. As a result, regulatory strategies like reappraisal may be health promoting [7, 11, 12]. Building on prior work in this area, we hypothesize that reappraisal may confer cardiovascular protection whereas suppression may increase cardiovascular risk.…”

Self-Concealment: Integrative Review and Working Model

“…The significant correlation (r = .44; Uysal & Lu, 2011) between the SCS and the suppression subscale of the Emotional Regulation Questionnaire (ERQ; Gross & John, 2003) links the high self-concealer with the emerging health profile for the emotionally suppressive person. Emotional inhibition is linked to increased sympathetic activation of the cardiovascular system (Gross & Levenson, 1993); more rumination, less positive affect, and more depressive symptoms (Gross & John, 2003;John & Gross, 2004); and higher levels of inflammation, a biological state associated with stress and coronary heart disease (Appleton, Buka, Loucks, Gilman, & Kubzansky, 2013).…”

Emotion Regulation in Chronic Disease Populations: An Integrative Review

“…Optimizing emotion regulation promotes adaptation in the presence of aversive stressors (Gratz & Roemer, 2008). Inability to effectively manage emotions triggered by a health event can diminish self-care activities and impact mental and physical health (Appleton, Buka, Loucks, Gilman, & Kubzansky, 2013; de Ridder, Geenen, Kuijer, & van Middendorp, 2008; Evers, Stok, & de Ridder, 2010). …”