The effects of distraction and reappraisal on children’s parasympathetic regulation of sadness and fear

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Highlights

  • Children can use cognitive emotion regulation strategies to manage sadness and fear.

  • Distraction and reappraisal emotion regulation strategies promote better parasympathetic regulation.

  • Reappraisal was effective for regulating sadness and fear.

  • Distraction was effective for regulating sadness only.

Abstract

Children commonly experience negative emotions like sadness and fear, and much recent empirical attention has been devoted to understanding the factors supporting and predicting effective emotion regulation. Respiratory sinus arrhythmia (RSA), a cardiac index of parasympathetic function, has emerged as a key physiological correlate of children’s self-regulation. But little is known about how children’s use of specific cognitive emotion regulation strategies corresponds to concurrent parasympathetic regulation (i.e., RSA reactivity while watching an emotion-eliciting video). The current study describes an experimental paradigm in which 101 5- and 6-year-olds were randomly assigned to one of three different emotion regulation conditions: Control, Distraction, or Reappraisal. All children watched a sad film and a scary film (order counterbalanced), and children in the Distraction and Reappraisal conditions received instructions to deploy the target strategy to manage sadness/fear while they watched. Consistent with predictions, children assigned to use either emotion regulation strategy showed greater RSA augmentation from baseline than children in the Control condition (all children showed an overall increase in RSA levels from baseline), suggesting enhanced parasympathetic calming when children used distraction or reappraisal to regulate sadness and fear. But this pattern was found only among children who viewed the sad film before the scary film. Among children who viewed the scary film first, reappraisal promoted marginally better parasympathetic regulation of fear (no condition differences emerged for parasympathetic regulation of sadness when the sad film was viewed second). Results are discussed in terms of their implications for our understanding of children’s emotion regulation and affective physiology.

Introduction

Children commonly experience negative emotions like sadness and fear, and much empirical attention has aimed to clarify the factors that support and predict effective regulation of these negative emotions. This interest is driven, in part, by research linking emotion regulation processes to a host of social, emotional, and cognitive outcomes with substantial consequences for children’s daily lives (e.g., academic achievement, friendships, psychopathology). Given the tight conceptual coupling between emotion and regulatory processes (Cole et al., 2004, Thompson, 2011), a key challenge for developmental scientists is to identify and employ methods that meaningfully distinguish these affective processes. At the same time, there is a need for improved clarity in our understanding of the psychobiological underpinnings and components of these emotion and regulatory processes. Respiratory sinus arrhythmia (RSA), a cardiac index of parasympathetic function, has emerged as a key psychophysiological correlate of children’s self-regulation. But no prior work has examined how children’s use of specific emotion regulation strategies predicts parasympathetic regulation. This study experimentally manipulated the emotion regulation strategies that children used while viewing emotion-eliciting films. Our goal was to examine the effects of emotion regulation strategies on parasympathetic regulation of sadness and fear to refine our understanding of emotion regulation during childhood.

A functional view of emotion holds that people experience emotions when they appraise events as relevant to their goals, values, or well-being. Although emotions provide useful status updates about goals, negative emotions must often be down-regulated in the service of long-term goals like positive social relationships and academic achievement. Emotion regulation can be defined as any process that increases or decreases positive or negative emotions (Gross, 1998, Koole, 2009, Ochsner and Gross, 2005, Thompson, 2011). By adulthood, people have a wide range of emotion regulation strategies to draw on when faced with emotionally challenging events (Li and Lambert, 2007, Ochsner and Gross, 2005, Ochsner and Gross, 2008, Sheppes and Meiran, 2007). Strategies to alter an emotional experience can be classified, broadly, as behavioral or cognitive. Behavioral strategies allow people to change external events so that the events conform to their goals, whereas cognitive strategies allow people to change their goals, thoughts, or appraisals of events. Use of behavioral strategies to manage emotion emerges early and remains relatively constant in frequency across the lifespan (Heckhausen, Wrosch, & Schulz, 2010). From infancy, children make use of behavioral emotion regulation strategies as they shift attention away from a stranger who makes them feel wary or increase the intensity of their cries to elicit help from parents (Kopp, 1989, Thompson, 1994). In contrast, deliberate use of cognitive strategies to manage emotion requires an appreciation of the interrelation of goals, thoughts, and emotions, including awareness that changing goals and thoughts can lead to changes in emotional experience (Davis, Levine, Lench, & Quas, 2010).

When and how well children can use cognitive emotion regulation strategies is less clear. Evidence in support of regulatory sophistication comes from work demonstrating that children have a (tenuous) understanding of the link between thoughts and feelings from very early in development (Bell & Calkins, 2012). Toddlers and preschoolers talk about emotions and can correctly predict how another person will feel if they get (or do not get) something they want (Wellman and Banerjee, 1991, Wellman et al., 2000). The appreciation that two people can react differently to the same event (demonstrating a rudimentary understanding of the link between emotions and beliefs) appears to emerge by 4 or 5 years of age (e.g., Harris, Johnson, Hutton, Andrews, & Cooke, 1989), with considerable advancements in the understanding of emotion–cognition links documented across the elementary school ages (Bamford and Lagattuta, 2012, Lagattuta, 2008, Lagattuta and Wellman, 2001). These early indicators of the understanding that one’s thoughts may influence one’s feelings provide a conceptual foundation for cognitive emotion regulation during childhood.

Despite the acquisition of these developmental precursors to cognitive emotion regulation, other findings call into question whether children understand that feelings can be changed by thoughts alone before 7 or 8 years of age (e.g., Flavell et al., 2001, Lagattuta, 2007, Pons et al., 2004). For instance, Bamford and Lagattuta (2012) examined the development of children’s knowledge of cognitive reframing or reappraisal strategies for regulating negative emotions among 5- to 10-year-olds. Older children demonstrated more consistent understanding of how reframing an event could lead to changes in emotions, but all children considered cognitive reframing to be least effective in unambiguously negative (vs. positive or ambiguous) contexts. Thus, even an awareness of the fact that thoughts can change feelings does not necessarily mean that children view cognitive strategies as useful means of regulating or changing negative emotions.

Less sophisticated cognitive emotion regulation strategies may, however, be easier for young children to recognize as useful (and to use in their own lives). A study of preschoolers’ understanding of emotion regulation strategies by Dennis and Kelemen (2009) used puppets to act out negative emotion situations and different ways to stop negative feelings. Young children rated distraction as more effective than rumination for managing negative feelings, suggesting that 3- and 4-year-olds recognize the relative utility of some cognitive regulatory strategies. Davis and colleagues (2010) showed that 5- and 6-year-olds spontaneously generate a wide range of emotion regulation strategies (including cognitive ones like changing thoughts and changing goals) in response to being asked how a hypothetical protagonist could make herself or himself feel better after experiencing an angry, sad, or scary event. When children recalled a time when they had personally experienced these same negative emotions and described what they had done to make themselves feel better, cognitive emotion regulation strategies were frequently mentioned, particularly as a response to sad and scary events in children’s lives. Given the studies reviewed above, we chose to focus on two cognitive emotion regulation strategies that 5- and 6-year-olds have been shown to generate and use: distraction and reappraisal. Distraction simply involves changing one’s thoughts (i.e., thinking about something else), and reappraisal involves changing the way one thinks about a situation or an event (i.e., thinking about how it is not that big a deal or not that important). Delineating the effects (or effectiveness) of these strategies across emotion contexts was a goal of this study. Cognitive change strategies to alleviate negative emotion may be relevant to children’s experiences of sadness (a lost or failed goal) and fear (a threatened goal) in line with functionalist accounts, but no studies have directly compared how distraction and reappraisal strategies influence children’s parasympathetic regulation of sadness and fear.

Respiratory sinus arrhythmia is an index of parasympathetic regulation of the heart derived by measuring heart rate variability within the respiratory cycle (Calkins and Keane, 2004, Obradović et al., 2010). Parasympathetic regulation is mediated by the 10th cranial (vagus) nerve, which influences variability in heart rate; greater vagal influence leads to slower heart rate and dampening of the sympathetic nervous system’s effect on the heart (Bell & Calkins, 2012). Contemporary perspectives on the psychophysiology of emotion highlight parasympathetic regulation of heart rate variability (RSA) as a useful marker of emotion regulation (Beauchaine, 2001, Porges, 2007) and as being implicated in physiological regulation of stress (Porges, 1995, Porges et al., 1996). Resting RSA levels are thought to index the amount of regulatory resources available for a child to draw on during times of challenge, so higher resting RSA typically has been linked to more adaptive outcomes (Calkins and Keane, 2004, Liew et al., 2011). Flexible parasympathetic regulation (e.g., the application or withdrawal of vagal influence over the heart in response to changing circumstances) underlies adaptive emotional and self-regulation. Decreases in RSA from resting levels (RSA suppression) under conditions of challenge enable greater sympathetic response and resource mobilization, reflecting a shift in focus from homeostatic demands to facilitation of sustained attention, behavioral self-regulation, and the generation of coping strategies to control affective or behavioral arousal (Porges, 1996, Porges, 2007).

Many studies have illustrated that children’s RSA reactivity to lab challenges is associated with general measures of adaptive functioning, including less negative emotionality and risk for behavior problems and better emotion regulation and sustained attention (Calkins and Dedmon, 2000, Calkins and Keane, 2004, El-Sheikh, 2001, Hastings et al., 2008, Porges, 1996, Suess et al., 1994). For instance, Calkins and Keane (2004) examined how RSA reactivity (in this case RSA suppression from initial levels) during challenge tasks related to children’s adjustment and self-regulation in a longitudinal study of early childhood (2.0–4.5 years). Children who maintained pronounced patterns of RSA suppression during challenging tasks across these ages were rated by mothers as being better regulated and more socially skilled at 4.5 years than children who showed less pronounced RSA suppression at one or both time points. Although more research is needed to fully understand the relation between parasympathetic regulation and self-regulation, these results suggest that this aspect of physiology has important implications for the development of behavioral and cognitive regulatory abilities from early in childhood. Further supporting this idea, Hastings and colleagues (2008) studied how RSA reactivity related to socioemotional development in a sample of 2- to 5-year-olds. Children who showed greater RSA reactivity to activities in a social group context had fewer internalizing symptoms and better behavioral self-regulation. Thus, parasympathetic regulation (measured by RSA reactivity) has been implicated in children’s effective self-regulation, but no studies have yet examined how RSA reactivity is associated with children’s use of emotion regulation strategies.

Other work has linked a lack of RSA suppression (or RSA augmentation relative to baseline) with risk for internalizing and externalizing behaviors (Calkins & Dedmon, 2000), and these associations appear to be relatively robust; Graziano and Derefinko (2013) showed a small association between internalizing problems and less RSA suppression in a meta-analysis of RSA reactivity during childhood. Thus, patterns of RSA reactivity have implications for many domains of children’s functioning beyond just emotion regulation. Of note, the studies described here have focused either on early childhood (e.g., longitudinal investigations of change from toddlerhood to preschool ages) or on middle childhood (e.g., investigations of psychophysiology among elementary school-aged children). Very little work on parasympathetic regulation has explicitly targeted kindergarten-age children (5- and 6-year-olds), although this appears to be the age at which children first begin to demonstrate an understanding that thoughts can change feelings (Davis et al., 2010). Given the lack of extant knowledge about this particular age group, and our goal of understanding how parasympathetic regulation relates to emotion regulation, the current study focused on kindergarten-age children to document these emerging associations.

Although there is general consensus that RSA reactivity in the form of RSA suppression represents an adaptive parasympathetic response to cognitive, social, or emotional challenges that children may experience, some studies have indicated that RSA augmentation (rather than suppression) correlates with adaptive outcomes (e.g., fewer internalizing and externalizing behaviors) (Cipriano et al., 2011, Hastings et al., 2008, Obradović et al., 2010). Because of the heterogeneity in research findings, recent investigations of children’s parasympathetic regulation have noted the importance of considering the specifics of the context (e.g., discrete emotions, type of evocative or challenging task) in which RSA is measured when interpreting patterns (Hastings et al., 2014, Morales et al., 2015). For example, Hastings and colleagues noted that RSA reactivity patterns should be interpreted as physiological changes that may or may not be adaptive given the eliciting context (Hastings, Klimes-Dougan et al., 2014, Hastings and Miller, 2014).

Despite the insights provided by research on children’s parasympathetic regulation within challenging contexts, very little is known about how specific emotion regulation strategies (rather than a broad assessment of general emotion regulatory skill) influence children’s physiology. Polyvagal theory (Porges, 2011) guides predictions about how emotion regulation strategies could influence RSA. When contexts are appraised as nonthreatening, RSA augmentation prepares an individual for calm engagement with the environment. Enhanced parasympathetic influence over the heart would indicate an absence of concurrent affective challenge (e.g., sadness, fear). Thus, if cognitive emotion regulation strategies like distraction and reappraisal are effectively enabling children to alleviate negative emotions, the expected pattern would be RSA augmentation (relative to children reacting normally to emotion elicitation in a control group). In support of this reasoning, Butler, Wilhelm, and Gross (2006) examined the parasympathetic regulation of pairs of adult women who viewed an upsetting film and then discussed it together. Half of the dyads had one partner instructed to either suppress or reappraise her emotional experience during the conversation. Women who used specific emotion regulation strategies showed greater RSA augmentation during the conversation. No studies have examined the patterns of parasympathetic regulation associated with cognitive emotion regulation strategies during childhood, so charting these associations was a goal of the current study.

The goal of this study was to provide new insight into the psychophysiological consequents of an experimental manipulation of cognitive emotion regulation strategies during childhood. Although previous research suggests that kindergarten-age children can describe and use cognitive emotion regulation strategies to manage their feelings of sadness and fear (Davis et al., 2010), little is known about the physiological effects of using specific strategies, especially during childhood. RSA is an index of physiology that corresponds to children’s affective and regulatory functioning, but no previous studies with children have examined RSA changes in response to experimental instructions to use specific cognitive emotion regulation strategies. This study examined how children’s RSA reactivity to sadness and fear changed as a function of the emotion regulation strategies that children were instructed to use to mitigate their negative feelings. A sample of 101 5- and 6-year-olds were randomly assigned to one of three emotion regulation instruction conditions—Distraction, Reappraisal, or Control—and viewed two short emotion-eliciting movie clips: one designed to elicit sadness and one designed to elicit fear. RSA reactivity was calculated as the change in RSA from a resting baseline to each of the age-appropriate film clips (i.e., a difference score). Positive values indicated RSA augmentation, whereas negative values indicated RSA suppression. We addressed the following research questions.

The primary question was whether instructed cognitive emotion regulation strategies (i.e., distraction and reappraisal) would lead to differences in children’s parasympathetic regulation (RSA reactivity) of sadness and fear. We predicted that use of either instructed emotion regulation strategy when regulating sadness or fear should lead to greater parasympathetic augmentation relative to baseline (i.e., an increase in RSA levels from baseline to task) than would be seen among children reacting naturally in the Control condition. We suggest that RSA augmentation can be thought of as evidence of an effective calming response (emotion regulation) in the context of this study as children sit quietly, watch mildly sad and scary films, and deliberately deploy a coached emotion regulation strategy of distraction or reappraisal. Thus, differences in RSA reactivity to sadness and fear between the instructed emotion regulation strategy and control groups would indicate that distraction and reappraisal assist children in effectively regulating parasympathetic reactivity and managing these negative emotions. A recent review of associations between emotion elicitation procedures and psychophysiology underscores the need for careful consideration of the specific methodology in use when interpreting patterns of parasympathetic regulation (Kreibig, 2010). Patterns of RSA suppression tend to be linked to experiencing fear and sadness, but RSA augmentation has been reported when sadness and fear are evoked via film clips (Hastings, Klimes-Dougan et al., 2014, Kreibig, 2010). Thus, we anticipated that the emotion-eliciting film clips would lead to RSA augmentation across all experimental groups but that augmentation would be stronger in the Distraction and Reappraisal conditions.

Two exploratory questions concerned the relative effectiveness of distraction and reappraisal for regulating sadness and fear and the potential impact of the order of the sad and scary film presentations on children’s parasympathetic regulation. These questions were guided by our reasoning about how appraisal theories of emotion inform predictions about the utility of a given emotion regulation strategy in a particular emotional context. For instance, attempting to distract oneself from thinking about threatening/fear-eliciting information in an ambiguous context might not be an adaptive strategy because attending to cues from the environment would help to resolve the ambiguity (e.g., was that rustling noise in the bushes a bear or a squirrel?). We made no specific directional assumptions but sought to explore how distraction and reappraisal may differ in their effectiveness for children too, as qualified by context—the nature (or ordering) of the discrete emotion being regulated.

Section snippets

Participants

This investigation makes use of data obtained from 101 5- and 6-year-old children (Mage = 5.818 years, SD = 4.076 months; 46 girls) who participated in a larger prospective longitudinal investigation of temperament and socioemotional development. Children were recruited as toddlers from a rural area of the northeastern part of the United States. Children’s race/ethnicity was reported by parents as predominantly non-Hispanic, European American (90.1%), 5% Asian/Asian American, 2% multiracial, 1%

Results

Results are organized into two sections. First, we report evidence that the emotional films elicited the target emotions (manipulation checks) as well as analyses to examine gender differences in RSA (a potential covariate) and to characterize the general pattern of parasympathetic regulation from baseline to the films. Second, we report the primary analyses of emotion regulation strategies and emotional context and follow-up comparisons to pinpoint differences among the experimental

Discussion

The goal of this study was to examine the effects of distraction and reappraisal on children’s parasympathetic regulation of sadness and fear. We gave children explicit instructions to regulate emotion (by distracting themselves, reappraising the importance of the event, or just reacting normally in the Control condition) before they watched film clips designed to evoke sadness or fear. Consistent with previous work that has documented a pattern of RSA augmentation while people actively use

Conclusion

This study is the first to provide experimental evidence that cognitive emotion regulation strategies like distraction and reappraisal enhance children’s parasympathetic regulation of sadness and fear. These findings suggest that, despite developmental limitations in their knowledge that changing what or how one thinks can repair negative emotions, young children can effectively make use of sophisticated cognitive emotion regulation strategies to manage negative emotions.

Acknowledgments

We gratefully acknowledge the support provided by the National Institute of Mental Health (NIMH, R01-MH075750) and the Penn State Children, Youth, and Family Consortium to Kristin A. Buss. We extend our appreciation to the families that participated in this study and the staff and students in Buss’s Emotion Development Lab.

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