Cognitive emotion regulation fails the stress test
Open accessAbstract
Cognitive emotion regulation has been widely shown in the laboratory to be an effective way to alter the nature of emotional responses. Despite its success in experimental contexts, however, we often fail to use these strategies in everyday life where stress is pervasive. The successful execution of cognitive regulation relies on intact executive functioning and engagement of the prefrontal cortex, both of which are rapidly impaired by the deleterious effects of stress. Because it is specifically under stressful conditions that we may benefit most from such deliberate forms of emotion regulation, we tested the efficacy of cognitive regulation after stress exposure. Participants first underwent fear-conditioning, where they learned that one stimulus (CS+) predicted an aversive outcome but another predicted a neutral outcome (CS−). Cognitive regulation training directly followed where participants were taught to regulate fear responses to the aversive stimulus. The next day, participants underwent an acute stress induction or a control task before repeating the fear-conditioning task using these newly acquired regulation skills. Skin conductance served as an index of fear arousal, and salivary α-amylase and cortisol concentrations were assayed as neuroendocrine markers of stress response. Although groups showed no differences in fear arousal during initial fear learning, nonstressed participants demonstrated robust fear reduction following regulation training, whereas stressed participants showed no such reduction. Our results suggest that stress markedly impairs the cognitive regulation of emotion and highlights critical limitations of this technique to control affective responses under stress.
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Even well-trained individuals use cognitive reappraisal effectively only in low but not high stress conditions.
“Moreover, even when individuals are well-trained in the use of cognitive reappraisal strategies to manage fear responses to an aversive stimulus, they use those strategies effectively only in low but not high stress conditions (Raio, Orederu, Palazzolo, Shurick, & Phelps, 2013).”
From Mindfulness and cognitive-behavioral interventions for chronic pain: Differential effects on daily pain reactivity and stress reactivity (2015) · cites this paper as Raio, Orederu, Palazzolo, Shurick, & Phelps, 2013
The Discussion reports that, after cognitive regulation training, only the nonstressed group reduced fear arousal; the stressed group did not. But the Methods describe a single training session followed by a test the next day, not well-trained individuals, and characterize the stress induction as mild to moderate rather than high stress. (LLM, conf=0.84)
Experimental — accuracy not yet measuredMild acute stress in humans impairs the efficacy of previously acquired cognitive reappraisal strategies in reducing conditioned threat and subjective fear.
“In addition, mild acute stress in humans impairs the efficacy of previously acquired cognitive reappraisal strategies in reducing conditioned threat and subjective fear [146] and results in enhanced spontaneous recovery following extinction training [147].”
From Prefrontal cortex, amygdala, and threat processing: implications for PTSD (2022) · cites this paper as [146]
Stress may impair explicit-controlled regulation, perhaps by disrupting prefrontal function.
“For instance, recent work suggests that stress may impair explicit-controlled regulation (Raio et al., 2013), perhaps by disrupting prefrontal function (Arnsten, 2009; van Ast et al., 2014).”
From Explicit and implicit emotion regulation: a multi-level framework (2017) · cites this paper as Raio et al., 2013
Cognitive-behavioral therapies can be less beneficial during states of stress or dissociation.
“and they can be less beneficial during states of stress ( van der Kolk and Fisler, 1995 ; Raio et al., 2013 ) or dissociation ( Michelson et al., 1998 ; Rufer et al., 2006 ; Spitzer et al., 2007 ; Kleindienst et al., 2011 ; LeBois et al., 2022 ; but see also Halvorsen et al., 2014 ; Zoet et al., 2018 ; Vancappel et al., 2022 ).”
From The brain-body disconnect: A somatic sensory basis for trauma-related disorders (2022) · cites this paper as Raio et al., 2013
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- Authors
- Raio, C. M., Orederu, T. A., Palazzolo, L., Shurick, A. A., & Phelps, E. A.
- Affiliations
- New York University (US)
- Hunter College (US)
- State University of New York (US)
- Stanford University (US)
- Nathan Kline Institute for Psychiatric Research (US)
- Venue
- Proceedings of the National Academy of Sciences
- Publisher
- National Academy of Sciences
- Published
- 2013-08-26
- Volume
- 110
- Issue
- 37
- Pages
- 15139-15144
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- PMC
- PMC3773739
- OpenAlex
- W2101852723
- Cited by
- 302
- References
- 72
- Citations by year
- 2026: 24 · 2025: 23 · 2024: 24 · 2023: 28 · 2022: 29 · 2021: 30 · 2020: 21 · 2019: 30 · 2018: 16 · 2017: 22 · 2016: 23 · 2015: 17 · 2014: 15
- FWCI
- 8.32
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Proceedings of the National Academy of Sciences (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging (R01AG039283)
- National Institute of Mental Health (R01MH080756, R01MH097085, MH 080756, MH097085)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- cognitive emotion regulation, acute stress, fear conditioning, fear extinction, prefrontal cortex, executive function, skin conductance, salivary cortisol, salivary amylase, stress response, emotion regulation training
- MeSH terms
- Adolescent, Adult, Arousal, Conditioning, Psychological, Emotions, Fear, Female, Galvanic Skin Response, Humans, Hydrocortisone, Male, Middle Aged, Stress, Psychological, Cognitive Behavioral Therapy, Salivary alpha-Amylases, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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