Emotion regulation strategies modulate the effect of adverse childhood experiences on perceived chronic stress with implications for cognitive flexibility
Open accessAbstract
Exposure to early life adversity is associated with chronic stress and a range of stress-related health problems in adulthood. Since chronic stress debilitates activity in the prefrontal cortex (pFC), maladaptive regulatory strategies in response to stress have been proposed as one explanation for the impact of early life adversity on health outcomes in adulthood. We conducted a study to examine the impact of adverse childhood experiences (ACEs) on cognitive flexibility, a key executive function implicated in activity in the pFC, in a sample of adults (N = 486). Additionally, we investigated whether perceptions of chronic stress in adulthood would mediate the influence of ACEs on cognitive flexibility. However, stress is a subjective experience, and emotion regulation strategies can attenuate the stress response. So, we also examined if individual differences in emotion regulation strategies would modulate the relationship between ACEs and chronic stress. Our results demonstrate that early life adversity, as characterized by ACEs, is associated with decreased cognitive flexibility in adulthood. Additionally, number of ACEs was positively correlated with perceived stress, which in turn was negatively correlated with cognitive flexibility. But, individual differences in the habitual use of emotion regulation strategies moderated the influence of ACEs on chronic stress. Specifically, habitual use of cognitive reappraisal attenuated the stress levels whereas habitual use of expressive suppression exacerbated stress levels. Overall, our study highlights the importance of examining emotion regulation in individuals who have experienced early life adversity.
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A consensus appears to be emerging that what is most needed is enough healthy psychological distance from thought, so that beliefs and cognitive constructions are not excessively entangling, either through avoidance and suppression, or attachment and rigid adoption.
“A consensus appears to be emerging that what is most needed is enough healthy psychological distance from thought, so that beliefs and cognitive constructions are not excessively entangling, either through avoidance and suppression, or attachment and rigid adoption 81,82 .”
From “Third-wave” cognitive and behavioral therapies and the emergence of a process-based approach to intervention in psychiatry (2021) · cites this paper as [82]
The Introduction describes reappraisal as changing how one frames an event, and the Discussion links expressive suppression to inflexible appraisal of stressors. These passages support a preference for flexible reappraisal over suppression, but they do not establish an emerging consensus that healthy psychological distance from thought is what is most needed, or address attachment to beliefs and their rigid adoption. Page numbers are unavailable in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe most frequently supported affective process is acceptance.
“The most frequently supported is acceptance 82,84,85 -the willingness to experience affect without needless escape, avoidance or constraint.”
From “Third-wave” cognitive and behavioral therapies and the emergence of a process-based approach to intervention in psychiatry (2021) · cites this paper as [82]
The Introduction’s “Emotion regulation strategies” section discusses cognitive reappraisal and expressive suppression, but does not identify acceptance as an affective process or compare how frequently processes are supported. Searches for acceptance and its description as willingness to experience affect found no passage addressing the claim. The indexed passages provide no page numbers. (LLM, conf=0.74)
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- Authors
- Kalia, V., & Knauft, K.
- Affiliations
- Miami University (US)
- Corresponding author
- Kalia, Vrinda
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2020-06-26
- Volume
- 15
- Issue
- 6
- Pages
- e0235412
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC7319341
- OpenAlex
- W3037439589
- Cited by
- 86
- References
- 76
- Citations by year
- 2026: 11 · 2025: 20 · 2024: 13 · 2023: 15 · 2022: 13 · 2021: 11 · 2020: 3
- FWCI
- 4.20
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- adverse childhood experiences, emotion regulation strategies, cognitive flexibility, childhood adversity, cognitive reappraisal, expressive suppression, prefrontal cortex, executive function, stress response, mediation
- MeSH terms
- Adverse Childhood Experiences, Emotional Regulation, Adult, Child, Chronic Disease, Cognition, Female, Humans, Male, Perception, Stress, Psychological
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