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A multi-country test of brief reappraisal interventions on emotions during the COVID-19 pandemic
Journal article   Peer reviewed

A multi-country test of brief reappraisal interventions on emotions during the COVID-19 pandemic

Ke Wang, Amit Goldenberg, Charles A Dorison, Jeremy K Miller, Andero Uusberg, Jennifer S Lerner, James J Gross, Bamikole Bamikole Agesin, Márcia Bernardo, Olatz Campos, …
Nature Human Behaviour, Vol.5, pp.1089-1110
2021
DOI: https://doi.org/10.1038/s41562-021-01173-x
Appears in  COVID-19 Research
url
https://doi.org/10.1038/s41562-022-01441-4View
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Abstract

COVID-19
The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation. Participants from 87 countries and regions (n = 21,644) were randomly assigned to one of two brief reappraisal interventions (reconstrual or repurposing) or one of two control conditions (active or passive). Results revealed that both reappraisal interventions (vesus both control conditions) consistently reduced negative emotions and increased positive emotions across different measures. Reconstrual and repurposing interventions had similar effects. Importantly, planned exploratory analyses indicated that reappraisal interventions did not reduce intentions to practice preventive health behaviours. The findings demonstrate the viability of creating scalable, low-cost interventions for use around the world. Protocol registration These disturbing trends are caused partly by heightened levels of negative emotion and diminished levels of positive emotion, which have been found to contribute to a number of negative psychological, behavioural and health consequences. These include increased risk of anxiety and depressive disorders as well as other forms of psychopathology 14 ; impaired social connections 15 ; increased substance use 16–18 ; compromised immune system functioning 19–21 ; disturbed sleep 22 ; increased maladaptive eating 23,24 ; increased aggressive behaviour 25,26 ; impaired learning 27 ; worse job performance 28,29 ; and impaired economic decision-making 30,31. As the COVID-19 pandemic unfolds around the world, we believe it is crucial to mitigate expected adverse outcomes by reducing negative emotions and increasing positive emotions. Such a change in emotions is central to increasing psychological resilience, a multifaceted concept that involves adaptive emotional responses in the face of adversity 32–34. Reappraisal—an emotion regulation strategy that involves changing how one thinks about a situation with the goal of influencing one's emotional response 35 —is a promising candidate as an intervention to increase psychological resilience due to its adaptability, simplicity and efficiency 34,36–38. In contrast to less effective emotion-regulation strategies such as suppression, reap-praisal generally leads to more successful regulation (d = 0.45, 95% confidence interval (CI) = [0.35, 0.56] in changing emotion experience in a meta-analysis 39 ; see caveats about interpreting effect sizes in past research in Methods, 'Sampling plan'). In particular, over the short term, reappraisal leads to decreased reports of negative emotion and increased reports of positive emotion 40–42 , as well as corresponding changes both in peripheral physiological responses 43–45 and central physiological responses 46–53. Over the longer term, reap-praisal is associated with stronger social connections 54 ; higher academic achievement 55,56 ; enhanced psychological well-being 57 ; fewer psychopathological symptoms 58,59 ; better cardiovascular health 60,61 , and greater resilience during the COVID-19 pandemic 62. Despite these shorter-term and longer-term benefits, most people do not reappraise consistently 63,64 , which has motivated efforts to teach people to use reappraisal (reviewed in refs. 65,66). For example, in the context of anxiety, reappraisal training led to reduced intrusive memories 67 and increased emotion-regulation self-efficacy 68,69. Reappraisal training also led to long-lasting changes in the neural representation of unpleasant events 70. Although demand characteristics are always a concern when examining the effects of reappraisal (given that one is teaching people to change their thinking in order to change how they're feeling, and then asking them how they feel) 71 , the wide array of self-report and non-self-report outcomes 39–53 that show reappraisal effects across studies increases confidence that these effects are real.

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