Emotion suppression and acute physiological responses to stress in healthy populations: a quantitative review of experimental and correlational investigations

ABSTRACT

Emotion suppression may be linked to poor health outcomes through elevated stress-related physiology. The current meta-analyses investigate the magnitude of the association between suppression and physiological responses to active psychological stress tasks administered in the laboratory. Relevant articles were identified through Medline, PsychINFO, PubMed, and ProQuest. Studies were eligible if they (a) used a sample of healthy, human subjects; (b) assessed physiology during a resting baseline and active psychological stress task; and (c) measured self-report or experimentally manipulated suppression. Twenty-four studies were identified and grouped within two separate random effects meta-analyses based on study methodology, namely, manipulated suppression (k = 12) and/or self-report (k = 14). Experimentally manipulated suppression was associated with greater physiological stress reactivity compared to controls (H_g= 0.20, 95% CI [0.08, 0.33]), primarily driven by cardiac, hemodynamic, and neuroendocrine parameters. Self-report trait suppression was not associated with overall physiological stress reactivity but was associated with greater neuroendocrine reactivity (r ₌ 0.08, 95% CI [0.01, 0.14]). Significant moderator variables were identified (i.e., type/duration of stress task, nature of control instructions, type of physiology, and gender). This review suggests that suppression may exacerbate stress-induced physiological arousal; however, this may differ based upon the chosen methodological assessment of suppression.

KEYWORDS:

• Emotion regulation
• suppression
• psychological stress
• physiological stress reactivity
• meta-analysis

Acknowledgements

The authors would like to thank Peter. J. Gianaros, Ph.D., for his valuable contributions to the final manuscript. We would also like to acknowledge our current funding sources (NIH K01HL145021).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are openly available in Open Science Framework at (https://osf.io/aw8h4/). The search strategy, list of included study references, summary of included studies, and additional tables/figures can be found in the online supplemental materials.

Notes

1 F. Alexander’s anger and hypertension theory is still popularly supported through later 20th century research, revealing that inhibition of anger and hostility may indeed be linked to hypertension and coronary heart disease (Brosschot & Thayer, 1998; Friedman & Booth-Kewley, 1987; Smith, 1992).

2 This lack of heterogeneity in the types of suppression assessed prevented any follow-up moderation analyses in that regard.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.