Good things better? Reappraisal and discrete emotions in acquired brain injury

ABSTRACT

There has been substantial interest in emotion after acquired brain injury (ABI), but less attention paid to emotion regulation (ER). Research has focused primarily on the ER strategy of reappraisal for regulating negative emotions, without distinguishing between classes of emotion, and there has been no attempt at exploring these differences in patients with ABI. The present study explored components of reappraisal, across classes of emotion, and their associated neuropsychological mechanisms. Thirty-five patients with ABI and twenty-two matched healthy control participants (HCs) completed two questionnaires, a battery of cognitive tasks, and an emotion regulation task (the Affective Story Recall Reappraisal task). Results suggest that those with ABI take longer, and generate fewer reappraisals than HCs across several discrete emotions. Notably, their ability to decrease emotional intensity did not differ significantly to HCs for negative emotions, but findings suggest that their reappraisals are less effective when up-regulating neutral emotions to positive. Working memory was the only significant predictor of the total number of reappraisals generated, and the time taken to produce a first reappraisal. Implications of these findings are discussed in the context of neuropsychological rehabilitation, including the role of the relatives in implementing and reinforcing micro-interventions.

KEYWORDS:

• Emotion regulation
• reappraisal
• acquired brain injury
• discrete emotions
• cognitive control

Acknowledgements

We would like to thank all the participants and staff at the North Wales Brain Injury Service, Headway in North Wales, and the Headforward Centre. We would also like to thank the reviewers for their suggestions.

Disclosure statement

No potential conflict of interest was reported by the authors.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Notes

1 The alternative, making positive emotions more positive, would effectively be promoting unrealistic optimism (Fleming & Strong, 1995). It would also be difficult to measure any differences in emotional intensity because of ceiling effects.

2 Given the distributed nature of lesion site and underlying pathology of the sample, Mann Whitney U tests were carried out to compare reappraisal difficulty, productivity, and ability across all emotions; between those with TBI (n = 20) vs CVA (n = 13), and those with frontal brain injury (n = 13) vs non-frontal injury (n = 6). There were no significant differences or obvious trends. A Kruskal-Wallis test was used to compare the components of reappraisal across emotions between those with left lateralized (n = 7), right lateralized (n = 7), and bilateral lesions (n = 9). Again, there were no significant differences or obvious trends.

3 Due to the differences in reappraisal ability between the negative emotions and the neutral emotion, reported in the discrete emotion hypothesis, a total score of negative emotions only (excluding neutral) was calculated and the regression run again. The results remained similar, with low explanation of variance (6%) and no significant predictors in the model.

Additional information

Funding

This study was supported by the Welsh Government’s European Social Fund (ESF).