Assessing emotion regulation

As discussed in the previous sections, emotion is a multifaceted concept englobing physical responses, perceived feelings, cognitions and affective expressions. Therefore, assessment usually relies on these different components. A distinction can be made between subjective and objective measures. The only way to access feelings and cognitions is through subjective approaches such as self-report questionnaires or interviews, while objective measures are used to assess emotional expression and physiological reactions.

For instance, self-report questionnaires allow apprehending various features of emotion expression and regulation (Wilhelm & Grossman, 2010). They basically rely on self-observation in natural settings (usually daily life events) or following emotion induction in experimental settings. Ratings concern inward feelings, physical sensations, manners of expression and emotion regulation strategies. Some questions may also take into account how emotion expression of the subject affects his environment. Administration of self-report questionnaires is practical, as it can be done in any setting and without necessarily involving the experimenter. However, individual differences in self-observation abilities (due to its highly subjective nature) and the accuracy of these questionnaires have been questioned (Mauss & Robinson, 2009). Some studies suggest that questionnaires referring to ongoing

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emotional experience are less biased than those assessing general emotional experience (Robinson & Clore, 2002). This finding favours the use of such instruments in experimental settings. Parallel versions given to proxies (who usually know well the participant) may help to assess emotion regulation, but these may also be subjectively biased because they may reflect a view based on intimate relationship established between the proxy and the participant, rather than the interaction between the latter and a larger environment (Cavallo, Kay, & Ezrachi, 1992).

Emotion expression can also be measured with observational methods. This may be done by external raters (sometimes with the help of specific observation grids) in specific natural settings such as hospitals, or in laboratory settings in which emotions are induced. In addition, specific apparatus such as facial electromyography provide important data regarding expressive aspects of emotional states (Cacioppo & Gardner, 1999).

Finally, psychophysiological measures have been extensively used to assess the physiological component of emotions. They provide an alternative to self-report methods in participants whose subjective ratings may be biased due to a lack of insight (C. Williams &

Wood, 2012). In order to assess psychophysiological reactions related to acute emotional states, emotions are artificially induced in experimental settings. This can be done with emotion-eliciting clips (Stephens, Christie, & Friedman, 2010), artificially arranged situations (Kazen, Kuenne, Frankenberg, & Quirin, 2012) or autobiographical recall of emotional events (Marci, Glick, Loh, & Dougherty, 2007). Though standardized paradigms of emotion induction such as emotion-eliciting films may be more easily replicated, auto-biographical recall is emotionally more relevant to the person and induces higher levels of physiological arousal (Marci et al., 2007). Psychophysiological activity related to more general affective states (unrelated to specific situations) can also be assessed in natural contexts, without prior emotion induction, but this depends on the type of physiological marker used. For instance, some physiological markers cannot be assessed outside the laboratory.

Physiological markers of emotions may rely on autonomous nervous system activity (ANS) or hormonal activity mediated by the hypothalamus-pituitary-adrenal axis (HPA) (Cacioppo et al., 2000). The ANS is responsible for the regulation of peripheral functions reflecting the activation (sympathetic) or relaxation (parasympathetic) of the organism.

Besides physiological manifestations of emotion, it regulates digestion, attentional processes and other functions related to homeostasis such as body temperature and water balance (Kenney & Ganta, 2014). Activity of this system can be captured by measuring responses of

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sweat glands (electrodermal activity) or of the cardiovascular system (such as heart rate, blood pressure) (Mauss & Robinson, 2009). For instance, sympathetic activation leads to increased electrodermal activity (skin conductance levels or skin conduction reaction), blood pressure and heart rate (Gerin, Davidson, Christenfeld, Goyal, & Schwartz, 2006; Marci et al., 2007; Ray et al., 2008). Psychophysiological measures of the activity of the autonomous nervous system are particularly sensitive to arousal (intensity of emotions) and cannot capture the emotional valence (positive or negative emotions) or allow discriminating the type of emotion (Mauss & Robinson, 2009). Also, while some authors observed that the use of reappraisal may down-regulate response of the ANS in healthy participants, others describe increased activation, which they attribute to increased cognitive effort necessary for successful reappraisal (Denson, Pedersen, Friese, Hahm, & Roberts, 2011).

Activity of the HPA axis is usually measured through cortisol secretion, which is the end-point of the axis cascade (Jacobson, 2014). HPA activity increases during acute negative emotions such as fear, anger and sadness and is an important marker of long lasting affective states such as chronic stress. Regarding its mechanism, the hypothalamus releases corticotropine releasing hormone that triggers secretion of the adrenocorticotropic hormone by the pituitary gland into the bloodstream, which in turn leads to secretion of cortisol by the adrenal glands. This axis usually functions as a positive feed-back loop, where increased cortisol levels inhibit subsequent secretion of corticotropine releasing hormone by the hypothalamus. However, in chronic stress this positive feed-back loop may be dysfunctional, leading to continuous hyperactivity of the hypothalamus and pituitary glands irrespective of cortisol levels in the bloodstream. As a consequence, diurnal secretion of cortisol is increased in people suffering from chronic stress. Cortisol secretion is generally highest in the morning and decreases progressively throughout the day (O'Donnell, Badrick, Kumari, & Steptoe, 2008). Flattened daily cortisol slopes are markers of psychological stress and are associated with increased health risks (Cohen et al., 2006; Kumari, Shipley, Stafford, & Kivimaki, 2011). Chronic excessive release of cortisol may lead to depression, lowered immune activity (as cortisol inhibits the immune system) (Vedhara et al., 1999) and chronic health problems (Chrousos, 2009). Cortisol may be quantified in the serum, urine or saliva (Turpeinen &

Hamalainen, 2013). Salivary cortisol has become a classical biomarker in stress research. It is a very simple low-cost method that can be performed by individuals in their daily life (participants are asked to chew ‘salivettes’, which are pieces of cotton that can be further