Neurobiological models of emotion regulation: a meta-analysis of neuroimaging studies of acceptance as an emotion regulation strategy

Abstract

Emotional acceptance is an important emotion regulation strategy promoted by most psychotherapy approaches. We adopted the Activation Likelihood Estimation technique to obtain a quantitative summary of previous fMRI (functional Magnetic Resonance Imaging) studies of acceptance and test different hypotheses on its mechanisms of action. The main meta-analysis included 13 experiments contrasting acceptance to control conditions, yielding a total of 422 subjects and 170 foci of brain activity. Additionally, subgroups of studies with different control conditions (react naturally or focus on emotions) were identified and analysed separately. Our results showed executive areas to be affected by acceptance only in the subgroup of studies in which acceptance was compared to natural reactions. In contrast, a cluster of decreased brain activity located in the posterior cingulate cortex (PCC)/precuneus was associated with acceptance regardless of the control condition. These findings suggest that high-level executive cortical processes are not a distinctive feature of acceptance, whereas functional deactivations in the PCC/precuneus constitute its specific neural substrate. The neuroimaging of emotional acceptance calls into question a key tenet of current neurobiological models of emotion regulation consisting in the necessary involvement of high-level executive processes to actively modify emotional states, suggesting a complementary role for limbic portions of the default system.

Evidence for lateralized functional connectivity patterns at rest related to the tendency of externalizing or internalizing anger

“…Moreover, the IFG is linked to response inhibition (Aron et al, 2014 ) and may play an important role to block the behavioral expression of anger, or in other words, the externalization of anger. The dlPFC (including the SFG and the MFG) may be involved not only in reappraising the angry stimulus and eventually in implementing emotion regulation strategies (Buhle et al, 2014 ; Grecucci et al, 2013b , c ; Messina et al, 2021 ; Ochsner & Gross, 2005 ) but also in directly suppressing anger expression, as shown by tDCS studies in which the stimulation of the right dlPFC mitigates aggressiveness and negative emotional responses (Dambacher et al, 2015 ). The OFC is similarly involved in emotion regulation, but it seems to have a key role in anger control for its mediatory role in guiding insula’s activity when anger is experienced (Seok & Cheong, 2019 ; Sorella et al, 2021 ).…”

Adaptive emotion regulation is associated with decreased emotion-related responses in prefrontal and other cortical regions with multi-componential organization

“…Suppression of the amygdala response by prefrontal functioning is a key feature of reappraisal (Buhle et al, 2014;Frank et al, 2014;Kohn et al, 2014). A meta-analysis revealed the absence of amygdala suppression during acceptance under explicit instructions, implying that mindful acceptance was independent of amygdala suppression (Messina et al, 2021). Previous studies of individual differences have revealed mixed results: the study that compared yoga mediators to controls supported the independence view by demonstrating an absence of the dlPFC-amygdala correlation (Froeliger et al, 2012); however, the study on Zen meditators showed larger deactivation in the amygdala of experts versus controls (Grant et al, 2011).…”

“…The neural correlates of the trait for adaptive emotion-focused coping have been investigated separately for reappraisal and acceptance, and the two lines of studies have reached different conclusions. The neural correlates of instructed, explicit use of these coping strategies have been studied extensively; recruitment of the prefrontal control system is involved in both reappraisal (Buhle et al, 2014;Frank et al, 2014;Kohn et al, 2014;Morawetz et al, 2017b) and acceptance (Messina et al, 2021), together with deactivation of the limbic system (e.g., amygdala) and the posterior cingulate cortex, respectively. The individual differences in the natural response to emotionally stressful stimuli depend on the different roles of the prefrontal executive system.…”

“…In these studies, a positive trait effect was demonstrated for differential activation under the explicit reappraisal condition relative to that during the natural response condition; that is, the trait effect was greater under explicit instruction than for the natural response. Furthermore, even in the studies intended to address natural responses, there may be some doubt as to whether the responses were indeed spontaneous; in these studies, participants have typically been explicitly instructed to "respond naturally" in the task (Frank et al, 2014;Messina et al, 2021), or have conducted each task while being aware that they would be required to rate the level of subjective emotional arousal immediately after each trial (Modinos et al, 2010;Kober et al, 2019). Such task requirements are likely to demand conscious monitoring of one's emotional state during exposure.…”

Interactive Model of Executive Functions to Understand Error Correction

“…In the clinical context, it provides greater clarity concerning the subcomponents existing before the correction of an error. This opens the way for neuropsychological treatment processes, whereby actions focus on stimulating the described executive functions within the rehabilitation process for those with frontal damage who have difficulties at this level [56][57][58]. From the theoretical perspective, this study presents a significant contribution, given that the body of research on executive functions is still developing in terms of its theoretical models [3].…”