The negative cognitive bias is common in affective disorder patients, which is resistance to treatment and recovery. Cognitive reappraisal is an emotion regulation strategy that involves the process of changing the emotion response by reinterpreting the meaning of the emotional stimulus. It has been shown that cognitive reappraisal decreases negative cognitive and emotion valance effectively. Conditioned fear is an important model of affective disorder. However, whether reappraisal changes the negative cognitive and emotion in the conditioned fear is controversial. Here, we investigate whether the short-term cognitive reappraisal training could change the process of conditioned fear for individuals with low reappraisal ability and further reveal the influence of cognitive reappraisal on the acquisition and extinction of conditioned fear.
Sixty-eight healthy individuals whose reappraisal scores were below the median of emotion regulation queationnaire were recruited and then assigned to reappraisal group and control group randomly. One or two days before the fearing condition, the experiment group was trained to reappraisal and learn how to decrease negative emotion to negative or neutral pictures. Like the program of Shurick (2013), the reappraisal training consisted of three parts: First, Participants were asked to talk about their feelings on a neutral picture such as “a person lying on a hospital bed”. Second, they were asked to reappraise the picture to reduce the negative emotion and isolate the emotional association between different pictures, such as, “although the person seems weak, it is merely a scene in a film and is not real”. To isolate the emotional association between two pictures, for example, one picture was a dog and the other picture was a patient. The negative association was that “the dog bitted the person seriously and the person was treated in hospital”, while the positive association would decrease negative emotion. for example, “the dog was waiting for its master who was in the hospital”. Third, the participants were asked to practice reappraisal to life events and negative pictures. The differential conditioned fear paradigm was used in two days. Participants were asked to complete acquisition and extinction of conditioned fear on the first day and re- extinction on the second day (24 hours later). CS fear valance were orally reported during the time of pre-acquisition, post-acquisition, post-extinction, pre re-extinction and post re-extinction. All pictures were displayed and the US expectancy was recorded by the e-prime 1.1 during the conditions of acquisition, extinction and re-extinction. CS fear, and US-expectancy were analyzed using a mixed analysis of variance (ANOVA) for repeated measures with the groups as the between-subjects factor, and stimulus (CS− vs. CS+) and trial (i.e., stimulus presentation) as the within-subjects factors.
A time × group repeated measures ANOVA indicated that CS fear increased significantly from pre-acquisition to post-acquisition [F(1, 61) = 44.56, p < 0.001, η2 = 0.76] and decreased remarkably from post-acquisition to post-extinction [F(1, 61) = 13.56, p < 0.05, η2 = 0.53] in two groups. The independent samples t-test for CS fear showed that, a significant difference in CS+ was observed between the reappraisal and control groups [post-acquisition: CS+ (t(28) = 10.32, p < 0.01), CS− (t(28) = 4.32, p = 0.0502); post-extinction: (CS+: t(28) = 11.58, p < 0.05; CS−: t(28) = 1.43, p = 0.282); pre re-extinction (CS+:t(28) = 25.63, p < 0.001;CS−: t(28) = 12.72, p < 0.05)]. A trial × CS type × group repeated measures ANOVA of US expectancy revealed that both groups acquired fear at acquisition [F(1,61) = 4.34, p = 0.069] and showed no differences. However, the interaction of group × type was significant [F(1,61) = 5.54, p = 0.047] at extinction, great difference were revealed by one samples t-test for CS+ and CS− [ CS+: t(28) = 7.11, p < 0.01 and CS−: t(28) = 10.40, p < 0.001]. The US expectancy of CS+ was much lower and declined faster in reappraisal group than that in the control group, F(1,61) = 72.26, p < 0.001, η2 = 0.53. In the last trial at extinction, the US expectancy to CS was still observed significant differences between groups (CS+: t(28) = 19.26, p < 0.001; CS−: t(28) = 11.06, p < 0.05). At re-extinction on the second day, the US expectancy of trials showed that both groups extinct the conditioned fear successfully, F(11,647) = 27.26, p < 0.001, η2 = 0.52. Compared to the US expectancy of e12 (the last trail of first extinction) and E1 (the first trail of re-extinction), the CS expectancy of the reappraisal group were much lower than those of the control group (CS−: t(28) = 12.12, p < 0.05; CS+: t(28) = 18.42, p < 0.001), which indicated that reappraisal promotes the extinction of conditioned fear and inhibited the return of conditioned fear.
In conclusion, the short-term reappraisal training can reduce the negative emotion effectively for the individuals with low scores of cognitive reappraisal, without changing the ability to distinguish safe signals from dangerous signals in the acute stress state. Moreover, cognitive reappraisal effectively reduces the fear in acquisition and extinction of conditioned fear and improve the conditioned fear extinction, as well as inhibited the return of conditioned fear.