Journal of Personality and Social Psychology
1998, Vol. 74, No. 1, 224-237
Copyright 1998 by (he American Psychological Association, Inc.
0O22-3514/98/$3.O0
Antecedent- and Response-Focused Emotion Regulation:
Divergent Consequences for Experience, Expression, and Physiology
James J. Gross
Stanford University
Using a process model of emotion, a distinction between antecedent-focused and response-focused
emotion regulation is proposed. To test this distinction, 120 participants were shown a disgusting
film while their experiential, behavioral, and physiological responses were recorded. Participants
were told to either (a) think about the film in such a way that they would feel nothing (reappraisal,
a form of antecedent-focused emotion regulation), (b) behave in such a way that someone watching
them would not know they were feeling anything (suppression, a form of response-focused emotion
regulation), or (c) watch the film (a control condition), Compared with the control condition, both
reappraisal and suppression were effective in reducing emotion-expressive behavior. However, reappraisal
decreased disgust experience, whereas suppression increased sympathetic activation. These
results suggest that these 2 emotion regulatory processes may have different adaptive consequences.
What happens when we get so angry with an erratic driver
that we feel like yelling at him, yet we do not? Or when we
feel down but want to be in good spirits for a party? Or when
we find something outrageously funny but need to stifle our
laughter during a formal ceremony? At times such as these, we
regulate our emotions. That is, we attempt to influence which
emotions we have, when we have them, and how these emotions
are experienced or expressed.
As these examples suggest, emotion regulation is a regular
feature of everyday life (Morris & Reilly, 1987; Rippere, 1977).
Nine out of 10 undergraduates report that they alter their emotions,
about once a day, and most can readily recall a recent
example (Gross, Feldman Barrett, & Richards, 1998). Indeed,
attempts at regulating emotions are so common that we typically
take emotion regulation for granted, noticing only its absence,
such as when a child throws a temper tantrum (Thompson,
1991), a friend shows too little happiness at our good news, a
depressed colleague is unable to stem overwhelming feelings
of sadness (Gross & Munoz, 1995), or we lose our composure
in the heat of the moment and say things we later regret.
Considering the ubiquity of emotion regulation, one might
expect theoretical and empirical analyses to abound. Surprisingly,
This research was supported by Behavioral Science Track Award for
Rapid Transition (B/STAKT) Grant MH53859 from the National Institute
of Mental Health. I would like to thank Paul Ekman, Oliver P. John,
Richard S. Lazarus, Jane M. Richards, Jeanne Tsai, and Robert Zajonc
for their thoughtful comments on a draft of this article and Robert
W. Levenson for making his laboratory facilities available. This article
benefited from the comments of both members of the Emotion Research
Group at its February 1996 meeting at Vanderbilt University, Nashville,
Tennessee, and members of the International Society for Research on
Emotional its August 1996 meeting at the University of Toronto, Toronto,
Ontario, Canada.
Correspondence concerning this article should be addressed to James
J. Gross, Department of Psychology, Stanford University, Stanford, California
94305-2130. Electronic mail may be sent via the Internet to
james@psych.stanford.edu.
this is not the case.1
Moreover, the two broad literatures in which
emotion regulation has been considered, one concerned with psychological
health and the other with physical health, offer remarkably
divergent conclusions about the consequences of emotion
regulation. In the following sections, I first review these two
literatures. I then use a process model of emotion to draw a
distinction between two forms of emotion regulation and suggest
that this distinction may help to reconcile these two literatures.
Emotion Regulation: Less Stress and Better
Psychological Health
Clinical tradition dating back to Freud has emphasized that
psychological health hinges on how affective impulses are regulated
(Freud, 1923/1961). This has led psychodynamic researchers
to focus on the health consequences of characteristic
emotion regulatory styles (e.g., Haan, 1993; Vaillant & Drake,
1985). Recently, proponents of other theoretical persuasions
also have elaborated the view that psychological health requires
that emotional impulses be regulated properly. For example,
Beck, Rush, Shaw, and Emery (1979) and Seligman (1991)
have argued that cognitive strategies may be used to prevent or
alleviate depression and Barlow (1991) has advanced a model
of emotion dysregulation and affective psychopathology.
But what support is there for the proposition that emotion
regulation has measurable beneficial consequences? Lazarus and
colleagues provided some of the first evidence in an influential
series of studies (Lazarus & Opton, 1966). In one representative
study, Lazarus and Alfert (1964) showed students a filmed circumcision
ritual and manipulated the accompanying soundtrack.
Some participants heard a soundtrack that had been designed
to minimize the negative emotional impact of the film by denying
the pain involved in the surgery and emphasizing the joyful
' In the developmental literature, however, there has been a recent
surge of interest in emotion regulation (e.g., Campos, Campos, & Barrett,
1989; Eisenberg el al., 1995; Fox, 1994; Garber & Dodge, 1991).
224
TWO FORMS OF EMOTION REGULATION 225
aspects of the procedure. Other participants heard no soundtrack
at all. Compared with the no-soundtrack condition, participants
who heard the soundtrack had slower heart rates, lower skin
conductance levels, and more pleasant mood ratings. These
findings suggested that leading participants to view the film less
negatively decreased the stressfulness of what otherwise would
have been a quite distressing experience.
Studies such as this one demonstrated that cognitive strategies
could reduce stress responses and suggested that such regulation
might have benefits for psychological health. This view has
been incorporated into theories of emotion {e.g., Frijda, 1988;
Lazarus, 1991; Plutchik, 1980), coping and stress reduction
(e.g., Katz & Epstein, 1991; Lazarus & Folkman, 1984; Meichenbaum,
1985), delay of gratification (Mischel, 1974; Shoda, Mischel,
& Peake, 1990), and psychopathology (e.g., Barlow, 1988;
Beck et al., 1979; Sayette, 1993). Despite its wide currency,
however, the view that cognitive strategies may be used to decrease
negative emotion has a surprisingly weak empirical foundation.
Since Lazarus's pioneering studies, there has been at least
one failure to replicate (Steptoe & Vogele, 19K6) and only one
successful replication (Dandoy & Goldstein, 1990). As Wegner
(1994) demonstrated so elegantly in the realm of thought suppression,
attempts to influence ongoing mental processes may
have paradoxical or unintended effects. This suggests caution in
assuming that the cognitive control of emotion has uniquely, or
even primarily, salutary consequences.
Emotion Regulation: More Physiological Activation
and Worse Physical Health
With the advent of psychosomatic medicine, the impact of
emotion regulation on physical health took center stage (Alexander,
1939). Here, however, emotion regulation was cast not as
hero, but as villain. Indeed, the notion that the regulation of
negative emotions could have deleterious consequences became
a cornerstone of the entire psychosomatic enterprise (Alexander
& French, 1946; Dunbar, 1954). The chronic inhibition of
sadness and crying was thought to lead to respiratory disorders,
such as asthma (Alexander, 1950; Halliday, 1937); the chronic
inhibition of affiliative tendencies was linked to gastrointestinal
disorders, such as ulcers (Alexander, 1950); and the chronic
inhibition of anger was associated with cardiovascular disorders,
such as hypertension (Alexander, 1939).
Although some of these hypotheses have fallen into disfavor,
others have remained popular, such as the view that chronic
hostility and anger inhibition may be linked to hypertension and
coronary heart disease (e.g., Friedman & Booth-Kewley, 1987;
Manuck & Krantz, 1986; T. W. Smith, 1992; Steptoe, 1993). In
addition, new hypotheses involving emotion regulation have
emerged, suggesting that emotion inhibition may exacerbate minor
ailments (Pennebaker, 1990) and that inexpressiveness may
accelerate cancer progression (Fawzy et al., 1993; Gross, 1989;
Spiegel, Bloom, Kraemer, & Gottheil, 1989).
The theme that unites these hypotheses is that tight control
of negative emotions may adversely affect physical health. Just
how this might happen is not known, but the underlying premise
usually is that inhibiting emotion leads to acute increases in
physiological response parameters that may, over the long term,
do damage (Krantz & Manuck, 1984). Results of studies that
have examined the acute physiological effects of emotion regulation
empirically have been mixed (for a review, see Gross &
Levenson, 1993), but more recent work has shown that emotional
suppression leads to acute increases in sympathetic activation
of the sort postulated by these models (Gross & Levenson,
1993. 1997).
Integrating the Two Literatures
When placed side by side, the literatures on psychological and
physical health give the uncomfortable impression that emotion
regulation may benefit psychological health but harm physical
health. Are psychological well-being and physical well-being
really at odds with one another?
To address this issue, I have adopted the process model of
emotion shown in Figure 1. This model is a distillation of major
points of convergence among researchers concerned with emotion
(e.g., Arnold, 1960; Ekman, 1972; Frijda, 1986; Izard,
1977; Lang, 1995; Lazarus, 1991; Levenson, 1994; Plutchik,
1980; Scherer, 1984; Tomkins, 1984). According to this consensual
model, emotion begins with an evaluation of external or
internal emotion cues. Certain evaluations trigger a coordinated
set of behavioral, experiential, and physiological emotional response
tendencies that together facilitate adaptive responding to
perceived challenges and opportunities. However, these response
tendencies may be modulated, and it is this modulation that
gives final shape to manifest emotional responses.
Clearly, this input-output model does not do—and is not
meant to do—full justice to the complexities of emotion. For
example, this model does not adequately represent the multifaceted
evaluation and modulation processes. Neither does this
model capture the dynamic and recursive nature of emotion.
Nor does it provide sufficient means of representing differences
among emotions or differences among individuals. These limitations
notwithstanding, this model does suggest two major ways
in which emotions might be regulated.
As shown in Figure 1, this model suggests that emotions may
be regulated either by manipulating the input to the system (antecedent-focused
emotion regulation) or by manipulating its output
(response-focused emotion regulation). Within these two broad
classes of emotion regulation, more fine-grained distinctions may
be made (see Frijda, 1986; Gross, 1998). For example, antecedent-focused
emotion regulation includes situation selection, in
which one approaches or avoids certain people or situations on
the basis of their likely emotional impact; situation modification,
in which one modifies an environment so as to alter its emotional
impact; attention deployment, in which one turns attention toward
or away from something in order to influence one's emotions;
and cognitive change, in which one reevaluates either the situation
one is in or one's capacity to manage the situation so as to
alter one's emotions. Response-focused emotion regulation also
includes a multiplicity of types, such as strategies that intensify,
diminish, prolong, or curtail ongoing emotional experience, expression,
or physiological responding.2
2
The distinction between antecedent- and response-focused emotion
regulation should not be confused wilh Lazarus and colleagues' distinction
between problem- and emotion-focused coping, a distinction recently
retired in favor of more specific coping strategies (Folkman &
Lazarus, 1988). Emotion-focused coping refers to efforts to regulate
stressful emotion and thus is coextensive with the superordinate category
226 GROSS
Emotional
Cues
fh Emotional
Response Tendencies
•Behavioral
•Experiential
•Physiological
fh Emotional
Responses
Antecedent-Focused
Emotion Regulation
(e.g., Reappraisal)
Response-Foe used
Emotion Regulation
(e.g., Suppression)
Figure I. A consensual process model of emotion that highlights two major classes of emotion regulation.
Yet even Ihis initial distinction between two broad classes of
emotion regulation may help to reconcile the two literatures
reviewed above. The psychological health literature might be
seen as concerned primarily with cognitive forms of antecedentfocused
emotion regulation, that is, regulation before the emotion
is triggered. The physical health literature, by contrast,
might be seen as concerned primarily with response-focused
emotion regulation that involves the inhibition of emotional
response tendencies once the emotion already has been
generated.
Might this model also be used to make more specific predictions
regarding these two forms of emotion regulation? Tn the
context of a potentially stressful situation, antecedent-foe used
emotion regulation might take the form of reevaluating the situation
so as to decrease its emotional relevance (see Lazarus,
1991; Scherer, 1984; C. A. Smith & Ellsworth, 1985). This
should decrease the extent to which emotion response tendencies
are activated, leading to lesser subjective, physiological, and
expressive signs of negative emotion than otherwise would have
been evident. Response-focused emotion regulation, by contrast,
should target response tendencies that have been produced once
the emotion is under way. For example, consider suppression,
defined as the conscious inhibition of ongoing emotion-expressive
behavior. Because regulatory efforts selectively focus on
behavior, we would expect lesser emotion-expressive behavior.
The subjective consequences of hiding expressive behavior are
a matter of some dispute, but recent reviews (Gross & Levenson,
1993, 1997) suggest that suppression should have little or no
impact on subjective experience, at least in the context of a
negative emotion.3
Because inhibitory pathways would be activated
concurrently with the physiological response tendencies
associated with emotion, we might expect a mixed physiological
state. This state would include increased sympathetic activation
due to the additional task of suppressing behavioral response
of emotion regulation (at least for "stressful" emotions). By contrast,
problem-focused coping refers to attempts to modify a troublesome environment
and thus is one form of antecedent-focused emotion regulation.
tendencies as they are generated (Gross & Levenson, 1993,
1997); decreased somatic signs of emotion, because these are
the target of suppression; and decreased heart rate, which is
influenced by somatic activity (Obrist, 1981).
The Present Study
The goal of the present study was to test the general proposition
that "shutting down" an emotion at the front end would
have different consequences from shutting down an emotion
that already had generated powerful response tendencies. Thus,
the present study directly compared one form of antecedentfocused
emotion regulation, reappraisal, and one form of response-focused
emotion regulation, suppression, with a control
condition. Reappraisal was defined as interpreting potentially
emotion-relevant stimuli in unemotional terms (see Speisman,
Lazarus, Mordkoff, & Davison, 1964). Suppression was denned
as inhibiting emotion-expressive behavior while emotionally
aroused (Gross & Levenson, 1993).
A potent film stimulus known to elicit disgust was used. This
film's potency ensured that most participants would have the
desired emotional response tendencies (Gross & Levenson,
1995). However, it also increased the likelihood that some participants
would be overwhelmed. To decrease this possibility, all
participants first viewed a neutral and a disgusting film under
no special instructions, to acquaint them with the film materials
and procedures. Only then did they view a second disgusting
film, during which participants in the two experimental conditions
were to regulate their responding while control participants
simply watched the film.
Although emotion theorists agree that emotions involve
changes in the response domains of experience, expression, and
physiology, previous studies of emotion regulation typically
3
The opposite prediction would be made by the facial feedback hypothesis
(FFH). However, recent reviews and empirical findings suggest
that the FFH-inspired notion that suppression and exaggeration are opposite
ends of a single continuum may be mistaken (see Gross & Levenson,
1993, 1997).
TWO FORMS OF EMOTION REGULATION 227
have sampled only one or two of these domains. One unique
contribution of this study was the examination of all three domains.
By directly comparing two forms of emotion regulation
with a control condition, this study tested three hypotheses.
The first hypothesis concerned expressive behavior. I predicted
that both reappraisal and suppression participants would
show fewer behavioral signs of disgust than would control participants.
[ expected this effect to be evident whether expressive
behavior was assessed in discrete terms (i.e., specific signs
of disgust), dimensional terms (i.e., the intensity of overall
emotional responding), or global terms (i.e., overall activity
levels). Because of the way I operationalized reappraisal and
suppression, I did not expect emotion regulation participants to
look away from the film or avert their gaze to a greater extent
than control participants (which would represent yet another
form of emotion regulation).
The second hypothesis concerned subjective experience. I expected
that reappraisal participants would report less subjective
experience of emotion than control participants; in the context
of a film that specifically targeted disgust subjective experience,
I expected that these reductions would be specific to disgust.
By contrast, on the basis of prior findings, I predicted that
suppression and control participants would report equivalent
experience of disgust.
The third hypothesis concerned physiological responding.
Here, my expectation was that reappraisal participants would
show less sympathetic activation (as measured by finger pulse
amplitude, finger temperature, and skin conductance), less somatic
activity, and lower heart rates than control participants.
By contrast, because I conceptualize suppression as involving
the activation of inhibitory processes over and above the ongoing
emotion, I expected suppression participants to evidence a
mixed physiological pattern, characterized by greater sympathetic
activation than control participants but less somatic and
heart rate reactivity.
Method-
Overview
Participants watched a disgust-eliciting rtlm under one of three conditions.
In the reappraisal condition, participants were asked to adopt a
detached and unemotional attitude as they watched the film. In the
suppression condition, participants were asked to behave in such a way
that a person watching them would not know that they were feeling
anything at all. The watch condition served as a control; in this condition,
participants were simply asked to watch the film. Participants were
videotaped, and their physiological responses were monitored. Participants
also used emotion-rating forms to describe their subjective experience
of emotion.
Participants
One hundred twenty undergraduates (60 men and 60 women) participated
in individual experimental sessions, to fulfill a research requirement
in their psychology course.4
On average, participants were 21 years
old (SD = 4.1). The ethnic composition of this sample was mixed: 1%
African American, 55% Asian American, 33% Caucasian, 3% Latino,
and 8% other.
Stimulus Films
Three well-validated silent films were used (Gross & Levenson,
1995). The first film (1 min) was a dynamic abstract display that elicits
very little emotion of any kind. The second and third films showed
medical procedures. These were first used by Paul Ekman of the University
of California, San Francisco (see Ekman, Friesen, & O'Sullivan,
1988). The first showed the treatment of bum victims (burn film) and
was 55 s long. The second showed a close-up of the amputation of an
arm (amputation film) and was 64 s long. In pretesting, these two films
elicited self-reported disgust, with little report of other emotions.
Procedure
On arrival, participants were seated in a well-lit 4 x 6-m room. They
were informed that the experiment was concerned with emotion and that
they would be videotaped. Physiological sensors were attached, and
participants used a self-report form to answer questions concerning
demographics and current mood. Participants then were shown three
short films on a 19-in. color television monitor at a distance of 1.75
m. All instructions were prerecorded and presented via the television
monitor.
Before the first and second film trials, participants were told lhat the
television screen would be blank for about a minute and that this time
should be used to "clear your mind of all thoughts, feelings, and memories."
After this 1-min baseline period, participants received the following
instructions: "We will now be showing you a short film clip. It is
important to us that you watch the film clip carefully, but if you find
the film too distressing, just say 'stop.' " These instructions were followed
by either the neutral film (first trial) or the burn film (second
trial). After each film, there was a 1-min postfilm period, at the end of
which participants completed an emotion-rating form (described below),
to assess their emotional reactions during the film.
The third trial began with the same 1-min baseline procedure. Participants
then received one of three instructions, determined by random
assignment to one of three conditions (watch, reappraisal, or suppression
). Assignment was constrained so that equal numbers of men and
women were assigned to each condition. For watch participants (n =
40), the foregoing instructions were repeated. Reappraisal participants
(n = 40) received the following instructions:
We will now be showing you a short film clip. It is important to
us that you watch the film clip carefully, but if you find the film
too distressing, just say "stop." This time, please try to adopt a
detached and unemotional attitude as you watch the film. In other
words, as you watch the film clip, try to think about what you are
seeing objectively, in terms of the technical aspects of the events
you observe. Watch the film clip carefully, but please try to think
about what you are seeing in such a way that you don't feel anything
at all.
Participants in the suppression condition (n = 40) received the following
instructions:
We will now be showing you a short film clip. It is important to
us that you watch the film clip carefully, but if you find the film
too distressing, just say "stop." This time, if you have any feelings
as you watch the film clip, please try your best not to let those
feelings show. In other words, as you watch the film clip, try to
behave in such a way that a person watching you would not know
4
A total of 127 students initially participated. Of these, 7 were excluded
from analyses because they requested to stop the amputation film
(3 in the watch condition and 4 in the suppression condition).
228 GROSS
you were feeling anything. Watch the film clip carefully, but please
try to behave so that someone watching you would not know that
you are feeling anything at all.
Participants then watched the amputation film, which was followed by
a I -min postfilm period. After the postfilm period, participants completed
an emotion-rating form and answered several additional questions
concerning their responses to the amputation film.
Measures
Data were collected in three response domains: expressive behavior,
subjective experience, and physiology. Because the first film (abstract
display) was included solely to accustom participants to the laboratory,
data from this film were not analyzed. R>r the bum and amputation
films, data reduction for behavioral and physiological data was based
on the prefilm (1 min), instructional (1 min), film (approximately 1
min), and postfilm (1 min) periods. Self-report data were available for
baseline and film periods. As manipulation checks, after the amputation
film, participants rated three statements using a 9-point Likert-type scale,
ranging from 0 {strongly disagree) to 8 (strongly agree): (a) During
the film, I tried not to feel anything at all; (b) during the film, I felt
emotions but tried to hide them; and (c) during the film, I reacted
completely spontaneously.
Behavior. A remote control video camera placed behind darkened
glass unobtrusively recorded participants' facial behavior and upper
body movement. Participants' behavioral responses were rated by four
coders (two men and two women), who were unaware of stimuli and
experimental conditions. Coders used a modified version of the Emotional
Behavior Coding System (Gross & Levenson, 1993), including
(a) overall disgust, (b) emotional intensity, (c) overall activity (an a
priori composite defined by four codes: mouth movement, facial movement,
face touching, and body movement), and (d) obscures vision. The
first three measures were designed to assess emotion-expressive behavior
in discrete (disgust), dimensional (intensity), and global (activity)
terms. Obscures vision was a control variable, designed to assess
whether emotion regulation participants prevented themselves from
seeing the films by shielding their gaze or looking away from the screen.
Reliabilities were good (mean r = .92), ranging from .83 for disgust
to .98 for obscures vision. As expected, the four components of the
activity composite were correlated, and the composite had alphas ranging
from .68 to .75. Final values for each of the measures were determined by
averaging the coders' ratings. Participants received scores for baseline,
instructional, film, and postfilm periods; change scores were computed
by subtracting baseline scores from each of the other scores.
Subjective experience. Participants rated how they felt before each
film (baseline rating) and, after viewing each film, how they had felt
during the film (film rating). On each occasion, participants rated their
disgust, which was embedded in a set of 15 distractor items (amusement,
anger, arousal, confusion, contempt, contentment, embarrassment, fear,
happiness, interest, pain, relief, sadness, surprise, and tension). Each
emotion was rated using a 9-point Likert-type scale, ranging from 0
(none) to 8 (most in my life), adapted from Ekman, Friesen, and Ancoli
(1980). The primary focus was on disgust experience, but change scores
were computed for all 16 measures by subtracting the baseline score
from the film score.
Physiology. Five measures were selected for use in this study to
provide a broad index of the activity of physiological systems especially
relevant to emotional responding. The first three measures assessed activation
of the sympathetic branch of the autonomic nervous system:
1. Finger pulse amplitude. A UFi photoplethysmograph recorded
the amplitude of blood volume in the finger using a photocell taped
to the distal phalange of the second finger of the nondominant hand.
2. Finger temperature. A thermistor attached to the palmar surface
of the distal phalange of the fourth finger recorded temperature in
degrees Fahrenheit.
3. Skin conductance level. A constant-voltage device was used to
pass a small voltage between Beckman regular electrodes (using
an electrolyte of sodium chloride in Unibase) attached to the palmar
surface of the middle phalanges of the first and third fingers of the
nondominant hand.
The fourth and fifth measures assessed somatic activity and heart rate,
respectively:
4. General somatic activity. An electromechanical transducer
attached to the platform under the participant's chair generated an
electrical signal proportional to the amount of movement in any
direction.
5. Cardiac interheat interval. Beckman miniature electrodes with
Redux paste were placed in a bipolar configuration on opposite
sides of the participant's chest. The interbeat interval was calculated
as the interval (in milliseconds) between successive R-waves.
During the experimental sessions, laboratory software computed second-by-second
averages for each of the five physiological measures
throughout each baseline, instructional, film, and postfilm period. These
second-by-second physiological values later were used to compute
scores for each participant representing the averages of the physiological
variables for the baseline, instructional, film, and postfilm periods.
Change scores for the five measures were computed by subtracting baseline
scores from instructional, film, and postfilm periods.
Results
Random Assignment and Manipulation Checks
All participants viewed the initial disgust-eliciting film (the
burn film) under the same instructions to simply watch the film.
This film therefore provided an opportunity to evaluate the effectiveness
of our random assignment of participants to experimental
conditions. Overall multivariate analyses of variance
(MANOVAs) for the behavioral, subjective, and physiological
domains failed to reveal any differences among participants
assigned to the three instructional groups during this film, suggesting
that our random assignment had been successful.5
As emotion regulation participants received their instructions,
was there evidence of preparatory activity that might distinguish
them from watch participants? In the behavioral domain, reappraisal
participants showed greater increases in emotional intensity
than watch participants (e.g., interest, concentration), and
suppression participants showed greater increases in activity
than watch participants (see Table 1 ).fi
As compared with watch
participants, both reappraisal and suppression participants
showed greater decreases in finger pulse amplitude and finger
temperature and greater increases in skin conductance and somatic
activity (see Table 1). In general, physiological responding
was somewhat greater in the suppression condition
5
In each analysis, participant sex was initially included as a factor.
Because sex did not interact with instructional condition, sex was
dropped from the final analyses,
6
As might be expected, during the prefilm period, there were no
group differences in ratings of disgust-expressive behavior or obscuring
vision.
TWO FORMS OF EMOTTON REGULATION 229
Table 1
Mean Change in Expressive Behavior and Physiological Responding
During the Instructional Period
Measure
Behavioral
Emotional intensity
Overall activity
Physiological
Finger pulse amplitude
Finger temperature
Skin conductance
Somatic activity
Interbeat interval
Reappraise
M
0.90a
-0.06a
-2.26a
-0.07a
0.06a
0.06a
-25.90,
SD
1.01
0.81
3.19
0.52
0.62
0.14
39.62
Instructions
Watch
M
0.35h
-0.24a
-0.13b
0.18b
-0.20b
-0.0 lh
-10.99a
SD
0.86
0.76
2.07
0.62
0.51
0.13
36.54
Suppress
M
0.58ab
0.30b
-4.13,
-0.1 X
0.36,
0.12a
-47.73b
SD
0.87
0.60
2.78
0.45
0.55
0.23
52.09
Note. Means in a given row with different subscripts differ significantly at p < .05, two-tailed.
than in the reappraisal condition, and only suppression participants
showed greater increases in heart rate than watch participants.
Although the behavioral signs of preparation differed
somewhat for the two groups, the overall similarity in responses
suggests that these preparatory effects may be quite general.
When participants in the two emotion regulation groups heard
that they soon would be called on to manage their emotions, they
appeared to steel themselves, and their heightened autonomic
activation (relative to the watch participants) suggests both their
concern about the assigned task and the efforts they made to
prepare themselves.
After the amputation film, three questions were administered
to assess compliance with instructions. Compared with the
watch participants, both suppression participants, ;(78) = 4.7,
p < .001, and reappraisal participants, f(78) = 3.2, p < .01,
reported reacting less spontaneously during the amputation film,
consistent with their having been asked to regulate their emotions.
As expected, reappraisal participants reported trying not
to feel the emotion to a greater degree than watch participants,
/(78) = 8.8,/? < .001, and suppression participants, r(78) =
2.2, p < .05. Also as expected, suppression participants reported
feeling but hiding emotions to a greater degree than watch participants,
?(78) = 7.3, p < .001, and reappraisal participants
r(77.7) = 2.0, p < .05.
Emotion Regulation and Expressive Behavior
Hypothesis 1 predicted that emotion regulation participants
would show less expressive behavior during film and postfilm
periods than watch participants. Indeed, as presented in Table
2, this is precisely what was found. During the film period,
reappraisal and suppression participants showed lesser increases
in disgust, emotional intensity, and activity than watch participants.
For disgust and intensity, this reduction was somewhat
more pronounced for suppression participants than for reappraisal
participants. During the postfilm period, reappraisal and
suppression participants showed lesser increases in disgust than
watch participants, and suppression participants showed lesser
increases in intensity than reappraisal or watch participants.
There were no differences among groups in the degree to which
participants obscured their vision, indicating that emotion regulation
participants did not simply cover their eyes to lessen the
emotional impact of the film.
Emotion Regulation and Subjective Experience
Extensive pretesting had shown that the amputation film generally
elicits high levels of disgust experience. Hypothesis 2
suggested that reappraisal would lessen the subjective impact
of this film but that suppression would not. As presented in
Figure 2, this was indeed the case. Reappraisal participants had
lesser increases in disgust experience while watching the film
than watch participants, f(77) = 2.2, p < .05, whereas suppression
participants did not, /(78) = 0.8, ns.
Was this alteration in subjective experience specific to the
target emotion of disgust? Or was there a general dulling of
subjective experience? The other emotion terms were included
as distractors to make the key comparison less obvious to participants,
but they permitted an examination of whether this
reduction in disgust was part of a larger pattern of altered subjective
experience. To test this possibility, I conducted an overall
three-level condition (watch, suppress, or reappraise)
MANOVA for the 15 other emotion experience ratings. The
condition effect was not significant, F(30, 202) = 1.1, suggesting
that emotion regulation did not have an overall effect
on experience.
Emotion Regulation and Physiology
Hypothesis 3 predicted that reappraisal participants would
show less sympathetic, somatic, and heart rate responding than
the watch participants during the film and postfilm periods. By
contrast, suppression participants were hypothesized to show
greater sympathetic responding during the film and postfilm
periods than watch participants but less somatic and heart rate
responding. As presented in Table 3, analyses were conducted
using period averages; continuous physiological plots also are
presented for the three measures of sympathetic activation, to
230 GROSS
Table 2
Mean Change in Expressive Behavior During the Film and Postfilm Periods
Behavioral measure
Target variables
Overall disgust
Film
Postfilm
Emotional intensity
Film
Postfilm
Overall activity
Film
Postfilm
Control variable
Obscures vision
Film
Postfilm
Reappraise
M
0.82a
0.35,
1.03.
0.80a
-0.12,
-0.01,
0.43a
o.ooa
SD
1.11
0.92
1.05
1.07
0.66
0.68
1.58
0.00
Instructions
M
2.30b
O.85h
2.27h
1.00a
0.24b
0.11n
0.53a
o.ooa
Watch
SD
2.10
1.27
1.69
1.01
0.96
0.77
1.52
0.00
Suppress
M
0.35,
0.13a
0.45c
0.30b
-0.12,
-0.10,
0.53,
0.00a
SD
1.00
0.40
0.90
0.52
0.56
0.69
3.16
0.00
Note. Means in a given row with different subscripts differ at p < .05, two-tailed.
elucidate the dynamic effects of emotion regulation (see Figures
3-5).
Did the two emotion regulation conditions diverge from the
control condition? As predicted, during the film period, suppression
participants showed greater sympathetic activation than
watch participants, and this effect was evident for all three
measures of sympathetic responding. Compared with both
watch and reappraisal participants, suppression participants
.3 -
2Reappraise
Watch Suppress
Figure 2. Mean change in self-reported disgust experience during the
amputation film for the three instructional groups. Error bars indicate
standard error of the mean.
showed greater decreases in finger pulse amplitude and greater
decreases in finger temperature (both indicative of greater vasoconstriction
and hence greater sympathetic activation), as well
as greater increases in skin conductance (another sign of increased
sympathetic activation). This effect continued into the
postfilm period in a somewhat attenuated form. Here, suppression
participants had greater decreases in finger pulse amplitude
and finger temperature than the other two groups. Unexpectedly,
however, suppression participants did not show less somatic or
heart rate responding than watch participants during either film
or postfilm periods. The hypothesis that reappraisal participants
would show fewer physiological signs of emotion than watch
participants also was not confirmed. Reappraisal participants
showed physiological responses that were indistinguishable
from watch participants during film and postfilm periods.
Discussion
These findings suggest a number of differences between the
antecedent-foe used and response-focused forms of emotion regulation
studied here. In the following sections, I review the
present results and discuss their implications for psychological
and physical health.
What Happens When We Regulate Our Emotions?
Despite striking commonalties in the effects of preparing to
regulate emotions, participants in the two emotion regulation
conditions showed quite different responses during the actual
period of emotion regulation. Reappraisal led to decreases in
both behavioral and subjective signs of emotion, with no hint of
elevations in physiological responding. Thus, it was a relatively
effective means of inhibiting emotion. Suppression, by contrast,
although effective at diminishing expressive behavior, had no
impact on subjective experience and led to increases in multiple
indices of sympathetic nervous system activation.
TWO FORMS OF EMOTION REGULATION 231
Table 3
Mean Change in Physiological Responding During the Film and Postfilm Periods
Physiological measure
Sympathetic activation
Finger pulse amplitude
Film
Postfilm
Finger temperature
Film
Postfilm
Skin conductance
Film
Postfilm
Activity and heart rate
Somatic activity
Film
Postfilm
Interbeat interval
Film
Postfilm
Reappraise
M
-2.70a
-0.60a
-0.49a
-0.54a
0.13.
-0.10a
-0.06a
0.03a
38.27a
9.32B
SD
4.40
3.28
0.83
1.10
0.87
0.75
0.11
0.11
44.87
26.40
Instructions
Watch
M
-3.25a
-0.01a
-0.1 %
-0.45a
0.34a
0.10a
-0.05a
0.05a
33.81a
12.07ib
SD
4.77
3.82
1.00
1.35
1.28
0.90
0.18
0.25
51.83
29.43
Suppress
M
-6.08b
-2.17b
- U 3 b
-1.47b
0.79b
0.21.
-0.08fl
-0.02a
32.61fl
30.68h
SD
4.71
3.82
0.79
1.31
0.89
0.82
0.25
0.22
70.38
56.73
Note. Means in a given row with different subscripts differ from one another at p < .05. All tests are
two-tailed except skin conductance, which was predicted on the basis of results of three prior studies
(Gross & Levenson 1993, 1997).
Effects of reappraisal On the basis of the process model
of emotion depicted in Figure 1,1 hypothesized that reevaluating
the significance of a potentially emotion-eliciting film would
lead to fewer experiential, behavioral, and physiological signs
of emotion than simply watching the film. Indeed, compared
with watch participants, reappraisal participants reported less
disgust experience and showed fewer behavioral signs of disgust,
suggesting the efficacy of this emotion regulatory strategy,
even in the context of a potent negative emotion. This point is
reinforced by the observation that although 7 watch and suppression
condition participants asked for the film to be stopped (and
thus were replaced; see footnote 4), none of the reappraisal
participants did so, x2
(l, N - 120) = 3.41, p = .07 (one-
tailed).
Surprisingly, however, reappraisal and watch participants had
comparable physiological responses to the film. An inspection
of the continuous plots of physiological responding (see Figures
3-5) reveals that reappraisal participants may have shown
slightly less physiological activation, but these differences were
not significant. Why didn't reappraisal decrease physiological
responding? Null findings are susceptible to divergent explanations,
but one possibility is that reappraisal simply does not
affect the physiological component of an emotional response
(Steptoe & Vogele, 1986). Given the small correlations among
the components of an emotional response (e.g., Lang, Rice, &
Sternbach, 1972), an intervention such as reappraisal might
selectively target just two of the components of the response
(behavior and experience) and not a third (peripheral physiology
). Alternatively, it may be that the potency of the amputation
film gave reappraisal participants little chance to shut down its
powerful (possibly subcortically mediated) autonomic effects
(see LeDoux, 1989). Perhaps with a milder film, a more cognitively
elaborated emotion, a longer emotion episode, or more
detailed reappraisal instructions, reappraisal participants would
have shown lesser physiological responding.
Effects of suppression. Compared with watch participants,
those in the suppression condition showed the expected decrease
in expressive behavior. Moreover, they experienced just as much
disgust and showed more sympathetic activation on all three
measures (finger pulse amplitude, finger temperature, and skin
conductance level). This pattern of findings is consistent with
previous studies using this paradigm (Gross & Levenson, 1993,
1997) and suggests that response-focused emotion regulation
comes at the cost of heightened physiological responding, possibly
due to the parallel activation of subcortical emotion centers
alongside higher order inhibitory structures.
In previous studies (Gross & Levenson, 1993), participants
who suppressed disgust showed decreased somatic activity and
had concomitant decreases in heart rate. In the present study,
however, even though suppression participants were rated as
showing less expressive behavior than watch participants, they
showed neither less somatic activity nor lower heart rates. Why
might this feature of the suppression response found in two
previous studies of disgust be absent in the present study? An
examination of activity level means across studies provides one
possible explanation. Whereas participants in the watch condition
in the two prior studies (Gross & Levenson, 1993) showed
an average increase of 0.11 units of somatic activity, participants
in the watch condition in the present study showed a decrease
from baseline of —0.05 units (as compared with —0.08 in the
suppression condition). This makes it likely that a floor effect
was operative: Suppression could not decrease somatic activity
further because the somatic activity levels of the participants in
the watch condition already were well below their baseline lev-
232 GROSS
-12-r
41 61 81 101 121 141
Time (s)
161 181 201 221 241
Figure 3. Mean change in finger pulse amplitude during the amputation trial for the three instructional
groups. Note that the ordinate's scale is such that increased sympathetic activation is upward.
els. This suggests that the specific effects of suppression on
somatic activity, and hence heart rate, will depend on the precise
pattern of somatic activity generated by the target emotion in a
given setting (see Gross & Levenson, 1997).
Implications for Psychological Health
The present research suggests that for negative emotions such
as disgust, antecedent-focused and response-focused emotion
regulation may have quite different consequences. Reappraisal
led to decreased feelings of disgust, even when this strategy
was foisted on participants in the context of a potent emotioneliciting
film, where it might be thought there would be little
room for such cognitive strategies. This suggests that reappraisal
might have much to recommend it as an effective route to experiencing
less negative emotion, and it may well be reappraisal
and other antecedent-focused emotion regulatory strategies that
theorists have in mind when espousing the positive consequences
of emotion regulation for psychological health (Thayer, Newman,
& McClain, 1994). By contrast, inhibiting the outward
expression of negative emotion fails to provide any relief from
the subjective experience of negative emotion.
These findings indicate that reappraisal may be preferable to
suppression as a route to psychological well-being. But antecedent-focused
emotion regulation is not itself without costs. For
example, inflexible or unrealistic reappraisals might lead one
to deny important features of one's environment, such as hazards
at work or abusive tendencies in a partner. In such cases,
the short-term benefits of relief from negative emotion would
almost certainly be outweighed by the long-term costs of stifling
the adaptive behavioral tendencies, such as flight, associated
with negative emotions. In addition, there may be more general
costs of any form of emotion regulation that diminishes emotion-expressive
behavior. Theorists since Darwin (1872/ 1965)
have argued that we rely on the emotional expressions of our
social partners to give us information about their needs and
preferences. For example, if we inadvertently anger someone,
their angry expression signals what has happened, and we are
able to apologize. But if the person we have angered regulates
emotion in a way that diminishes expressive behavior, we may
be oblivious to the problem and do nothing to change our actions.
In this case, the person who is regulating is likely to
continue to have emotional responses, perhaps at even greater
intensity levels.
If, as I have argued, different forms of emotion regulation
have different consequences, no one strategy is likely to prove
uniformly superior to all others across all contexts. Thus, what
is crucial is knowing how and when to use various emotion
regulatory strategies (Tavris, 1984). Such knowledge may be
communicated in a variety of ways (Gross & Mufioz, 1995),
and a more complete understanding of the costs and benefits of
diverse regulatory processes promises to inform clinical interventions
designed to promote healthy forms of emotion regula-
TWO FORMS OF EMOTION REGULATION 233
-3.5 -r
- 2 . 5 - -
-1.5--
0.5
llnBtructaom |PoBtfUm|
•™ Reappraise
— Watch
-- Suppress
21 41 61 81 101 121 141
Time (s)
161 181 201 221 241
Figure 4. Mean change in finger temperature during the amputation trial for the three instructional groups.
Note that the ordinate's scale is such that increased sympathetic activation is upward.
tion that are well matched to situational demands. These interventions
may target individuals known to be at elevated risk for
depression or anxiety, or those whose professions (e.g., airline
personnel and paramedics) require them to regularly manage
intense emotions such as anger and disgust (Hochschild, 1983;
A. C. Smith & Kleinman, 1989; Sutton, 1991).
Implications for Physical Health
The present results are consistent with the view that emotion
regulation, particularly emotional suppression, may play a role
in physical health. Although the long-term health consequences
of acute emotional suppression were not assessed in this study,
the present results do show that each time emotion is suppressed
rather than expressed, sympathetic tone will be elevated. Any
one response of increased intensity would be unlikely to have
deleterious consequences, but it is conceivable that if such responses
were repeated many times there might be adverse health
consequences (Krantz & Manuck, 1984). Extrapolating further,
suppression might increase not only the intensity of physiological
responses but also their frequency. As noted above, one
important function of emotions is to signal to others one's
wishes and needs. If these signals are systematically concealed,
others may not know one's wishes. This would make it less
likely that one's interactants would be accommodating and more
likely that one would have intense and frequent negative-emotion-laden
interactions.
But how might these intense, frequent emotional responses
affect physical health? One link between emotional suppression
and physical health is suggested by the literature on cardiovascular
disease. Here, emotional suppression has been shown to
be associated with essential hypertension and coronary artery
disease (Friedman & Booth-Kewley, 1987; Manuck & Krantz,
1986; Roter & Ewart, 1992; Steptoe, 1993). One possible mechanism
underlying this association may be sustained physiological
reactivity that is in excess of current metabolic demands
(Steptoe, 1981; Williams, 1986). The evidence from the present
study is consistent with this possibility, showing that the acute
effects of emotional suppression include increased sympathetic
activation of the cardiovascular system despite low levels of
somatic activity. It remains to be determined, of course, whether
repeated episodes of this sort do in fact affect the integrity of
the cardiovascular system in vulnerable individuals.
A second potential link between emotional suppression and
health is suggested by the stress tradition (Ursin & Olff, 1993)
and, more particularly, by research on stress and immune functioning
(Kiecolt-GIaser & Glaser, 1991). Here, the suggestion
is that the stress response (which involves both autonomic and
neuroendocrine components) may lead to the selective inhibition
of certain aspects of the immune response (Maier, Watkins, &
Fleshner, 1994; Sapolsky, 1994). Clearly, the links between various
components of the stress response and immune functioning
are extremely complex (Dienstbier, 1989; O'Leary, 1990).
234 GROSS
2.5-r
41 61 81 101 121 141
Time (s)
161 161 201 221 241
Figure 5. Mean change in skin conductance during the amputation trial for the three instructional groups.
Note that the ordinate's scale is such that increased sympathetic activation is upward.
Nonetheless, the finding that inhibiting moderate levels of emotional
expressive behavior leads to increased sympathetic activation
of the cardiovascular system raises the possibility that suppression
may activate some elements of the classic stress response,
which in turn may influence the nature and course of
immune responding (Esterling, Antoni, Kumar, & Schneiderman,
1990; Felten & Felten, 1994; Pennebaker, Kiecolt-Glaser,
&Glaser, 1988).
Directions for Future Research
One direction for future research concerns the generalizability
of the present findings. For example, might the consequences
of emotion regulation vary according to whether the emotion
being regulated is anger, disgust, sadness, or some other emotion?
The lack of consensus as to whether each emotion calls
forth emotion-specific physiological (e.g., Cacioppo, Klein,
Berntson, & Hatfield, 1993; Levenson, 1992; Zajonc & Mclntosh,
1992) and behavioral (e.g., Ekman, 1994; Izard, 1994;
Russell, 1994) response tendencies makes this question difficult
to answer, but different emotions conceivably might present different
emotion regulatory challenges. Note, however, that in the
context of emotional suppression, results to date suggest that
commonalities in the effects of suppression outweigh differences
(Gross & Levenson, 1997). A second form of generalizability
concerns participant characteristics. Over half of the participants
in the present study were Asian American, and all were
college-age. Given known differences in emotional experience,
expression, and control across ethnic groups (e.g., Gross &
John, 1998) and age groups (e.g., Gross et al., 1997), it will
be important to assess whether these findings generalize to other
research participants. A third aspect of generalizability concerns
relations with other forms of emotion regulation, such as distraction
or exaggeration (see Ekman & Friesen, 1969). It also will
be important to test limits of generalizability by examining other
regulatory processes, such as negative mood regulation (Catanzaro
& Mearns, 1990; Nolen-Hoeksema, Parker, & Larson, 1994;
Thayeretal., 1994), thought suppression (Roemer& Borkovec,
1994; Wegner, 1994), and even self-esteem regulation (Steele,
Spencer, & Lynch, 1993). By tracing points of divergence and
convergence across different emotions, participant groups, and
regulatory processes, a more differentiated view of emotion
regulation will emerge—one that avoids premature synthesis
but reveals interconnections among apparently diverse processes
(e.g., Westen, 1994).
Future work also must consider emotion regulation in all its
complexity outside the confines of the laboratory. Interview data
(Gross et al., 1998; Tice & Baumeister, 1993) suggest that
individuals use a rich variety of emotion regulation strategies
and that these may vary rapidly over the course of an interaction.
Some of these would have been difficult to observe in a laboratory
paradigm such as the one used here. Examples include
situation selection and situation modification (primary control
strategies in which a person modifies a bothersome environment;
see Rothbaum, Weisz, & Snyder, 1982), as well as strategies
TWO FORMS OF EMOTION REGULATION 235
that occur outside conscious awareness, such as repression
(Brown et al., 1996; Weinberger, 1990). Laboratory-based studies
must be complemented with fieldwork, and the range of
dependent measures should be broadened to include a wider
range of cognitive, experiential, physiological, and behavioral
measures.
In addition, it will be important to consider how individuals'
emotion regulatory goals (e.g., King & Emmons, 1990; Swinkels
& Giuliano, 1995) and spontaneously chosen strategies
(e.g., Bandura & Rosenthal, 1966) affect proximal intraindividual
and interpersonal functioning, as well as more distal psychological
and physical health outcomes. For example, does the
effect of reappraisal depend on whether someone habitually uses
this strategy? Or how, specifically, a person goes about trying
to reappraise a potentially emotion-eliciting situation? Complementing
this idiographic approach, nomothetic analyses will be
needed to integrate broader but related constructs, such as the
internalizer-externalizer dimension (Buck, 1979; Cacioppo et
al., 1992), diverse facets of emotional expressivity (Gross &
John, 1997), emotional ambivalence (King & Emmons, 1990),
and emotional intelligence (Goleman, 1995; Salovey, Hsee, &
Mayer, 1993). By examining these personal and contextual factors,
we will learn whether some people are better suited cognitively
and temperamentally to use some emotion regulatory strategies
rather than others in particular situations (e.g., Engebretson,
Matthews, & Scheier, 1989; Rothbart & Ahadi, 1994).
Summary
In the complex social world in which we live, strong emotions
occasionally may be unwelcome (e.g., when they compromise
task performance or betray secret preferences). At such times,
we attempt to regulate our emotions, and I have suggested that
we may do so in two quite different ways. The first is to reappraise
our circumstances so as to alter their emotional impact.
This study has shown that such reappraisals decrease expressive
behavior and subjective experience. The second is to inhibit
emotion-expressive behavior once the emotion is already under
way. This study has shown that such emotional suppression
decreases expressive behavior, but does not affect subjective
experience, and actually increases certain aspects of physiological
responding. With these divergent consequences in mind, I
have speculated that certain forms of antecedent-foe used emotion
regulation (e.g., reappraisal) often may be better for one's
health than certain forms of response-focused emotion regulation
(e.g., suppression).
References
Alexander, F. (1939). Psychological aspects of medicine. Psychosomatic
Medicine, 1, 7-18.
Alexander, F. (1950). Psychosomatic medicine: Its principles and applications.
New York: Norton.
Alexander, K, & French, T M. (1946). Psychoanalytic therapy: Principles
and applications. New "fork: Ronald Press.
Arnold, M. A. (1960). Emotion and personality. New \brk: Columbia
University Press.
Bandura, A., & Rosenthal, T. L. (1966). Vicarious classical conditioning
as a function of arousal level. Journal of Personality and Social
Psychology, 3, 54-62.
Barlow, D. H. (1988). Anxiety and its disorders. New York: Guilford
Press.
Barlow, D. H. (1991). Disorders of emotion. Psychological Inquiry, 2,
58-71.
Beck, A. T, Rush, A. J., Shaw, B. E, & Emery, G. (1979). Cognitive
therapy of depression. New \brk: Guilford Press.
Brown, L. L., Tomarken, A. J., Orth, D. N., Loosen, P. T., Kalin, N. H., &
Davidson, R. J. (1996). Individual differences in repressive-defensiveness
predict basal salivary cortisol levels. Journal of Personality
and Social Psychology, 70, 362-371.
Buck, R. (1979). Individual differences in non-verbal sending accuracy
and electrodermal responding: The extemalizing-internalizing dimension.
In R. Rosenthal (Ed.), Skill in non-verbal communication (pp.
140-170). Cambridge, MA: Oelgeschlager, Gunn & Hain.
Cacioppo, J.T., Klein, D.J., Berntson, G. G., & Hatfield, E. (1993).
The psychophysiology of emotion. In M. Lewis & J. M. Haviland
(Eds.), Handbook of emotions (pp. 109-142). New York: Guilford
Press.
Cacioppo, J. X, Uchino, B. N., Crites, S. L., Snydersmith, M. A., Smith,
G., Berntson, G. G., & Lang, P. J. (1992). Relationship between facial
expressiveness and sympathetic activation in emotion: A critical review,
with emphasis on modeling underlying mechanisms and individual
differences. Journal of Personality and Social Psychology, 62,
110-128.
Campos, J. J., Campos, R. G., & Barrett, K. C. (1989). Emergent themes
in the study of emotional development and emotion regulation. Developmental
Psychology, 25, 394-402.
Catanzaro, S. J., & Mearns, J. (1990). Measuring generalized expectancies
for negative mood regulation: Initial scale development and implications.
Journal of Personality Assessment, 54, 546-563.
Dandoy, A. C, & Goldstein, A. G. (1990). The use of cognitive appraisal
to reduce stress reactions: A replication. Journal of Social Behavior
and Personality, 5, 275-285.
Darwin, C. (1965). The expression of the emotions in man and animals.
Chicago: University of Chicago Press. (Original work published
1872)
Dienstbier, R. A. (1989). Arousal and physiological toughness: Implications
for mental and physical health. Psychological Review, 96, 84-
100.
Dunbar, F. (1954). Emotions and bodily changes (3rd ed.). New \brk:
Columbia University Press.
Eisenberg, N., Fabes, R. A., Murphy, B., Maszk. P., Smith, M., & Karbon,
M. (1995). The role of emotionality and regulation in children's
social functioning: A longitudinal study. Child Development, 66,
1360-1384.
Ekman, P. (1972). Universal and cultural differences in facial expression
of emotion. In J. Cole (Ed.), Nebraska Symposium on Motivation,
1971 (pp. 207-283). Lincoln: University of Nebraska Press.
Ekman, P. (1994). Strong evidence for universal in facial expressions:
A reply to Russell's mistaken critique. Psychological Bulletin, U5,
268-287.
Ekman, P., & Friesen, W. V. ( 1969). The repertoire of nonverbal behavior:
Categories, origin, usage, and coding. Semiotica, I, 49-98.
Ekman, P., Friesen, W. V., &Ancoli, S. (1980). Facial signs of emotional
experience. Journal of Personality and Social Psychology, 39, 1124-
1134.
Ekman, P., Friesen, W. V., & O'Sullivan, M. (1988). Smiles when lying.
Journal of Personality and Social Psychology, 54, 414-420.
Engebretson, T. O., Matthews, K. A., & Scheier, M. F. (1989). Relations
between anger expression and cardiovascular reactivity: Reconciling
inconsistent findings through a matching hypothesis. Journal of Personality
and Social Psychology, 57, 513-521.
Esterling, B. A., Antoni, M. H., Kumar, M., & Schneiderman, N. (1990).
236 GROSS
Emotional repression, stress disclosure responses, and Epstein-Barr
viral capsid antigen titers. Psychosomatic Medicine, 52, 397-410.
Fawzy, F. I.. Fawzy, N. W., Hyun, C. S., Elashoff, R., Guthrie, D., Fahey,
J. L., & Morton, D. L. (1993). Malignant melanoma: Effects of an
early structured psychiatric intervention, coping, and affective state
on recurrence and survival 6 years later. Archives of Genera! Psychiatry,
50, 681-689.
Felten, S. Y., & Felten, D. L. (1994). Neural-immune interactions. Progress
in Brain Research, 100, 152-157.
Folkman, S., & Lazarus, R. S. (1988). Ways of Coping Questionnaire.
Palo Alto, CA: Consulting Psychologists Press.
Fox, N. J. (Ed.). (1994). The development of emotion regulation: Biological
and behavioral considerations. Monographs of the Society for
Research in Child Development, 59 (2-3, Serial No. 240).
Freud, S. (1961). The ego and the id. In J. Strachey (Ed. and Trans.),
The standard edition of the complete psychological works of Sigmund
Freud (Vol. 19, pp. 3—66). London: Hogarth Press. (Original work
published 1923)
Friedman, H. S., & Booth-Kewley, S. (1987). Personality, Type A behavior,
and coronary heart disease: The role of emotional expression.
Journal of Personality and Social Psychology, 53, 783-792.
Frijda, N. H. (1986). The emotions. Cambridge, England: Cambridge
University Press.
Frijda, N. H. (1988). The laws of emotion. American Psychologist, 43,
349-358.
Garber, J., & Dodge, K. A. (Eds.). (1991). The development of emotion
regulation and dysregulation. Cambridge, England: Cambridge University
Press.
Goleman, D. (1995). Emotional intelligence. New York: Bantam Books.
Gross, J. (1989). Emotional expression in cancer onset and progression.
Social Science and Medicine, 28, 1239- 1248.
Gross, J. J. (1998). Emotion regulation. Manuscript submitted for
publication.
Gross, J. J., Carstensen, L. C, Pasupathi, M., Tsai, J., Gottestam, K., &
Hsu, A. Y. C. (1997). Emotion and aging: Experience, expression,
and control. Psychology and Aging, 12, 590-599.
Gross, J. J., Feldman Barrett, L. A., & Richards, J. M. (1998). Emotion
regulation in everyday life. Manuscript in preparation.
Gross, J. J., &. John, O. P. (1997). Revealing feelings: Facets of emotional
expressivity in self-reports, peer ratings, and behavior. Journal
of Personality and Social Psychology, 72, 435-448.
Gross, J. J., & John, 0. P. (1998). Mapping the domain of expressivity:
Multimethod evidence for a hierarchical model. Journal of Personality
and Social Psychology, 74. 170-191.
Gross, J. J., &Levenson, R. W. (1993). Emotional suppression: Physiology,
self-report, and expressive behavior. Journal of Personality and
Social Psychology, 64, 970-986.
Gross, J. J., & Levenson, R. W. (1995). Emotion elicitation using films.
Cognition and Emotion, 9, 87-108.
Gross, J. J., & Levenson, R. W. (1997). Hiding feelings: The acute
effects of inhibiting negative and positive emotion. Journal of Abnormal
Psychology, J06, 95-103.
Gross, J. J., & Mufio7, R. F. (1995). Emotion regulation and mental
health. Clinical Psychology: Science and Practice, 2, 151-164.
Haan, N. (1993). The assessment of coping, defense, and stress. In L.
Goldberger (Ed.), Handbook of stress: Theoretical and clinical aspects
(2nd ed., pp. 258-273). New York: Free Press.
Halliday, J. L. (1937). Approach to asthma. British Journal of Medical
Psychology, 17, 1-53.
Hochschild, A. R. (1983). The managed heart: Commercialization of
human feeling. Berkeley: University of California Press.
lzard, C. is. (1977). Human emotions. New York: Plenum.
Izard, C. E. (1994). Innate and universal facial expressions: Evidence
from developmental and cross-cultural research. Psychological Bulletin,
115, 288-299.
Katz, L., & Epstein, S. (1991). Constructive thinking and coping with
laboratory-induced stress. Journal of Personality and Social Psychology,
61, 789-800.
Kiecolt-Glaser, J. K., & Glaser, R. (1991). Stress and immune function
in humans. In R. Ader, D. L. Fellen, & N. Cohen (Eds.), Psychoneuroimmunology
(2nd ed., pp. 849-867). San Diego, CA: Academic
Press.
King, L. A., & Emmons, R. A. ( 1990). Conflict over emotional expression:
Psychological and physical correlates. Journal of Personality
and Social Psychology, 58, 864-877.
Krantz, D. S., & Manuck, S. B. (1984). Acute psychophysiologic reactivity
and risk of cardiovascular disease: A review and methodologic
critique. Psychological Bulletin, 3, 435-464.
Lang, P. J. (1995). The emotion probe: Studies of motivation and attention.
American Psychologist, 50, 372-385.
Lang, P. J., Rice, D. G., & Sternbach, R. A. (1972). The psychophysiology
of emotion. In N. J. Greenfield & R. A. Sternbach (Eds.), Handbook
of psychophysiology (pp. 623-643). New York: Holt, Rinehart
& Winston.
Lazarus, R. S. (1991). Emotion and adaptation. New York: Oxford
University Press.
Lazarus. R. S., & Alfert, E. (1964). Short-circuiting of threat by experimentally
altering cognitive appraisal. Journal of Abnormal and Social
Psychology, 69, 195-205.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal and coping.
New \brk: Springer.
Lazarus. R. S., & Opton, E. M., Jr. (1966). The study of psychological
stress: A summary of theoretical formulations and experimental findings.
In C D . Spielberger (Ed.), Anxiety and behavior (pp. 225-
262). New ^>rk: Academic Press.
LeDoux, J.E. (1989). Cognitive-emotional interactions in the brain.
Cognition and Emotion, 3, 267-289.
Levenson, R. W. (1992). Autonomic nervous system differences among
emotions. Psychological Science, 3, 23-27.
Levenson, R. W. (1994). Human emotion: A functional view. In P. Ekman
& R. J. Davidson (Eds.), Fundamental questions about the nature
of emotion (pp. 123-126). New 'fork: Oxford University Press.
Maier, S. F., Watkins, L. R., & Fleshner, M. (1994). Psychoneuroimmunology:
The interface between behavior, brain, and immunity. American
Psychologist, 49, 1004-1017.
Manuck, S. B., & Krantz, D. S. (1986). Psychophysiologic reactivity in
coronary heart disease and essential hypertension. In K. A. Matthews,
S. M. Weiss, T. Detre, T M. Dembroski, B. Falkner, S. B. Manuck, &
R. B. Williams, Jr. (Eds.), Handbook of stress, reactivity, and cardiovascular
disease (pp. 11-34). New 'Vbrk: Wiley.
Meichenbaum, D. A. (1985). Stress inoculation training. New York:
Pergamon Press.
Mischel, W. (1974). Processes in delay of gratification. In L. Berkowitz
(Ed.), Advances in experimental social psychology (Vol. 7, pp. 249-
291). New "Vbrk: Academic Press.
Morris, W. N., & Reilly, N. P. (1987). Toward the self-regulation of
mood: Theory and research. Motivation and Emotion, II, 215-249.
Nolen-Hoeksema, S., Parker. L. E., & Larson, J, (1994). Ruminative
coping with depressed mood following loss. Journal of Personality
and Social Psychology, 67, 92-104.
Obrist, P. A. (1981). Cardiovascular psychophysiology. New York: Plenum
Press.
O'Leary, A. (1990). Stress, emotion, and human immune function. Psychological
Bulletin, 108, 363-382.
Pennebaker, J. (1990). Opening up: The healing powers of confiding in
others. New York: Morrow.
Pennebaker, J., Kiecolt-Glaser, J. K., & Glaser, R. (1988). Disclosure of
TWO FORMS OF EMOTION REGULATION 237
traumas and immune function: Health implications for psychotherapy.
Journal of Consulting and Clinical Psychology, 56, 239-245.
Plutchik, R. (1980). Emotion: A psychoevolutionary synthesis. New
"fork: Harper & Row.
Rippere, V. (1977). "What's the thing to do when you're feeling depressed?"—A
pilot study. Behavior Research and Therapy, 15, 185—
191.
Roemer, L., & Borkovec, T. D. (1994). Effects of suppressing thoughts
about emotional material. Journal of Abnormal Psychology, 103,
467-474.
Roter, D. L., & Ewart, C. K. (1992). Emotional inhibition in essential
hypertension: Obstacle to communication during medical visits?
Health Psychology, 11 163-169.
Rothbart, M. K., & Ahadi. S. A. (1994). Temperament and the development
of personality. Journal of Abnormal Psychology, 103, 55-66.
Rothbaum, F, Weisz, J, R., & Snyder, S. S. (1982). Changing the world
and changing the self: A two-process model of perceived control.
Journal of Personality and Social Psychology, 42, 5-37.
Russell. J. A. (1994). Is there universal recognition of emotion from
facial expression? A review of the cross-cultural studies. Psychological
Bulletin, 115, 102-141.
Salovey, P., Hsee, C. K., & Mayer, J. D. (1993). Emotional intelligence
and self-regulation. In D. M. Wegner & J. W. Pennebaker (Eds.),
Handbook of mental control (pp. 258-277). Englewood Cliffs, NJ:
Prentice Hall.
Sapolsky, R. M. (1994). Why zebras don't get ulcers. New York:
Freeman.
Sayette, M. A. (1993). An appraisal-disruption model of alcohol's effects
on stress responses in social drinkers. Psychological Bulletin,
114, 459-476.
Scherer, K. (1984). On the nature and function of emotion: A component
process approach. In K. R. Scherer & P. Ekman (Eds.), Approaches
to emotion (pp. 293-317). Hillsdale, NJ: Erlbaum.
Seligman, M. E. P. (1991). Learned optimism. New York: Knopf.
Shoda, Y., Mischel, W, & Peake, P. K. (1990). Predicting adolescent
cognitive and self-regulatory competencies from preschool delay of
gratification: Identifying diagnostic conditions. Developmental Psychology,
26, 978-986.
Smith, A. C, & Kleinman, S. (1989). Managing emotions in medical
school: Students' contacts with the living and the dead. Social Psychology
Quarterly, 52, 56-69.
Smith, C. A., & Ellsworth, P. C. (1985). Patterns of cognitive appraisal
in emotion. Journal of Personality and Social Psychology, 48, 813—
838.
Smith, T. W. (1992). Hostility and health: Current status of a psychosomatic
hypothesis. Health Psychology, 11, 139-150.
Speisman, J. C, Lazarus, R. S., Mordkoff, A., & Davison, L. (1964).
Experimental reduction of stress based on ego-defense theory. Journal
of Abnormal and Social Psychology, 68, 367-380.
Spiegel, D.. Bloom, J. R., Kraemer, H. C, Gottheil, E. (1989). Effect
of psychosocial treatment on survival of patients with metastatic breast
cancer. Lancet, 2, 888-891.
Steele, C. M., Spencer, S. J., & Lynch, M. (1993). Self-image resilience
and dissonance: The role of affirmational resources. Journal of Personality
and Social Psychology, 64, 885-896.
Steptoe, A. (1981). Psychological factors in cardiovascular disease.
New ^brk: Academic Press.
Steptoe, A. (1993). Stress and the cardiovascular system: A psychosocial
perspective. In S. C. Stanford & P. Salmon (Eds.), Stress: From synapse
to syndrome (pp. 119-141). London: Academic Press.
Steptoe, A., & Vogele, C. (1986). Are stress responses influenced by
cognitive appraisal? An experimental comparison of coping strategies.
British Journal of Psychology, 77, 243-255.
Sutton, R. I. (1991). Maintaining norms about expressed emotions: The
case of bill collectors. Administrative Science Quarterly, 36, 245-
268.
Swinkels, A., & Giuliano, T. A. (1995). The measurement and conceptualization
of mood awareness: Monitoring and labeling one's mood
states. Personality and Social Psychology Bulletin, 21, 934-949.
Tavris, C. (1984). On the wisdom of counting to ten: Personal and
social dangers of anger expression. In P. Shaver (Ed.), Review of
personality and social psychology (pp. 170-191). Beverly Hills, CA:
Sage.
Thayer, R. E., Newman, J. R., & McClain, T. M. (1994). Self-regulation
of mood: Strategies for changing a bad mood, raising energy, and
reducing tension. Journal of Personality and Social Psychology, 67,
910-925.
Thompson, R. A. (1991). Emotional regulation and emotional development.
Educational Psychology Review, 3, 269-307.
Tice, D. M., & Baumeister, R. F. (1993). Controlling anger: Self-induced
emotion change. In D. M. Wegner & J. W. Pennebaker (Eds.), Handbook
of mental control (pp. 258-277). Englewood Cliffs, NJ: Prentice
Hall.
Tomkins, S. (1984). Affect theory. In P. Ekman (Ed.), Emotion in the
humanface (2nd ed., pp. 353-395). New \brk: Cambridge University
Press.
Ursin, H., & Olff, M. (1993). The stress response. In S. C. Stanford &
P. Salmon (Eds.), Stress: From synapse to syndrome (pp. 3-22).
London: Academic Press.
Vaillant, G. E., & Drake, R. E. (1985). Maturity of ego defense in
relation to DSM-II1 Axis II personality disorder. Archives of General
Psychiatry, 42, 597-601.
Wegner, D. M. (1994). Ironic processes of mental control. Psychological
Review, 101, 34-52.
Weinberger, D. A. (1990). The construct validity of the repressive coping
style. In J. L. Singer (Ed.), Repression and dissociation: Implications
for personality theory, psychopathology, and health (pp. 337-
386). Chicago: University of Chicago Press.
Westen, D. (1994). Toward an integrative model of affect regulation:
Applications to social-psychological research. Journal of Personality,
62, 641-667.
Williams, R. B., Jr. (1986). Patterns of reactivity and stress. In K. A.
Matthews, S. M. Weiss, T. Detre, T. M., Dembroski, B. Falkner, S. B.
Manuck, &. R. B. Williams, Jr. (Eds.), Handbook of stress, reactivity,
and cardiovascular disease (pp. 109-125). New \brk: Wiley.
Zajonc, R. B., & Mclntosh, D. N. (1992). Emotions research: Some
promising questions and some questionable promises. Psychological
Science, 3, 70-74.
Received September 6, 1996
Revision received January 31, 1997
Accepted February 3, 1997 •