An Experimental Investigation of the Relationship Between Emotion Regulation Flexibility, Negative Affect and Posttraumatic Stress Disorder

Emerging research investigating mechanisms underpinning PTSD hasidentified emotion regulation (ER) flexibility – the ability to flexiblyuse ER strategies according to contextual demands – as one promisingmechanism. To date, however, no study has investigated whether brief training inER flexibility can minimise negative affect elicited from evocative stimuli.This study investigated the impact of instructed ER flexibility on emotionalresponding in probable PTSD.

Participants (N = 148) viewed images that differed in negativeemotional intensity (high or low). For each image, participants followedinstructions to adopt either a flexible or inflexible ER approach throughrandomisation to either an ER flexiblecondition or one of three control conditions (InflexibleReappraisal, InflexibleDistraction, ContextInsensitive). In the ERFlexible condition, participants were instructed to switchbetween distraction and reappraisal according to the emotional intensity of theimage. The control conditions required participants to either employ a single ERstrategy (Inflexible Distraction andInflexible Reappraisal) or switch betweenstrategies in a way that did not align with image intensity (Context Insensitive). Negative affect was ratedafter each image.

Participants with probable PTSD in the ERFlexible condition demonstrated the lowest levels of negativeaffect. For participants without probable PTSD, negative affect did not differbetween the ER conditions.

Findings suggest that individuals with probable PTSD benefitted frombeing instructed in ER flexibility. This finding supports the adaptiveness of ERflexibility and provides a preliminary temporal link between instructed ERflexibility and improved emotional responding for those with PTSD.