Acceptance versus reappraisal: Behavioral, autonomic, and neural effects

  • Philippe R. GoldinEmail author
  • Craig A. Moodie
  • James J. Gross


Emotion regulation (ER) is an important skill for well-being. Cognitive reappraisal is a goal-oriented cognitive change strategy. Acceptance involves decentering from immediate habits of reactivity, observing moment-to-moment shifts in thoughts, emotions, and sensations. These two regulation strategies are thought to have different effects on emotion; however, no study has examined the differential effects of reappraisal and acceptance on behavioral, autonomic, and brain responses in the context of ideographic personally salient negative self-beliefs. Thirty-five right-handed, healthy adults were presented idiographic negative self-beliefs embedded in autobiographical scripts. We measured negative emotion ratings, autonomic psychophysiology, and functional magnetic resonance imaging blood oxygen-level dependent responses while participants read neutral statements, reacted to their own negative self-beliefs, and implemented reappraisal and acceptance strategies. Compared with react, reappraisal resulted in significantly lesser negative emotion and respiration rate; no differences in heart rate and skin conductance level; greater brain responses implicated in cognitive control, language, and social cognition; and lesser amygdala responses. Compared with react, acceptance resulted in significantly lesser negative emotion, respiration rate, and heart rate; no difference in skin conductance level; and greater brain responses in networks implicated in cognitive control and attention. Compared with acceptance, reappraisal resulted in significantly lesser negative emotion; no difference in respiration rate and skin conductance level; higher heart rate; greater brain responses in brain regions implicated in cognitive control; and lesser brain responses in amygdala. Reappraisal is more effective than acceptance in down-regulating negative emotion, but may require greater recruitment of autonomic, cognitive, and brain resources. identifier: NCT02036658


Acceptance Emotion regulation fMRI Reappraisal Mindful attention Neuroimaging 



This research was supported by NIMH Grant R01 MH076074, awarded to James Gross. We wish to thank Gary Glover for his technical assistance with magnetic resonance imaging. Philippe Goldin, who is independent of any commercial funder, had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Compliance with ethical standards

Conflict of interest

None of the authors of this manuscript have any biomedical financial interests or potential conflicts of interest.


  1. Alberts, H. J. E. M., Schneider, F., & Martijn, C. (2012). Dealing efficiently with emotions: Acceptance-based coping with negative emotions requires fewer resources than suppression. Cognition and Emotion, 26(5), 863–870. CrossRefPubMedGoogle Scholar
  2. Aldao, A., & Nolen-Hoeksema, S. (2012). The influence of context on the implementation of adaptive emotion regulation strategies. Behaviour Research and Therapy, 50(7/8), 493–501. CrossRefPubMedGoogle Scholar
  3. Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217-237. CrossRefPubMedGoogle Scholar
  4. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
  5. Ayduk, O., & Kross, E. (2008). Enhancing the pace of recovery: Self-distanced analysis of negative experiences reduces blood pressure reactivity. Psychological Science, 19(3), 229–231. CrossRefPubMedGoogle Scholar
  6. Banks, S. J., Eddy, K. T., Angstadt, M., Nathan, P. J., & Luan Phan, K. (2007). Amygdala-frontal connectivity during emotion regulation. Social Cognitive and Affective Neuroscience, 2(4), 303–312.CrossRefPubMedPubMedCentralGoogle Scholar
  7. Brosschot, J. F., & Thayer, J. F. (2003). Heart rate response is longer after negative emotions than after positive emotions. International Journal of Psychophysiology, 50(3), 181–187. CrossRefPubMedGoogle Scholar
  8. Buhle, J. T., Silvers, J. A., Wager, T. D., Lopez, R., Onyemekwu, C., Kober, H., ... Ochsner, K. N. (2013). Cognitive reappraisal of emotion: A meta-analysis of human neuroimaging studies. Cerebral Cortex.
  9. Christoff, K., & Gabrieli, J. D. E. (2000). The frontopolar cortex and human cognition: Evidence for a rostrocaudal hierarchical organization within the human prefrontal cortex. Psychobiology, 28(2), 168–186.Google Scholar
  10. Cohen, M. S. (1997). Parametric analysis of fMRI data using linear systems methods. NeuroImage, 6(2), 93–103.CrossRefPubMedGoogle Scholar
  11. Corbetta, M., Patel, G., & Shulman, G. L. (2008). The reorienting system of the human brain: From environment to theory of mind. Neuron, 58(3), 306–324. CrossRefPubMedPubMedCentralGoogle Scholar
  12. Corbetta, M., & Shulman, G. L. (2002). Control of goal-directed and stimulus-driven attention in the brain. Nature Reviews Neuroscience, 3(3), 201–215.CrossRefPubMedGoogle Scholar
  13. Cox, R. W. (1996). AFNI: Software for analysis and visualization of functional magnetic resonance neuroimages. Computers and Biomedical Research, 29, 162–173.CrossRefPubMedGoogle Scholar
  14. Dan-Glauser, E. S., & Gross, J. J. (2015). The temporal dynamics of emotional acceptance: Experience, expression, and physiology. Biological Psychology, 108, 1–12. CrossRefPubMedGoogle Scholar
  15. Di Nardo, P. A., Brown, T. A., & Barlow, D. H. (1994). Anxiety Disorders Interview Schedule for DSM-IV: Lifetime version (ADIS-IV-L). New York, NY: Oxford University Press.Google Scholar
  16. Ellard, K. K., Barlow, D. H., Whitfield-Gabrieli, S., Gabrieli, J. D. E., & Deckersbach, T. (2017). Neural correlates of emotion acceptance vs. worry or suppression in generalized anxiety disorder. Social Cognitive and Affective Neuroscience, 12(6), 1009–1021. CrossRefPubMedPubMedCentralGoogle Scholar
  17. Fan, J., McCandliss, B. D., Fossella, J., Flombaum, J. I., & Posner, M. I. (2005). The activation of attentional networks. NeuroImage, 26(2), 471–479.CrossRefPubMedGoogle Scholar
  18. Forman, S. D., Cohen, J. D., Fitzgerald, M., Eddy, W. F., Mintun, M. A., & Noll, D. C. (1995). Improved assessment of significant activation in functional magnetic resonance imaging (fMRI): Use of a cluster-size threshold. Magnetic Resonance in Medicine, 33, 636–647.CrossRefPubMedGoogle Scholar
  19. Garnefski, N., Kraaij, V., & Spinhoven, P. (2002). Manual for the use of the cognitive emotion regulation questionnaire: English version. Leiderdorp, The Netherlands: DATEC.Google Scholar
  20. Gerritsen, R. J. S., & Band, G. P. H. (2018). Breath of life: The respiratory vagal stimulation model of contemplative activity. Frontiers Human Neuroscience, 12, 397. CrossRefGoogle Scholar
  21. Giuliani, N. R., McRae, K., & Gross, J. J. (2008). The up- and down-regulation of amusement: Experiential, behavioral, and autonomic consequences. Emotion, 8(5), 714–719. CrossRefPubMedPubMedCentralGoogle Scholar
  22. Glover, G. H., & Law, C. S. (2001). Spiral-in/out BOLD fMRI for increased SNR and reduced susceptibility artifacts. Magnetic Resonance in Medicine, 46(3), 515–522.CrossRefPubMedGoogle Scholar
  23. Goldin, P., Ziv, M., Jazaieri, H., Hahn, K., & Gross, J. J. (2013). MBSR vs. aerobic exercise in social anxiety: fMRI of emotion regulation of negative self-beliefs. Social Cognitive Affective Neuroscience, 8(1), 65–72. CrossRefPubMedGoogle Scholar
  24. Goldin, P. R., Manber-Ball, T., Werner, K., Heimberg, R., & Gross, J. J. (2009). Neural mechanisms of cognitive reappraisal of negative self-beliefs in social anxiety disorder. Biological Psychiatry, 66(12), 1091–1099. CrossRefPubMedPubMedCentralGoogle Scholar
  25. Goldin, P. R., McRae, K., Ramel, W., & Gross, J. J. (2008). The neural bases of emotion regulation: Reappraisal and suppression of negative emotion. Biological Psychiatry, 63(6), 577–586.CrossRefPubMedGoogle Scholar
  26. Goosheh, B., Ravanbakhsh, M., Salavati, M., Ebrahimi Takamjani, I., Akhbari, B., & Kahlaee, A. H. (2017). Attention-demand effects on respiration in chronic low back pain patients. Journal of Bodywork and Movement Therapies, 21(4), 788–793. CrossRefPubMedGoogle Scholar
  27. Gross, J. J. (2002). Emotion regulation: Affective, cognitive, and social consequences. Psychophysiology, 39(3), 281–291. CrossRefPubMedGoogle Scholar
  28. Gross, J. J. (2013). Emotion regulation: Taking stock and moving forward. Emotion, 13(3), 359–365. CrossRefPubMedGoogle Scholar
  29. Gross, J. J. (2015). Emotion Regulation: Current status and future prospects. Psychological Inquiry, 26(1), 1–26. CrossRefGoogle Scholar
  30. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York, NY: Guilford Press.Google Scholar
  31. Hofmann, S. G., Heering, S., Sawyer, A. T., & Asnaani, A. (2009). How to handle anxiety: The effects of reappraisal, acceptance, and suppression strategies on anxious arousal. Behaviour Research and Therapy, 47(5), 389.CrossRefPubMedPubMedCentralGoogle Scholar
  32. Holzman, J. B., & Bridgett, D. J. (2017). Heart rate variability indices as bio-markers of top-down self-regulatory mechanisms: A meta-analytic review. Neuroscience and Biobehavioral Review, 74(Pt. A), 233–255. CrossRefGoogle Scholar
  33. Kross, E., & Ayduk, O. (2008). Facilitating adaptive emotional analysis: Distinguishing distanced-analysis of depressive experiences from immersed-analysis and distraction. Personality and Social Psychology Bulletin, 34(7), 924–938. CrossRefPubMedGoogle Scholar
  34. Lebois, L. A. M., Papies, E. K., Gopinath, K., Cabanban, R., Quigley, K. S., Krishnamurthy, V., . . . Barsalou, L. W. (2015). A shift in perspective: Decentering through mindful attention to imagined stressful events. Neuropsychologia, 75, 505–524. CrossRefPubMedPubMedCentralGoogle Scholar
  35. LeDoux, J. (2007). The amygdala. Current Biology, 17(20), R868-874.CrossRefPubMedGoogle Scholar
  36. Levy, B. J., & Wagner, A. D. (2011). Cognitive control and right ventrolateral prefrontal cortex: Reflexive reorienting, motor inhibition, and action updating. Annals of the New York Academy of Sciences, 1224(1), 40–62. CrossRefPubMedPubMedCentralGoogle Scholar
  37. Liverant, G. I., Brown, T. A., Barlow, D. H., & Roemer, L. (2008). Emotion regulation in unipolar depression: The effects of acceptance and suppression of subjective emotional experience on the intensity and duration of sadness and negative affect. Behaviour Research and Therapy, 46(11), 1201–1209. CrossRefPubMedGoogle Scholar
  38. Morawetz, C., Bode, S., Baudewig, J., Kirilina, E., & Heekeren, H. R. (2016). Changes in effective connectivity between dorsal and ventral prefrontal regions moderate emotion regulation. Cerebral Cortex, 26(5), 1923–1937. CrossRefPubMedGoogle Scholar
  39. Ochsner, K. N., Silvers, J. A., & Buhle, J. T. (2012). Functional imaging studies of emotion regulation: A synthetic review and evolving model of the cognitive control of emotion. Annals of the New York Academy of Sciences, 1251, E1–E24.CrossRefPubMedPubMedCentralGoogle Scholar
  40. Oldfield, R. C. (1971). The assessment and analysis of handedness: The Edinburgh Inventory. Neuropsychologia, 9(1), 97–113. CrossRefPubMedGoogle Scholar
  41. Olson, I. R., McCoy, D., Klobusicky, E., & Ross, L. A. (2013). Social cognition and the anterior temporal lobes: A review and theoretical framework. Social Cognitive and Affective Neuroscience, 8(2), 123–133. CrossRefPubMedPubMedCentralGoogle Scholar
  42. Pascoe, M. C., Thompson, D. R., Jenkins, Z. M., & Ski, C. F. (2017). Mindfulness mediates the physiological markers of stress: Systematic review and meta-analysis. Joural of Psychiatry Research, 95, 156–178. CrossRefGoogle Scholar
  43. Smith, S. M., & Nichols, T. E. (2009). Threshold-free cluster enhancement: Addressing problems of smoothing, threshold dependence and localisation in cluster inference. NeuroImage, 44(1), 83–98. CrossRefPubMedGoogle Scholar
  44. Smoski, M. J., Keng, S. L., Ji, J. L., Moore, T., Minkel, J., & Dichter, G. S. (2015). Neural indicators of emotion regulation via acceptance vs. reappraisal in remitted major depressive disorder. Social Cognitive and Affective Neuroscience, 10(9), 1187–1194. CrossRefPubMedPubMedCentralGoogle Scholar
  45. Stange, J. P., Hamilton, J. L., Fresco, D. M., & Alloy, L. B. (2017). Flexible parasympathetic responses to sadness facilitate spontaneous affect regulation. Psychophysiology, 54(7), 1054–1069. CrossRefPubMedPubMedCentralGoogle Scholar
  46. Talairach, J., & Tournoux, P. (1988). Co-planar stereotaxic atlas of the human brain. New York, NY: Thieme.Google Scholar
  47. Touroutoglou, A., Andreano, J. M., Barrett, L. F., & Dickerson, B. C. (2015). Brain network connectivity-behavioral relationships exhibit trait-like properties: Evidence from hippocampal connectivity and memory. Hippocampus, 25(12), 1591–1598. CrossRefPubMedPubMedCentralGoogle Scholar
  48. Wolgast, M., Lundh, L. G., & Viborg, G. (2011). Cognitive reappraisal and acceptance: An experimental comparison of two emotion regulation strategies. Behaviour Research and Therapy, 49(12), 858–866. CrossRefPubMedGoogle Scholar
  49. Wolgast, M., Lundh, L. G., & Viborg, G. (2013). Cognitive restructuring and acceptance: An empirically grounded conceptual analysis. Cognitive Therapy and Research, 37(2), 340–351. CrossRefGoogle Scholar
  50. Zvolensky, M. J., & Eifert, G. H. (2001). A review of psychological factors/processes affecting anxious responding during voluntary hyperventilation and inhalations of carbon dioxide-enriched air. Clinical Psychology Review, 21(3), 375–400.CrossRefPubMedGoogle Scholar

Copyright information

© The Psychonomic Society, Inc. 2019

Authors and Affiliations

  • Philippe R. Goldin
    • 1
    Email author
  • Craig A. Moodie
    • 2
  • James J. Gross
    • 2
  1. 1.University of California, DavisSacramentoUSA
  2. 2.Stanford UniversityStanfordUSA

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