Research finding · August 2025
Cognitive strategies to offset intense emotions can make the leap from the lab to real life
People with depression can struggle to manage their emotions during stressful moments, and this can increase their risk for suicidal thoughts. One coping strategy known to help is cognitive reappraisal, which can be thought of as rethinking a situation to change its emotional impact. While this skill has been linked to lower distress and lower suicide risk, most studies test it in lab settings where people are told exactly when and how to regulate their emotions. Many times, that doesn’t reflect how people actually respond in real life, where stress often comes without warning and emotion regulation happens (or doesn’t) on the fly. To better understand how emotion regulation plays out day to day, especially among people with major depressive disorder (MDD), efforts to look at not just whether someone can use reappraisal when asked, but whether they tend to use it naturally, and how that relates to real-world stress and suicide risk are needed.
With her AFSP funds, Dr. Sarah Herzog examined both the capacity and tendency to engage in cognitive reappraisal among 82 unmedicated adults with MDD. Using a machine learning–based “neural signature” developed from brain imaging data, Dr. Herzog and her team measured reappraisal-related brain activity while participants recalled upsetting personal memories in three ways: freely (unstructured), while deliberately distancing (reappraisal), and while emotionally immersing in the stressful memory. After the scan, participants reported their stress, mood, and suicidal thoughts multiple times a day for one week using real-time phone surveys. Interestingly, people who showed stronger reappraisal-related brain activity during unstructured recall (i.e., a proxy for their spontaneous tendency to regulate) were more likely to experience spikes in suicidal thoughts after daily stress. In contrast, those who showed stronger reappraisal activity when directed to distance had fewer increases in negative mood. These findings suggest that while the ability to reappraise when directed may help protect against emotional distress, a tendency to spontaneously engage in reappraisal, even during low-stakes reflection, may actually reflect underlying emotional vulnerability that could be addressed with treatment.
Citation: Herzog, S., Schneck, N., Galfalvy, H., Hwei-Choo, T., Schmidt, M., Michel, C. A., Sublette, M. E., Burke, A., Ochsner, K., Mann, J. J., Oquendo, M. A., & Stanley, B. H. (2025). A Neural Signature for Reappraisal as an Emotion Regulation Strategy: Relationship to Stress-Related Suicidal Ideation and Negative Affect in Major Depression. Biological psychiatry. Cognitive neuroscience and neuroimaging, 10(1), 94–102. https://doi.org/10.1016/j.bpsc.2024.08.011
This finding comes from an AFSP-funded study — see the grant below ↓
