Studies exploring the neural correlates of the emotion regulation strategy called cognitive change (reappraisal) have been thoroughly discussed and synthesized. This is not the case for another emotion regulation strategy called response modulation. The aim of this thesis was to conduct a systematic review on the neural correlates of one specific emotion regulation technique in response modulation, called expressive suppression. Expressive suppression is the inhibition of emotion expressive behavior. Using a systematic search, screening, and selection process, out of the initial 557 articles eight studies were included for data extraction and discussion. The studies exposed participants to negative emotion-inducing stimuli and instructed participants to either suppress their emotional behavior or to watch the stimuli without regulating the emotion. All studies used functional magnetic resonance imaging (fMRI). Expressive suppression yielded increased activation in frontal and parietal regions, especially in the right dorsolateral prefrontal cortex and bilateral inferior parietal cortex, compared to a non-regulation condition. Results of amygdala activation were inconsistent with different studies showing an increase, decrease, or no difference in activation during expressive suppression versus the non-regulation contrast condition. The thesis ends with a discussion of methodological issues and future directions.

Researchers have categorized emotion regulation strategies generally as adaptive or maladaptive, depending on impacts of the strategy on psychophysiological, cognitive, and emotional outcomes. A strategy that is widely considered to be maladaptive is expressive suppression, which refers to inhibiting one’s facial expression, to appear neutral. Another emotion regulation strategy that is commonly used but infrequently studied is expressive dissonance, which refers to showing the opposite of how one feels. There is limited research on expressive dissonance, but the longstanding facial feedback hypothesis suggests that facial expressions can further enhance or lower one’s mood; if this is the case, then smiling, even when feeling anxious, may be more adaptive than showing no emotion at all. The objective of my thesis was to examine whether using expressive dissonance was more adaptive than expressive suppression, for regulating negative emotions. To determine adaptiveness, I examined the effect of these two strategies on both intrapersonal factors (i.e., impacts of the strategy on one’s own psychophysiology, memory accuracy, and affect) and interpersonal factors (i.e., impacts of the strategy on social qualities like friendliness and likeability). In the first study, I tested the intrapersonal impacts of expressive suppression and expressive dissonance, compared to a control condition, while women participants (n = 144) viewed negatively arousing images. In the second study, I expanded on the first study by examining intrapersonal and interpersonal qualities (e.g., friendliness, likeability, warmth), in an ecologically valid context (i.e., a conversation with an unacquainted opposite gender confederate). Across both studies, I found no effect of strategy on intrapersonal factors; however, there were effects on interpersonal factors in Study 2. Participants engaging in expressive dissonance were rated more positively, and people in the expressive suppression condition were rated more negatively on interpersonal qualities, relative to the control condition. Taken together, our findings suggest that neither strategy impacted the participant intrapersonally, but both strategies influenced the observer’s impression of the participant. Based on the findings, I encourage a shift from conceptualizing strategies as overall maladaptive or adaptive, to considering specific strategies as helpful or unhelpful based on the regulation’s goal.

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Social anxiety and depression are commonly comorbid, and together they result in greater functional impairment and a poorer prognosis than when either condition occurs alone. Although the onset of social anxiety precedes the development of depression in the large majority of comorbid cases, little research has directly examined factors that contribute to the occurrence of depression in individuals with social anxiety. Theoretical models implicate emotion and emotion regulation in the development and maintenance of internalizing disorders. Emotion regulation research has predominantly focused on expressive suppression (ES), the suppression of outward emotion, and cognitive reappraisal (CR), the modification of cognitions to manage emotion. Social anxiety and depression are both characterized by maladaptive patterns of emotion regulation, exhibiting an overreliance on ES and an underutilization of CR. The present study investigated the role of emotion regulation, specifically ES and CR, in the relationship between social anxiety and depression over time. Our primary aim was to evaluate ES and CR, separately, as mediators of the relationship between social anxiety and depression. Our secondary aim was to evaluate additional mediating and/or moderating effects of related variables (i.e., relationship quality, positive and negative affect, and reward sensitivity). Our final exploratory aim was to evaluate whether emotion regulation (i.e., ES and CR) for positive emotions differs from emotion regulation for negative emotions in the relationships proposed by our primary and secondary aims. Undergraduate participants (N=137) completed an in-person laboratory session (i.e., baseline), followed by a 14-day daily diary period. During the daily diary period, participants reported on their daily experiences of social anxiety, depressed mood, emotion, emotion regulation, and relationship quality. Approximately two weeks after the end of the daily diary period (i.e., four weeks after baseline), participants completed a final in-person laboratory session (i.e., endpoint). Multilevel modeling was used to analyze observation-level data over the two-week diary period, and bootstrapping methods were used for person-level analyses over the full four-week study period. Daily diary analyses failed to support the hypothesized mediation models. Average social anxiety across the daily diary period was positively associated with daily depressed mood, but observation-level social anxiety was not. Exploratory analyses revealed affect-specific effects of emotion regulation, such that higher perceived success in ES (i.e., daily ES self-efficacy) for positive affect and less frequent use of CR (i.e., daily CR frequency) for negative affect significantly predicted higher next-day depressed mood. Person-level analyses across the four-week study period yielded some support for our hypotheses, in that ES frequency and positive affect acted as sequential mediators of the relationship between social anxiety and depression. Higher social anxiety predicted more frequent ES, which predicted lower positive affect, which then predicted higher depression. However, the mediation model was no longer significant after controlling for baseline depression. Our results highlight the role of emotion dysregulation in predicting depression and provide initial support for the mediating effects of ES and CR in the relationship between social anxiety and depression. These findings also emphasize the importance of investigating affect-specific effects, with particular attention paid to emotion regulation for positive affect and its role in the co-occurrence of social anxiety and depression. Future research would benefit from longitudinal studies across longer time periods and examining these relationships within a clinical sample. / Psychology

La forte prévalence des conduites alimentaires à risque (CAAR), par exemple la restriction alimentaire, les vomissements auto-induits ainsi que les crises d’hyperphagie boulimique de sévérité non diagnostique, et les conséquences importantes qu’elles peuvent entraîner ont amené les chercheurs à vouloir mieux comprendre les facteurs impliqués dans leur développement. Cette thèse s’intéresse à un phénomène à la base d’un nombre grandissant de théories sur les CAAR : la régulation émotionnelle. Le premier article se concentre sur le concept d’alexithymie, un trait de personnalité jouant un rôle clé dans la régulation émotionnelle ainsi que le développement, le maintien et la rechute des CAAR. Bien que l’association entre l’alexithymie et les CAAR soit bien établie, les études n’offrent pas d’explication quant aux facteurs qui contribuent à l’apparition de traits de personnalité alexithymiques qui, à leur tour, placent l’individu à risque de développer des CAAR. En explorant la documentation scientifique disponible, il est possible de constater que plusieurs psychanalystes ont autrefois proposé des concepts pour expliquer le développement de l’alexithymie (p. ex. refoulement primaire, expérience non formulée, déni), mais ces théories ont rarement fait l’objet d’études empiriques. L’objectif du premier article est donc de tester ces modèles en utilisant deux stratégies de régulation émotionnelle provenant du modèle de James J. Gross, soit la suppression expressive et la réévaluation cognitive. Un échantillon de 292 femmes provenant majoritairement d’une population non clinique universitaire a complété le Toronto Alexithymia Scale-20 items, le Emotion Regulation Questionnaire et le Eating Disorder Inventory-2. Les résultats des médiations proposent que la suppression expressive prédit positivement les traits de personnalité alexithymiques, ce qui prédit positivement les CAAR. Inversement, la réévaluation cognitive prédit négativement les traits de personnalité alexithymiques, ce qui prédit ensuite négativement les CAAR. Ces résultats suggèrent qu’il pourrait être pertinent d’intervenir sur certains mécanismes potentiellement précurseurs de l’alexithymie afin de favoriser la diminution d’agirs comportementaux comme les CAAR. Les résultats de cette première étude ouvrent la réflexion sur des pistes d’intervention concrètes pouvant être mises en application auprès des personnes souffrant de CAAR. En effet, les résultats de cette thèse suggèrent qu’il pourrait être important d’aider l’individu à diminuer l’évitement/la suppression de ses émotions pour plutôt encourager leur exploration. Il est possible d’émettre l’hypothèse que ce type d’intervention permettrait, avec le temps, la diminution des traits alexithymiques, ceci en favorisant la formation de représentations mentales des émotions. Conséquemment, la diminution de décharges somatiques comme les CAAR pourrait s’en suivre. L’implication des résultats pour les thérapies de différentes approches (p.ex. psychodynamique, cognitivo-comportementale et basée sur la mentalisation) est ensuite discutée. Afin de préciser l’étude de la régulation émotionnelle dans les CAAR, le second article a pour but d’identifier les émotions jouant un rôle particulier au sein de ces comportements. Pour ce faire, cet article, qui comprend deux études, s’intéresse aux liens entre les catégories émotionnelles distinctes du modèle des émotions différentielles d’Izard (p. ex. tristesse, joie) et les CAAR. La première étude a pour objectif d’explorer l’association entre les émotions-traits et les conduites alimentaires de recherche de minceur et boulimiques. Un total de 244 femmes provenant en majorité d’une population non clinique universitaire a complété le Eating Disorder Inventory-2 et le Differential Emotion Scale-trait version. Les analyses de régression démontrent que le modèle d’Izard prédit significativement les conduites de recherche de minceur et boulimiques. La contribution unique de chaque émotion-trait est ensuite étudiée. Les résultats indiquent que la honte est la seule émotion qui reste un prédicteur significatif des conduites de recherche de minceur et que seuls la culpabilité, le mépris et l’hostilité dirigée contre soi demeurent des prédicteurs significatifs des comportements boulimiques. Pour sa part, la seconde étude a pour but d’explorer l’association entre les émotions-états et les CAAR. Un total de 155 participantes provenant de l’échantillon de la première étude a complété un questionnaire leur demandant de rapporter par écrit un comportement de restriction ou de boulimie ayant eu lieu dans le passé. Elles ont ensuite complété le Differential Emotion Scale-state version. Les analyses descriptives démontrent que nonobstant la nature du comportement, la tristesse est l’émotion vécue la plus intensément par les participantes avant l’épisode rapporté. De plus, une comparaison de groupes a révélé que les personnes ayant décrit un épisode de boulimie ressentent significativement moins de joie et d’intérêt avant l’épisode que celles ayant rapporté un comportement restrictif. En résumé, les résultats suggèrent tout d’abord que les émotions négatives semblent jouer un rôle important au sein des CAAR. En ce sens, cet article appuie les recommandations de certains chercheurs à l’effet que l’intervention auprès des personnes ayant des CAAR nécessite d’inclure des volets dédiés à la régulation des émotions. Toutefois, ces études vont encore plus loin en proposant qu’il pourrait être pertinent de développer des interventions ciblées et concrètes permettant la gestion d’émotions ou de patrons d’émotions qui jouent un rôle prédominant auprès des différents CAAR. / The high prevalence of disordered eating (DE), for example food restriction, selfinduced vomiting or binge eating that are not of diagnostic severity, and the important consequences that they can entail have led researchers to further investigate the premorbid factors involved in them. The present thesis is interested in a phenomenon that is the basis of a growing body of theories on DE: emotion regulation. The first paper focuses on the concept of alexithymia, a personality trait that plays a key role in emotion regulation as well as in the development, maintenance, and relapse of DE symptoms. Although the association between alexithymia and DE is well established, current studies offer no explanation as to what factors contribute to the development of alexithymic personality traits, which in turn puts the individual at risk for DE. Several psychoanalysts have offered theoretical concepts to explain the development of alexithymia (e.g. primary repression, unformulated experience, denial), but these have not been submitted to empirical studies. The aim of the first study is to test these theories using two empirically established emotion regulation strategies taken from James J. Gross's model, namely expressive suppression and cognitive reappraisal. A sample of 292 women, the majority being undergraduated students, completed the Toronto Alexithymia Scale-20 items, the Emotion Regulation Questionnaire, and the Eating Disorder Inventory-2. The results of the mediation analyzes suggest that expressive suppression significantly and positively predicts alexithymic personality traits, which positively predicts DE. Inversely, cognitive reappraisal negatively predicts alexithymic personality traits, which then negatively predicts DE. These results suggest that it could be important to intervene on certain mechanisms that are potential precursors of alexithymia in order to promote the reduction of DE. More specifically, the results of this first study open up reflection on concrete lines of intervention that could be applied to vii people suffering from DE. Indeed, the results propose that it could be beneficial to encourage these individuals to explore their emotions rather then to avoid / suppress them. It can be hypothesised that these types of intervention will allow, over time, the reduction of alexithymic traits by promoting the formation of mental representations of emotions. Consequently, it is possible that the decrease in somatic discharges such as DE will follow. The implication of the results for different therapeutic approaches (psychodynamic, cognitive behavioral and mentalization-based) is then discussed. In order to further clarify the role of emotional regulation in DE, the second paper aims to identify emotions that play a key role in the disorder. This article, divided into two studies, focuses on the association between distinct emotional categories from Izard's differential emotions theory (e.g. sadness, joy) and pathological eating. The first study explores the relationship between trait-emotions and DE. A total of 244 women, the greater part being undergraduated students, completed the Eating Disorder Inventory-2 and the Differential Emotion Scale-trait version. Regression analyzes show that Izard's model significantly predicts both drive for thinness and bulimic behaviors. The unique contribution of each trait-emotion is then explored. The results indicate that shame is the only emotion that remains a significant predictor of drive for thinness and that only guilt, contempt and self-directed hostility remain significant predictors of bulimic behavior. As for the second study, a total of 155 participants coming from the first study sample completed a questionnaire asking them to report in writing an episode of restriction or bulimia that occurred in the recent past. They then completed the Differential Emotion Scale-state version. Descriptive analyzes reveal that regardless of the kind of DE, sadness is the emotion experienced most intensely by the participants before the reported episode. Furthermore, group comparisons indicate that people who report a bulimic episode felt viii significantly less joy and interest before the event than those who recalled a restrictive behavior. In summary, the results first suggest that people with DE experience more negative emotions on a daily basis. Thereby, this article supports the recommendations of certain researchers suggesting that interventions with people exhibiting DE should include components dedicated to the regulation of emotions. Moreover, these studies go even further by suggesting that it could be relevant to develop targets and concrete interventions allowing the regulation of specific emotions or patterns of emotions, which could play a predominant role with the various DE.