Cultivating Emotion Regulation and Mental Health

December 16, 2019 in Blog

The ability to regulate our emotions is essential to reaching our goals and feeling mentally healthy. Since this is such an important topic, I was delighted to get a chance to interview Dr. Susanne Schweizer, a Sir Henry Wellcome fellow at the UCL Institute of Cognitive Neuroscience. Dr. Schweizer studies the role of cognitive processes (e.g., emotion regulation) and their neural substrates in the development and maintenance of common mental health problems across the lifespan, with a particular focus on adolescence. Adopting a translational perspective, Dr. Schweizer applies insights from basic developmental cognitive neuroscience to design novel interventions for mental health problems including depression and posttraumatic stress disorder. Before moving to UCL she completed her PhD as a Gates Scholar and later postdoc at the University of Cambridge.

How did you become interested in emotion regulation?

Credit: Susanne Schweizer

My interest was sparked a decade ago. I spent a summer working with the late Professor Nolen-Hoeksema in the Department of Psychology at Yale University. Part of my job was to read about emotion regulation. What I was struck by then was the pervasiveness of emotion regulation difficulties across different types of mental health problems from depression to eating disorders. This sense was brought home the following spring, which I spent completing my clinical internship on an acute closed psychiatric ward. It didn’t seem to matter what the disorder was – every form of psychopathology appeared to be accompanied by a breakdown in the ability to regulate emotions and mood. This was fascinating to me and I needed to understand what was causing these problems in emotion regulation. So I went to do a PhD with one of the world’s foremost experts on mood and emotions in mental health, Professor Tim Dalgleish at the University of Cambridge’s MRC Cognition and Brain Sciences Unit.

What can the brain tell you about emotion regulation?

Just a couple of years before I started my PhD, James Gross at Stanford and Kevin Ochsner at NYU developed their influential neuroscientific account of emotion regulation. Their model proposed that successful emotion regulation relies on cognitive control. Cognitive control refers to our ability to attend to information that is relevant to our goals, while ignoring distracting information. Their reason for suggesting this was accumulating evidence from brain imaging studies, which showed that the brain regions that are recruited during cognitive control overlapped with the brain regions involved in emotion regulation. This was particularly interesting to me because we know that this cognitive control capacity is reduced in individuals who suffer from mental health problems.

The question “How does our cognitive control capacity interact with our affective experiences?” became the focus of my work. Professor Dalgleish and I showed that when people’s ability to exert cognitive control in emotional contexts improved by training with basic computerized tasks, their ability to regulate their emotions also improved. Not only did participants report becoming better able to downregulate their distress to aversive films after our training but there were also changes in their brains. Specifically, the improved emotion regulation ability following the training was associated with changes in activation of a region of the brain called the ventrolateral prefrontal cortex. Previous work had shown that this region is critical to deploying cognitive control in affective contexts. Our initial work was carried out with healthy individuals but since then we have taken the training to clinical populations including posttraumatic stress disorder and showed similar benefits in emotion regulation. Based on this work I became interested in whether we could prevent emotion regulation difficulties from appearing in the first place, but to do this I needed to understand how emotion regulation develops.

How does emotion regulation develop across the lifespan?

There is robust evidence that emotion regulation rapidly improves during early childhood. Less is known, however, about the development of emotion regulation in adolescence and beyond. To explore this, I joined world-renown developmental cognitive neuroscientist Professor Sarah-Jayne Blakemore and her research group who study adolescent development at University College London’s Institute of Cognitive Neuroscience. Together we have been looking at age-related differences in the cognitive building blocks that underlie successful emotion regulation. That is, we study how adolescents and adults differ in their ability to exert cognitive control in emotional compared to neutral contexts. To study this we ask individuals to do cognitively demanding tasks, such as remembering numbers that are presented one after another in working memory. To manipulate emotional context we present these numbers over neutral or emotional background images. We found that the impact of emotional information on performance is associated with adolescents’ mental health, particularly in early adolescence (11-14 years). This means, the more difficulty adolescents have performing working memory tasks in emotional relative to neutral contexts, the more mental health difficulties they experience at an early age.

However, these cross-sectional studies don’t tell us anything about development of emotion regulation ability across time. For example, we don’t know whether these underlying abilities remain stable within an individual or improve with age. Or whether they fluctuate from day to day or even moment to moment? To study this we have developed a citizen science app – the Emotional Brain Study app.

How do you study emotion regulation with a citizen science app and what is citizen science?

The idea behind citizen science is that science and science policy are made open and accessible to the public. Citizen science ensures that science remains responsive to society’s concerns and needs, and acknowledges that anyone in society can themselves produce reliable scientific knowledge. In the case of our app, we ask the general public to help us study emotion regulation development and its association with mood across the lifespan. By providing us with very basic information about themselves and playing games on the app, individuals who use the app become ‘citizen scientists’. Within the app they first record their current mood as well as what they are doing that moment in time, and they then play any one of five games. These games tap into the cognitive functions that underlie successful emotion regulation. Specifically, they test memory, attention and other complex cognitive functions in the context of emotional and neutral information. The scientific data this citizen science project creates will allow us to start modelling how the cognitive control of emotions develops across the lifespan and how it might fluctuate within individuals. This is invaluable information that will improve our understanding of the basic cognitive functions underlying successful emotion regulation and, by extension, good mental health.

What can app-based research tell us that lab-based research can’t?

From our lab-based work we know that individuals who suffer from or who are at-risk for mental health problems find playing these games harder in emotional compared to neutral contexts. However, we know very little about how these functions relate to every day mood and moment-to-moment mood fluctuations. Gathering larger scale data on the association between performance on these games and mood using our app will allow us to explore these relationships and detect potential avenues for intervention. That means we will be able to optimize our training protocols to improve emotion regulation, hopefully before people even start experiencing mental health problems related to poor emotion regulation.

How will this research help those who struggle with emotion regulation or even mental health problems?

Imagine a scenario where regular digital mental health and cognition check-ups become common place. Symptoms can be recorded on apps and the types of game included in our app can be played to measure changes in cognitive functioning. Changes can indicate cognitive improvement or decline. Adding an affective dimension to the games, we may find that they can also help us discover when our abilities to regulate our emotions may be optimal or on the contrary start to become impaired. We can start tracking what improves/reduces our emotion regulation capacity. However, for these games to realize their prognostic potential we need to ensure they are reliable markers of emotion regulation and data from our Emotional Brain Study app will help us do exactly that. The more people use our app regularly, the more data we will have and the finer-grained the data modelling and validation we will be able to do when exploring the association between cognition, emotion regulation and mood across the lifespan. These are new frontiers for mental health researchers who study mental health from a developmental cognitive neuroscience perspective. Results from these new avenues of research will hopefully bring much needed improvements to our existing means of preventing and treating mental health problems.

For more, see:

Emotional Brain Study 

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Follow Dr. Susanne Schweizer on twitter

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