Background: Successful emotion regulation is a critical component of psychological health. One of the most effective emotion regulation strategies, “cognitive reappraisal”, consists of adjusting the way a situation is perceived to alter its emotional response. Extant literature suggests that cognitive reappraisal is not only effective for reducing negative affect in subclinical populations but is also a component of clinical interventions like cognitive-behavioral therapies. Nonetheless, concerns have been raised about the efficacy of cognitive reappraisal in situations of high distress. We tested whether general emotional distress symptom severity and pre-emotion regulation distress moderates the efficacy of cognitive reappraisal (vs. expressive writing) in predicting post-regulation distress. Methods: We recruited a sample of adults (N=2,449), representative of the U.S. on age, sex assigned at birth, and race-ethnicity. After describing a recently upsetting event, participants were randomized to reappraisal or expressive writing conditions. Distress symptoms were measured with the K6 and pre- and post-regulation distress were measured with a 100-point visual analogue scale. Results: Higher levels of both pre-regulation distress and general emotional distress were positively associated with higher levels of post-emotion regulation distress. However, there was no interaction with condition and either distress variable in predicting post-regulation distress. Conclusion: Despite a large and representative sample, we did not find that cognitive reappraisal is less effective than a comparator when distress is elevated. These findings suggest that cognitive reappraisal may be efficacious even at heightened levels of distress.
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