Impact of Rumination on Cognitive Reappraisal Neural Activity in Social Anxiety and Major Depression

Major depressive disorder (MDD) and social anxiety disorder (SAD) are highly prevalent internalizing disorders characterized by poor emotion regulation. Both disorders are associated with high use of maladaptive emotion regulation approaches (e.g., rumination) and low use of adaptive regulation approaches (e.g., reappraisal). Emerging research indicates that rumination may interfere with cognitive reappraisal; yet, the impact of rumination on brain response during reappraisal is under-researched. We hypothesized that individuals with MDD or SAD would exhibit elevated levels of rumination and report less reappraisal than a healthy control (HC) group and predicted that these two emotion regulation strategies would be negatively correlated in the diagnostic groups. Additionally, we expected that self-reported rumination would correspond with activity in prefrontal cognitive control regions implicated in reappraisal. To test hypotheses, self-reported rumination and reappraisal from diagnostic groups [MDD (n = 60), SAD (n = 50), HC (n = 38)] were submitted to analyses of variance (ANOVAs). Partial correlations were conducted within the clinical groups controlling for symptom severity to evaluate the relationships between these two types of emotion regulation strategies. During fMRI, participants completed a validated emotion regulation task which involved reappraising (i.e., decreasing negative affect) as compared to viewing aversive images. Regression analysis was used to investigate whether self-reported rumination modulated activity in brain regions implicated in cognitive reappraisal during reappraisal. ANOVA results showed MDD and SAD groups exhibited elevated levels of rumination relative to the HC group, whereas reappraisal was lower among the clinical groups compared to the HC group. MDD and SAD groups reported similar levels of rumination and reappraisal. Partial correlations did not reveal an association between self-reported rumination and reappraisal. Thus, hypotheses were partially supported. Finally, fMRI analysis showed self-reported rumination modulated dorsolateral prefrontal cortex activity during reappraisal among the clinical groups (MDD, SAD), such that higher levels of rumination were associated with less dorsolateral prefrontal cortex activation. In line with our hypotheses, neuroimaging results suggest that rumination, a maladaptive cognitive strategy, may interfere with more adaptive forms of emotion regulation. Findings have the potential to increase our understanding of emotion regulation in MDD and SAD and inform interventions.