Reappraisal is less effective than distraction in downregulation of neural responses to physical threats-An event-related potential investigation.

Evolutionary threats (ETs), such as predatory animals and heights, elicit stronger fear responses and are more often the subject of specific phobias, as compared to modern threats (MTs, such as guns and motorcycles). Since processing of ET depends on lower-order, phylogenetically conserved neural fear circuits, it may be less susceptible to higher-order (vs. simpler) cognitive emotion regulation. Given the relevance for treatment of specific phobias, we tested this hypothesis in an ERP study. Sixty-one female participants passively watched high- and low-threat pictures of evolutionary (snakes, lizards) and modern (guns, water-guns) origin, and downregulated responses to the high-threat pictures (snakes and guns) using either cognitive reappraisal or a simpler cognitive distraction strategy. ET elicited stronger early (EPN) and sustained (LPP) attention processing compared to MT. Both strategies successfully downregulated subjective and LPP (but not EPN) responses compared to passive watching. Although reappraisal was more effective subjectively, distraction downregulated the LPP earlier and stronger than reappraisal, irrespective of the threat type. These findings provide novel evidence that neural responses to physical threat might be less susceptible to cognitive emotion regulation via higher-order (reappraisal) versus simpler (distraction) strategies, irrespective of the evolutionary or modern relevance of threat. Combining both strategies could be beneficial for the emotion regulation-enhancing interventions for specific phobias. Distraction could be used during initial exposure, to reduce immediate emotion responding and help endure the contact with the feared stimulus, whereas reappraisal could be used subsequently, when emotions are less intense, to change maladaptive thoughts about the stimulus for future encounters.