Training in cognitive reappraisal normalizes whole-brain indices of emotion regulation in borderline personality disorder.

BACKGROUND: Borderline personality disorder is the prototypical disorder of emotion dysregulation. We have previously shown that borderline personality disorder patients are impaired in their capacity to engage cognitive reappraisal, a frequently-employed adaptive emotion regulation strategy. METHODS: Here we report on the efficacy of longitudinal training in cognitive reappraisal to enhance emotion regulation in borderline patients. Specifically, the training targeted psychological distancing, a reappraisal tactic whereby negative stimuli are viewed dispassionately as though experienced by an objective, impartial observer. At each of 5 sessions over 2 weeks, 22 borderline (14 Female) and 22 healthy control (13 Female) participants received training in psychological distancing and then completed a widely-used picture-based reappraisal task. Self-reported negative affect ratings and functional magnetic resonance imaging (fMRI) data were acquired at the first and fifth sessions. In addition to behavioral analyses, we performed whole-brain pattern expression analyses using independently-defined patterns for negative affect and cognitive reappraisal implementation for each session. RESULTS: Borderline patients showed a decrease in negative affect pattern expression following reappraisal training, reflecting a normalization in neural activity. They did not, however, show significant change in behavioral self-reports. CONCLUSIONS: To our knowledge, this study represents the first longitudinal fMRI examination of task-based cognitive reappraisal training. Using a brief, proof-of-concept design, the results suggest a potential role for reappraisal training in the treatment of borderline patients.

Neural correlates of drinking reduction during a clinical trial of cognitive behavioral therapy for alcohol use disorder.

BACKGROUND: Cognitive behavioral therapy (CBT) is an effective treatment for alcohol use disorder (AUD). We hypothesized that the dorsolateral prefrontal cortex (DLPFC), a region implicated in cognitive control and goal-directed behavior, plays a role in behavior change during CBT by facilitating the regulation of craving (ROC). METHODS: Treatment-seeking participants with AUD (N = 22) underwent functional magnetic resonance imaging (fMRI) scanning both before and after a 12-week, single-arm trial of CBT, using an ROC task that was previously shown to engage the DLPFC. RESULTS: We found that both the percentage of heavy drinking days (PHDD) and the overall self-reported alcohol craving measured during the ROC task were significantly reduced from pre- to post-CBT. However, we did not find significant changes over time in either the ability to regulate craving or regulation-related activity in any brain region. We found a significant 3-way interaction between the effects of cue-induced craving, cue-induced brain activity and timepoint of assessment (pre- or post-CBT) on PHDD in the left DLPFC. Follow-up analysis showed that cue-induced craving was associated with cue-induced activity in the left DLPFC among participants who ceased heavy drinking during CBT, both at pre-CBT and post-CBT timepoints. No such associations were present at either timepoint among participants who continued to drink heavily. CONCLUSIONS: These results suggest that patients in whom DLPFC functioning is more strongly related to cue-induced craving may preferentially respond to CBT.

Estradiol effects on an emotional interference task in adolescents with current and remitted depression.

Attentional biases to emotional stimuli are thought to reflect vulnerability for mood disorder onset and maintenance. This study examined the association between the endogenous sex hormone estradiol and emotional attentional biases in adolescent females with either current or remitted depression. Three groups of participants (mean age ± SD) completed the Emotional Interrupt Task: 1) 20 adolescent females (15.1 ± 1.83 years) currently diagnosed with Major Depressive Disorder (MDD), 2) 16 adolescent females (16.4 ± 1.31 years) who had experienced at least one episode of MDD in their lifetime but currently met criteria for MDD in remission, and 3) 30 adolescent female (15.4 ± 1.83 years) healthy controls. Attentional interference (AI) scores were calculated as differences in target response reaction time between trials with emotional facial expressions versus neutral facial expressions. Estradiol levels were assayed by Salimetrics LLC using saliva samples collected within 30 min of waking on assessment days. Robust multiple regression with product terms evaluated estradiol's main effect on AI scores, as well as hypothesized estradiol × diagnostic group interactions. Although neither mean estradiol levels nor mean AI scores in the current-MDD and remitted-MDD groups differed from controls, the relationship between estradiol and overall AI score differed between control adolescents and the remitted-MDD group. Specifically, the remitted-MDD adolescents performed worse (i.e., showed greater attentional interference) when they had higher estradiol; no significant relationship existed in the current-MDD group. Because this finding was driven by angry and not happy stimuli, it appears higher estradiol levels were associated with greater susceptibility to the attention-capturing effects of negatively-valenced emotional content in girls at risk for MDD from prior history.

Frontoparietal functional connectivity moderates the link between time spent on social media and subsequent negative affect in daily life.

Evidence on the harms and benefits of social media use is mixed, in part because the effects of social media on well-being depend on a variety of individual difference moderators. Here, we explored potential neural moderators of the link between time spent on social media and subsequent negative affect. We specifically focused on the strength of correlation among brain regions within the frontoparietal system, previously associated with the top-down cognitive control of attention and emotion. Participants (N = 54) underwent a resting state functional magnetic resonance imaging scan. Participants then completed 28 days of ecological momentary assessment and answered questions about social media use and negative affect, twice a day. Participants who spent more than their typical amount of time on social media since the previous time point reported feeling more negative at the present moment. This within-person temporal association between social media use and negative affect was mainly driven by individuals with lower resting state functional connectivity within the frontoparietal system. By contrast, time spent on social media did not predict subsequent affect for individuals with higher frontoparietal functional connectivity. Our results highlight the moderating role of individual functional neural connectivity in the relationship between social media and affect.

Psychological distance intervention reminders reduce alcohol consumption frequency in daily life.

Modifying behaviors, such as alcohol consumption, is difficult. Creating psychological distance between unhealthy triggers and one's present experience can encourage change. Using two multisite, randomized experiments, we examine whether theory-driven strategies to create psychological distance-mindfulness and perspective-taking-can change drinking behaviors among young adults without alcohol dependence via a 28-day smartphone intervention (Study 1, N = 108 participants, 5492 observations; Study 2, N = 218 participants, 9994 observations). Study 2 presents a close replication with a fully remote delivery during the COVID-19 pandemic. During weeks when they received twice-a-day intervention reminders, individuals in the distancing interventions reported drinking less frequently than on control weeks-directionally in Study 1, and significantly in Study 2. Intervention reminders reduced drinking frequency but did not impact amount. We find that smartphone-based mindfulness and perspective-taking interventions, aimed to create psychological distance, can change behavior. This approach requires repeated reminders, which can be delivered via smartphones.

The Road Not Taken: Disconnection of a Human-Unique Cortical Pathway Underlying Naturalistic Social Perception in Schizophrenia.

Background: Efficient processing of complex and dynamic social scenes relies on intact connectivity of many underlying cortical areas and networks, but how connectivity anomalies affect the neural substrates of social perception remains unknown. Here we measured these relationships using functionally based localization of social perception areas, resting-state functional connectivity, and movie-watching data. Methods: In 42 participants with schizophrenia (SzPs) and 41 healthy control subjects, we measured the functional connectivity of areas localized by face-emotion processing, theory-of-mind (ToM), and attention tasks. We quantified the weighted shortest path length between visual and medial prefrontal ToM areas in both populations to assess the impact of these changes in functional connectivity on network structure. We then correlated connectivity along the shortest path in each group with movie-evoked activity in a key node of the ToM network (posterior temporoparietal junction [TPJp]). Results: SzPs had pronounced decreases in connectivity in TPJ/posterior superior temporal sulcus (TPJ-pSTS) areas involved in face-emotion processing (t81 = 4.4, p = .00002). In healthy control subjects, the shortest path connecting visual and medial prefrontal ToM areas passed through TPJ-pSTS, whereas in SzPs, the shortest path passed through the prefrontal cortex. While movie-evoked TPJp activity correlated with connectivity along the TPJ-pSTS pathway in both groups (r = 0.43, p = .002), it additionally correlated with connectivity along the prefrontal cortex pathway only in SzPs (rSzP = 0.56, p = .003). Conclusions: These results suggest that connectivity along the human-unique TPJ-pSTS pathway affects both the network architecture and functioning of areas involved in processing complex dynamic social scenes. These results demonstrate how focal connectivity anomalies can have widespread impacts across the cortex.

Fluency generating emotion words correlates with verbal measures but not emotion regulation, alexithymia, or depressive symptoms.

How do you feel? To answer this question, one must first think of potential emotion words before choosing the best fit. However, we have little insight into how the ability to rapidly bring to mind emotion words-emotion fluency-relates to emotion functioning or general verbal abilities. In this study, we measured emotion fluency by counting how many emotion words participants could generate in 60 s. Participants (N = 151 in 2011-2012) also completed a behavioral measure of verbal fluency (i.e., how many words starting with "P" or "J" participants could produce in 60 s), a cognitive reappraisal emotion regulation task, and emotion functioning questionnaires. In preregistered analyses, we found that participants produced more negative emotion words than positive words and more positive words than neutral words in the emotion fluency task. As hypothesized, emotion fluency was positively related to verbal fluency, but contrary to hypotheses, emotion fluency was not related to self-reported or task-based emotion functioning (e.g., alexithymia, depression, and emotion regulation ability). As such, in community samples, emotion fluency may reflect general cognitive abilities rather than processes crucial to emotional well-being. While emotion fluency as measured here does not track indices of well-being, future research is needed to investigate potential contexts in which verbal fluency for emotion words may be key to emotion regulation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Within-Person Temporal Associations Among Self-Reported Physical Activity, Sleep, and Well-Being in College Students.

OBJECTIVE: A holistic understanding of the naturalistic dynamics among physical activity, sleep, emotions, and purpose in life as part of a system reflecting wellness is key to promoting well-being. The main aim of this study was to examine the day-to-day dynamics within this wellness system. METHODS: Using self-reported emotions (happiness, sadness, anger, anxiousness) and physical activity periods collected twice per day, and daily reports of sleep and purpose in life via smartphone experience sampling, more than 28 days as college students ( n = 226 young adults; mean [standard deviation] = 20.2 [1.7] years) went about their daily lives, we examined day-to-day temporal and contemporaneous dynamics using multilevel vector autoregressive models that consider the network of wellness together. RESULTS: Network analyses revealed that higher physical activity on a given day predicted an increase of happiness the next day. Higher sleep quality on a given night predicted a decrease in negative emotions the next day, and higher purpose in life predicted decreased negative emotions up to 2 days later. Nodes with the highest centrality were sadness, anxiety, and happiness in the temporal network and purpose in life, anxiety, and anger in the contemporaneous network. CONCLUSIONS: Although the effects of sleep and physical activity on emotions and purpose in life may be shorter term, a sense of purpose in life is a critical component of wellness that can have slightly longer effects, bleeding into the next few days. High-arousal emotions and purpose in life are central to motivating people into action, which can lead to behavior change.

Dense Sampling Approaches for Psychiatry Research: Combining Scanners and Smartphones.

Together, data from brain scanners and smartphones have sufficient coverage of biology, psychology, and environment to articulate between-person differences in the interplay within and across biological, psychological, and environmental systems thought to underlie psychopathology. An important next step is to develop frameworks that combine these two modalities in ways that leverage their coverage across layers of human experience to have maximum impact on our understanding and treatment of psychopathology. We review literature published in the last 3 years highlighting how scanners and smartphones have been combined to date, outline and discuss the strengths and weaknesses of existing approaches, and sketch a network science framework heretofore underrepresented in work combining scanners and smartphones that can push forward our understanding of health and disease.

Mindful attention promotes control of brain network dynamics for self-regulation and discontinues the past from the present.

Mindful attention is characterized by acknowledging the present experience as a transient mental event. Early stages of mindfulness practice may require greater neural effort for later efficiency. Early effort may self-regulate behavior and focalize the present, but this understanding lacks a computational explanation. Here we used network control theory as a model of how external control inputs-operationalizing effort-distribute changes in neural activity evoked during mindful attention across the white matter network. We hypothesized that individuals with greater network controllability, thereby efficiently distributing control inputs, effectively self-regulate behavior. We further hypothesized that brain regions that utilize greater control input exhibit shorter intrinsic timescales of neural activity. Shorter timescales characterize quickly discontinuing past processing to focalize the present. We tested these hypotheses in a randomized controlled study that primed participants to either mindfully respond or naturally react to alcohol cues during fMRI and administered text reminders and measurements of alcohol consumption during 4 wk postscan. We found that participants with greater network controllability moderated alcohol consumption. Mindful regulation of alcohol cues, compared to one's own natural reactions, reduced craving, but craving did not differ from the baseline group. Mindful regulation of alcohol cues, compared to the natural reactions of the baseline group, involved more-effortful control of neural dynamics across cognitive control and attention subnetworks. This effort persisted in the natural reactions of the mindful group compared to the baseline group. More-effortful neural states had shorter timescales than less effortful states, offering an explanation for how mindful attention promotes being present.

The Temporal Dynamics of Emotion Regulation in Subjects With Major Depression and Healthy Control Subjects.

BACKGROUND: Emotion regulation (ER) processes help support well-being, but ineffective ER is implicated in several psychiatric disorders. Engaging ER flexibly by going online and offline as needs and capacities shift may be more effective than engaging ER rigidly across time. Here, we sought to observe the neural temporal dynamics of an ER process, reappraisal, during regulation of responses to negative memories in healthy control subjects (n = 33) and subjects with major depressive disorder (n = 36). METHODS: To track the temporal dynamics of reappraisal neural systems, we used a functional magnetic resonance imaging neural decoding approach. In task 1, subjects explicitly engaged reappraisal on instruction in response to aversive images, and we used this task to develop the decoder for detecting reappraisal. In task 2, subjects experienced negative autobiographical memories from a distant (third person, ER condition) or immersed (first person, control condition) perspective. RESULTS: The neural decoder, trained to detect reappraisal in task 1, predicted greater reappraisal occurring during the task 2 distance versus immerse trials and was engaged more intensely during memories that were rated as being more negative. Across time, decoder output manifested a temporal dynamic of early engagement followed by disengagement. These results were replicated in an independent subject dataset (n = 59). Relative to healthy control subjects, subjects with major depressive disorder had a comparable initial increase in decoder engagement at the beginning of the trial but an attenuated decrease at the end. CONCLUSIONS: Subjects with major depressive disorder evidenced a more rigid neural dynamic of reappraisal compared with healthy control subjects. Rigid ER may indicate diminished ability to flexibly and effectively regulate emotion.

Controllability of Structural Brain Networks and the Waxing and Waning of Negative Affect in Daily Life.

Background: The waxing and waning of negative affect in daily life is normative, reflecting an adaptive capacity to respond flexibly to changing circumstances. However, understanding of the brain structure correlates of affective variability in naturalistic settings has been limited. Using network control theory, we examine facets of brain structure that may enable negative affect variability in daily life. Methods: We used diffusion-weighted imaging data from 95 young adults (age [in years]: mean = 20.19, SD = 1.80; 56 women) to construct structural connectivity networks that map white matter fiber connections between 200 cortical and 14 subcortical regions. We applied network control theory to these structural networks to estimate the degree to which each brain region's pattern of structural connectivity facilitates the spread of activity to other brain systems. We examined how the average controllability of functional brain systems relates to negative affect variability, computed by taking the standard deviation of negative affect self-reports collected via smartphone-based experience sampling twice per day over 28 days as participants went about their daily lives. Results: We found that high average controllability of the cingulo-insular system is associated with increased negative affect variability. We also found that greater negative affect variability is related to the presence of more depressive symptoms, yet average controllability of the cingulo-insular system was not associated with depressive symptoms. Conclusions: Our results highlight the role that brain structure plays in affective dynamics as observed in the context of daily life, suggesting that average controllability of the cingulo-insular system promotes normative negative affect variability.

Trait Intolerance of Uncertainty Is Associated with Decreased Reappraisal Capacity and Increased Suppression Tendency.

The COVID-19 pandemic has been a time of great uncertainty for the general population and highlights the need to understand how attitudes towards uncertainty may affect well-being. Intolerance of uncertainty is a trait associated with worry, anxiety, and mood disorders. As adaptive emotion regulation supports well-being and mental health, it is possible that intolerance of uncertainty is also associated with the ability and tendency to regulate emotions. However, the relationships between intolerance of uncertainty and widely studied cognitive emotion regulation strategies - such as reappraisal and suppression - have received little attention. In two studies that recruited participants online from the United States, we tested the hypotheses that higher trait intolerance of uncertainty would be associated with greater worry, decreased capacity and tendency to use reappraisal, and increased tendency to use suppression in daily life. Study 1 provided an initial test of our hypotheses. Study 2 was a confirmatory, preregistered study that replicated findings in a young adult sample, demonstrating that scores on the Intolerance of Uncertainty Scale (IUS) were associated with greater COVID-related worry, decreased capacity to regulate negative emotions on a task that manipulated the use of reappraisal, and greater self-reported use of suppression in daily life. Together, these results indicate that intolerance of uncertainty is associated with the capacity and tendency to use emotion regulation strategies important for well-being. Supplementary Information: The online version contains supplementary material available at 10.1007/s42761-022-00115-8.

Brief training in regulation of craving reduces cigarette smoking.

INTRODUCTION: Craving is an important contributing factor in cigarette smoking and has been added as a diagnostic criterion for addiction in the DSM-5. Cognitive-behavioral therapy and other treatments that incorporate craving regulation strategies reduce smoking and the likelihood of relapse. Although this finding suggests that the regulation of craving is an important mechanism underlying smoking cessation, whether targeted interventions that train smokers to regulate craving can directly impact real-world smoking behaviors is unclear. METHOD: Across two pilot studies (N = 33; N = 60), we tested whether a brief, computer-delivered training session in the cognitive regulation of craving altered subsequent smoking behaviors in daily life. The study first randomly assigned participants to either a no training (control) group, or one of two Regulation of Craving Training (ROC-T) conditions. Next, all participants came into the lab and those assigned to ROC-T conditions were trained to implement a cognitive strategy to regulate their craving, by either focusing on the negative consequences of smoking, or by distracting themselves. Then, these participants underwent ROC-T during which they practiced using the strategy to regulate their craving during cue exposure. The study subsequently assessed participants' smoking via daily diaries for 3-6 days, and via self-report up to 1-month follow-up. RESULTS: Across both studies, ROC-T conditions were associated with significant reductions in average cigarettes smoked per day, with effects persisting through follow-up. CONCLUSION: These results confirm that the regulation of craving is an important mechanism of smoking cessation, and can be targeted via easily administered training procedures, such as ROC-T.

Failure to engage the temporoparietal junction/posterior superior temporal sulcus predicts impaired naturalistic social cognition in schizophrenia.

Schizophrenia is associated with marked impairments in social cognition. However, the neural correlates of these deficits remain unclear. Here we use naturalistic stimuli to examine the role of the right temporoparietal junction/posterior superior temporal sulcus (TPJ-pSTS)-an integrative hub for the cortical networks pertinent to the understanding complex social situations-in social inference, a key component of social cognition, in schizophrenia. Twenty-seven schizophrenia participants and 21 healthy control subjects watched a clip of the film The Good, the Bad and the Ugly while high resolution multiband functional MRI images were collected. We used inter-subject correlation to measure the evoked activity, which we then compared to social cognition as measured by The Awareness of Social Inference Test (TASIT). We also compared between groups the TPJ-pSTS blood oxygen level-dependent activity (i) relationship with the motion content in the film; (ii) synchronization with other cortical areas involved in the viewing of the movie; and (iii) relationship with the frequency of saccades made during the movie. Activation deficits were greatest in middle TPJ (TPJm) and correlated significantly with impaired TASIT performance across groups. Follow-up analyses of the TPJ-pSTS revealed decreased synchronization with other cortical areas, decreased correlation with the motion content of the movie, and decreased correlation with the saccades made during the movie. The functional impairment of the TPJm, a hub area in the middle of the TPJ-pSTS, predicts deficits in social inference in schizophrenia participants by disrupting the integration of visual motion processing into the TPJ. This disrupted integration then affects the use of the TPJ to guide saccades during the visual scanning of the movie clip. These findings suggest that the TPJ may be a treatment target for improving deficits in a key component of social cognition in schizophrenia participants.

Emotion Naming Impedes Both Cognitive Reappraisal and Mindful Acceptance Strategies of Emotion Regulation.

Friends and therapists often encourage people in distress to say how they feel (i.e., name their emotions) with the hope that identifying their emotions will help them cope. Although lay and some psychological theories posit that emotion naming should facilitate subsequent emotion regulation, there is little research directly testing this question. Here, we report on two experimental studies that test how naming the emotions evoked by aversive images impacts subsequent regulation of those emotions. In study 1 (N = 80), participants were randomly assigned into one of four between-subjects conditions in which they either (i) passively observed aversive images, (ii) named the emotions that these images made them feel, (iii) regulated their emotions by reappraising the meaning of images, or (iv) both named and regulated their emotions. Analyses of self-reported negative affect revealed that emotion naming impeded emotion regulation via reappraisal. Participants who named their emotions before reappraising reported feeling worse than those who regulated without naming. Study 2 (N = 60) replicated these findings in a within-participants design, demonstrated that emotion naming also impeded regulation via mindful acceptance, and showed that observed effects were unrelated to a measure of social desirability, thereby mitigating the concern of experimenter demand. Together, these studies show that the impact of emotion naming on emotion regulation opposes common intuitions: instead of facilitating emotion regulation via reappraisal or acceptance, constructing an instance of a specific emotion category by giving it a name may "crystalize" one's affective experience and make it more resistant to modification. Supplementary Information: The online version contains supplementary material available at 10.1007/s42761-021-00036-y.

Social emotion regulation strategies are differentially helpful for anxiety and sadness.

Little is understood about how emotion regulation strategies typically used to regulate one's own emotions can be used to help others in distress, a process we refer to as social emotion regulation. We integrated research on social support, the self-regulation of emotion, and appraisal theories to hypothesize that different kinds of support and emotion regulation strategies should be differentially helpful for others, depending on the kind of emotion they are experiencing. Specifically, we predicted that helping others to actively modify their situation, as opposed to their appraisals and emotional responses, will be more effective for those experiencing anxiety as anxiety is a response to appraising threat in one's environment. However, helping others to modify their appraisals and emotions should be more effective for those experiencing sadness as sadness is a response to an irrevocable loss. To test this, we created a novel paradigm in which regulation targets were recruited online to write about personal events causing anxiety or sadness and regulation providers were recruited to provide written help to the targets. Study 1 supported the hypothesis using strategies drawn from the social support literature (advice vs. emotional support). Study 2 used strategies drawn from the literature on the self-regulation of emotion (situation modification vs. reappraisal) to demonstrate that as predicted, different strategies are believed to be differentially helpful depending on the target's emotion and when adjusting for individual differences in social and affective functioning, targets judge social emotion regulation strategies to be differentially helpful when implemented by providers. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Emotion regulation across the life span.

Being able to flexibly regulate one's emotions is critical for adaptive functioning across the life span. The importance of emotion regulation for human cognition has been reflected in the marked increase in the amount of psychologic research on emotion and its regulation in the past two decades. In this chapter, we review theoretical and empirical advances in this research, with a particular focus on the neural bases of emotion regulation. We begin with a brief overview of the field at present and provide a general primer on the behavioral and neuroimaging methods used to study emotion regulation. We then outline the brain regions involved in both triggering and modulating affect, and how they may change throughout development and into old age. Finally, we conclude with a roadmap for the future study of emotion regulation, in particular focusing on how to integrate measures with high ecologic validity (e.g., experience sampling, social emotion regulation) with neuroimaging techniques.

Longitudinal changes in brain structures related to appetitive reactivity and regulation across development.

In the United States over one-third of the population, including children and adolescents, are overweight or obese. Despite the prevalence of obesity, few studies have examined how food cravings and the ability to regulate them change throughout development. Here, we addressed this gap in knowledge by examining structural brain and behavioral changes associated with regulation of craving across development. In a longitudinal design, individuals ages 6-26 completed two structural scans as well as a behavioral task where they used a cognitive regulatory strategy to decrease the appetitive value of foods. Behaviorally, we found that the ability to regulate craving improved with age. Neurally, improvements in regulatory ability were associated with cortical thinning in medial and lateral prefrontal cortex. We also found that models with cortical thickness measurements and age chosen by a lasso-based variable selection method could predict an individual's regulation behavior better than age and other behavioral factors alone. Additionally, when controlling for age, smaller ventral striatal volumes were associated with higher body mass index and predicted greater increases in weight two years later. Taken together, these results demonstrate a role for structural brain changes in supporting the ability to resist cravings for appetitive foods across development.

Let it be: mindful acceptance down-regulates pain and negative emotion.

Mindfulness training ameliorates clinical and self-report measures of depression and chronic pain, but its use as an emotion regulation strategy-in individuals who do not meditate-remains understudied. As such, whether it (i) down-regulates early affective brain processes or (ii) depends on cognitive control systems remains unclear. We exposed meditation-naïve participants to two kinds of stimuli: negative vs. neutral images and painful vs. warm temperatures. On alternating blocks, we asked participants to either react naturally or exercise mindful acceptance. Emotion regulation using mindful acceptance was associated with reductions in reported pain and negative affect, reduced amygdala responses to negative images and reduced heat-evoked responses in medial and lateral pain systems. Critically, mindful acceptance significantly reduced activity in a distributed, a priori neurologic signature that is sensitive and specific to experimentally induced pain. In addition, these changes occurred in the absence of detectable increases in prefrontal control systems. The findings support the idea that momentary mindful acceptance regulates emotional intensity by changing initial appraisals of the affective significance of stimuli, which has consequences for clinical treatment of pain and emotion.