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Rethinking Feelings: An fMRI Study of the

Cognitive Regulation of Emotion

Kevin N. Ochsner1, Silvia A. Bunge2, James J. Gross1, and


John D. E. Gabrieli1

Abstract
& The ability to cognitively regulate emotional responses to experience of negative affect. Neural correlates of reappraisal
aversive events is important for mental and physical health. were increased activation of the lateral and medial prefrontal
Little is known, however, about neural bases of the cognitive regions and decreased activation of the amygdala and medial
control of emotion. The present study employed functional orbito-frontal cortex. These findings support the hypothesis
magnetic resonance imaging to examine the neural systems that prefrontal cortex is involved in constructing reappraisal
used to reappraise highly negative scenes in unemotional strategies that can modulate activity in multiple emotion-
terms. Reappraisal of highly negative scenes reduced subjective processing systems. &

INTRODUCTION
studied forms of cognitive control. In general, cognitive
We humans are extraordinarily adaptable creatures. control is thought to involve interactions between
Drawing upon a vast array of coping skills, we can regions of lateral (LPFC) and medial prefrontal cortex
successfully manage adversity in even the most trying (MPFC) that implement control processes and subcor-
of circumstances. One of the most remarkable of these tical and posterior cortical regions that encode and
skills was described by Shakespeare’s (1998/1623, p. 216) represent specific kinds of information (Miller & Cohen,
Hamlet, who observed, ‘‘there is nothing either good or 2001; Knight, Staines, Swick, & Chao, 1999; Smith &
bad, but thinking makes it so.’’ Although Hamlet himself Jonides, 1999). By increasing or decreasing activation of
failed to capitalize on this insight, his message is clear: particular representations, prefrontal regions enable
We can change the way we feel by changing the way we one to selectively attend to and maintain goal-relevant
think, thereby lessening the emotional consequences of information in mind and resist interference (Miller &
an otherwise distressing experience. Cohen, 2001; Knight et al., 1999; Smith & Jonides, 1999).
The cognitive transformation of emotional experience Based on these cognitive neuroscience models, as well
has been termed ‘‘reappraisal.’’ In both experimental as process models of emotion and emotion regulation
and individual-difference studies, reappraising an aver- (Gross, 2002; Ochsner & Feldman Barrett, 2001), we
sive event in unemotional terms reduces negative affect hypothesized that comparable interactions between cog-
with few of the physiological, cognitive, or social costs nitive control and emotion-processing systems would
associated with other emotion-regulatory strategies, underlie reappraisal.
such as the suppression of emotion-expressive behavior With respect to cognitive-processing systems, we
( Jackson, Malmstadt, Larson, & Davidson, 2000; hypothesized that reappraisal would involve three pro-
Richards & Gross, 2000; Gross, 1998, 2002; Gross & cesses implemented by lateral and medial frontal corti-
John, in press). The mechanisms that mediate such ces. The first is the active generation of a strategy for
reappraisals, however, are not yet understood. The goal cognitively reframing an emotional event in unemo-
of the present study was to use functional magnetic tional terms, and keeping that strategy in mind as long
resonance imaging (fMRI) to elucidate the neural bases as the eliciting conditions endure. In neuropsycholog-
of reappraisal. ical (Barcelo & Knight, 2002; Stuss, Eskes, & Foster,
Although little prior work has directly examined the 1994), functional imaging (Cabeza & Nyberg, 2000;
neural systems involved in the cognitive control of Smith & Jonides, 1999; Barch et al., 1997), and electro-
emotion, we expected that it would involve processing physiological (Barcelo, Suwazono, & Knight, 2000; Niel-
dynamics similar to those in implicated in other well- sen-Bohlman & Knight, 1999) studies, these functions
have been associated with working memory processes
localized in the LPFC. The second process may monitor
1
Stanford University, 2Massachusetts Institute of Technology interference between top – down reappraisals that

D 2002 Massachusetts Institute of Technology Journal of Cognitive Neuroscience 14:8, pp. 1215 – 1229
neutralize affect and bottom –up evaluations that con- Strong
tinue to generate an affective response, signaling the 4
need for reappraisal to continue. In a variety of tasks 3.5
involving response conflict (Barch et al., 2001; van

negative affect
Veen, Cohen, Botvinick, Stenger, & Carter, 2001; 3

Strength of
Phelps, Hyder, Blamire, & Shulman, 1997) or overriding
prepotent response tendencies (Carter et al., 2000; 2.5
Peterson et al., 1999), these functions have been asso-
ciated with the dorsal anterior cingulate cortex (for 2
reviews, see Botvinick, Braver, Barch, Carter, & Cohen,
1.5
2001; Bush, Luu, & Posner, 2000). The third process
involves reevaluating the relationship between internal Weak 1
(experiential or physiological) states and external stim-
uli, which may be used to monitor changes in one’s
emotional state during reappraisal. The dorsal regions
of the MPFC are activated when making attributions
about one’s own (Paradiso et al., 1999; Lane, Fink, Attend Reapp Attend
Chau, & Dolan 1997) or another person’s (Gallagher
et al., 2000; Happe et al., 1996) emotional state as well Negative Neutral
as during viewing of emotional films (Beauregard et al.,
1998; Lane, Reiman, Ahern, Schwartz, & Davidson, 1997; Figure 1. Average negative ratings made during scanning for the
most negative photos (the third of photos that elicited the most
Reiman et al., 1997) or photos (Lane, Reiman, Bradley,
negative affect for a given participant). Negative affect was strong on
et al., 1997). Importantly, activation of the medial Attend trials and decreased significantly on Reappraise (Reapp) trials
frontal cortex when anticipating painful shock (Chua, ( p < .01). When participants attended to their feelings towards neutral
Krams, Toni, Passingham, & Dolan, 1999; Hsieh, Stone- photos, the negative affect elicited was significantly weaker than for all
Elander, & Ingvar, 1999; Ploghaus et al., 1999) may be other trial types ( both p < at least .01).
inversely correlated with the experience of anxiety
(Simpson et al., 2000), suggesting its importance for of a stimulus (Kawasaki et al., 2001; O’Doherty, Kringel-
regulatory control (cf. Morgan & LeDoux, 1995). bach, Rolls, Hornak, & Andrews, 2001; Davidson & Irwin,
With respect to emotion-processing systems, we hy- 1999; Rolls, 1999; Elliott, Frith, & Dolan, 1997) in a
pothesized that reappraisal would modulate the pro- flexible format that is sensitive to momentary changes
cesses involved in evaluating a stimulus as affectively in social and motivational context (Ochsner & Feldman
significant. Many theories of emotion posit that at least Barrett, 2001; Bechara, Damasio, & Damasio, 2000; Rolls,
two types of evaluative processing are involved in emo- 1999). Together, the amygdala and the MOFC differ-
tion generation (Lazarus, 1991; for a review, see Scherer, entially encode and represent the affective properties of
Schorr, & Johnstone, 2001). One type is important for stimuli (Bechara et al., 1999; Rolls, 1999), and we sought
determining whether a stimulus is affectively relevant to determine whether reappraisal modulates activity in
and may be relatively automatic, whereas a second type the MOFC, amygdala, or both.
is important for evaluating contextual meaning and the To test these hypotheses, we adapted an experimen-
appropriateness of possible responses (Scherer et al., tal procedure used to study regulation of the fear-
2001; Lazarus, 1991). Evidence suggests that two highly potentiated startle eyeblink response ( Jackson et al.,
interconnected brain structures (Cavada, Company, 2000). In that study, participants viewed aversive pho-
Tejedor, Cruz-Rizzolo, & Reinoso-Suarez, 2000), the tos and were instructed either to increase, maintain, or
amygdala and medial orbital frontal cortex (MOFC), decrease (postexperimental debriefing suggested that
are associated with these two types of emotion process- participants reappraised) their emotional reactions.
ing (Ochsner & Feldman Barrett, 2001; LeDoux, 2000; Startle eyeblink magnitude (which was used as an
Bechara, Damasio, Damasio, & Lee, 1999). On one hand, indicator of the relative strength of an emotional reac-
the amygdala is important for the preattentive detection tion across trial types) increased, remained constant, or
and recognition of affectively salient stimuli (Anderson & decreased according to the regulatory strategy being
Phelps, 2001; Morris, Ohman, & Dolan, 1999; Whalen employed. This result suggests that participants can
et al., 1998), learning and generating physiological and successfully regulate their emotional responses on a
behavioral responses to them (LeDoux, 2000; Bechara trial-by-trial basis. To isolate the processes related to
et al., 1999), and modulating their consolidation into the cognitive control of emotion, we needed to com-
declarative memory (Hamann, Ely, Grafton, & Kilts, pare reappraisal to another condition that draws on
1999; Cahill, Babinsky, Markowitsch, & McGaugh, processes invoked by reappraisal, but are not related to
1995). On the other hand, the MOFC is important for the regulation of affect per se. Because we hypothe-
representing the pleasant or unpleasant affective value sized that reappraisal involves both attention to and

1216 Journal of Cognitive Neuroscience Volume 14, Number 8


awareness of one’s emotional state, as well as regula- time the photo disappeared from the screen. Because
tory processes directed towards altering it (Gross, we were interested in the processes used to actively
1998), we employed two conditions: On ‘‘Attend trials,’’ reappraise an affective event as it unfolds, we focused
participants were asked to let themselves respond emo- our analyses on this portion of each trial. During this
tionally to each photo by being aware of their feelings portion of the trial, we predicted that (a) Reappraise
without trying to alter them. On ‘‘Reappraise trials,’’ trials would result in greater lateral prefrontal activation
participants were asked to interpret photos so that they than Attend trials and ( b) that Attend trials would show
no longer felt negative in response to them. Because greater activation of the MOFC and the amygdala than
both Attend and Reappraise trials involve attention to would Reappraise trials. For approximately three more
emotion, regions more active when reappraising than seconds, participants could continue attending to or
attending were thought to reflect processes used to reappraising any feelings that lingered after presentation
exert cognitive control. In contrast, regions more active of the photo. A rating scale then appeared, which
for Attend than Reappraise trials were thought to be participants used to rate the strength of their current
important for emotion processing that would be deac- negative affect and which we used to verify that that
tivated by reappraisal. reappraisal had successfully reduced negative feelings as
Each trial began with a 4-sec presentation of a neg- compared to Attend trials. Finally, participants were
ative or neutral photo, during which participants were instructed to relax for 4 sec before the next trial began.
instructed simply to view the stimulus on the screen.
This interval was intended to provide time for partic-
RESULTS
ipants to apprehend complex scenes and to allow an
emotional response to be generated that participants The experimental procedure included a measure that
then would be asked to regulate. The word Attend (for allowed us to segregate and analyze separately the trials
negative or neutral photos) or Reappraise (negative on which participants experienced their strongest emo-
photos only) then appeared beneath the photo and tional responses without biasing the initial perception of
participants followed this instruction for 4 sec, at which photos during scanning. In a post-scanning session,

Figure 2. Group-averaged
brain activations when
reappraising or attending to
Right Left
feelings in response to the LPFC
most negative photos. Two
contrasts are shown: The
Attend > Reappraise (shown
in red) contrast shows regions
important for emotion
processing that are significantly
modulated by reappraisal and
the Reappraise > Attend
(shown in green) contrast
shows regions significantly MOFC
activated when exerting
cognitive control over emotion
activated by reappraisal. Top
Bottom Front
and bottom brain images on LPFC
the right show regions of the
left dorsal and ventral LPFC
associated with cognitive
control that were activated by
reappraisal. Right side and
bottom left brain images show
reappraisal-related modulation
of a region of left MOFC
associated with representing
the affective properties MOFC
of stimuli.

Modulation Activation by
by reappraisal reappraisal

Ochsner et al. 1217


Table 1. Group Activations for Reappraise > Attend Contrast
Coordinates
Region of Activation Brodmann’s Area x y z Z Score Volume (mm3)
Group Contrast
Superior frontal gyrus L6 36 14 58 3.90 2736
Superior frontal gyrus L6/8 24 6 64 3.71 (L)
Middle frontal gyrus L6/8 24 10 56 3.68 (L)
Middle frontal gyrus L6/8 40 2 60 3.60 416
Inferior frontal gyrus L46 54 42 12 3.79 736
L44/10 48 46 4 3.31 (L)
Dorsomedial prefrontal cortex 8 12 18 54 3.47 1040
8 4 20 54 3.39
Dorsomedial prefrontal cortex 8/32 8 28 40 3.88 224
Temporal pole 28 22 4 26 4.21 128
Lateral occipital cortex 19 38 74 40 4.23 240
Supramarginal gyrus R39/40 54 70 30 4.23 688

Positive Correlation between Activation and Drop in Negative Affect When Reappraising
Anterior cingulate R24 6 14 32 4.67 88
Supramarginal gyrus R40 54 48 34 4.05 40

Clusters of 5 or more contiguous voxels whose global maxima meet a t threshold of 3.09, p < .001 uncorrected, are reported. Local maxima for
these clusters are denoted with (L). Coordinates are in MNI space.

participants viewed each negative photo a second time suggests that in-scan reappraisals did not bias post-scan
and rated the strength of their initial affective response emotional responses to photos. However, because these
(i.e., when they first viewed it, before they had attended ratings were provided retrospectively, it is important to
or reappraised). These ratings were used to identify the provide independent evidence that post-test ratings
third of the negative photos of each trial type that were can be correlated with a participant’s initial affective
rated most negative by each participant. As has been response to a stimulus (Ochsner & Schacter, in press).
found in prior studies (Canli, Zhao, Brewer, Gabrieli, & A separate pilot behavioral study was conducted to
Cahill, 2000), preliminary analyses indicated that reliable provide such evidence. Eight female participants rated
activation of emotion-processing systems was observed their affective response to photos an average of 3 days
only for these most negative images. Given that the goal before completing a test session that procedurally was
of this study was to examine the modulation of these equivalent to the scanning session used in the present
systems by reappraisal, the analyses reported here fo- study. They then completed post-test retrospective rat-
cused only on these trial types. ings of the affective response they had to each photo
when it was viewed during the test session. Results
indicated that pre- and post-test ratings of negative affect
Subjective Reports of Negative Affect
were highly correlated for all trial types and all levels of
Segregating Most Negative Photos negative photos (i.e, most, moderately, or least negative,
Post-scan ratings of affective response indicated that the all p < .01), which suggests that post-test ratings can
third of photos rated most negative (M = 3.77) elicited provide a reliable index of one’s initial affective response
significantly greater negative affect than the moderately to a photo.
negative (M = 2.99) or least negative (M = 1.93) third of
photos (all differ p < .01). Affect ratings for negative
Success of Reappraisal
photos selected from Attend as compared to Reappraise
trials did not differ significantly at any level of affect (all Ratings made during scanning showed that overall, mod-
p > .16). The fact that retrospective ratings of negative erate, and least negative photos elicited less negative
affect were equivalent on Attend and Reappraise trials affect than the most negative photos (both p < .01),

1218 Journal of Cognitive Neuroscience Volume 14, Number 8


which is consistent with post-test reports of initial Reappraise M = 1.43, t(14) = 4.27, p < .01]. However,
affective response. Significantly, reappraisal was success- comparisons with affect reported on Attend– neutral
ful for the most negative photos: The average ratings of trials (M = 1.08) showed that in no case did reappraisal
the strength of negative affect were high on Attend trials entirely eliminate negative affect ( p < .01 for all
(M = 3.48) and were significantly lower on Reappraise comparisons).
trials1 [M = 1.90, t(14) = 17.41, p < .01] (Figure 1).
Reappraisal was potent enough that affect was dimin-
Manipulation Check
ished to that experienced when attending to the least
negative photos ( p > .5). Although negative affect was In a pre-scan training session, participants were in-
not as great as that reported for most negative photos, structed to reappraise photos during scanning by gen-
ratings for both the moderately negative and least erating an interpretation of, or story about, each photo
negative photos showed a similar pattern of successful that would explain apparently negative events in a less
reappraisal [moderate: Attend M = 2.75, Reappraise negative way. To verify that participants had, in fact,
M = 1.52, t(14) = 7.66, p < .01; least: Attend M = 2.05, reappraised in this manner, during the post-scan rating

Figure 3. Region of right


anterior cingulate cortex
(MNI coordinates: 6, 14, 32)
identified in a regression
analysis as showing a significant 4
correlation between increasing
activation and decreasing
negative affect on Reappraise as
compared to Attend trials with 3
negative photos. Activation is
shown on SPM99 canonical
T1 image.
2

0
Z-value

R2 = .645, r = .805, p = .0001


Parameter estimate of Cingulate

2.00
activation when Reappraising

1.50

1.00

.50

.00

-.50

.80 1.0 1.2 1.4 1.6 1.8 2.0 2.2


Drop in negative affect due to Reappraisal

Ochsner et al. 1219


Table 2. Group Activations for Attend > Reappraise Contrast
Coordinates
Region of Activation Brodmann’s Area x y z Z Score Volume (mm3)
Medial orbito-frontal cortex L11 6 44 22 4.17 112
Posterior insula L13 44 16 2 3.84 240
Inferior parietal cortex R39/19 38 64 34 3.86 640
Medial occipital cortex R19 22 76 40 3.46 240
Amygdala R 16 12 20 2.88* 112

Clusters of 5 or more contiguous voxels whose global maxima meet a t threshold of 3.09, p < .001 uncorrected, are reported. Local maxima for
these clusters are denoted with (L). Coordinates are in MNI space.
*
T = 2.98, p < .005.

session participants also were asked to indicate for each tions were highly significant both for the foci in the
photo whether they had reinterpreted the photo (as anterior cingulate (R2 = .649, r = .805, p = .0001) and
instructed) or had used some other type of reappraisal the supramarginal gyrus (R2 = .570, r = .755, p < .0006).
strategy. Compliance with instructions was very high: On
less than 4% of trials with highly negative photos did
Modulation by Reappraisal
participants report using another type of strategy.
Emotion-sensitive regions modulated by reappraisal
were identified by greater activation in response to the
Brain Imaging Results
most negative photos on Attend than on Reappraise
Activation by Reappraisal trials. Activation was observed in a region of left MOFC
Reappraisal-sensitive regions were identified by greater (Figure 2, Table 2). Additional regions of activation were
activation in response to the most negative photos on found in the left posterior insula, right medial occipital
Reappraise than on Attend trials. Consistent with pre- cortex, and right inferior parietal cortex (Figure 2, Table
dictions, significantly activated regions included the 2). The amygdala, an a priori region-of-interest (ROI),
dorsal and ventral regions of the left LPFC, as well as was not significantly activated at a map-wise statistical
the dorsal MPFC (Figure 2, Table 1). Additional reap- threshold of p < .001. However, significant activation
praisal-related activations were observed in left temporal was observed in the right amygdala at a more liberal
pole, right supramarginal gyrus, and left lateral occipital threshold ( p < .005) (Figure 4). This finding was
cortex (Figure 2, Table 1). Contrary to expectations,
activation of the cingulate cortex was not observed.
Cingulate involvement in reappraisal was revealed,
however, in an SPM99 regression analysis used to iden- 6
tify regions for which level of brain activation across
participants correlated significantly with reappraisal suc- 5
cess. An index of reappraisal success was computed for
each participant by subtracting the mean level of neg-
4
ative affect reported on Reappraise trials from that
reported on Attend trials when highly negative images
3
were shown. Larger difference scores thus corresponded
to a greater decrease in negative affect, which is indica-
tive of a more effective reappraisal. At a threshold of 2
p < .001 (uncorrected), activity in no brain regions was
1
negatively correlated, and in only two regions was
positively correlated, with reappraisal success such that
greater activation predicted greater decreases in negative Z-value
affect. These two regions were located in the right ante-
rior cingulate and right supramarginal gyrus (Figure 3,
Table 1). To more precisely characterize these correla- Figure 4. Coronal image showing the group-averaged cluster of
activation in right amygdala for the Attend > Reappraise contrast for
tions, mean parameter estimates of the response in- trials with the most negative photos ( p < .005). The focus is centered
crease when reappraising as compared to attending on MNI coordinates (16, 12, 20). Activation is shown on group-
were correlated with reappraisal success. These correla- averaged anatomy.

1220 Journal of Cognitive Neuroscience Volume 14, Number 8


confirmed by the results of a planned ROI analysis in (Figure 5). No significant differences in response were
which parameter estimates that model the amplitude shown across trial types for the left amygdala ROI
of the fMRI response were extracted from structurally [all t(14) < 1, p > .5].
defined ROIs (see, e.g., Figure 4). For the right amyg- To further characterize the relationships between
dala, this analysis revealed a significantly greater ampli- reappraisal-related increases and decreases in brain acti-
tude of response on Attend than Reappraise trials vation, mean parameter estimates across trial types were
( p < .025, one-tailed for planned comparison). The contrasted for a set of functionally defined ROIs: The
response to most negative photos on Reappraise trials first was the region of MOFC identified by the Attend >
was not significantly different from the response to Reappraise contrast, and the others were regions of the
neutral photos on Attend trials [t(14) < 1, p > .5] LPFC activated by the Reappraise > Attend contrast

Figure 5. ROI analyses. (a)


Functionally or structurally
defined ROIs and ( b) group a b
mean parameter estimates
(M ± SEM) for each ROI on Left
Attend and Reappraise (Reapp) ventral LPFC
trials using negative photos,
and Attend trials using neutral
.25
photos. Note that the negative .20
images contributing to this .15
analysis were identified as the
.10
third of negative images that
were given the most negative .05
rating by each participant 0
(see Methods and Results). -.05
Top row: A functionally defined
ROI within the left ventral -.10
LPFC (BA 46/10) activated by -.15
Reappraise > Attend contrast, -.20
centered on MNI coordinates
( 54, 42, 12) and shown on
Parameter estimate of activation

group-averaged anatomy. This


is the only prefrontal region Left
whose activation during .10 MOFC
reappraisal was inversely
correlated with activation in .075
emotion-processing regions
(shown in Figure 6). Middle .05
row: A functionally defined ROI
within left MOFC (BA 11) .025
identified by the Attend >
Reappraise contrast, centered
0
on MNI coordinates ( 6, 46,
20) and shown on group-
-.025
averaged anatomy. Bottom row:
-.05
Sample structurally defined ROI
for the right amygdala from a
single subject centered on MNI
coordinates (24, 7, 15). Right
Ventral LPFC activation on .15 Amygdala
Reappraise – most negative
trials was significantly greater .10
than on Attend – most negative
trials ( p < .025, one-tailed),
whereas the MOFC and
.05
amygdala showed the opposite
pattern ( both p < .025, 0
one-tailed).
-.05

-.10
Attend- Reapp- Attend-
Most-Neg Most-Neg Neutral

Ochsner et al. 1221


(Table 1). These analyses indicated that MOFC exhibited from activity on Reappraise – most negative trials in
greater activation to most negative photos on Attend MOFC and amygdala [both t(14) < 1, p > .5] (Figure 5).
than on Reappraise trials, whereas activated regions of
the LPFC exhibited precisely the opposite pattern ( p <
DISCUSSION
.025, one-tailed for planned comparisons). For one of
the activated prefrontal regions—the ventral LPFC—the This study is one of the first to use functional imaging to
reappraisal-related increase in brain activation was cor- draw inferences about the neural bases of the cognitive
related across participants with the reappraisal-related control of emotion. Behaviorally, reappraisal of negative
decrease in amygdala activation (r = .677, p < .004; for photos successfully diminished negative affect. Neural
all other regions, p > .19). Ventral LPFC activation also correlates of effective reappraisal were (1) activation in
was negatively correlated with MOFC activation, albeit to the regions of the LPFC and MPFC essential for working
a lesser extent (r = .494, p < .06) (Figure 6). Activation memory, cognitive control (Miller & Cohen, 2001;
on Attend– neutral trials was not significantly different Knight et al., 1999; Smith & Jonides, 1999), and self-
from either activation on Attend– most negative trials in monitoring (Gusnard, Akbudak, Shulman, & Raichle,
this ventral prefrontal region [t(14) < 1.2, p > .24] or 2001) and (2) decreased activation in two regions in-
volved in emotion processing, the MOFC and the amyg-
dala (Adolphs, 2001; Ochsner & Feldman Barrett, 2001;
a Bechara et al., 1999; Davidson & Irwin, 1999; Rolls,
1999). In addition, the magnitude of ventral LPFC acti-
vation during reappraisal was inversely correlated with
.08 r = -.494, p < .061
Parameter estimate of MOFC
activation when Reappraising

activation in both emotion-processing regions. Taken


.06
together, these findings provide the first evidence that
.04
reappraisal may modulate emotion processes imple-
.02
mented in the amygdala and MOFC that are involved
0
in the evaluating the affective salience and contextual
-.02
relevance of a stimulus (Ochsner & Feldman Barrett,
-.04
-.06
2001; Phelps et al., 2001; Bechara et al., 2000; LeDoux,
2000; Bechara et al., 1999; Rolls, 1999).
-.08
-.1
-.12 Cognitive Processes Supporting Reappraisal
-.2 -.1 0 .1 .2 .3 .4 .5 .6 .7 .8 .9
The particular regions of the LPFC and MPFC activated
Parameter estimate of left ventral
LPFC activation when Reappraising by reappraisal are similar to the regions commonly acti-
vated across working memory and response-selection
b tasks that involve maintaining information in aware-
ness and resisting interference from competing inputs
.2 (Cabeza & Nyberg, 1999; Smith & Jonides, 1999; Court-
Parameter estimate of Amygdala

r = -.677, p < .004


activation when Reappraising

ney, Petit, Maisog, Ungerleider, & Haxby, 1998; Petit,


.1 Courtney, Ungerleider, & Haxby, 1998; Alexander,
Delong, & Strick, 1996). These similarities suggest that
0 an overlapping set of prefrontal regions support the
-.1 cognitive regulation of feelings and thoughts (Miller
& Cohen, 2001; Ochsner & Feldman Barrett, 2001;
-.2 Davidson & Irwin, 1999; Knight et al., 1999; Smith &
Jonides, 1999).
-.3 The finding that activation of the ventral LPFC was
-.4 inversely correlated with the activation of the amygdala
-.2 -.1 0 .1 .2 .3 .4 .5 .6 .7 .8 .9 and the MOFC suggests that this region may play a
direct part in modulating emotion processing, perhaps
Parameter estimate of left ventral
LPFC activation when Reappraising
related to the role of ventral frontal regions in interfer-
ence control and behavioral inhibition more generally
(Miller & Cohen, 2001; Smith & Jonides, 1999). It is
Figure 6. Correlations between reappraisal-induced changes in notable, however, that other prefrontal regions were
parameter estimates of activation for the functional and structural ROIs even more strongly activated by reappraisal, although
shown in Figure 5. During reappraisal, increases in response in the
ventral LPFC (a) correlated with decreases in response in the amygdala
these activations did not correlate significantly with
and ( b) to a lesser degree correlated with decreases in response in the activity in emotion-processing regions. Although this
MOFC. initial study was not designed to determine the precise

1222 Journal of Cognitive Neuroscience Volume 14, Number 8


contributions to the reappraisal process made by each 2001; O’Doherty et al., 2001; Bechara et al., 2000;
region, they may mediate processes necessary for, but Davidson & Irwin, 1999; Rolls, 1999; Elliott et al., 1997).
not directly related to, successful reappraisal. For exam- Further work will be needed to determine which
ple, dorsomedial prefrontal cortex was the region most specific aspects of amygdala and OFC functioning can
strongly activated by reappraisal. This region has been be modulated by reappraisal. On one hand, the appraisal
associated with emotional awareness (Lane, 2000; Lane, function of the amygdala often is characterized as auto-
et al., 1997), drawing inferences about one’s own (Para- matic (e.g., LeDoux, 2000; Morris et al., 1999). In the
diso et al., 1999) or others’ (Gallagher et al., 2000; present study, it likely that reappraisal did not modulate
Happe et al., 1996) emotional states, and self-related this early amygdala response, which is thought to
processing (Gusnard et al., 2001) more generally. The depend upon subcortical inputs from the senses.
need to monitor and evaluate the self-relevance of Instead, reappraisal may have influenced a more sus-
emotional stimuli could be important whenever one tained response that may depend (as discussed below)
reappraises (Scherer et al., 2001; Lazarus, 1991) and on cortical inputs and is more amenable to control by
may be used to regulate anxiety in anticipation of cognitive processes. It will be important to determine
aversive events (Simpson et al., 2000). Similarly, the whether and how reappraisal could influence the early
superior prefrontal regions have been associated with automatic response as well. On the other hand, the
spatial working memory and control of eye movements MOFC often is characterized as serving a regulatory
(Smith & Jonides, 1999; Courtney et al., 1998), both of function,2 as evidenced, for example, by its roles in
which could be needed for analyzing and reinterpreting decision-making involving risky choices (e.g., Bechara
perceptual inputs during reappraisal. et al., 2000) and extinction of conditioned fear responses
We also hypothesized that the anterior cingulate (e.g., Morgan et al., 1995; see, however, footnote 2). On
cortex would be involved in reappraisal. Although cin- our view, the cognitive processes supporting reap-
gulate activation was not observed in the group contrast praisal, as well as the emotional processes supporting
of Reappraise and Attend trials, there was, across partic- context-sensitive evaluation, may both exert regulatory
ipants, a positive correlation between cingulate activa- effects, albeit in different ways. Whereas the evaluation
tion and effective reappraisal. The anterior cingulate processes supported by OFC may support the selection
cortex is thought to be important for monitoring on- of appropriate, and the transient suppression of inap-
going processing and evaluating the need for cognitive propriate, affective responses, the reappraisal processes
control (e.g., Botvinick et al., 2001), and it might be supported by lateral and medial prefrontal regions may
expected that successful reappraisal would depend upon be important for modulating these evaluation processes
the use of this process to monitor for conflicts between themselves. By down-regulating multiple types of evalu-
initial emotional appraisals and cognitively restructured ation processes, reappraisal may shift from an emotional
reappraisals. In the present study, cingulate activation to an unemotional mode of stimulus analysis.
may therefore reflect active monitoring that enhanced Further work will also be needed to determine exactly
the cognitive transformation of an aversive experience. how prefrontal regions modulate the amygdala and
MOFC during reappraisal. In the present study, we
observed an inverse correlation between lateral prefron-
Emotion Processes Modulated by Reappraisal
tal and amygdala activation during reappraisal, although
The observation that reappraisal can influence brain these two structures share few direct connections. One
systems implicated in emotion processing may have route by which the LPFC could influence the amygdala is
significance for contemporary appraisal theories of emo- via the MOFC, which has reciprocal connections with
tion (for a review, see Scherer et al., 2001). It has been both regions (Cavada et al., 2000). By directly modulat-
clear that reappraisal diminishes negative emotion ex- ing representations of the affective significance of a
perience and negative emotion-expressive behavior stimulus in the MOFC, activation in the LPFC could
(Gross, 1998), but theorists have not specified the types blunt processing in the amygdala indirectly. This seems
of emotion processing that might be influenced by somewhat unlikely, however, because the correlation
reappraisal. Although the present study was not de- between the LPFC and the MOFC activity was not as
signed to determine which specific emotion-processing strong as the correlation between LPFC and amygdala
functions attributable to the amygdala and MOFC are activity (which could be due, in part, to signal loss in
modulated by reappraisal, modulation of these two MOFC). A second possible route involves prefrontal
brain structures is consistent with the idea that reap- modulation of posterior perceptual and semantic inputs
praisal can influence processes involved in evaluating to the amygdala from the occipital and parietal regions
the affective salience of a stimulus (Anderson & Phelps, (de Fockert, Rees, Frith, & Lavine, 2001; Miller & Cohen,
2001; Morris et al., 1999; Whalen et al., 1998), as well 2001; Knight et al., 1999; Smith & Jonides, 1999).
those important for evaluating the salience of that Reappraising the affective significance of images in work-
stimulus in the context of current situational or personal ing memory may reorganize these inputs so that the
goals (Kawasaki et al., 2001; Ochsner & Feldman Barrett, amygdala and the MOFC no longer register the presence

Ochsner et al. 1223


of an aversive stimulus. This view is supported by the A second question concerns the lateralization of
fact that reappraisal modulated activation in the lateral activations and deactivations related to reappraisal and
occipital cortex, a region associated with visual object emotion processing, respectively. One possibility is that
processing, and the supramarginal gyrus, an inferior these findings are related to properties of the particular
parietal region associated with attentional selection regulatory processes involved in the present study. Left
and storage of information held in working memory lateralization of reappraisal-related prefrontal activa-
(Cabeza & Nyberg, 1999; Culham & Kanwisher, 2001; tions may, for example, reflect a common verbal com-
Smith & Jonides, 1999). Future research may help ponent of reappraisal strategies employed by
determine which account is correct. participants, who typically reported mentally talking
themselves through their reappraisals.3 Left prefrontal
regions have been implicated in interference tasks
The Nature of Emotion Regulation
involving verbal stimuli (e.g., Bunge, Ochsner, Des-
The present study provides insight into the processes mond, Glover, & Gabrieli, 2001; Macdonald, Cohen,
supporting reappraisal. However, a number of additional Stenger, & Carter, 2000; D’Esposito, Postle, Jonides, &
steps will be necessary to develop a more complete Smith, 1999; Jonides, Smith, Marshuetz, Koeppe, &
framework for understanding the cognitive and affective Rueter-Lorenz, 1998), which suggests that this region
mechanisms of emotion and emotion regulation more may represent verbal reappraisal strategies and help
generally (Ochsner & Feldman Barrett, 2001). In partic- resolve interference with competing negative evalua-
ular, the present research raises at least two important tions generated by the perception of aversive stimuli.
questions about the nature of emotion regulation. Were one to examine other types of reappraisal or
The first question concerns the way in which emotion other emotion-regulation strategies that do not share
processing might be modulated differently by cognitive this interpretive verbal component (e.g., those involv-
reappraisal as compared to other forms of emotion ing attentional deployment, as discussed above, or the
regulation. A pair of studies have examined attentional suppression of expressive emotional behavior; Gross,
influences on emotion processing and found that 1998), it is possible that activation of the right prefron-
enhanced amygdala responses to fearful faces did tal systems would be observed. This hypothesis is
not change as attention to a fear stimulus decreased supported by a study showing that regulating responses
(Anderson et al., 2001; Vuilleumier, Armony, Driver, & to a sexually arousing film clip by viewing them from a
Dolen, 2001). These results contrast with the present detached third-person perspective activated right PFC
finding that attempts to cognitively transform feelings and deactivated structures related to sexual arousal,
can modulate amygdala activity. A handful of other including the hypothalamus and the amygdala (Beau-
studies have examined the influence on amygdala pro- regard, Levesque, & Bourgouin, 2001). In this context,
cessing of cognitive judgments that involve explicit eval- the deactivation of the right amygdala and the left
uation of the emotional properties of faces as compared MOFC may reflect stimulus (as compared to verbally)-
to evaluation of stimulus dimensions unrelated to emo- driven processing of affective information by the amyg-
tion, such as gender or age. Results have been mixed, dala (Phelps et al., 2001; Morris et al., 1999), and the
with some studies finding that evaluative judgments observation that the right amygdala and the left orbito-
diminish amygdala activation (Hariri, Bookheimer, & frontal cortex activity may be coupled during sensory
Mazziotta, 2000; Liberzon et al., 2000) and others finding processing of aversive stimuli (Zald & Pardo, 1997).
the opposite (Winston, Strange, O’Doherty, & Dolan, A second possible explanation for lateralized activa-
2002; Critchley et al., 2000). Although the precise rele- tions relates to findings associating negative affect with
vance of these judgments to emotion regulation is not the right hemisphere and positive affect with the left
clear, some of the discrepant findings could be attribut- hemisphere (e.g., Canli, Desmond, Zhao, Glover, &
able to a differential dependence of some evaluative Gabrieli, 1998; see Davidson & Irwin, 1999, for a review).
judgments on processes involved in reappraisal. More Thus, right amygdala deactivation could reflect down-
generally, the present results may be difficult to directly regulation of systems that generate negative appraisals
relate to these studies because of the differences in the whereas left PFC activation could reflect engagement of
stimuli employed and the responses they evoke. Where- systems supporting positivizing reappraisals. This inter-
as the present study used stimuli that elicit relatively pretation is consistent with the finding that relatively
strong responses that induce changes in emotional greater resting activation of the left than the right PFC is
experience, the words and faces employed in other correlated with resistance to depression, which may in
studies elicit weaker responses overall and only rarely turn reflect baseline differences in the ability to repre-
alter experience (Ochsner & Feldman Barrett, 2001; sent cognitive control strategies used to down-regulate
Davidson & Irwin, 1999). Future work may serve to clarify emotion processing (Davidson, Putnam, & Larson,
the precise ways in which different types of regulation 2000). Consistent with this view, studies of resting brain
modulate different aspects of emotion (Ochsner & metabolism in individuals with depression or obsessive –
Feldman Barrett, 2001; cf. Gray, in press). compulsive disorder—who may be unable to effectively

1224 Journal of Cognitive Neuroscience Volume 14, Number 8


represent these strategies—have shown hypoactivation instructed to reinterpret the photo so that it no longer
of the prefrontal regions coupled with hyperactivation of elicited a negative response. The 4-sec epoch during
the amygdala and/or the orbito-frontal cortex that nor- which participants were attending or reappraising neg-
malizes with effective treatment (Davidson et al., 2000; ative photos is the subject of the functional imaging
Brody et al., 1999; Saxena et al., 1999). analyses reported in the present study. The photo then
disappeared and, for 3.1 sec, participants could continue
attending to, or reappraising, any feelings that lingered
Conclusions after its presentation. A four-point scale (1 = ‘‘weak’’ to
The aim of the present study was to use information 4 = ‘‘strong’’) for rating the strength of current negative
about brain function to draw inferences about the affect then was presented for 3 sec, and participants
mechanisms supporting one type of cognitive control indicated how they felt currently. Finally, an instruction
of emotion. As such, it represents one example of a to RELAX appeared in the center of the screen for 5 sec.
growing trend towards using neuroscience methods to A 900-msec interval separated each trial.
address questions that traditionally have been of interest
to social and personality psychologists (Ochsner & Testing Procedure
Lieberman, 2001). Although findings suggest that cogni-
tive reappraisal can modulate multiple types of emotion One to three days before scanning, participants
processing, questions remain about the functional sig- received extensive instruction in reappraisal. Pilot test-
nificance of observed frontal and amygdala activations, ing suggested reappraisal was commonly accomplished
their relation to other forms of regulation, and their by generating an interpretation of, or a story about, each
relevance to clinical populations. As future work ad- photo that would explain apparently negative events in a
dresses these questions, we may be able to better less negative way (e.g., women depicted crying outside
connect Hamlet’s timeless observation that thinking of a church could be described as attending a wedding
can make things good or bad with an increased under- instead of a funeral). No single type of reinterpretation
standing of how the brain makes this possible. was universally applicable to all photos, which was
expected given that individuals must generate context-
appropriate reappraisals in everyday life. To strike a
METHODS balance between generalizability and experimental con-
trol, we instructed participants to select the reinterpre-
Participants tation that was most effective for each photo. Training
Fifteen healthy right-handed female volunteers4 re- began by asking participants to spontaneously generate
cruited from Stanford University and the surrounding reappraisals of sample photos. After appropriate coach-
community (ages 18 – 30, M = 21.9) gave informed ing and shaping by the researcher to ensure that partic-
consent and were paid $50 for their participation. ipants could reinterpret photos quickly and effectively,
the training ended with the completion of 18 practice
trials. It was stressed that when asked to reappraise,
Task
participants should neither look away (unless necessary;
On the basis of normative ratings, two sets of 38 negative no subjects reported that it was) nor distract themselves
color photos and one set of 38 neutral color photos with irrelevant and/or positive thoughts.
were selected from the International Affective Picture During scanning, participants completed one hun-
System (Lang, Greenwald, Bradley, & Hamm, 1993). The dred and fourteen 20-sec trials over six separate scans.
task design was adapted from Jackson et al. (2000). At Each scan included approximately equal numbers of
the beginning of each trial, a photo (subtending approx- each trial type, and trial order was counterbalanced
imately 20  208 of visual angle) appeared in the center across scans so that every trial type followed every
of a black screen for 4 sec with the instruction VIEW other with equal probability. Assignment of photos to
printed in white underneath. Many photos depicted trial types and scans was counterbalanced across par-
complex scenes, and during this viewing period partic- ticipants. Psyscope was used to control stimulus pre-
ipants were instructed to view the photo, understand its sentation and response collection. Upon completion of
content, and allow themselves to experience/feel any scanning, participants viewed all the negative photos
emotional response it might elicit. The photo remained they had seen in the scanner and indicated the
on the screen for an additional 4 sec with an instruction strength of their initial negative reaction to each one
either to ATTEND or REAPPRAISE replacing the instruc- (i.e., during the viewing period, before attending, or
tion to VIEW. On Attend trials, either a negative or a reappraising). These ratings were used to identify the
neutral photo was shown and participants were in- trials that involved the photos rated most negatively by
structed to attend to and be aware of, but not to try each participant. To verify that participants had, in fact,
to alter, any feelings elicited by it. On Reappraise trials, reappraised, for each photo they were asked to in-
a negative photo was shown and participants were dicate whether they had generated an alternative

Ochsner et al. 1225


interpretation or whether they had used some other To determine whether reappraisal modulated the
types of reappraisal strategy. amygdala’s response to negative photos, structurally de-
fined ROIs were drawn around each participant’s amyg-
dalae on their in-plane anatomical images (Desmond
Data Acquisition
& Lim, 1997). Parameter estimates (that model the am-
Whole-brain imaging data were acquired on a 3-T MRI plitude of the fMRI response) averaged across all voxels
Signa LX Horizon Echospeed scanner (GE Medical for each ROI were then extracted for Reappraise and
Systems, 8.3_m4 systems revision). T2-weighted flow- Attend trials on which the most negative photos had been
compensated spin-echo anatomical images (TR, 2000 presented. For comparison, parameter estimates on
msec; TE, 85 msec) were acquired in 16 contiguous Attend neutral trials also were extracted. Planned t tests
7-mm axial slices. Functional images were acquired (a = .05, one-tailed) were used to compare amygdala
with the same slice prescription using a T2*-sensitive activation across these three trial types. This analysis
gradient-echo spiral pulse sequence (Glover & Lai, also was performed for functionally defined ROIs in
1998) (TE, 30 msec; TR, 1000 msec; two interleaves; regions of a priori interest in the LPFC and MOFC.
flip angle 608, field of view, 24 cm; 64  64 data acqui-
sition matrix).
Acknowledgments
This research was supported by NSF grant BCD-0084496,
Data Analysis McDonnel-Pew grant 98-23, and grant 5 F32 MH11990-03 from
Functional images were motion-corrected and normal- the National Institute of Health. The authors thank Adam
Anderson and Kalina Christoff for discussion of relevant issues
ized to a standard template brain using SPM99 (Well- and comments on earlier drafts of this article.
come Department of Cognitive Neurology). Normalized
images were interpolated to 2  2  4-mm voxels and Reprint requests should be sent to Kevin Ochsner, Department
of Psychology, Stanford University, Building 420, Main Quad,
spatially smoothed with a Gaussian filter (6 mm full Stanford, CA, 94305-2130, USA, or via e-mail: ochsner@psych.
width half maximum). Low-frequency noise and differ- stanford.edu.
ences in global signal between participants were
The data reported in this experiment have been deposited in
removed. Single participants’ data were analyzed with The fMRI Data Center (http://www.fmridc.org). The accession
a fixed-effects model (Friston, Jezzard, & Turner, 1994) number is 2-2002-1137G.
and group data were analyzed using a random-effects
model (Holmes & Friston, 1998). Effects were modeled
using a box-car convolved with a canonical hemody- Notes
namic response function for the 4-sec trial epoch during 1. To provide an independent check for bias in participants’
which participants reappraised or attended while a subjective reports, and the affect ratings in particular, in a
photo was on the screen. An anatomically defined gray pre-scan session participants were asked to complete the
Marlowe – Crowne social desirability scale, which is commonly
matter mask was created and explicitly specified during used as a measure of the tendency to provide responses that
analysis. This ensured that statistical analysis was per- would be demanded in an experiment. Overall, scores on
formed in all brain regions, including those where signal this scale were low (M = 13.125) and were uncorrelated
may be low due to susceptibility artifacts. For the group (r = .099, p > .80) with reappraisal success (as indexed by
analysis, functional images were averaged to create a the drop in negative affect on reappraise as compared to
attend trials). Furthermore, if affect ratings reflected com-
single image of mean activation per trial type and pliance with experimental demand, then ratings might have
participant. To identify regions recruited across partic- been expected to drop on reappraise trials to the level of
ipants that were activated or relatively deactivated by affect reported on aware trials with neutral photos. This did
reappraisal, one-sample t tests were performed on these not occur. In fact, ratings on reappraise trials remained
average images to create a series of SPM{Z} maps sensitive to differences in intensity across photos: ratings on
reappraise trials with most negative photos were greater than
depicting differences in brain activation between trial on reappraise trials for least negative images, which in turn,
types. To identify regions for which the level of reap- were still greater than rating on aware neutral trials.
praisal-related activation across participants was corre- 2. Two points concerning the MOFC’s role in regulation are
lated with the reappraisal-related decreases in negative relevant here. First, recent studies suggest that the relation of
affect, a simple regression analysis was performed on MOFC to extinction is not yet clear. Some animal lesion studies
indicate that medial lesions impair extinction (Morgan et al.,
the average images for the Reappraise > Attend con- 1995), others suggest that they do not (Gewirtz, Falls, & Davis,
trast. Except as noted below, for group contrasts and 1997), whereas others suggest that the impairments may be
regression analysis, a voxel-level threshold of p < .001 observed only during some phases of extinction (Quirk, Russo,
uncorrected for multiple comparisons (t = 3.09) was Barron, & Leborn, 2000). Although the reasons for these
used. An extent threshold of five contiguous voxels was discrepancies await clarification, one possible contributing
factor may be that subtle differences in learning contexts lead
applied to activated clusters meeting the voxel-level to differential dependence on context-sensitive appraisal
threshold. Maxima are reported in MNI305 coordinates, processes associated with MOFC. In some circumstances,
as in SPM99. when a UCS no longer follows a CS, these appraisal processes

1226 Journal of Cognitive Neuroscience Volume 14, Number 8


might be used to try and figure out what action to take next. Beauregard, M., Leroux, J. M., Bergman, S., Arzoumanian, Y.,
This decision process might transiently suppress a CR, which Beaudoin, G., Bourgouin, P., & Stip, E. (1998). The
research has shown can spontaneously reemerge at a later functional neuroanatomy of major depression: An fMRI
point. Second, prior work has shown that OFC is involved in study using an emotional activation paradigm. NeuroReport,
modifying associations established in the amygdala (e.g., Rolls, 9, 3253 – 3258.
1999). This modification does not always involve down- Beauregard, M., Levesque, J., & Bourgouin, P. (2001). Neural
regulation of amygdala activity, however, and in many cases correlates of conscious self-regulation of emotion. Journal
may involve coactivation of the two structures during emo- of Neuroscience, 21, RC165.
tional learning and evaluation (e.g., Schoenbaum, Chiba, & Bechara, A., Damasio, H., & Damasio, A. R. (2000). Emotion,
Gallagher, 1998). In the case of extinction, OFC activity could decision making and the orbitofrontal cortex. Cerebral
also reflect the use of appraisal processes to encode new Cortex, 10, 295 – 307.
properties of the stimulus – context relationship. We would Bechara, A., Damasio, H., Damasio, A. R., & Lee, G. P. (1999).
suggest, therefore, that these data, along with the results of the Different contributions of the human amygdala and
present study, are consistent with the conclusion that ventromedial prefrontal cortex to decision-making. Journal
reappraisal may down-regulate two processing components of Neuroscience, 19, 5473 – 5481.
of a system important for analyzing different kinds of emotion Botvinick, M. M., Braver, T. S., Barch, D. M., Carter, C. S., &
features. Under certain circumstances, these two emotion- Cohen, J. D. (2001). Conflict monitoring and cognitive
related processors may themselves configure to regulate control. Psychology Review, 108, 624 – 652.
responses. In the present circumstances, regulatory effects Brody, A. L., Saxena, S., Silverman, D. H., Alborzian, S.,
are achieved by shutting them both down. Ultimately, brain Fairbanks, L. A., Phelps, M. E., Huang, S. C., Wu, H. M.,
systems might best be thought of as performing task non- Maidment, K., & Baxter, L. R., Jr. (1999). Brain metabolic
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behavior, whether or not that behavior is best described as treatment with paroxetine. Psychiatry Research, 91, 127 – 139.
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