Dunn, B.; (2004) Emotional suppression when processing trauma: Consequences for mood and memory. Doctoral thesis , University of London.

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Abstract

The thought suppression literature (Wegner et al. 1987; Wegner and Erber, 1992) illustrates that there are secondary costs of suppressing the cognitive content of conscious experience. A 'thought rebound' effect has been demonstrated in both healthy populations and psychopathology (Purdon, 1999), whereby the harder a thought is pushed out of mind the more likely it is to subsequently return. It is increasingly realised that people try to control affect as well as cognitions (Gross, 1998; 2001), but as yet the secondary consequences of different forms of emotion regulation have not been studied in detail. In particular, whether an 'emotional rebound' effect occurs following suppression of emotions rather than thoughts during processing of distressing material has not been investigated. 'Emotional rebound' could potentially help explain some of the secondary symptoms seen in PTSD and related conditions. This thesis examines the concurrent and subsequent impact of attempting to suppress (both internally experienced and externally expressed) emotion while processing traumatic information, and is intended as a preliminary investigation of whether emotion suppression contributes to PTSD. Healthy participants were asked to watch a video trauma induction, either under emotional suppression (n = 21) or control (n = 23) conditions. The consequences of emotional suppression on mood, emotional response to novel material, episodic memory, and occurrence of intrusive memories were then measured, using both self-report and psychophysiological methods. Results found that emotional suppression did not alter self-reported emotional experience, lead to a more variable heart response, and did not change electrodermal response while watching the trauma induction. This suggests that emotional suppression is a largely ineffective way of regulating emotional experience and that it alters psychophysiological activity, although exactly what the change in heart rate means at a psychological level is unclear. Subsequently, emotional suppression impaired free recall but not recognition memory of the trauma material, suggesting there is a slight mnemonic impact of this form of affect regulation. There was also a trend for suppression to lead to a reduction in the experience of intrusive memories about the trauma content, although this did not reach statistical significance. There was no change in self-reported experience of emotion following suppression, either in terms of background mood or when processing novel emotional material. There was, however, an increased heart rate deceleration when viewing subsequent emotional material and a slight increase in depression scores at one week follow-up, perhaps indicative of ongoing emotional costs of suppression. These findings, replicating and extending work from the normative emotion regulation literature (Gross, 1998; 2001), suggest that emotional suppression is not an effective form of emotion regulation at the time of encoding and that it leads to some subsequent emotional and mnemonic changes. A provisional clinical implication is that clients should perhaps be discouraged from using emotional suppression as form of mood control. In terms of understanding PTSD, it seems plausible to tentatively suggest that emotional suppression could contribute to the hyper-arousal and impaired recall of trauma seen in PTSD. It is important, however, to replicate and extend these findings to clinical populations to support these conclusions. While emotional suppression has been found not to lead to a 'rebound' effect directly analogous to that seen following thought suppression, it does appear to have some unexpected secondary costs that could perhaps contribute to symptoms of PTSD.

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