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The current study investigated spontaneous anger coping, cardiac autonomic regulation and phasic heart rate responses to anger provocation. Forty-five adolescents (27 female, mean age 14.7 years) attended the single experimental session, which included monitoring of continuous heart rate and blood pressure responses to anger provocation (receiving an unfair offer) using a modified version of the Ultimatum Game (UG). Vagal activation was operationalized as high frequency component of heart rate variability during rest periods, and spontaneous baroreflex-sensitivity (SBR) during the UG. Adolescents employing cognitive reappraisal showed higher vagal activity under resting conditions and attenuated heart rate deceleration after receiving the unfair offer compared with participants who tended to ruminate about their anger and experienced injustice. Results from SBR suggested vagal withdrawal in anger ruminators during contemplation of the unfair offer. These results provide further support for the specificity and sensitivity of vagal responses to higher cortical functions such as emotion regulation.

Anger is among the emotions elicited by conflicted interaction, perceived unfairness and blocked goals. Its experience and expression have been shown to represent a major public health concern for children and adolescents today. Prevalence reports show that anger-related problems such as oppositional behavior, verbal and physical aggression and violence are some of the more common reasons for children to be referred to mental health services (Nock et al., 2007). The experience of anger and its expression in adolescents have also been linked to negative health outcomes through direct physiological pathways (Pajer, 2007). Although disease endpoints such as cardiovascular disorders do not usually become manifest until mid-life, some of the presumed processes linking negative emotions and physical disorders may well begin as early as adolescence. For example, a review of studies in youths (Grunbaum et al., 1997) found that hostility and anger are associated with high blood pressure, and results from more recent investigations are similar (Gump et al., 1999 and Raikkönen et al., 2003). Taken together these results suggest increased health risks for adolescents high in anger. Successful control of this emotion may, therefore, serve a health protective function, which may be of particular importance at a developmental age when negative emotions often first become problematic and the pathogenesis of cardiovascular disease appears to accelerate. Nevertheless, such control is often difficult to achieve, particularly for potent negative emotions such as anger (Gross et al., 2006). In this context two emotion regulation strategies have recently been investigated: expressive suppression and cognitive reappraisal (Gross, 2002). Expressive suppression aims at inhibiting ongoing emotion-expressive behavior and is considered a prototypical example of a response-focused emotion regulation strategy. Cognitive reappraisal, in contrast, is conceptualized as an antecedent-focused strategy: it aims at cognitively changing the interpretation of a situation such that the resulting emotion is modified, e.g. by construing a stressful situation as a challenge rather than a threat. Previous studies in adults have shown that cognitive reappraisal, compared with no emotion regulation or response-focused emotion regulation, is associated with an adaptive profile of affective responding across a range of negative emotions including anger (Gross, 2001 and Mauss et al., 2007). In our own studies investigating adolescents and young adults we consistently found the highest blood pressure reactivity to anger-provoking laboratory tasks in those employing response-focused emotion regulation (anger-suppression) together with a family risk of essential hypertension (Vögele and Steptoe, 1992, Vögele and Steptoe, 1993, Vögele et al., 1997 and Vögele, 2002). Nevertheless, several issues in the existing literature remain. Firstly, most experimental studies investigating the effects of emotion regulation strategies such as anger reappraisal and its physiological concomitants focus on adults, although prevention interventions would particularly benefit from results in adolescents. Secondly, few studies have used ecologically valid emotional situations, relying mostly on passive slide or film viewing. Thirdly, studies tended to either experimentally manipulate emotion regulation or relied on measuring trait emotion regulation by using self-report questionnaires. We are aware of only one report of a series of studies (Egloff et al., 2006) that investigated spontaneous emotion regulation, i.e. naturally occurring emotion regulation strategies in an experimental context. The present study was designed to address these issues by investigating the effects of spontaneous emotion regulation on psychophysiological and psychological responses to an ecologically valid anger-provoking situation in adolescents. Psychophysiological responses to emotional stimuli have mostly been investigated in terms of cardiovascular reactivity and orienting and/or defense reactions. Previous studies have mostly used visual stimuli of different affective values and found a marked cardiac deceleration in response to viewing unpleasant pictures (e.g. Sánchez-Navarro et al., 2006). In the current study we wanted to address the question whether an ecologically more valid stressor would provoke a similar response pattern, and whether this is affected by emotion regulation strategies. A fourth issue we wanted to address concerns the central nervous system processes (e.g. executive function, inhibition) and their associated neural networks that are presumed to be involved in emotion regulation. There is recent evidence that adolescence is a particularly sensitive period for the development of the prefrontal cortex (PFC) and the associated development of social-cognitive functions (Blakemore, 2008 and Casey et al., 2008). Taken together these findings suggest a central role of executive functions such as inhibition in emotion regulation. Hoeksma et al. (2004), for example, investigated this hypothesis in a small observational study by studying the association between children's inhibitory control as indexed by their performance in a Stop Signal Paradigm (Logan, 1994) and emotion regulation capacity operationalized as anger variability over 3–4 days. The results show a moderate to strong relationship between the stop signal reaction time and the mean standard deviation of anger variability and confirm the notion that response inhibition affects the regulation of anger. Inhibitory control and emotion regulation have been closely linked to a peripheral physiological parameter, i.e. heart rate variability (HRV) as an indicator of cardiac autonomic regulation (Appelhans and Luecken, 2006). Low vagal activation (low HRV) has been shown to be associated with hyper vigilance and the activation of a defensive behavioral system in response to non-threatening stimuli while high vagal activity (high HRV) was related to the most differentiated emotion-modulated response (Ruiz-Padial et al., 2003). In support of the notion of an association between HRV and emotion regulation capacity, Pu et al. (2010) have recently shown that respiratory sinus arrhythmia (RSA) as a measure of cardiac vagal tone modulated the facial expression of negative emotions in that those with high RSA showed less but reported feeling just as much negative emotions as those with low RSA. Further evidence for low HRV as an index of disinhibition and affective dysregulation comes from studies in psychopathology, which generally find low HRV to be associated with disorders such as depression and general anxiety disorder (Friedman, 2007) and post-traumatic stress disorder (Blechert et al., 2007). In this context we hypothesized that adolescents using cognitive reappraisal to be characterized by HRV suggesting increased vagal activity and a less marked cardiac deceleration to anger provocation when compared with participants emphasizing the experienced injustice.