Reappraisal, Suppression and Acceptance: What the Studies Compared
Experiments and trials comparing cognitive reappraisal, expressive suppression and acceptance: reappraisal produced larger reductions in negative emotion than acceptance in several experiments, suppression was least effective in one and linked to worse outcomes in surveys, both reappraisal and acceptance reduced distress against control in a trial, and reappraisal's effectiveness is reported as context-dependent.
People with marked, persistent emotion dysregulation should seek professional assessment rather than rely on self-help.
- Low mood, sadness, or loss of interest that persists most days for more than 2 weeks
- Anxiety, worry, or fear that persists more than 2 weeks or interferes with work, relationships, sleep, or daily functioning
- Any thoughts of self-harm or suicide, stop and contact a crisis line (e.g., 988 Suicide & Crisis Lifeline in the US) or emergency services immediately
- Distress that worsens or feels unmanageable during or after a practice
- Using these practices to avoid, delay, or replace care for a diagnosed or suspected mental health condition
- Persistent difficulty controlling emotions that damages relationships or work
What the evidence says
The sources compare cognitive reappraisal with expressive suppression and acceptance in experiments, trials and surveys, and test whether reappraisal can be trained. In experiments, Boehme 2019 reports that reappraisal had a compelling effect on emotional experience, skin conductance and P300, that acceptance was almost as effective, and that suppression was least effective; Troy 2017 reports that reappraisal produced “larger decreases in negative and larger increases in positive emotions than acceptance”, and that both may be considered effective strategies; Goldin 2019 reports that reappraisal produced significantly less negative emotion than acceptance, with different autonomic and neural effects; Wolgast 2011 (randomised trial) reports that both reappraisal and acceptance reduced distress, physiological reactions and avoidance compared with control, with few differences between them and slight advantages for reappraisal. In surveys, Salimzadeh 2020 (cross-sectional) reports reappraisal as health-beneficial and suppression as detrimental, and Brockman 2017 reports suppression associated with lower positive and higher negative daily affect. On training, LeBlanc 2017 (randomised trial) reports a significant increase in reappraisal at one-year follow-up compared with control, LeBlanc 2020 reports increased reappraisal associated with decreased depressive symptoms and worry, Feng 2025 (randomised trial) reports an 8-week mindfulness program increased reappraisal (3.95 to 4.58) and decreased suppression (3.18 to 2.78), and Stover 2024 (meta-analysis) reports higher reappraisal associated with higher resilience (r = 0.47). On acceptance, Kotsou 2018 (cross-sectional) reports that acceptance accounted for between 4 and 30 times the variance in distress explained by other measures, and Berking 2008 (cohort) reports acceptance, tolerance and active modification of negative emotions as particularly important for mental health. On context, Marciniak 2026 reports reappraisal's effectiveness as context-dependent, Dawel 2023 (cohort) reports that reappraisal may be particularly helpful for people with stable vulnerabilities such as neuroticism, and Alkoby 2019 and Ardi 2021 report that mindfulness training increased regulatory choice flexibility and the likelihood of choosing reappraisal. Rompilla 2021 (laboratory study) reports that in older adults acceptance did not alter emotional experience but felt most successful.
- Misconception: 'Good regulation means never feeling negative emotions.' Healthy regulation includes accepting and experiencing them.
- Misconception: 'Suppressing feelings is regulation.' Habitual suppression is generally less adaptive than reappraisal or acceptance.
- Does not diagnose, treat, cure, or prevent depression, anxiety, PTSD, or any mental health disorder
- Not a substitute for psychotherapy, counseling, or psychiatric care
- Cannot claim to 'fix' emotions, eliminate stress, or guarantee happiness
- No claim of clinical, therapeutic, or medication-like effects
- Cannot claim to remediate clinically diagnosed emotion dysregulation or personality-related conditions
- Agreement
- Direction recorded for 0 of 17 sources; not yet recorded for the rest.
- The claim's outcome
- Outcome not yet recorded
- Certainty
- No source states a certainty rating.
- Authors
- Sources share authors: Sara Leblanc (first author of 2 sources); C. Mohiyeddini (senior author of 2 sources); N. Levit-Binnun (senior author of 2 sources).
- How the sources were read
- Some sources are based on abstracts, not full texts.
What each source measured and concluded (17)
- What it measured
- Emotion regulation (reappraisal) and mental well-being
- How it was read
- based on the abstract, not the full text
- What it measured
- Reappraisal.
- How it measured it
- Emotion Regulation Questionnaire (ERQ; validated).
- Its conclusion, in its own words
- “The results of this research may provide the first step in this direction, by demonstrating that a brief, theoretically derived intervention can elicit enduring, positive changes in mental health.”
- How it was read
- read in full text
- What it measured
- Emotion regulation.
- How it measured it
- Emotion Regulation Questionnaire (ERQ) (self-report).
- How it was read
- read in full text
- What it measured
- Regulatory choice flexibility.
- How it measured it
- ER choice task (validated).
- Its conclusion, in its own words
- “Our study points to MBSR as an effective intervention to increase regulatory choice flexibility.”
- How it was read
- read in full text
- What it measured
- Change in emotion regulation strategy selection (increased reappraisal).
- How it measured it
- Emotion Regulation Choice (ERC) task (validated).
- Its conclusion, in its own words
- “Mindfulness seems to increase the sensitivity of regulatory selections to interoceptive signals, and this is associated with subjective well-being. This may be a central pathway through which MBIs exert their positive effects on mental health and resilience.”
- How it was read
- read in full text
- What it measured
- Effectiveness of cognitive reappraisal in regulating real-world stressors
- How it was read
- screened only, not extracted
- What it measured
- Emotion regulation effectiveness (self-report, skin conductance response, P300)
- How it was read
- screened only, not extracted
- What it measured
- Changes in depression, anxiety, loneliness, functional impairment, and wellbeing
- How it was read
- screened only, not extracted
- What it measured
- Subjective negative/positive emotion, physiological responses, and perceived cognitive costs
- How it was read
- screened only, not extracted
- What it measured
- Negative emotion ratings, autonomic psychophysiology, and fMRI BOLD responses
- How it was read
- screened only, not extracted
- What it measured
- Well-being outcomes (emotional exhaustion, job satisfaction, quitting intentions, psychological maladjustment, illness symptoms)
- How it was read
- screened only, not extracted
- What it measured
- Psychological distress (anxiety, depression) and well-being (happiness)
- How it was read
- screened only, not extracted
- What it measured
- Daily negative and positive affect
- How it was read
- screened only, not extracted
- What it measured
- Emotion-regulation skills application and treatment outcome
- How it was read
- screened only, not extracted
- What it measured
- Association between cognitive reappraisal and personal resilience
- How it was read
- screened only, not extracted
- What the review says it includes
- Meta-analysis
- Studies and participants, as stated
- 64 independent samples from 55 studies (N=29,824)
- What it measured
- Subjective distress, physiological reactions, behavioral avoidance to aversive emotional states
- How it was read
- screened only, not extracted
- What it measured
- Emotional experiences, physiology, and perceptions of regulation success/motivation in response to loss film clips
- How it was read
- screened only, not extracted
Each source below is shown with its study design and a link to the original study, or, where it is not a completed research paper, with what kind of record it is; those are not counted. This is the audit trail.
Why do some records show a record type instead of a study design?
A study design is shown for a completed, peer-reviewed paper. A registered protocol, a preprint, a conference abstract, a referee report or a book chapter has not been through peer review as a finished paper, so it is labelled for what it is, and it is counted in no source count. Where a record could not be confirmed as a completed paper at all, it says so rather than guessing. They all stay in the list, and their DOI still resolves, because the count of what was screened is part of the audit trail.
- Protocol / registration A registered plan for a review or trial, not its results.
- Preprint Posted by its authors before peer review.
- Conference abstract A conference summary rather than a peer-reviewed paper.
- Peer-review report A referee's report on a paper, not the paper itself.
- Guideline / position stand A recommendation derived from evidence, which is a step further from the data than the evidence itself.
- Book chapter A chapter in a scholarly book rather than a journal paper.
- Type not recorded Our record does not say what kind of publication this is, so it is counted in no source count. That is a gap in our data, not a judgement about the research.
“Abstract only” means the review read that paper’s abstract, not its full text; “screened only” means it was included at re-screening and not extracted. Both stay in the trail with their DOI, because how a source was read is part of the audit.