Author Note
All data sets and scripts will be made available on the Open Science
Framework. The authors have no conflicts of interest to report. This
research did not receive any specific grant from funding agencies in the
public, commercial, or not-for-profit sectors.
Abstract
Exposure to stress can have significant, negative consequences on
long-term health. Among potentially modifiable targets for promoting
more adaptive stress responses, executive functioning has emerged as a
promising candidate. These functions may be involved in limiting
excessive stress reactivity when exposed to an acute stressor, while
also promoting faster recovery (i.e., return to baseline). Fewer studies
have been conducted to date on the role of executive functioning in
acute stress – especially with a focus on its distinct facets (e.g.,
inhibition, flexibility, working memory, and updating). Moreover, there
is a need for research focused on potential cognitive and behavioral
mediators explaining the relationship between executive functioning and
stress responses. Thus, the current study sought to examine the extent
to which executive functioning facets may play a beneficial role in
acute stress reactivity and recovery. Furthermore, we will examine the
mediational role of cognitive appraisals, repetitive negative thinking,
and emotion regulation. The findings may shed light on existing
cognition-stress pathways that promote more adaptive acute stress
responses.
Keywords : Inhibition, Flexibility, Working Memory, Updating,
Stress, Cognitive Appraisals, Repetitive Negative Thinking, Emotion
Regulation
Stress is a natural phenomenon in our lives. When it is repeated and
sustained, however, it can lead to adverse consequences. To prevent
excessive stress and stress-related disorders, research has converged on
the need for identifying personal, modifiable factors that could be
targeted by prevention programs. Among these factors, executive
functioning represents a potential resource for promoting more adaptive
stress responses.
Executive functions are higher-order neurocognitive processes that
enable individuals to organize and carry out goal-related actions and
behaviors (Rodríguez-Nieto et al., 2022). They are an umbrella term that
can be conceptualized as a global index while distinguishing several
subdomains, including inhibition, flexibility, and working memory
updating (Eslinger & Grattan, 1993; Miyake & Friedman, 2012; Packwood
et al., 2011). Inhibition involves preventing previously relevant
responses, thoughts, and emotions that may be no-longer relevant or
inappropriate for the task at hand. Flexibility allows us to shift from
one goal, thought, idea, or perspective to another, as well as to
achieve optimal choice in a task, or to optimize the fluidity of our
thoughts (Diamond, 2013; Hofmann et al., 2012). Working memory updating
facilitates the monitoring of incoming information in working memory and
the deletion of content that is no longer relevant to the current task
(Miyake & Friedman, 2012).
Given the unity and diversity of executive functions (Miyake &
Friedman, 2012; Rodríguez-Nieto et al., 2022), it is interesting to
examine how they contribute both independently and collaboratively to
the orchestration of cognition and behavior. While previous research has
focused primarily on the cognitive deficits caused by acute stress
(e.g., Kan et al., 2021; Shields et al., 2016), our recent systematic
literature review and meta-analysis (Grimm et al., 2021) revealed that
executive functions may reduce subjective and physiological stress
responses to acute stressors induced in the laboratory.
Stressor Reactivity and
Recovery
An adaptive response to a stressful event is denoted by both the
reactivity of the physiological systems during the stressor (al’Absi,
2018) and their recovery, namely the prompt return to baseline following
stressor discontinuation (Panaite et al., 2015). Stress reactivity, on
the one hand, is defined as the change in physiological and cognitive
responses when an individual is exposed to a stressful situation. The
recovery phase, on the other hand, corresponds to the period following
the stressor offset, during which the body attempts to achieve
homeostasis and modify physiological activity for a return to baseline.
Two major systems are involved in the initial reactivity phase: the
immediate activation of the sympathetic-adrenaline-medullary axis and
the more delayed hypothalamic-pituitary-adrenal axis release of cortisol
(i.e., the primary glucocorticoid stress hormone). The sympathetic
system releases epinephrine, norepinephrine, and alpha amylase (Nater &
Rohleder, 2009). With both the sweat glands and skin blood vessels being
innervated by the sympathetic nervous system, the galvanic skin
conductance and blood pressure are also indexes of sympathetic
activation and autonomous emotional regulation (Paszkiel et al., 2020;
Setz et al., 2010).
In contrast, heart rate is influenced by both the sympathetic and
parasympathetic nervous systems (Malik, 1996; Reyes del Paso et al.,
2013; Thayer & Lane, 2000). It is caused by both direct neural
innervation and the epinephrine and norepinephrine neuroendocrine
activity (Everly & Lating, 2002). Heart rate variability (HRV), a
measure of the interval between consecutive heartbeats, represents the
ability to respond and adapt to fluctuating stimuli, with lower
variability indicating higher stress reactivity (Dimitriev & Saperova,
2012; Kim et al., 2018).
In parallel to these physiological responses, stressful events can also
impact the subjective experience of stress (Calvo & Gutierrez-Garcia,
2016). Subjective stress, defined as the psychological response to a
stressor, is often measured through self-reported questionnaires. Items
include self-related anxiety and stress, as well as feelings of
nervousness or tension.
In the laboratory, acute stress has been induced using validated,
standardized stress tasks. These include the Trier Social Stress Test
(TSST, social-evaluative stressor, Kirschbaum et al., 1993), the Cold
Pressor Test (CPT, physiological stressor with social elements, Becker
et al., 2019; Schwabe & Schächinger, 2018), the Paced Auditory Serial
Addition Test (cognitive stressor, Gronwall, 1977), and the Maastricht
Acute Stress Test (MAST, social and physiological stressor, Smeets et
al., 2012). The latter is particularly interesting, as it is intended to
be rapid, non-invasive, and less resource-intensive, while combining the
social-evaluative and pain elements of the TSST and CPT, respectively.
The advantage of these induction methods is that they allow the
observation of different stages of the acute stress response, namely
reactivity and recovery, which would be otherwise difficult to capture
using less controlled paradigms.
Executive Functioning and Acute
Stress
Crum and colleagues (2020) recently proposed a stress optimization model
that outlines the importance of shifting one’s attentional focus away
from negative-related stimuli and towards goal-specific information to
adjust stress responses. In line with this idea, our systematic review
found poorer executive functioning to correlate significantly with
subsequent higher reactivity to an acute stressor, as well as poorer
physiologically and subjectively return to baseline levels (Grimm et
al., 2021). In the meta-analysis, better working memory was associated
with lower cortisol reactivity during an acute stressor (Grimm et al.,
2021). In specific studies of the review, preconscious biases in
attentional control towards threat-related cues tended to enhance
cortisol reactivity to an acute stressor (Fox et al., 2010), while the
more voluntary control of attention away from negative information
towards positive material led to more adaptive stress responses
(Schwerdtfeger & Derakshan, 2010). These findings imply that facets of
executive functioning may restrict excessive physiological stress
activation and promote a faster recovery.
This premise opens a new field of research that motivated our interest
in investigating the specific impact of multiple executive functions for
these stress phases. Indeed, the primary limitation in the field,
currently, lies in inconsistencies revealed in existing associations
between executive functioning and acute stress (e.g., Grimm et al.,
2021), the need for replication, and the lack of simultaneous
consideration of multiple executive subdomains in statistical models for
differentiating facet effects. Furthermore, cognitive and behavioral
factors such as primary and secondary cognitive appraisals, repetitive
negative thinking, and emotion regulation strategies (Grimm et al.,
2021) may also be implicated as mediators of the executive
functioning-stress relationship.
Cognitive Appraisals, Repetitive Negative Thinking, and
Emotion
Regulation
Cognitive Appraisals
According to Lazarus and Folkman’s (1984) Transactional Model of Stress
and Coping, when confronted with a potential stressor, individuals
engage in two types of appraisals. Primary appraisals correspond to the
preliminary assessment of whether ”the encounter with the environment is
relevant to his or her well-being” (e.g., centrality, Folkman et al.,
1986) and whether the event is perceived as neutral, positive, or
negative (Lazarus & Folkman, 1984). If an individual rates the event
negatively, the event is further classified based on whether it is
depicted as harmful (i.e., if damage or loss has already occurred),
threatening (i.e., expecting harm or loss as a result of the upcoming
event), or challenging (i.e., a threat that may be overcome) (Carpenter,
2016). Secondary appraisals are evaluations of the range of coping
options, taking into account the demands of the situation, available
personal resources, and realistic control possibilities (Gaab et al.,
2005; Lazarus & Folkman, 1984). The imbalance between the two appraisal
types, in turn, will influence the selection of emotional regulation and
coping strategies, as well as the degree of stress reactivity and
recovery.
Preliminary associations have been reported regarding the role of
executive functioning for cognitive appraisal. Better inhibition, for
example, has been associated with lower threat appraisal and stress
uncontrollability (Panganiban & Matthews, 2014), whereas working memory
has also been negatively associated with threat appraisal (Zandara et
al., 2016). Similarly, Xin and colleagues (2020) discovered that lower
– but not higher – inhibition abilities moderated the relationship
between exposure to recent stressful events and smaller change in HRV
markers (Root Mean Square Successive Difference, RMSSD, and
High-Frequency HRV) during the TSST. The authors interpreted the lack of
findings for higher executive functioning as the result of these
individuals’ more flexible and adaptive appraisal of stressful life
events, given a better performance of the prefrontal cortex.
Repetitive Negative
Thinking
Repetitive negative thinking is defined as recurring, passive and/or
uncontrollable thinking that focuses on negative content (Ehring &
Watkins, 2008; Segerstrom et al., 2003). Depressive ruminations and
worry are two of the most emblematic examples of repetitive thoughts.
The former is a distress response in which the individual passively and
repeatedly focuses on his or her symptoms, as well as their causes and
consequences of the latter (Nolen-Hoeksema et al., 2008). Worry, on the
other hand, is characterized by a chain of negative thoughts and images
that are frequently perceived as uncontrollable (Borkovec et al., 1983;
Freeman et al., 2020). Despite a minor difference in temporal focus (one
oriented towards the past, the other towards the future), authors agree
that they form a larger, multidimensional, and transdiagnostic process
known as repetitive negative thinking (Gustavson et al., 2018;
McLaughlin & Nolen-Hoeksema, 2011).
In the stress literature, this concept is also referred to as
perseverative cognitions (Brosschot et al., 2006). These are
representations of the stressor that are activated in a repeated and
chronic manner and maintained in working memory despite the stressor no
longer being objectively present. A systematic review and meta-analysis
on the relationship between perseverative cognitions and stress-related
physiological outcomes found that these thoughts exacerbate and prolong
physiological stress responses (Brosschot et al., 2006). They impact
cardiovascular, autonomic, and endocrine nervous system activity
(Ottaviani et al., 2016). Experimental studies have shown that the
presence of ruminations or worries after a stressor predicts a greater
increase in heart rate, blood pressure, and cortisol levels, as well as
a decrease in HRV (Maeda et al., 2017; Ottaviani et al., 2016; Zoccola
& Dickerson, 2015). Even in non-clinical samples, negative repetitive
thinking induction also appears to reduce HRV (Rocha-Oliveira &
Zibetti, 2022). In turn, prospective studies have established that
repetitive negative thinking and cognitive perseverations are involved
in the onset and/or maintenance of emotional difficulties and
psychopathology (e.g., Watkins & Roberts, 2020), as well as increased
chronic stress, health risk behaviors, and health-related diseases over
time (Brosschot, 2010; Brosschot et al., 2006; Clancy et al., 2016;
Verkuil et al., 2010).
Interestingly, repetitive thoughts do not systematically have negative
implications. According to the processing-mode theory (Watkins et al.,
2008; Watkins, 2008), when an individual is faced with a stressful
event, he or she may engage in one of two modes of processing repetitive
thoughts: the abstract-analytical mode and the concrete-experiential
mode. The former corresponds to a generalized and decontextualized mode
of processing the event. It prompts the individual to ruminate on the
causes, meanings, and implications of an event (e.g., the “why” mode;
“why does this always happen to me?” Watkins et al., 2008). Given that
this mode requires few cognitive resources, it is favored when
confronted with a stressor. This thinking mode is associated with
negative outcomes, such as mood deterioration, decreased participation
in pleasurable activities, persistence of psychological difficulties,
and poor therapeutic efficacy (Nolen-Hoeksema et al., 2008; Tanner et
al., 2013; Watkins et al., 2008).
In parallel, one can engage in concrete-experiential repetitive
thinking. The latter prompts individuals to focus on event elements that
are specific to the situation, on contextual and emotion-related details
and on solution options to deal with the stressor (e.g., the
“how ” mode; “how can I handle this situation?”; Moberly &
Watkins, 2006). Unlike abstract thinking, this mode requires substantial
cognitive resources and is associated with improved emotional recovery
and problem solving (Bassanini et al., 2014; Harvey et al., 2004).
Given the effort required for switching towards concrete thinking,
executive functioning should play a role in the choice of thought
processing mode. In their H-EX-A-GO-N model, Watkins and Roberts (2020)
identify executive functioning as a causal contributor to the onset and
maintenance of ruminative thinking. Deficits in monitoring, shifting,
and updating working memory could cause excessive access to negative
information, inciting individuals to continue dwelling on this negative
material. In addition, deficits in executive functioning could also
prevent individuals to disregard habitual tendencies to ruminate when
faced with difficult situations. Similarly, in a review by Ottaviani
(2018), inhibition and flexibility were suggested as two essential
facets for stress regulation.
In support of these theories, correlational, experimental,
interventional, and longitudinal studies have supplied evidence for
executive functioning deficits linked to higher tendencies for
repetitive thinking. For example, deficits in flexibility (Cropley et
al., 2016; Davis & Nolen-Hoeksema, 2000), updating (Joormann et al.,
2011; Meiran et al., 2011), or general executive functions (Whitmer &
Gotlib, 2013) have been associated with greater rumination.
Meta-analytical efforts have shown significant negative associations
with ruminations for both inhibition and flexibility (Yang et al.,
2017). Experimental designs using cognitive control training have led to
improvements in ruminative tendencies (see Watkins & Roberts, 2020 for
a review of existing literature for rumination). With respect to stress,
De Lissnyder and colleagues (2012) reported a moderating role for
executive functioning, where higher switch costs in the presence of
emotional material led to higher tendencies to ruminate in response to
daily stressful events. However, there has been few research into the
link between executive functioning and these modes of thought processing
in the context of acute stress.
Emotion Regulation
Emotion regulation is the process of modulating one’s cognitive,
physiological, behavioral, and emotional responses to meet
context-specific goals (Gross, 2014; McRae & Gross, 2020). Gross (1998,
2014) proposes five core elements of emotion regulation after the
activation of an emotion-related goal (e.g., reducing negative affect):
situation selection, situation modification, attention deployment,
cognitive change, and response modulation. Numerous strategies have been
studied (see Gross, 2014 for an overview), with considerable research
devoted to reappraisal (i.e., cognitive change example) and expressive
suppression (i.e., response modulation example). The former consists of
modifying cognitive appraisals of the situation, as such to increase
positive emotions and/or decrease expressions of subjective negative
emotions (Gross, 2014). It is proposed as one of the most effective
strategies for emotion regulation, with small-to-medium sized effects on
emotions (Webb et al., 2012). The latter refers to the active attempt at
controlling the behavioral component of the emotion (i.e., hiding the
way they are feeling, Webb et al., 2012). Experimental studies have
reported that suppression reduces positive emotions but fails to impact
negative emotions (Gross, 2014).
Emotion regulation is increasingly being recognized as an important
factor for stress management. The Dynamic Fit Model of Stress and
Emotion Regulation (Myruski et al., 2018), for example, has highlighted
the concept of “good” and “bad” fit between emotion regulation
processes and subsequent stress responses. According to their theory,
adaptive strategies can be identified by their successful reduction of
“the negative impact of stress” and promoting “emotional well-being
and resilience to adversity”. When systematically applied in the
context of chronic stress, specific emotion regulation strategies may
become maladaptive, generating poor mental-health consequences (for
example, higher depression in the context of rumination).
Given the overlap in brain regions solicited by executive functioning
and emotion regulation, the two are intrinsically linked. According to
Zelazo and Cunningham (2007), successful executive function is involved
in emotion regulation during (1) the assessment of one’s own emotions,
(2) the assessment of one’s goal state, (3) the generation of strategies
to reduce the discrepancy between the two states, (4) the evaluation of
strategy efficacy after its implementation, and (5) the learning to
switch deliberately and flexibly to other strategies if this one fails
to meet expectations. Furthermore, Pruessner and colleagues (2020)
propose an overall cognitive control framework, explaining the role of
executive functioning for strategy stopping and switching, strategy
maintenance, and monitoring. Schmeichel and Tang (2015) posit that
inhibition is important for suppressing negative emotions in response to
an event, flexibility is required to shift attention away from negative
material, and updating is involved in modifying initial emotional
appraisals within working memory.
In the context of stress regulation, Crum and colleagues (2020)
highlighted the role of executive functioning in appropriate situation
selection (i.e., choosing to expose oneself to goal-relevant situations
that may generate stress), attentional deployment towards goal-specific
material, and the reappraisal of the situation and emotions. Johnson
(2009) had previously reported that people who were better at switching
from emotional to neutral set were less frustrated during a stressful
anagram task and, moreover, persisted longer on the task. Similarly,
Hendricks and Buchanan (2016) found that working memory updating
predicted greater negative affect reduction during both reappraisal and
expressive suppression. However, research has yet to focus on the role
of different facets of executive functioning for emotion regulation
during acute stress, a limitation we address with the current study.
Current Study
The goal of this study is to examine the relationship between executive
functioning facets and acute stress reactivity and recovery in a
controlled laboratory setting (Axis 1). We will also investigate the
role of cognitive appraisals (Axis 2), repetitive negative thinking
(Axis 3), and emotion regulation (Axis 4) in the relationship through
three additional research axes.
Axis 1: Executive Functioning and Acute
Stress
This study will explore physiological and subjective reactivity and
recovery to a stress-inducing laboratory task using the Maastricht Acute
Stress Test (Smeets et al., 2012). Based on our previous findings (Grimm
et al., 2021), we expect the four facets (inhibition, flexibility,
working memory, and updating) to be negatively associated with
reactivity (i.e., lower stress reactivity), and positively with recovery
indicators (i.e., faster return to baseline; Hypothesis 1 ).
Axis 2: Cognitive
Appraisals
Axis 2 focuses on the role of primary and secondary appraisals in the
executive functioning-stress relationship. Based on the literature
reviewed (Panganiban & Matthews, 2014; Zandara et al., 2016), it could
be postulated that better inhibition and working memory should play a
role in keeping more adaptive appraisals in mind in anticipation of the
task (e.g., higher perceptions of challenge and control over the
stressor; Hypothesis 2a ). Consequently, this should reduce
physiological and subjective activations during the reactivity phase,
while predicting a faster return to baseline levels during recovery
(Hypothesis 2b ).
Axis 3: Negative Repetitive Thinking
The objective of Axis 3 is twofold: first, to evaluate whether a
mediating role of repetitive negative thinking linking executive
functioning facets with stress reactivity and recovery can be
replicated. Second, our goal is to differentiate the roles of abstract
and concrete modes of processing. We expect the executive functions to
be associated with higher concrete-experiential thoughts and lower
abstract-analytical repetitive thoughts throughout the stressor
(Hypothesis 3a). Based on past research (Ottaviani, 2018;
Watkins & Roberts, 2020), inhibition and flexibility should be the most
relevant facets. In turn, we expect to observe lower stress reactivity,
as well as a more rapid return to baseline levels after the stress
offset (Hypothesis 3b ).
Axis 4: Emotion Regulation Strategies
The role of emotion regulation during an acute stressor is the final
project axis. We will explore the role of each facet for reappraisal and
suppression during reactivity. We expect inhibition, flexibility, and
updating to predict higher reappraisal and lower suppression(Hypothesis 4a ). In turn, these should lead to lower
stress reactivity and faster recovery following the MAST
(Hypothesis 4b ).