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 ).