Study shows “reappraisal” strategies helps build emotional resilience during COVID-19

The novel coronavirus (COVID-19) pandemic increased negative emotions across the world. People reported poor mental health and behavior problems including sleeping less, consuming more drugs and alcohol, struggling to concentrate, and fighting more with loved ones.

Over the past year, researchers from several countries studied whether interventions to mitigate negative emotions and increase positive emotions could improve psychological resilience and help people respond better to adversity. The findings of their research were published in the journal Nature Human Behaviour.

The studies show that using a simple method to help people think differently about their situations improved their emotional response. That emotion regulation strategy, known as reappraisal, “consistently reduced negative emotions and increased positive emotions” among study participants. The “effects of the intervention were not meager,” according to the study, helping ease the emotional toll caused by lockdown and self-isolation.

For the study, the authors collected nearly 28,000 responses from May to October 2020 from participants in 87 countries. That breadth allowed the researchers to test emotional responses in varying circumstances of lockdown among people from different cultures and across a wide spectrum of income and education levels.

As a measure of potential practical impact, the data revealed that the magnitude of emotional benefits driven by reappraisal were equal to, or even greater than, the emotional harms caused by such extreme conditions as being in lockdown or self-isolation during the pandemic.

Study methods included showing participants photos about the pandemic and measuring their emotional responses after learning reappraisal techniques briefly (~5 minutes) in an online survey and comparing the findings to the responses of an active control group (reflecting on thoughts and feelings) and a passive control group (responding naturally) that did not learn any reappraisal techniques.

The authors also tested two methods of reappraisal intervention, namely reconstrual and repurposing. Reconstrual involves changing how a person construes or mentally represents a situation to change the emotional response. The other method, called repurposing, calls for focusing on a potentially positive outcome to change the emotional response, such as thinking that the pandemic helps us recognize who are the most important people in our lives.

Overall, the study found little difference between the effectiveness of the two reappraisal methods—they both had marked positive impact. The report concludes that “both approaches significantly decreased negative emotional responses and significantly increased positive emotional responses across all primary outcome measures.”

The researchers also found that the improved emotional response to the pandemic did not reduce subjects’ intentions to practice preventive health behaviors. One expectation going in was that improved emotions about the pandemic might encourage people to let their guard down about prevention. The data did not bear out that concern.

For those in the behavioral sciences, the researcher’s analysis of the two forms of reappraisals offers nuanced insights into those specific interventions. For policymakers, the primary takeaway is the broader conclusion that reappraisal interventions work and are worth investing in where resilience is important for public welfare, the researchers said.

For all those who seek to help others respond to emotionally distressing events with resilience, the study provides clear, low-cost, scalable strategies, according to the study. Rather than rely on intuition or anecdotal evidence, public health leaders can now rely on hard data from scores of countries documenting that reappraisal heightens improvements in emotional resilience.

“Essential workers, nurses and doctors, students, patients and many other populations whose work and life are highly affected by the pandemic could potentially benefit from reappraisal interventions,” the authors write. “Because these interventions are inexpensive, brief, and scalable, they could be implemented through a variety of media and communication mechanisms, such as advertising campaigns, speeches, courses, apps and mobile games.”

Editor's note: Click here for more information and ongoing COVID-19 updates for integrative healthcare professionals.