Regulating intense fear: Does cognitive reappraisal attenuate physiological and behavioral fear responses in an immersive VR environment?

Emotional experience and the regulation thereof are typically studied using picture inventories or short films to induce and modify affective states. These approaches, however, lack ecological validity due to their passive and receptive nature. Recent innovations in virtual reality and mobile neurophysiological technologies have enabled researchers to study the behavioral and neural correlates of more ecologically valid emotional responses. In this preregistered study, 58 healthy participants were randomly assigned to either use cognitive reappraisal (intervention) or to immerse themselves in their senses and surroundings (control) while walking across a wooden plank suspended 80 stories above the ground in virtual reality. We measured behavioral ratings, salivary alpha amylase and cortisol levels, as well as frontal brain asymmetries, captured using mobile electroencephalography (EEG). Across both conditions, we found decisive evidence of increased subjective fear and salivary alpha amylase, a marker of sympathetic activation. However, we found no increase in cortisol levels following the task suggesting that subjective fear alone is not sufficient to trigger an HPA-axis response. In contrast to our hypotheses, the reappraisal group did not show any difference compared to the control group for neither behavioral, endocrine nor neural measures. On the one hand, our findings may suggest that reappraisal might not be a suitable strategy to regulate realistic and intensely frightening situations. On the other hand, further analyses also indicated that the control group may have also regulated their emotions due to increased mindfulness of their inner states and their environment. Future studies are needed to confirm these observations and ascertain the efficacy of cognitive reappraisal on fear in realistic settings.