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Pers Soc Psychol Rev. Author manuscript; available in PMC 2012 February 1.
Published in final edited form as:
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Pers Soc Psychol Rev. 2011 February ; 15(1): 75–102. doi:10.1177/1088868310365565.

Fixing our focus: Training attention to regulate emotion

Heather A. Wadlinger and Derek M. Isaacowitz


Department of Psychology, Brandeis University, Waltham, MA

Abstract
Empirical studies have frequently linked negative attentional biases with attentional dysfunction
and negative moods; however, far less research has focused on how attentional deployment can be
an adaptive strategy that regulates emotional experience. We argue that attention may be an
invaluable tool for promoting emotion regulation. Accordingly, we present evidence that selective
attention to positive information reflects emotion regulation, and that regulating attention is a
critical component of the emotion regulatory process. Furthermore, attentional regulation can be
successfully trained through repeated practice. We ultimately propose a model of attention training
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methodologies integrating attention-dependent emotion regulation strategies with attention


networks. While additional interdisciplinary research is needed to bolster these nascent findings,
meditative practices appear to be among the most effective training methodologies in enhancing
emotional well-being. Further exploration of the positive and therapeutic qualities of attention
warrants the empirical attention of social and personality psychologists.

Keywords
emotion regulation; attention; attention training; selective attention; meditation

Attention is a most valuable instrument that serves as a telescope through which we select,
bring into focus, and magnify the stimuli we experience in our world (Wallace, 1999). In
Principles of Psychology, William James writes, “My experience is what I agree to attend to.
Only those items which I notice shape my mind - without selective interest, experience is an
utter chaos” (1890, p. 402). As James suggests, without our ability to use attention as a tool
to hone specific aspects of our experience, we would be lost in superfluous information.
Salient sensory, emotional, and mental information is filtered, processed, and analyzed
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through various attentional processes, which can be automatically or consciously regulated


(Calvo & Nummenmaa, 2007). Clearly, what we attend to can shape our experiences, good
or bad. How successful individuals are at influencing their attentional processes can dictate
their subsequent affective experience and behavioral trajectories. Although individual
differences exist in the ability to regulate attention, recent literature has suggested that the
processes involved in attentional regulation can be trained and improved through repeated
practice (Lutz, Slagter, Dunne, & Davidson, 2008; Rueda, Rothbart, Saccomanno, & Posner,
2007). If attention can be trained, then it may be used to actively guide individuals’ emotion
regulation processes and downstream behavior, ultimately enhancing subjective well-being.
That is, people could learn to selectively attend to specific types of information in the
service of optimizing their emotional experience.

Please address correspondence to: Derek M. Isaacowitz, Department of Psychology, Brandeis University, MS 062, Waltham,
Massachusetts 02454-9110. dmi@brandeis.edu.
Heather Wadlinger is currently a postdoctoral fellow at the Prevention Research Center and the Methodology Center at The
Pennsylvania State University.
Wadlinger and Isaacowitz Page 2

This paper considers how attention can be trained as a way to regulate emotional experience.
We will first examine the role of attentional deployment as an emotion regulation strategy.
Accordingly, we will present evidence that selective attention patterns not only reflect
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emotion regulation, but that they can also actively influence the emotional response process.
We will draw evidence from a wide array of cognitive, experimental, and clinical sources
including studies that investigate gaze patterns, implicit learning, clinical interventions, and
meditative practices. Reviewing relevant literature on attention training methodologies, we
will attempt to integrate the findings from these different subdisciplines. Most importantly,
using Posner and Petersen’s (1990) attentional networks as a foundation, we propose a new
model of attention training methods that elucidates what unique types of attention-based
emotion regulation strategies comprise different training techniques as well as what
components of attentional processes may be recruited and modified by each type of training.
Next, we consider which method of training attention can be used to most optimally improve
emotion regulation. Although not frequently investigated in social psychological research,
one type of attention training method, meditative practice, stands out in our model as being
particularly promising in improving emotion regulation. Ultimately, we suggest that further
interdisciplinary research between clinical, cognitive, social, developmental, and
contemplative fields will help to both elucidate the mechanisms behind how attentional
processes may facilitate emotion regulation and clarify which types of training methods may
work most effectively for specific populations.
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The Role of Attention in Emotion Regulation


Defining Emotion Regulation
In this paper, we utilize a functionalist perspective in which emotions are viewed as
adaptive, behavioral, and physiological response tendencies enhancing individuals’ physical
and social fitness (for a review see Keltner & Gross, 1999; cf. Barrett, 2006). These
response tendencies are malleable, transient, and may be modulated by individuals; in others
words, they can be regulated (Gross, 1998).

The goal of emotion regulation need not only be to decrease negative emotion and increase
positive emotion; depending on the situation, one may wish to increase or initiate negative
emotion and stop or decrease positive emotion (Gross, 1998; Tamir, Chiu, & Gross, 2007).
Therefore, the interplay of how individuals transition between negative and positive states
may be critical in defining successful emotional regulation (Diamond & Aspinwall, 2003).
For instance, positive emotions facilitate psychological and physiological recovery from
negative emotional experiences (Fredrickson & Levenson, 1998; Fredrickson, Mancuso,
Branigan, & Tugade, 2000). Emotion regulation might therefore be best defined as
maintaining desirable emotional states and terminating undesirable emotional states
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(Carstensen, Pasupathi, Mayr, & Nesselroade, 2000; Gross, Richards, & John, 2006; Larsen,
2000). For most individuals across most settings this would involve maintaining high levels
of positive affect and low levels of negative affect, or increasing levels of positive affect
when they are low and decreasing levels of negative affect when they are high (cf. Tamir,
2009). Experiencing more frequent positive emotions and less frequent negative emotions
would therefore constitute more effective or successful emotion regulation (e.g. Carstensen
et al. 2000; Diener, Sandvik, & Pavot, 1991). Several studies have found that maintaining a
high ratio of positive affect relative to negative affect (2.9 or more positive to negative
emotional interactions) constitutes optimal emotional functioning of individuals, married
partners, and business teams (Gottman, 1994; Fredrickson & Losada, 2005; Schwartz et al.,
2002; Schwartz, 1997). However, too much positivity (a positivity ratio of 11.6 or higher)
may have aversive emotional effects since certain forms of negative emotion may promote
emotional growth and flourishing (Fredrickson & Losada, 2005), and particular negative
states may have immediate instrumental value (Tamir, 2009).

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Gross outlines five emotion regulatory processes, which can each encompass a multitude of
distinct regulatory strategies: situation selection, situation modification, attentional
deployment, cognitive change, and response modulation (for a review see Gross, 1998). He
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further distinguishes between antecedent-focused strategies occurring before the full


generation of an emotional response, and response-focused emotion regulatory strategies
that are used after. Antecedent-focused regulatory strategies may be more adaptive than
response-focused strategies and may require less resources, time, and energy to initiate
because they occur early in the emotion generative process (Mauss, Bunge, & Gross, 2007a;
Schutte, Manes, & Malouff, 2009).

Attentional Deployment
Attentional deployment1 is an antecedent strategy where different attentional processes are
recruited to shape affective experience. In this paper we explore whether attention allocation
can be trained and if training can improve emotion regulation. In the emotion regulation
literature, attentional deployment broadly involves selectively attending to certain aspects of
situations. Different attentional processes may have more or less influence on generating,
maintaining, or modifying different emotional responses. Gross (1998) has identified three
primary strategies of attentional deployment: distraction, concentration, and rumination.
These categorizations are not comprehensive, but rather serve as an initial starting point in
attempting to delineate unique functions and mechanisms by which attention deployment
processes may work in the service of emotion regulation.
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One primary strategy of emotion regulation, attentional distraction, involves shifting


attention from one aspect of a situation (or goal) to another aspect of the situation or entirely
away from the situation altogether (Gross, 1998). An example of effective distraction may
be in shifting attention to a positive thought (“I performed well on this aspect of the task.”)
in lieu of a current negative one (“I did not perform well enough on this task.”). Another
deployment strategy delineated by Gross (1998), concentration, involves fully utilizing
cognitive resources within an activity. In concentration an individual actively chooses what
they want to mentally focus on in order to regulate their emotions (e.g. the source and
triggers of their emotions). As part of concentration meditation practices, individuals
selectively focus sustained attention on an object such as their breathing, a sound, or a visual
stimulus (Brefczynski-Lewis, Lutz, Schaefer, Levinson, & Davidson, 2007). When attention
wanders from the object of meditation (e.g. attention is drawn from attending to the breath to
attending to thoughts), an individual disengages from the distracter (i.e. the thought) and
returns their attention to the object of meditation (i.e. the breath).

Rumination involves directing attention selectively inward towards feelings and the
consequences of certain feelings (Gross, 1998). Ruminating on negative emotions for long
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periods of time can lead to clinical conditions such as depression or anxiety disorders
(Nolen-Hoeksema & Morrow, 1993). However, rumination may not always necessarily lead
to negative affect (Kross, Ayduk, & Mischel, 2005) and in the context of positive emotion,
rumination may be beneficial. Ruminating on positive emotional experiences, defined as
savoring, may prolong the affective benefits of those positive emotions (Bryant, 2007).
However, excessive rumination on the positive may also be maladaptive if attentional
resources are not appropriately allocated and environmental dangers are overlooked.
Importantly, there are many other types of attentional deployment processes that do not fit

1This paper focuses specifically on strategies of emotion, not mood, regulation, although moods can result from repetitive emotional
states. Nonetheless, in defining mood regulation Larsen (2000, p. 133) identifies a similar regulatory stage to attentional deployment
deemed “attention to affect-relevant stimuli in the environment” where individuals attend to, encode, and process affective
information. Thus, there may be some overlap in our discussion of emotion regulation strategies that is also relevant to more general
mood regulation.

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within these three primary strategies and that have not been systematically described and
investigated (e.g. maintaining a state of awareness without any attentional focus, employing
selective attention to information of a particular valence - positive or neutral). This paper
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will further elaborate on some of the attentional processes that have been used so far in
training interventions to modify patterns of attentional deployment. In addition, we will later
discuss how these attentional processes can be mapped on to the three primary strategies of
distraction, concentration, and rumination.

Why Attend to Attention? Attentional Deployment versus Other Regulatory Strategies


Attentional deployment was initially chosen as the focus of the current review because it is a
relatively nascent field within emotion regulation that seemed to warrant further exploration.
However, other good reasons to focus on attention in the context of emotion regulation
quickly became apparent. First, as an early antecedent-focused regulatory process,
attentional deployment may hold great promise as a strategy that curtails the unfolding of
subsequent negative emotional experiences. Attentional deployment may be, in some
contexts, a more automatic regulatory strategy (Jackson et al., 2003; Mauss et al., 2007a;
Mauss, Cook, & Gross, 2007b) requiring less cognitive effort to enact (and therefore being
more cognitively efficient) than other regulatory strategies.

Attentional deployment may also be an extremely versatile regulatory process. To the degree
that attentional deployment can be an automatic regulatory strategy, it may be more
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extensively used as a “first line of defense” since it requires minimal cognitive effort.
Furthermore, attentional regulation can also be enacted in some form at any stage of the
emotion generative process (Koole, 2009). Recently, researchers have found that when
distraction is employed late in the emotion generative process (after an emotional response
has manifested) it can still be effective in helping individuals effectively regulate their
emotions (Sheppes & Meiran, 2007; Sheppes & Meiran, 2008). Moreover, attentional
deployment may be both a regulatory strategy itself as well as a component of other
regulatory strategies such as reappraisal, suppression, and certain cognitive change and
response-focused strategies. For example, during reappraisal portions of the dorsal
prefrontal cortex (PFC), implicated in selective attention, are activated, as well as portions
of the dorsal anterior cingulate cortex (ACC), which seem involved in monitoring control
processes (Ochsner & Gross, 2008).

Attentional deployment may in fact serve as a precursory “gateway” strategy for other
emotion regulatory processes. For example in order to reappraise a negative situation,
attention must disengage from the negative information or interpretation and reorient
towards finding or creating evidence for an alternative interpretation. Further research that
combines attentional deployment with other regulatory strategies such as reappraisal may
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help to elucidate what aspects of attentional deployment are recruited (e.g. selective
attention, executive control) to facilitate different regulatory strategies across different
situations (Ochsner & Gross, 2005; Ochsner & Gross, 2008).

If attentional deployment is used successfully in conjunction with reappraisal in helping


individuals regulate their emotions (e.g. individuals orient their attention towards aspects of
a situation that allows them to adequately reappraise its meaning) then these strategies may
augment each others’ efficiency, thereby reinforcing the likelihood of being enacted as a
future strategy-combination. However, if individuals cannot successfully reorient their
attention to reconstruct a reappraisal strategy (e.g. they cannot visually find information to
aide the story formation or they cannot disengage from negative material) then they may
have to enlist an additional strategy (e.g. suppression) to attempt to regulate their emotional
experience. Put differently, how successful individuals are using other regulatory strategies
may be influenced by how successful they are at deploying their attention.

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Attentional deployment may nonetheless sometimes be a maladaptive regulatory strategy.


Kross and Ayduk (2008) had participants recall a depressive experience and then regulate
their emotions with one of three conditions: analyzing their feelings from a self-distancing
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perspective, analyzing their feelings from a self-immersed perspective, or using a distracting


strategy. Immediately after the training the self-distancing and distraction strategies were
most effective at reducing negative affect; however, at one and seven days after the
manipulation, the self-distancing manipulation group was the most buffered (experiencing
less negative affect and fewer recurring thoughts). Using distraction as a regulatory strategy
may have immediate short-term benefits, but also may have aversive long-term
consequences.

Another aversive consequence may be that using distraction as a regulatory strategy has
some cognitive costs (Sheppes & Meiran, 2008). Distraction may impair memory processes.
If distraction requires processing extraneous information (e.g. to reduce the encoding of
negative information), working memory capacity may be depleted. However, relative to
cognitive reappraisal, using distraction as a regulatory strategy preserves self-control
resources (Sheppes & Meiran, 2008) and elicits less sympathetic physiological activation
and consequences (Sheppes, Catran, & Meiran, 2009). So while costly, distraction may be
less costly than other possible strategies. While further research is needed to more fully
elucidate the relationships between attentional deployment and other emotion regulatory
strategies, preliminary evidence suggests that attending to attention holds much promise for
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facilitating emotion regulation.

Evidence of Attention as a Form of Emotion Regulation


Selective attention has evolved as one mechanism through which individuals can filter the
plethora of sensory stimuli in their environments at any given moment (Parkhurst, Law, &
Niebur, 2002). Because our attentional resources are limited, it is likely that the salient
stimuli that capture our attention will also direct our future choices and behaviors (Pashler,
Johnston, & Ruthruff, 2001). Which stimuli individuals find to be salient is not merely
random or accidental but is related to person-level variables such as motivation (Fiske,
1995). Isaacowitz (2006) has argued that individuals seek out visual stimuli congruent with
their goals and avoid incongruent stimuli. Goal-congruent gaze has been demonstrated in
certain groups possessing positive affective profiles, such as optimists and older adults:
these groups display distinctive gaze patterns away from negative and favoring positive
stimuli (Isaacowitz, 2005; Isaacowitz, Wadlinger, Goren, & Wilson, 2006a, 2006b). Both
individuals’ motivations and their emotional state can influence their attentional patterns
(Tamir & Robinson, 2007); yet the converse is also true: what individuals pay attention to
affects their emotions and goals. Below we will review evidence suggesting that links
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between affect and attention are ultimately bidirectional: while affect clearly impacts
attention, regulating attention also influences affect.

It is first necessary to make a distinction between emotion regulation processes and emotion
regulation outcomes. Emotion regulation outcomes (e.g. whether or not one reaches their
hedonic goals, a positive regulatory outcome) are distinct from emotion regulatory processes
(e.g. where an individual looks, how they reappraise an event, and other strategies that may
be used in the service of emotion regulation). Using a particular emotion regulation process
could but does not necessarily lead to positive emotion regulation outcomes. This distinction
is important because we contend that attentional deployment, itself, can be an emotion
regulatory process that potentially leads to positive emotion regulation outcomes. We will
refer to emotion regulation processes and strategies interchangeably because strategies may
be the behavioral manifestations of the processes, but will keep regulatory processes distinct
from outcomes. Figure 1 provides a schematic representation of the components we consider

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in attempting to link attention training to emotion regulation outcomes via emotion


regulation processes: starting from the left, different types of attention training methods
(detailed later in the paper in Table 1) may modify (arrow A) different attention-based
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emotion regulation strategies in unique ways (discussed in more detail in Table 2), thus
potentially influencing emotion regulation outcomes (arrow B). The emotional experience,
expression, and neurobiological effects of these outcomes may then in turn, through
experience, influence how attention is used for regulatory purposes (arrow C), though these
reciprocal effects are beyond the scope of this paper. Throughout the paper we will provide
evidence linking multiple components of this figure, ultimately arguing that attentional
training can affect both attention processes and emotion regulation outcomes. In the
following section we will review evidence that attentional processes influence the
experience of affect.

Bidirectional Links between Selective Attention and Affect


Attention toward positive information may work in the service of maintaining individuals’
positive moods. How an individual feels often acts as a good indicator of the motivational
significance of their goal pursuits (see the affect-as-information model: Schwarz, 1990).
That is, in order to determine whether information is important, a person may rely on their
affect at the time. The hedonic contingency model (HCM) proposes that individuals seek out
stimuli in their environments that are congruent with their current affective state (Wegener
& Petty, 1994). Therefore, individuals motivated to attain and preserve positive moods
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would direct their attention to mood-facilitating stimuli (Isaacowitz, 2006). Over time, this
attentional preference toward positive information may become habitual. One study suggests
that mood maintenance has become an automated response due to over-learning (Handley,
Lassiter, Nickell, & Herchenroeder, 2004).

A recent study suggests that positive, automatic biases may also occur such that individuals
who experienced higher daily positive mood states showed heightened selective attention
towards positive, rewarding words in a dot probe task (Tamir & Robinson, 2007). Goetz,
Goetz, and Robinson (2007) specifically propose that positive emotions make individuals
more sensitive towards rewarding stimuli in their environments and that the repetition of this
preference creates stronger memory-encoding pathways for similar positive stimuli in the
future (e.g., Clark & Isen, 1982). Another explanation is that experiencing positive affect
initiates an approach tendency, which may in turn lead individuals to be more likely to
attend to subsequent positive information (Carver, 2001; Tamir & Robinson, 2007; Watson,
Wiese, Viadya, & Tellegen, 1999).

Positive emotions may also enlarge individual’s breadth of attention (e.g. taking in more of
the world around them as well as broadening attentional allocation to internal conceptual
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space – expanding the “spotlight”: Fenske & Eastwood, 2003; Fredrickson, 1998; Rowe,
Hirsh, & Anderson, 2008; Wadlinger & Isaacowitz, 2006, cf. Gable & Harmon-Jones, 2008)
and increase their attentional flexibility (Ashby, Isen, & Turken, 1999). Broadened attention
towards positive information may facilitate emotion regulation by helping individuals to see
opportunities for reward in their environment. Greater attentional flexibility may promote
emotion regulation through easier disengagement from irrelevant negative information and
more frequent shifts of attention towards positive information. Individuals with better
attentional flexibility may also be able to use other emotion regulation strategies like
reappraisal more quickly and effectively.

The experience of positive affect itself may increase individuals’ selective attention
preferences for positive information and these positive attentional preferences may improve
individuals’ mood. Yet even in the absence of positive affect, attentional processes can still
impact how individuals regulate their emotions. A number of studies have provided

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evidence that attention itself, even in the absence of positive emotions, may act to direct
emotion regulation (Compton, 2000; Ellenbogen, Schwartzman, Stewart, & Walker, 2006;
Rueda, Posner, & Rothbart, 2004). Attentional dysfunction has been shown to lead to
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persistent negative mood states, indicative of unsuccessful emotion regulation2 (Compton,


2000; Ellenbogen et al., 2006). For instance, in one study, individuals who were slow to
disengage their attention in an orienting task showed increased negative affect in response to
a subsequent distressing film clip (Compton, 2000). Thus an inability to shift attention
effectively may contribute towards experiencing prolonged negative affect. In another study,
depressed individuals were slower than control participants to disengage their attention from
all types of stimuli while engaged in a stress task (Ellenbogen et al., 2006). Supporting the
idea that dysfunction in attentional disengagement may contribute to unsuccessful
regulation, individuals who were currently or formerly depressed selectively attended to sad
faces, rather than neutral or happy faces, in a dot-probe task (Joormann, & Gotlib, 2007).
The above research suggests that maladaptive attentional biases may exist beyond the period
of the actual depressive episode and may heighten vulnerability for future depressive
episodes.

Other studies have shown that individuals may engage certain early, automatic attentional
processes in an effort to regulate their emotion. In these studies, individuals were given
some instructions to regulate their emotions, and then the researchers assessed the role of
attention during regulation, using measures such as LPP or eye tracking. For example, when
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participants were instructed to down-regulate their emotional response to pleasant, highly-


arousing images (e.g., view the pleasant image from a detached perspective or imagine it
gets worse), they showed an attenuation of late positive potential (LPP) magnitudes
(Krompinger, Moser, & Simons, 2008). This neural response, representative of attentional
processing, was modulated within 325ms of stimulus delivery. These results may reflect a
general disengagement of attentional processing from the arousing components of highly
relevant, positive stimuli. In other words, individuals were using attentional processes to
regulate their emotions. In another study, researchers manipulated the motivational state of
young adults as they watched a series of images by varying the task instructions across three
conditions: 1) to regulate their emotions while watching the images, 2) to focus on acquiring
information about the images, or 3) to just attend to the images naturally as if watching
television (Xing & Isaacowitz, 2006). Individuals motivated to regulate their emotions
attended less to negative images than positive images, and looked less at all stimulus types
(negative, positive, neutral) than the other conditions, suggesting that gaze serves as a
mechanism through which individuals can regulate their emotions (Xing & Isaacowitz,
2006). Specifically, the young adults may have been using distraction as a regulatory
strategy (Gross, 1998).
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Interestingly, it has been suggested that older adults may be especially likely to use
distraction as a regulative strategy. In one study, researchers instructed a sample of older
women to decrease their emotional responses to negative pictures (van Reekum et al., 2007).
Specifically, they told participants use one of two cognitive reappraisal strategies while
viewing the images: to either imagine the depicted visual scene was not real, or to imagine
that the outcome was better than it looked in the image. Participants instructed to decrease
their negative emotion while viewing negative images (as opposed to the increase negative
emotion or naturally attend to the images conditions) looked less at the entirety of the
negative images, despite the researchers’ insistence not to look away from the images (van
Reekum et al., 2007). The older women also looked less at the most relevant objects in the
images and made more frequent saccades around the negative images, with larger distances

2Successful emotion regulation may sometimes require feeling and attending to salient negative emotional states and stimuli.
However, in these experiments, participants were attending to irrelevant negative stimuli.

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between saccades than in the other two conditions. This suggests that the older adults, in an
effort to decrease their negative emotions while viewing the images, were scanning around
the image more, looking particularly at the extremities and least relevant parts of the picture.
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Put another way, the older adults were using multiple attention strategies (e.g. looking away
from negative components of images, looking around the images more) while reappraising
the images. Van Reekum (2007) proposes that this was in an attempt to construct a new
reappraisal narrative. The results of this study therefore indicate that, under certain
conditions, attentional deployment may be an active component of cognitive reappraisal.
Alternatively, attentional deployment and reappraisal may sometimes be distinct: in an
experiment where gaze was held constant, Urry (2010) found that cognitive reappraisal
nonetheless uniquely affected individuals’ ratings of their emotional experience.

Very few studies have used real-time measurements of emotion to establish evidence for a
causal relationship between attentional processes directing emotion regulatory outcomes
(arrow B). The studies summarized above assessed regulatory processes (box 2) only and
did not explicitly measure regulatory outcomes (box 3), such as changes in self-reported
affect during the experimental tasks (cf. Urry, 2010). Therefore, these studies can only offer
indirect evidence for attention guiding emotion regulation. However, a few other recent
studies have included assessments of participants’ affect while also measuring their
attentional deployment. These studies, though small in number, begin to establish an even
more direct link (arrow B) between attention and emotion regulation. We next review
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studies that provide further evidence for attentional deployment acting as a regulatory
process (box 2), and in a few cases also provide evidence linking the regulatory processes to
outcomes (arrow B).

One study has demonstrated that older adults selectively activate positive gaze preferences
when they are in a bad mood, looking towards positive faces and away from negative ones
(Isaacowitz, Toner, Goren, & Wilson, 2008). Older and younger adults were eye-tracked in
real-time to a series of synthetic, emotional face pairs (happy, sad, angry, or fear paired with
neutral) while continuously rating their mood on a potentiometer slider. Participants were
classified into mood conditions by their initial slider rating. When participants started in a
negative mood, younger adults showed mood-congruent gaze patterns towards angry and
afraid faces; however, older adults showed mood-incongruent gaze patterns away from
angry and sad faces and towards happy faces. This evidence suggests that older adults’ gaze
did not reflect their mood state but rather that they used gaze as an active strategy to regulate
their mood (Isaacowitz et al., 2008).

Individual difference variables, such as the overall efficiency of the attentional system, may
influence how they use attention to regulate their emotion. Isaacowitz, Toner, and Neupert
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(2009) assessed how older adults use positive gaze preferences to regulate their moods.
They analyzed the differences in individuals’ mood changes while viewing a variety of
synthetic, emotional faces. Positive gaze preferences helped older adults avoid mood
declines during the task, but only for those with high-functioning executive control
networks. While this experiment is suggestive of an important attention-emotion regulation
link for certain individuals (i.e., this is a rare case in which arrow B is directly tested),
additional research is needed to further delineate and clarify the influence of different
individual difference factors on attentional deployment tactics and their real-time influence
on emotional experience and regulation. Isaacowitz and colleagues (2008) argue that older
adults use gaze as a regulatory tool to a greater extent than younger adults because it
requires less cognitive effort than a number of other regulatory processes (Knight, Seymour,
Gaunt, Baker, Nesmith, & Mather, 2007; Mauss et al., 2007b; Washburn & Putney, 2001).

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Feeling good and regulating mood are highly prioritized goals for older adults (Carstensen,
Mikels, & Mather, 2006). Compared to younger adults, older adults appear to show
improved emotion regulation abilities (Carstensen et al., 2000; Gross, Carstensen, Pasupathi,
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Tsai, Götestam Skorpen, & Hsu, 1997). These enhanced abilities may partially result from
age-related changes in emotional information processing (Carstensen & Mikels, 2005).
Specifically, older adults are said to exhibit an age-related “positivity effect”, because they
attend more to, and have better memory for, positive relative to neutral or negative
information than their younger counterparts (Carstensen & Mikels, 2005; Kennedy, Mather,
& Carstensen, 2004). This attentional shift may reflect a change in the prioritization of
different types of goals. With age, individuals shift from prioritizing, and thus paying more
attention to, informational goals to prioritizing emotion regulation goals thereby reallocating
their attentional resources to regulate their emotions and optimize their positive affect. Only
older adults who have adequate cognitive resources (e.g. sufficient levels of cognitive
control) may be able to enlist positive biases in memory or attention that could facilitate
emotion regulation (for a review see Kryla-Lighthall & Mather, 2009; Mather & Knight,
2005). One recent study demonstrated that older adults can compensate for age-related
declines in executive control areas (bilateral dorsolateral prefrontal cortex and the anterior
cingulate) by spontaneously recruiting other brain areas, such as middle and medial frontal
regions (Gutchess et al., 2007).

If older adults show preferences for positive information that emerge naturally as they age,
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then the question arises as to whether these attentional changes can be accelerated in
younger or middle-aged adults via attentional training. If individuals can learn how to use
their attention as a regulatory tool, then they may show increased efficacy in regulating their
emotions, just as older adults and other individuals possessing positive affective profiles do.
Exploring how to generate and train these attentional preferences in different populations
may shed light on how to use them as effective instruments for emotion regulation. Yet
before assessing how different training procedures might work in changing emotion
regulation processes and outcomes in different populations, we need to evaluate whether
attentional processes themselves can change.

Attentional Plasticity
The first step in demonstrating that attentional processes can be trained for emotion
regulation is to determine whether attention is plastic (i.e. malleable) and trainable. Several
studies suggest that the answer to this question is affirmative and that attentional processes
can become more efficient with practice. It is important to note that individual differences in
attentional abilities (e.g. attentional control) exist starting as early as infancy (Fox &
Calkins, 2003). Individuals have different baselines in their ability to regulate voluntary
attentional control (Derryberry & Reed, 2002). For example, highly trait anxious
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undergraduate students, who had good attentional control (as assessed by self report on the
Attentional Control Scale), were better able to disengage their attention (at 500ms) from a
threatening location and refocus their attention on a safe location on a visual cueing
response-time task. Highly trait anxious students with poor attentional control had trouble
disengaging their attention from the threatening location. There are also individual
differences in the plasticity of attention. In another study, individual differences in readiness
to acquire a bias towards threat cues experimentally predicted naturalistic bias and
heightened anxiety in a later stress task (Clarke, MacLeod, & Shirazee, 2008). These
findings may suggest individual differences in how malleable some individuals’ attentional
regulation abilities are, even if training is generally effective.

One piece of evidence for plasticity of attention comes from the observation that individuals
can adapt their attentional abilities to fit with environmental circumstances (Newman,
Keller, & Just, 2007; Sarter, Mumaw & Wickens, 2007; Slagter et al., 2007; Vidnyánszky &

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Sohn, 2005). For example, within many occupations there are attentional experts: fighter
pilots, doctors, taxi drivers, volleyball players, chess masters, and mail sorters. Polk and
Farah (1995) found that Canadian mail sorters’ attentional skills were easily transferable to
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sorting the US mail because the US zip codes consisted of familiar elements (i.e., numbers);
whereas US mail sorters could not effectively sort Canadian mail as Canadian zip codes
contained novel elements (i.e., letters). Task repetition can automate specific behaviors that
can be generalized to other behaviors (Bargh & Chartrand, 1999). However, how easily a
behavior becomes automatic is largely dependent on whether the external event is
synchronized with specific internal feelings (e.g. positive feelings or high arousal feelings,
Shiffrin & Dumais, 1981).

As individuals repeat specific attentional patterns and preferences over time, orienting
towards or away from certain stimuli may become habitual (Rothbart, Ziaie, & O’Boyle,
1992). These habitual attention preferences may influence individuals’ subsequent emotions.
For example, attentional preferences to negative information can be trained and untrained
(Derryberry & Reed, 2002; MacLeod, Rutherford, Campbell, Ebsworthy, & Holker, 2002;
Mathews, Mogg, & Kentish, 1995). These changes in attentional preferences may be
underscored by changes in neural activation. Monk and colleagues (2004) modified an
attentional-orientation task (from Posner, 1980) so that visual probes followed facial
emotion cues (angry and happy faces). The facial cues were then experimentally masked to
limit the timeframe in which they could be perceived. The researchers speculated that, in
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this masked condition healthy participants with repeated practice would eventually learn to
avoid threatening information (angry faces). This prediction was congruent with prior
findings that showed healthy participants, in a non-masked condition, demonstrated aversion
to angry faces (Fox, Russo, Bowles, & Dutton, 2001). Thus, if these time-related shifts were
produced, healthy individuals would gradually become more aware of the threatening
stimuli and start to regulate their attention away from the threatening information. This
pattern of findings would be indicated by an increase in neural activation due to repetitive
priming (as repeated exposure allows a near-threshold stimulus to have progressively greater
access to awareness).

Monk and his colleagues found that the healthy participants in the masked condition did
exhibit gaze biases away from the threatening information over time. Using fMRI, the
researchers specifically found that the behavioral learning/plasticity (change in gaze) was
associated with increased activation in the right occipito-temporal cortex. These findings
suggest that there were increased neurophysiologic responses when healthy adults adapted,
via attention-oriented processes, to threatening cues. Davidson, Jackson, and Kalin (2000)
have found experience-induced changes suggestive of neuroplasticity in regards to the
effects of stress on neural circuitry. In a range of settings (e.g., occupational, lab attention
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tasks) attentional abilities have therefore been found to be malleable and trainable to some
extent.

Evidence of attentional plasticity created through training has been demonstrated in older
adults as well. Older adults have demonstrated more difficulty in attempting to perform dual
tasks, which suggests the decline of attentional control skills (Hartley, 2001; McDowd &
Shaw, 2000). However, Bherer, Kramer, and Peterson (2005) recently found that older
adults could be trained through attentional regulation processes to show equivalent
performance to young adults on dual-tasks which required similar motor responses. They
found that this increase in performance could then later generalize to new tasks involving
attentional control (Bherer et al., 2005). Several studies have demonstrated that executive
attention skills can be trained in children, younger adults, older adults, and individuals with
attentional disorders (Bherer, Kramer, Peterson, Colcombe, Erickson, & Becic, 2006; Kerns,
Esso, & Thompson, 1999; Posner, Sheese, Odludas, & Tang, 2006; Rueda et al. 2004). All

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these populations demonstrate adequate attentional plasticity to learn new attentional


regulation skills (Bherer et al., 2005; Bherer et al. 2006). Not only do attentional training
paradigms improve individuals’ attentional regulatory processes, but below we will review
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evidence that different training paradigms improve individuals’ abilities to regulate their
emotions. If these training effects endure over time, then attentional deployment may be an
effective tool in facilitating emotion regulation.

Training Attention to Improve Emotion Regulation


Researchers have developed several types of attentional training (AT) methodologies. First,
we will first attempt to classify these training paradigms within a model that integrates AT
methods with the attentional substrates and the emotion regulation processes and outcomes
that training may modify. We will then describe why this model is important and how the
unique components of the model interrelate. Next, we will illustrate in detail the
methodology used with each training technique and provide evidence concerning how
specific types of training may improve emotional functioning. Returning to our process
diagram (see Figure 1), we will examine how each training method affects regulatory
strategies involving attentional processes (arrow A) and then later explore how these
changes in process affect emotion regulation outcomes (arrow B), improving regulation.
Finally, we will address limitations and challenges to attention training methods and provide
future directions suggesting what types of training may be most effective. Table 1 presents
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empirical AT studies and links them to the emotion regulation processes or outcomes that
were assessed. Studies were selected that incorporated an intervention or experimental
manipulation and also investigated whether attention training methods facilitate emotion
regulation processes or improve regulation outcomes as a result of training (i.e. whether they
assessed affect). To be able to explore specifically how these training interventions may
modify different attentional processes that act in the service of emotion regulation, a new
model is needed.

Constructing a Model of Attention Training Methods: Integrating Emotion Regulation


Strategies and Attentional Networks
We now propose a functional attention training model of attention-based emotion regulation
strategies and how these strategies might be modified by training. Why is such a model
needed? On the most basic level, having a model that further clarifies attentional constructs
allows cognitive, social, and clinical researchers to work within a more common and unified
nomenclature. However, this is not just an issue of word choice; there are serious
ambiguities concerning how training works and what attentional processes and emotion
regulation strategies might be changed by specific types of training. Therefore, the key
purpose of our model is to provide a hypothetical framework as to what specific attentional
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processes (i.e. alerting, orienting, and executive control processes) are affected by specific
training techniques in the service of emotion regulation. Clearly describing such a model is
necessary to facilitate more directed future research aimed at finding out what attentional
processes are modified with different types of attentional training (arrow A) and what active
ingredients (i.e. the mechanisms of working memory capacity, attentional control) may lead
to successful and lasting training effects.

The current model clarifies and informs many issues regarding how selective attention
influences affect. First, the model provides a context to assess how different training
methods may uniquely affect attentional processes in each of the attentional networks.
Investigating these processes will provide insight into what mechanisms are responsible for
changes in attentional plasticity allowing training effects to endure. Pairing emotion
regulation training strategies with specific attentional networks allows for future
investigation into what mechanisms create attentional flexibility, stability, broadening,

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narrowing, as well as the neurobiological correlates of these mechanisms. Knowing these


mechanisms, in turn, would allow researchers to optimize intervention design creating more
effective and customized training. For example, Isaacowitz et al. (2009) found that positive
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gaze preferences helped older adults avoid mood declines if they had high-functioning
executive control networks. This may indicate that individuals with more low-functioning
executive control networks may benefit most from gaze-based training (i.e. dot probe)
training techniques because these adults may not already exhibit positivity biases in their
gaze. In addition, these adults may benefit from training techniques that improve executive
function. The most effective attention training interventions will take into account individual
difference variables and then pair training techniques with individuals based upon what
mechanisms the technique modifies.

The model further allows us to speculate how attention training may affect other emotion
regulatory processes that sometimes include facets of attentional deployment, such as
cognitive reappraisal. Knowing how attentional deployment works in parallel with (or
differently than) reappraisal may allow interventions to be maximized to strengthen their
effect. In addition, if clinical psychologists know what aspects of attentional dysfunction or
maladaptive attentional patterns exist in their clients, then they can use this model to best
target what type of training intervention might be most effective for certain clinical
populations. In an effort to further improve emotion regulation, this model also lets us begin
to address the more practical question of whether different types of attention training can
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successfully generate lasting positive attentional and emotional profiles in individuals over
time. A positive threshold of attention may exist where paying attention to the positive is
optimal only to a certain degree. Our model is therefore important because it establishes a
framework to allow researchers to address research questions that are both conceptual (e.g.
which attentional processes are being changed by what mechanisms) in nature as well as
applied (what training methods may have the most therapeutic benefits). The new model is
outlined in Table 2.

Specific types of attentional training methods are listed in the first column: cognitive gaze
training tasks (dot-probe and visual search training), clinical attention training methods (i.e.
auditory attention training), and meditative practices (concentration, insight, and loving-
kindness). This list of methods is not intended to be exhaustive, but rather concentrates on
training techniques that have been argued to directly influence and improve individuals’
emotion regulation.

Along the bottom row of the model, the three types of attention networks are specified:
alerting, orienting, and executive control as well as an abbreviated description of their
primary functions. Posner and Petersen (1990) have defined attention as a complex,
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cognitive system containing three independent, but related, network stages: alerting,
orienting, and executive control. The alerting network heightens internal awareness and
maintains sufficient neural activation enabling the attention system to make a fast response
(Callejas, Lupiàñez, Funes, & Tudela, 2005). The orienting network guides our focus
towards selective and salient inputs, thereby augmenting attentional processing. The
executive control network resolves conflict among different neural systems competing for
control, facilitates the deconstruction of habitual responses, and directs planning, error
detection, decision-making, and novel-response formation functions (Norman & Shallice,
1986; Posner et al., 2006).

It is important to highlight that within the field of attention there is not universal agreement
concerning the nature and components of attention (see also Broadbent, 1958; Desimone,
1999; Desimone & Duncan, 1995; Müller, Malinowski, Gruber, & Hillyard, 2000;
Treisman, 2006) and that the model presented in this review seem to best fit the current

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objective of assessing how attentional deployment regulates emotion. It is also important to


note that although interrelated, the alerting, orienting, and executive control networks act
mostly independently (Fan, McCandliss, Fossella, Flombaum, & Posner, 2005; Fan,
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McCandliss, Sommer, Raz, & Posner, 2002) although some specific exceptions have been
found (cf. Callejas, et al., 2005; Fuentes & Campoy, 2008). Therefore it is not necessarily
accurate to think of the three networks as stages in a process model of attention, but rather as
concurrent processes that inform one another (Barrett & Bar, 2009). However even if a
particular type of training modifies all three networks, they may be modified in different
ways, and this may differentially predict regulatory outcomes. We attempted to be
comprehensive, rather than selective, in creating this model and therefore indicated ways in
which all networks could possibly be modified by training. To stimulate further research, we
explicitly state how different types of training may modify each network, rather than limit
our predictions to just the one network that is the most likely modified.

Importantly, a row identifying similar attentional constructs further clarifies what distinct
attentional terminology aligns with the three primary attentional networks (for example, the
orienting network consists of attentional selection and scanning constructs). This
specification of the model is critical because within the attention literature, a variety of
disparate terms are used that may share common meanings. This feature of the model was
derived from Raz and Buhle’s (2006) review of the specific components of attentional
networks, which provided an extension of Posner’s original categorization of the networks.
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In addition to proposing a unified attentional nomenclature, they also integrate several


theoretical standpoints that support the existence of the three separate networks and identify
the specific neuroanatomical structures lending further support for unique attentional
networks. Adding these components allows us to make more specific training – attention
links.

Within the remaining cells of the model, different types of attention-based emotional
regulatory strategies are listed. These strategies are educated, mostly a priori, conjectures
deduced from the limited body of literature on training methodologies. Therefore, although
future research is needed to add more definitive support or modify these demarcations, the
model may be a quite valuable starting point for hypothesis-testing about training effects on
emotion regulation. The model illuminates what attention-based regulation strategies, within
each attention network, are likely to be involved in each of the training methods. Breaking
these strategies and their underlying attentional processes into distinct categories both
creates a clearer picture of how they are impacted by training and allows for them to be
better empirically tested. For example, dot-probe training is likely to influence the orienting
network (Bradley, Mogg, & Millar, 2000; Posner & Petersen, 1990). Training might affect
orienting by biasing individuals’ first gaze fixations toward positive information, increasing
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the amount of time that they look at positive information, or increasing the quantity of
saccades towards positive information. Alternatively, dot probe training may also influence
the executive control network by increasing the probability that a negative or neutral first
fixation is followed by a subsequent positive fixation; this would indicate improved
attentional disengagement from negative information and reorientation towards positive
information.

This model also identifies more general training categories that share similar types of
attention-based regulatory strategies. We found it useful to attempt to classify these broad-
based training categories according to Gross’s (1998) three primary strategies of attentional
deployment: concentration, distraction, and rumination, so this is included in the model as
well. Concentration and insight meditative practices best correspond with the strategy of
attentional concentration. These practices require individuals to engage their cognitive
resources in maintaining a state of either attentional focus or awareness (in concentration

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practice maintaining focus on an object; in insight practice on maintaining a state of


awareness without focus). Concentration may utilize all the attentional networks as it
requires an attentional readiness component (alerting), selective attention (orienting), and
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the ability to inhibit competing stimuli from entering attention (executive control). Dot
probe training and visual search training (i.e. find-the-smile training) are best categorized
within the strategy of attentional distraction. All of these training methods require
individuals to shift their attention towards or away from affective information. Distraction
involves recruitment predominantly of the orienting network, to direct selective attention,
and the executive control network, to reconcile conflicting information (Posner & Petersen,
1990; Raz & Buhle, 2006). Clinical auditory attention training (ATT) incorporates aspects
of distraction and concentration. Individuals must first shift their attention to nonemotional
information (i.e. sounds) and then shift attention between forms of nonemotional
information. Individuals must also concentrate on maintaining their attention on one sound
and then concentrate on listening to multiple sounds. Finally, another type of training
method, loving-kindness meditation (LKM), seems to most closely fit the strategy of
rumination (albeit positive rumination), although it incorporates aspects of concentration as
well. Rumination most likely predominantly involves the orienting network (Posner &
Petersen, 1990). Positive rumination may be indicative of a well-functioning orienting
system (i.e. one that does not get entwined in negative thoughts or reactivity); however,
maladaptive rumination (or depressive rumination) may indicate that the orienting system is
not functioning optimally (i.e. one cannot disengage from repetitive negative thoughts).
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The current model also includes some speculation about the level of cognitive effort
required for different training procedures. Different emotion regulation strategies require
varying amounts of cognitive effort and have different cognitive costs (e.g. Richards &
Gross, 2000; Sheppes & Meiran, 2007; Sheppes & Meiran, 2008; Wenzlaff & Bates, 2000).
The level of cognitive effort and costs involved in initiating various strategies may be
important determinants of their effectiveness. The model predicts that training strategies
focused on distraction, which use implicit learning tasks to automatically reorient attention,
will require the least amount of cognitive effort. Strategies that require high levels of
concentration will require the highest amounts of cognitive effort (Erber & Tesser, 1992),
and strategies that combine multiple categories, such as ATT (distraction, concentration) or
LKM (rumination, concentration), likely require a moderate amount of cognitive effort.
Cognitive costs differ between regulatory strategies. Full attentional resources must be
devoted to meditative practices so an individual cannot concentrate on other or multiple
tasks (Brown, Ryan, & Creswell, 2007). Even distraction may have some cognitive costs in
impairing memory functions (Sheppes & Meiran, 2008).

A distinction should be made between the amounts of cognitive effort required for the
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acquisition of a strategy (e.g. learning to focus attention on an object) versus the effort
required for the execution of a regulatory strategy (i.e. employing a learned strategy such as
meditation); when we discuss cognitive effort in the text, we are referring to both acquisition
and executive effort, unless otherwise stated. Strategies based on distraction may require
less effort to acquire and less effort to execute relative to strategies based on concentration.
Concentration-based strategies may require more effort to acquire initially and more effort
to execute over time (see Table 2); however, for some individuals concentration may still be
an extremely effective regulatory strategy.

Below we will describe several types of attentional training techniques, connecting each to
the model and its components and providing evidence on how each type of training may
facilitate emotion regulation. It is important to note that some of the training interventions
outlined in the studies below assess hedonic-based emotion regulation outcomes (e.g. feeling
good, Fredrickson, Cohn, Coffey, Pek, & Finkel, 2008; reducing stress levels, Carmody &

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Baer, 2008; Dandeneau, Baldwin, Baccus, Sakellaropoulo, & Pruessner, 2007) while others
assess regulatory processes (e.g. how long one perseveres through difficult situations,
Johnson, 2009; how one deploys their attention when exposed to stressors, Wadlinger &
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Isaacowitz, 2008). However, not all of the following intervention studies assessed both
regulatory processes and outcomes simultaneously; this is a limitation of the research to
date. Successful changes in regulatory outcomes cannot necessarily be inferred from
changes in regulation processes (or vice versa); therefore future research would need to test
these links. Importantly, many other mechanisms may moderate the relationship between
regulatory process and outcome such as social support, social desirable responding, or the
experience of enhanced positive emotional states. Thus, the available evidence presented
below that demonstrates AT procedures successfully modifies attentional processes and/or
regulation outcomes must be interpreted conservatively. After we review types of attention
training methods, we will finally discuss what our model can tell us about the role of
attention in emotion regulation.

Training Gaze Patterns


The first type of training methodology we consider uses behavioral tasks to train
individuals’ gaze patterns. Research in cognitive psychology has employed AT
methodologies incorporating dot probe, flanker, and emotional Stroop tasks that train
individuals to either implicitly or automatically reorient their attention towards certain
affective stimuli. Stimuli for these training methodologies may include various images or
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words, typically presented in pairs -one each of a neutral and emotional valance. In a dot-
probe task, prototypic stimuli may include the word pair “death” (anxiety-inducing) and
“decal” (neutral) adjacently appearing on a computer screen for 1000ms. After these words
disappear, a visual probe appears on the screen (such as a pixilated arrow) and participants
have to determine the direction the arrow is facing. During the training, an individual’s
attention is drawn away from the negative word and redirected toward the neutral word by
having the probe appear consistently, for the majority of trials, behind the location of the
neutral word. How well an individual is able to perform on these tasks (i.e., response time)
acts as an indicator for whether attentional biases have changed in the expected direction or
not. In a successful manipulation an individual learns to automatically disengage from
negative cues and reorient their attention consistently toward neutral ones (Mohlman, 2004).
The length of performance on these tasks is typically 10–20 minutes and may involve
multiple training sessions (Dandeneau et al., 2007; MacLeod et al., 2002; Wadlinger &
Isaacowitz, 2008). Studies using these tasks have shown that attention can be successfully
trained towards certain affective information, suggesting that practice with tasks can reduce
the influence of negative emotional information (or increase the influence of positive
emotion information) on attention. What remains to be seen is whether these skills transfer
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to more general tasks and how long the effects last. Below we will explore how gaze
patterns can be trained, in the service of emotion regulation, towards neutral (away from
negative) information and analogously toward positive (away from neutral) information.

Training attention towards negative information—Individuals can be trained to


allocate their attention toward negative stimuli in their environment and this type of training
results in increased emotional susceptibility to subsequent negative stimuli (MacLeod et al.,
2002). However, individuals trained to attend towards neutral stimuli do not demonstrate
this susceptibility towards negative stimuli (Amir, Beard, Burns, & Bomyea, 2009; Amir,
Weber, Beard, Bomyea, & Taylor, 2008; MacLeod et al., 2002; Schmidt, Richey, Buckner,
& Timpano, 2009). In this study, undergraduate students attempted to complete several
unsolvable anagram puzzles under timed conditions with failure feedback while being
videotaped to elevate their stress level and elicit negative emotion. Next, participants were
trained to selectively attend to negative or neutral words in word-pairs through a dot-probe

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attentional training paradigm, like the one described in the previous section, incorporating
nearly 800 trials. Finally, participants completed another group of unsolvable puzzles under
the same conditions as the first set to determine whether their levels of emotional
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vulnerability had changed as a result of the attention training. Individuals in the attend-
negative condition showed attentional vigilance for negative information at the end of the
training task, a similar attention pattern as expected from highly anxious individuals. In
addition, they reported being in significantly worse negative moods, than the attend-neutral
group, in their post-test stress task as compared to their pre-test stress scores. Trained
selective attention to negative information reduces individuals’ abilities to successfully
regulate their emotions, resulting in heightened sensitivity to negative emotions.

Amir and his colleagues (2009) used a modified dot-probe task to train individuals’ attention
towards neutral and away from negative words. Schmidt et al. (2009) used a similar
procedure to train attention towards neutral and away from negative faces. Participants
included individuals with generalized anxiety disorder (Amir et al., 2009) and with season
affective disorder (Schmidt et al., 2009). Training consisted of 8 total sessions (completed
bi-weekly) lasting approximately 15–20 minutes each. GAD participants who received the
attend-neutral training demonstrated an attenuated attentional bias to negative (i.e.
threatening) words (as assessed by response time bias scores) and demonstrated less self-
rated and clinician-rated anxiety symptoms as compared to the attention control condition
(Amir et al., 2009). Similarly, SAD participants in the attend-neutral condition showed
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reductions in trait anxiety after training as compared to the attention control condition
(Schmidt et al., 2009).

Training attention towards positive information—Several studies have investigated


whether training attentional patterns to positive or rewarding information can influence
affective states or lead to successful emotion regulation (Dandeneau et al., 2007; Goetz,
Robinson, & Meier, 2008; Johnson, 2009; Wadlinger & Isaacowitz, 2008). In the first study,
researchers designed a visual probe task (comparable to a visual search task) that involved
repeatedly ignoring information associated with a social threat and instead searching for
information relaying positive social acceptance (Dandeneau et al., 2007). Participants, who
were undergraduate students, were divided into three conditions: train-acceptance, control,
and exposure. Train-acceptance participants were presented with a grid of 16 different faces,
fifteen frowning faces and one smiling face, and were instructed to click on the accepting
face as quickly as possible with a mouse. Control participants were presented with
schematic flowers and instructed to click on a five-petal flower amongst images of seven-
petal flowers. Exposure participants were instructed to simply look at a grid of 16 frowning
faces. Participants completed their assigned training task online for five days performing
112 training trials each session. After this period, train-acceptance participants reported
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feeling less stressed about an upcoming exam, and after completing the exam they felt less
anxious and more competent in their academic abilities (Dandeneau et al., 2007).

This visual probe training task was then administered to a group of telemarketers,
individuals who frequently face social rejection. Train-acceptance participants reported
higher self-esteem, lower stress, and higher self-confidence after just five consecutive days
of training. In addition, they had lower levels of cortisol and received higher objective
performance evaluations than their peers in the exposure and control conditions (Dandeneau
et al., 2007). This research demonstrated that training attention to positive information
helped individuals regulate their emotions in daily tasks; however, it did not address whether
these regulation improvements resulted from generalized attentional preferences towards
positive stimuli after the training.

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In the second study, Wadlinger and Isaacowitz (2008) explored whether positive visual
attentional preferences could be trained and if this training would result in future attentional
deployment towards positive stimuli. Undergraduate students were eye-tracked through a
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visual stress task where they viewed a set of highly negative images, which provided a
baseline measure of attentional deployment. Gaze away from unpleasant, stressful images
served as an indicator of successful emotion regulation (e.g., Isaacowitz, 2005; Isaacowitz et
al., 2006b; Xing & Isaacowitz, 2006). As suggested above, looking away from irrelevant
negative stimuli may be a distraction strategy that helps individuals effectively maintain a
positive or neutral emotional state when presented with negative information. After the
tracking to images, participants were experimentally trained to selectively attend to positive
or neutral information using a dot-probe training paradigm; that is, half of the participants
were in the train-positive condition, while the other half were in the train-neutral condition
(see MacLeod et al., 2002). Finally, participants were eye-tracked through another series of
highly negative visual images.

Prior to the attention training, there were no significant differences in the quantity of time
participants in the two conditions viewed the negative images at baseline; however, a
significant difference emerged in the amount of time they viewed the negative pictures after
training. Participants in the train-positive condition viewed the negative images in the
second visual stress task significantly less than the baseline task, appearing to have learned a
strategy of attentional avoidance toward negative stimuli. In contrast, the average looking
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times of the train-neutral participants suggested that they viewed the negative pictures more
after the training. Importantly, the trend for train-neutral participants to look more at
negative post-test images compared to their baseline looking behavior suggests that negative
stimuli in general remain salient and attention-catching even during the second stressor task.
These findings suggest that preferences toward positive information can be successfully
trained and that these positive preferences can be effectively generalized to subsequent
visual information. Individuals in the train-positive condition shift their attention away from
the negative components of the images, demonstrating gaze patterns indicative of successful
emotion regulation (Isaacowitz, 2006; Isaacowitz et al., 2006a, 2006b).

A third study has found that training goal-directed attention towards positive stimuli
facilitates effective emotion regulation (Johnson, 2009). Undergraduate participants first
completed baseline measures of state anxiety and frustration. Next, they performed an
anagram stress task followed by another state anxiety and frustration measure. Participants
then completed a dot-probe attention task where they were assigned to either a goal or no
goal condition. The dot-probe task consisted of responding to probes that appeared randomly
behind happy-angry face pairs. In the goal condition participants were instructed to focus
their attention on the happy faces and were told that the appearance of the probe would be
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completely random; therefore, they should keep their focus on the happy faces no matter
where the probe appeared. Participants in the no goal condition were simply instructed on
how to complete the dot-probe task. After the dot-probe, participants completed a third state
anxiety and frustration measure, and after that a final anagram stress task. Finally, a fourth
state anxiety and frustration measure was administered.

Participants in the goal condition, who deployed attention toward positive faces and away
from angry faces, showed almost three times significantly lower state frustration scores from
before to after the second anagram stress task (after the training) as compared to those in the
no goal condition. Moreover, individual differences in participants’ ability to attend to the
positive faces predicted how long they persisted in attempting to complete the anagram
stress task. Participants better at attending to the happy faces persevered longer on the stress
task. Importantly, this study demonstrated that individuals are able to pursue regulatory

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goals under stressful conditions and that selective attention is a successful regulatory
strategy (Johnson, 2009).
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Training techniques that modify gaze patterns may work through a number of mechanisms.
Because individuals experiencing negative emotions tend to bias their attentional patterns
towards negative stimuli (Beevers & Carver, 2003; Bradley, Mogg, & Lee, 1997; Caseras,
Garner, Bradley, & Mogg, 2007; Eizenman et al., 2003; MacLeod, Mathews, & Tata, 1986;
Mathews, Ridgeway, & Williamson, 1996; Mogg, Mathews, & Eysenck, 1992; Mogg,
Millar, & Bradley, 2002), learning to avoid them instead may prove adaptive by
preemptively evading the negative emotion they may elicit. Attentional training to positive
information may facilitate heightened preference for positive material; thereby, this process
may promote avoidance of ensuing negative information. Training positive attentional
preferences may modify the alerting network, creating attentional vigilance for positive
information, as well as the orienting network, directing selective attentional preferences
towards positive information. Repeated exposure to sizeable amounts of positive stimuli
may effectively redirect attentional guidance mechanisms towards positive representations,
making negative representations less accessible. In relation to Gross’s (1998) three types of
attentional regulatory processes, these training methods likely best fall under the category of
attentional distraction. Regulation strategies involving distraction have been shown to be
effective even when engaged late in the regulatory process (e.g. Sheppes & Meiran, 2008);
therefore, using gaze strategies like “looking happy” may be both cost-effective and
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adaptive (Allard, Wadlinger, & Isaacowitz, 2009).

The positive repetition priming generated by this type of training may facilitate later
encoding of positive information in naturalistic circumstances (surfing the web, reading the
paper, watching television) for certain positive affective information. Positive priming may
also make other positive emotional goals and emotion regulatory strategies (e.g. positive
reappraisal) more accessible (Johnston, 2009). Another mechanism of avoiding negative
information may be through mood maintenance (Wegener & Petty, 1994). By repeatedly
attending to positive information individuals may be better able to regulate their mood, with
positive mood acting as a moderator for its own self-preservation (Fredrickson & Joiner,
2002). One final potential mechanism may be that individuals learn to adaptively take in just
the minimal amount of information needed from a negative image to decode its meaning,
rather than visually ruminating on its negative details. Selective inattention to negative
information could be the result of an effortful process such as disengagement of goal-
irrelevant cues (e.g., negative images that might create a bad mood) or thought suppression.

While these gaze training methodologies require individuals to direct their visual attention
towards information of a particular emotional valence, other attentional training
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methodologies do not require the orientation of visual gaze patterns and instead often require
individuals to direct their internal attention towards neutral, instead of emotional, stimuli.
Research investigating these attentional training methodologies has utilized clinical
interventions targeted at reducing symptoms in clinical samples as well as meditative
interventions aimed at ameliorating stress in nonclinical samples. Below we will review
several clinical and meditative attention training methods as well as evidence that these
training techniques also improve individuals’ abilities to regulate their emotion.

Clinical Training Methods


Clinical AT methods involve the disengagement of attention from negative emotional
information and reorienting attention towards processing neutral information. Individuals
are taught to disengage self-focused attention from interoceptive (e.g., internal, cognitive-
emotional) cues and reorient their attention towards exteroceptive (e.g., external, sensory)
cues (Mohlman, 2004). Many emotional disorders feature dysfunctional information

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processing such as attentional patterns towards maladaptive information, automatic


activation of negative self-beliefs and appraisals, intrusive thoughts, and high self-focused
attention (MacLeod, Mathews, & Tata, 1986; Mogg et al., 2002; Papageorgiou & Wells,
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1998; Watson & Purdon, 2008; Wells & Mathews, 1996). Individuals with certain clinical
disorders, such as anxiety or depression, allocate more resources and energy towards
emotional processing, leaving fewer available for cognitive processing and flexibility.
Individuals with emotional disorders often lack the knowledge that they can focus and shift
their attention to control their emotions (Mohlman, 2004). Therefore, if individuals can be
effectively trained to reorient their maladaptive attentional patterns towards more neutral
content, they may be able to more effectively control their emotional states. This is in
contrast to desensitization approaches (e.g., Street & Barlow, 1994) that try to make
negative stimuli themselves more neutral through repeated exposure.

Wells (1990) developed the first clinical AT paradigm (ATT), which trains individuals to
reallocate their attention from emotional to neutral information processing through the use
of three auditory tasks. Participants are first asked to focus and sustain their attention on one
environmental cue (e.g., a metronome ticking) and then selectively shift their attention to
more remote sounds with increasing noise interference (e.g., a copy machine, passing
traffic). Next, participants practice alternating their attention between two sounds. To
improve their divided attention, participants are later instructed to focus on several sounds
simultaneously.
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Clinical ATT training may lead individuals to demonstrate an attentional vigilance for
particular auditory sounds within the alerting network. In terms of the orienting network,
participants trained in ATT enact the regulatory strategy of selectively attending to
particular auditory sounds. Using the regulatory strategy of alternating their attention
between auditory sounds, individuals trained in ATT engage the executive control network.
Within this network, ATT individuals disengage attention from internal thoughts and
reengage attention with external sounds to help manage their emotions. Therefore the
varying task instructions in ATT training may modify each of the three attentional networks
in unique ways. ATT methods require a moderate amount of cognitive effort and require the
engagement of attentional processes that are based in both distractive as well as
concentrative regulatory strategies (Gross, 1998).

This auditory ATT paradigm has been successful in reducing clinical symptoms of several
DSM-diagnosed disorders, including panic disorder (Wells, 1990), social phobia (Wells,
White, & Carter, 1997), major depression (Papageorgiou & Wells, 2000; Siegle, Ghinassi, &
Thase, 2007), and hypochondriasis (Papageorgiou & Wells, 1998). These reductions in
symptoms emerged after 2–10 weeks of practice and in several studies the non-clinical
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levels were maintained at 3, 6, and 12 months follow-up. Training included one weekly half-
hour session with a licensed clinician and two 15–20 minute practice sessions at home per
day. Participation in these studies was limited to clinical samples and the sample sizes for
these studies were small (only up to – 4 per group; with the exception of 31 in the Siegle et
al. study). These important limitations notwithstanding, clinical training methodologies
appear successful in facilitating emotion regulation with clinical populations by improving
regulation outcomes.

Meditative Attention Training Methods


Secular meditative training can be categorized into two common types of practices: focused
attention (FA) and open monitoring (OM; Lutz et al., 2008). Focused attention meditation
involves voluntarily directing sustained attention on a specific object (i.e. most often the
breath). Open monitoring meditation involves cultivating awareness in the absence of any
attentional focus. In open monitoring, participants may become aware of external stimuli

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(e.g. noises, movement); however upon noticing their mind wandering, they must disengage
their attention from the distracting stimuli and redirect their attention back to the process of
awareness.
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According to our model, concentration meditation (e.g., a type of focused attention training
such as Shamatha) and insight meditation (e.g., a type of open monitoring training such as
Vipassana) both initially require more cognitive effort to enlist as compared to other
attentional regulatory processes (although these techniques may require less effort with
substantial practice, Tang & Posner, 2009). However, the studies outlined below suggest
that both of these practices may improve individuals’ emotion regulation outcomes, such as
increasing their actual levels of well-being. Within the alerting network, concentration
meditative training involves sustaining attention on an object (e.g. the breath) while insight
meditation instead involves a more general sustained awareness without focus.
Concentration meditation is likely to influence the orienting network to a greater degree in
that it requires selectively attending to the object of meditation. In contrast, in requiring that
one has an open focus of attention, insight meditation does not involve selective attention to
an object. Both meditative practices require continual disengagement with distracters,
enlisting the executive control network. While concentration meditation involves a
reengagement with the selected object of attention, insight meditation involves a non-
reactive labeling of any distracters that may arise, followed by an immediate reorientation
back towards sustaining awareness without focus.
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Several other types of meditative practices are centered on mindfulness techniques:


mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT),
and integrative body-mind training (IBMT). Mindfulness combines two primary
components: the online self-regulation of attention and an open and accepting orientation
towards one’s experiences in the present moment (Bishop et al., 2004). Bishop and
colleagues (2004, p. 233) speculate that mindfulness involves components of sustained
attention, attentional switching, and a cognitive monitoring process that involves
“inhibit[ing] secondary elaborative processing of the thoughts, feelings, and sensations that
arise in the stream of consciousness.” MSBR involves a variety of meditative and yogic
practices that dissect the actual direct experience of stress into its individual components by
noticing the mind’s reaction to the perceived stress, and then learning how to let go of that
reactivity (Kabat-Zinn, 2003). MBSR allows the physiological effects of stress to pass
naturally while an individual reassesses their relation to that stressful event. Because MBSR
techniques incorporate a variety of methods, and not a single training technique, they were
not included in Table 2. MBSR likely modifies a number of mechanisms influencing
emotion regulation.
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MBCT has been developed within the field of clinical psychology as an intervention to
reduce relapses specifically in recurrent major depression, although current research is
extending MBCT techniques to other clinical disorders (Coelho, Canter, & Ernst, 2007;
Segal, Williams, & Teasdale, 2002; Teasdale et al., 2000). MBCT combines techniques
acquired from mindfulness practices with those of cognitive therapy. Individuals are taught
to view negative events or emotions as products of the mind and not inherent unchangeable
traits of the self. IBMT is derived from Chinese medicine and incorporates mindfulness
training, body relaxation and posture adjustment, breath adjustments, and guided mental
imagery techniques (Tang, Ma, Wang, Fan, Lu, Yu, et al., 2007).

In their review of the theoretical foundations of mindfulness, Brown and colleagues (2007)
call for the need to elucidate how mindfulness might converge with other attention processes
(e.g. attentional stability or concentration, attentional flexibility, and the three attentional
networks) in order to inform research on how mindfulness may impact other cognitive,

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affective, physiological, and neurobiological variables. A recent study has suggested that a
reduction of negative rumination may partially mediate a causal link between higher levels
of mindfulness and the reduction of individuals’ levels of anger, verbal aggression and
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hostility (Borders, Earleywine, & Jajodia, 2010). Evidence also has demonstrated that
participation in a Vipassana meditation retreat (i.e. insight meditation) show a reduction in
the reflective dimension of the ruminative responses scale, although reduction in the
brooding dimension was not significant (Chambers, Chuen Yee Lo, & Allen, 2008).

A final notable type of meditation is loving-kindness meditation (LKM). LKM is a


meditative practice, derived from South Asian Buddhist practices, where individuals learn to
actively generate a state of positive emotional experience (i.e. loving-kindness, compassion,
and empathy), for example -- wishing for positive experiences for other individuals (Lutz,
Brefczynski-Lewis, Johnstone, & Davidson, 2008). With practice the target of compassion
can change from being specific individuals to strangers and ultimately to being non-
referential -- not related to any specific object, person, or situation -- though this last stage is
only obtained with extensive practice. Although with LKM the explicit focus is not on
training attention but rather training oneself to generate this positive emotional state, we feel
it is important to include this type of training in the current model as LKM does incorporate
some components of maintaining and training attentional focus. Furthermore, many types of
meditative traditions view LKM as crucial to augment other practices (Lutz, Brefczynski-
Lewis, et al., 2008). LKM requires the use of the alerting network to create sustained
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attention to positive emotion and the orienting network to selectively attend towards this
positivity. Practicing LKM individuals must direct their attention towards evoking the
emotion as well as maintain this state with concentration. In this sense, LKM can be viewed
as an attentional process that requires both concentrative techniques as well as rumination on
the positive (Gross, 1998). The executive control network is required to facilitate the
individual’s disengagement with distracters and reengagement with attending to and
generating a positive emotional state.

While there are many different forms of meditative practices, only MBSR and LKM training
and their variants are reviewed because they have the most empirical backing. Below we
will consider evidence concerning how both MBSR and LKM practices improve emotional
regulatory processes.

MBSR interventions promote emotion regulation—Evidence that MBSR meditative


training helps individuals regulate their emotional state comes from studies of many
different populations: healthy adults, individuals experiencing high levels of stress,
physically ill patients, and college students (Anderson, Lau, Segal, & Bishop, 2007; Carlson,
Speca, Faris, & Patel, 2007; Carlson, Speca, Patel, & Goodey, 2004; Carmody & Baer,
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2008; Chang et al., 2004; Davidson et al., 2003; Ramel, Goldin, Carmona, & McQuaid,
2004; Rosenzweig, Reibel, Greeson, Brainard & Hojat, 2003; Shapiro, Oman, Thoresen,
Plante, & Flinders, 2008; Shapiro, Schwartz, & Bonner, 1998). In one study, healthy adults
were randomly assigned to either an eight-week MBSR course or a wait-list control group
(Anderson et al., 2007). Immediately after the training, participants in the MBSR course
showed significant reductions in emotion regulation outcome measures such as depression
and anxiety symptoms, anger, and anger-related rumination, as well as increases in positive
affect, compared to pre-training levels. In addition, improvements in the level of
experienced mindfulness predicted improvements in general emotional well-being.

In another study, the experimental group consisted of volunteers participating in an eight-


week MBSR workplace intervention (Davidson et al., 2003). During work hours, volunteers
attended two sessions per week taught by a facilitator trained in mindfulness meditation
(Davidson et al., 2003). The control group consisted of wait-listed employees who would

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receive the intervention at a later date. All participants completed a pre-and post-battery of
laboratory testing involving electroencephalography (EEG) readings and psychosocial
measures. Participants who had received MBSR training showed significant increases in
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left-sided activation in the anterior cortical area when compared with the activation levels in
these same regions of the control participants. This left anterior cortical activation increase
in MBSR participants may indicate emotion regulatory processes are taking place as
activation in this area is correlated with positive emotional expression and higher levels of
dispositional positive affect (Davidson et al., 2000; Urry et al., 2004). The authors conclude
that MBSR training can lead to brain changes that promote better handling of the negative
emotion when experiencing stress and that these changes are durable, lasting even after the
intervention has taken place (Davidson et al., 2003).

Another group to whom a MBSR intervention may be particularly beneficial is medical and
graduate students, who must deal with a high degree of stress. In one study a group of
medical students electively participated in a ten-week MBSR seminar and were paired with
matched controls, who took another optional seminar on alternative medicine (Rosenzweig
et al., 2003). The seminar started and ended during finals period where students completed
the Profile of Mood States questionnaire to assess their total mood disturbance (TMD)
(McNair, Lorr, & Droppleman, 1992). Upon completion of the seminar, the experimental
group’s TMD scores were significantly lower than those of the control group. The
experimental group scored eighteen-percent lower than their baseline score, while the
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control group scored thirty-eight percent higher than their baseline. Specifically, the
experimental group scored significantly lower than the control group on the tension-anxiety,
fatigue-inertia, and confusion-bewilderment domains and higher on the vigor-activity
domain (Rosenzweig et al., 2003). These results indicate students receiving the MBSR
training were better able to regulate their emotions during a stressful time as indicated with
the significant difference in the TMD, an emotion regulatory outcome measure. Another
similar study found that medical students who took an MBSR and loving-kindness training
course demonstrated lower self-reports of emotional outcomes of depression, state-and-trait
anxiety, and increased scores of empathy and spiritual experience compared to wait-listed
controls (Shapiro et al., 1998).

Meditative training has also been found to help individuals experiencing illnesses regulate
their emotions and reduce their stress levels. Carlson and colleagues (2004) studied the
effect of MBSR on patients with breast and prostate cancer. Patients enrolled in an eight-
week MBSR program that incorporated relaxation techniques, sitting meditation, hatha
yoga, and didactic courses as well as daily home practice. At the end of the study, there was
a difference between pre-and-post intervention scores such that individuals exhibited a
reduction in stress level and improved overall quality of life as assessed by the outcome of a
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total mood disturbance score.

A recent study illustrates that a modified MBSR training program, Mindfulness-based Mind
Fitness Training, may help military reservists preparing for deployment to regulate their
emotions (Jha, Stanley, Kiyonaga, Wong, & Gelfand, 2010). Soldiers enrolled in the 8-week
training program that had high levels of practice over time demonstrated increases in
working memory capacity (WMC) relative to those that had low levels or practice over time;
the latter showed decreases over time in WMC. Soldiers that had high levels of practice over
time also reported higher levels of positive affect and lower levels of negative affect than
soldiers with low levels of practice. In addition, the relationship between practice time and
negative affect was mediated by WMC.

Loving-kindness meditation promotes emotion regulation—While MBSR


meditative programs may be more effective in training individuals to manage negative

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emotions, interventions focused on loving-kindness practices may be more likely to


facilitate the generation of positive affect (Fredrickson et al., 2008). Loving-kindness
meditation may improve emotion regulation by bringing attention to and generating feelings
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of positivity. For example, one study found that social connection towards strangers could
be created in a laboratory setting through a brief loving-kindness meditation exercise
(Hutcherson, Seppala, & Gross, 2008). Individuals assigned to this meditative practice
showed increased feelings of positivity (positive social emotions) and social connectedness
just after a few minutes of practice, compared with a closely matched control group.

In another study, working adults participated in a six-week loving-kindness meditation


training (Fredrickson, et al., 2008). The training consisted of weekly hour-long workshops
and instructions to meditate daily if possible. Adults who received the training, compared to
a matched control group, showed increases over time in daily experiences of positive
emotions (Fredrickson et al., 2008). These positive emotions in turn facilitated increases in
personal resources such as social support, decreased illnesses, increased mindfulness, and
increased purpose in life.

Aside from generating more frequent positive emotions, meditative practices may also
increase levels of attentional control as demonstrated in the alerting, orienting, and conflict
monitoring networks (Jha, Krompinger, & Baime, 2007). Jha and colleagues recruited
novice meditators, who participated in an eight-week MBSR course, and more experienced
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meditators, who participated in a month-long mindfulness retreat. Both these groups, and an
additional matched control group, performed the Attention Network Test prior to and
immediately following their training. The experienced meditators in the retreat group
demonstrated greater efficiency in conflict monitoring before the retreat than the novice
group, and the novice meditators showed significant improvement, relative to the control
group, in attentional orienting after their MBSR training. These findings may reflect
improved abilities to voluntarily focus attention in the novice meditators and an existing
ability in the experienced meditators. The authors also found that after the retreat the
experienced meditators showed improved alerting abilities as opposed to the control and
MBSR groups and that this ability was directly correlated with their prior level of meditative
experience (Jha et al., 2007). Future work is needed to distinguish what additional
mechanisms may be responsible for the changes demonstrated by different types of
meditative practices.

Fixing our Focus


Now that we have reviewed the structure and contents of the model, we turn to a
consideration of what the model can tell us. First, just as antecedent-based regulatory
strategies may be more effective in modifying emotional experience than response-focused
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strategies that modify the emotion after it has fully transpired (Gross & John, 2003; Mauss
et al., 2007a; Schutte et al., 2009), the current model would lead to the prediction that if
attention can be modified or trained in the alerting or orienting networks, relative to the
executive control network, these types of training methodologies may be more efficient and
may require less effort to acquire. While all types of AT methods initially require some
degree of effort to acquire, it is likely that with repeated practice these attentional processes
can become more automated over time, requiring substantially less effort to execute
(Davidson & Lutz, 2008; Lutz et al., 2008; Lutz, Brefczynski-Lewis, et al., 2008; Wegner &
Bargh, 1998).

Individual differences will exist in what type of training procedure is most useful for certain
populations. Training gaze patterns may have the largest effect on modifying emotion
regulation processes. Gaze training may only modestly enhance downstream emotion
regulation outcomes and this relationship may only change as a result of the process itself

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being modified. More research is needed to show whether these changes in regulatory
processes also create changes in regulatory outcomes. Meditative attention training methods
have been shown to directly lead to positive emotion regulation outcomes such as increases
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in positive affect (Anderson et al., 2007), daily positive emotions (Fredrickson et al., 2008),
and positive social emotions (Hutcherson et al., 2008). Yet research that examines how
meditative techniques influence attentional processes is limited (Brefczynski-Lewis et al.,
2007; Jha et al., 2007; Lutz et al., 2008; Lutz et al., 2004). Meditative methods may yield
more pronounced improvements in emotion regulation through modifying individuals’
regulation processes concurrently with their emotional outcomes. Furthermore, directly
modifying emotion regulation outcomes might facilitate greater positive resource acquisition
helping individuals better cope with future challenges. While meditation seems to have the
potential for versatile effects, to what degree each network is modified is contingent upon
the amount of time an individual has practiced (Jha et al., 2007). Although meditative
practices take the most cognitive effort to initially enact, they may create the most lasting
regulatory outcomes of all the training techniques. Meditative practice also improves
individuals’ levels of mindfulness (Shapiro et al., 2008). Mindfulness is a trait which
impedes hedonic adaptation, a major barrier that minimizes the effectiveness of many
interventions (Lyubomirsky, Sheldon, & Schkade, 2005; Shapiro, Carlson, Astin, &
Freedman, 2006).

Another possibility raised by the model is that, because each of the different training
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techniques influences distinct attention networks in unique ways, combining strategies may
magnify their effect on improving emotion regulation. Practicing multiple training
techniques may uniquely influence more widespread neuroanatomical structures (Raz &
Buhle, 2006) and keep training practice novel. Learned automaticity from training would
free cognitive resources that could then be used to resolve other sources of neural conflict.
Future research is needed to clarify this prediction and more rigorously examine how each
attentional network is modified by the unique types of training methods.

The current model may also help determine what attention-based regulatory strategies are
used as components of other emotion regulatory strategies. For example, this model may be
useful in further determining how attentional deployment does and does not work within the
context of cognitive reappraisal, a regulatory strategy where attentional deployment is a key
component (e.g. van Reekum et al., 2007). In order to cognitively reappraise an extremely
negative visual scene (such as a car accident), an individual may selectively attend to aspects
of the scene (e.g. an ambulance in the background) in order to construct a successful
reappraisal story (e.g. the accident victim is ultimately rescued and survives the trauma).
This implicates the orienting attentional network. In addition, because the individual has to
reconcile competing interpretations of the scene (inhibit the initial negative interpretation
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and generate a more positive one), the executive network is also likely recruited. Therefore
since selective attention is being used, reappraisal may especially activate areas of the brain
involving orienting and executive control networks. However, these two regulatory
processes can also be dissociated and may recruit unique neural regions (i.e. “distancing”
instructions may require recruitment of medial systems and right PFC systems; Ochsner &
Gross, 2008).

To summarize, our model linking types of attention training to specific aspects of attention,
as well as to emotion regulation strategies and cognitive effort, suggests several main
conclusions. First, it is indeed possible to map forms of training onto specific attentional
processes, at least conceptually. Second, training can simultaneously modify all of the
attentional networks (i.e. the current model is not a process model). Third, attention training
directly modifies the use of attentional processes as regulatory strategies, which in turn, can
modify affective experience and other emotion regulation outcomes. Fourth, training

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techniques are likely to influence components of attentional processes or outcomes


differentially and the quantity of time spent training may moderate these effects. And
finally, meditation seems to have the most potential for impact across a wide variety of
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attentional networks as well as modifying a broad range of emotion regulation outcomes. All
training techniques that involve attentional concentration might require more cognitive
effort, but may ultimately be more effective than strategies based in distraction.

Limitations and Challenges to AT Methodologies


In addition to investigating what distinct mechanisms may underlie different attention
training methodologies, more research is needed to further augment existent training
procedures to make them more effective. It is important to emphasize that across all the
attention training interventions reviewed, only small effects have been observed in small
sample sizes over brief time intervals. In light of this limitation, several other challenges
hinder the development of effective AT methodologies: quantifying effective training
durations, developing positive AT stimuli, and keeping interventions salient and interesting.

The first challenge in developing AT methods involves discriminating how much training is
sufficient to show stable patterns of attention that are healthy and adaptive, as compared to
previously maladaptive or suboptimal attentional patterns. AT paradigms can range from
one session (Hutcherson et al., 2008; MacLeod et al., 2002; Wadlinger & Isaacowitz, 2008)
to several sessions across weeks of training (Dandeneau et al., 2007; Davidson et al., 2003;
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Fredrickson et al., 2008; Wells, 1990; Wells et al., 1997). The duration of the training effects
is most likely related to the length of the training. It has been suggested that an ideal amount
of training time for individuals with clinical disorders is five weeks; however, nonclinical
populations may see results in as little as one session of training (Dandeneau et al., 2007;
Papageorgiou & Wells, 1998, 2000). Future research needs to determine to what extent the
efficacy and impact of attention training methodologies is contingent on the duration of the
training and the frequency of practice during that training (e.g., daily, bi-weekly, weekly).

One challenge specific to cognitive training methodologies is how positive training stimuli
are developed. Overall, positive images are inherently of lower average arousal than
negative images (Grühn & Scheibe, 2008). Because low-to-moderate-arousal positive
stimuli do not elicit the same sense of increased urgency of attention as negative stimuli,
individuals experiencing depressive or anxiety disorders may have difficulty in orienting
their attention towards this type of positive information. AT methods aimed at inducing
changes in attention toward positive stimuli may need to employ positive stimuli of a high
emotional valence or use large numbers of stimuli over many training sessions. Tamir and
Robinson (2007) have suggested that positive stimuli depicting rewarding information,
specifically, may be most effective in attracting attention.
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A final challenge is to refine and create new AT paradigms that are interesting to
participants rather than repetitive, “mindless” behaviors. One avenue for future exploration
may be to intertwine training paradigms into virtual reality (VR) worlds. Participants in VR
experiments have been shown to have the same physiological responses as those
experienced in reality (Wilhelm, Pfaltz, Gross, Mauss, Kim, & Wiederhold, 2005). Another
direction may be to develop video games that modify specific attentional processes.
Research has shown that after just ten days of playing action video game training,
individuals demonstrated enhanced visual skills in the domains of spatial distribution,
temporal resolution, the capacity of visual attention (Green & Bavelier, 2003). Combining
training methodologies in different ways may help to capture and maintain the interest and
motivation of participants.

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Future Directions
While this review has demonstrated that different attentional training methodologies can
enhance individuals’ emotion regulation abilities, this work is merely a beginning. The
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evidence presented in this paper suggests that attentional deployment may be a critical tool
for regulating emotion; however it is important to note that this evidence remains
preliminary. Specifically, longitudinal training interventions are needed to elicit higher-
impact effects that may help elucidate the longevity and mechanisms of the training. In
addition, combining training methodologies may maximize training effectiveness. It is
possible that interventions promoting strategic regulatory goals may be more effective than
those that rely on automatically trained attentional biases (Johnson, 2009). An
interdisciplinary effort among cognitive, clinical, and social-developmental psychologists
may prove most fruitful in both designing effective interventions and investigating the
responsible mechanisms.

Additional research is particularly needed to investigate which training methodologies are


most successful for specific populations (geriatric, pediatric, clinical, non-clinical). Several
demographic and personality factors may influence the efficacy of AT methods. Because
older adults generally display positivity effects in their visual processing (Carstensen &
Mikels, 2005: Isaacowitz et al., 2006), training methods aimed at training internal attentional
states might generate more pronounced results. However, younger adults, and those older
adults who do not demonstrate positivity in their visual processing, may initially benefit
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more from gaze training methodologies that aim to increase attention to positive
information. Another individual difference variable that may affect training is emotional
intelligence (EI). Individuals higher in emotional intelligence have been found to use more
antecedent-focused regulatory strategies (Schutte et al., 2009). In fact, individuals high in
EI, who are more sensitive to emotional cues, may also have a greater ability to
automatically attend to and identify subliminally presented emotional stimuli (Fiore, 2009).
These patterns of attention may facilitate emotion regulation, especially within social
contexts. Fiore (2009) notes that in individuals high in EI the mere presence of emotional
cues may activate habitual tendencies towards adaptive emotion regulatory behaviors; these
individuals might also use more automatic strategies to regulate their emotions. In regards to
attention training, these individuals are likely to excel at the “find-a-smile” or other types of
gaze training tasks. However, if individuals high in EI also have superior emotion regulation
abilities, another type of concentration-based attention training strategy may be more
effective in engaging their interest as well as helping them further refine their attentional
skills. To what extent the types of training we describe may actually increase EI in those
naturally low in it remains to be investigated.

Finally, the individuals who may benefit the most from AT paradigms may be those with
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clinical emotional processing disorders (Mohlman, 2004). Because these individuals often
experience attentional dysfunction in their inability to disengage from negative information,
using training techniques to teach new patterns of selectively orienting towards more
positive and neutral information may help these groups improve their affect regulation. It is
possible that some types of attentional training might even serve to promote regulation of
the sources of emotion disruption, or problem-focused coping, rather than impacting just the
regulation of the emotional response, or emotion-focused coping. Such problem-focused
coping could be particularly adaptive in certain circumstances (e.g., Lazarus & Folkman,
1984). Different types of attention training procedures can modify emotion regulation
processes, regulation outcomes, or both. While training attention will most influence the
emotion regulation processes that encompass attentional deployment, it may also influence
other regulation strategies to the extent that they enlist attentional processes. Once research
determines which attention regulation strategies different clinical populations employ
successfully most frequently, interventions can be selected and tailored to maximize their

Pers Soc Psychol Rev. Author manuscript; available in PMC 2012 February 1.
Wadlinger and Isaacowitz Page 27

effectiveness and impact. Interventions designed to target both regulatory processes and
outcomes will most likely be the most effective.
NIH-PA Author Manuscript

Conclusion
Individuals can effectively regulate their emotion through their attentional deployment, and
this process can be successfully trained. Individuals who are able to better regulate their
emotions from attentional training may experience more positive emotions. Experiencing
increased positive emotions may in turn enhance attentional resources, such as increasing
attentional broadening, flexibility, and control. Therefore, training attention might
commence a series of codependent attentional and emotional processes that result in an
upward spiral of positivity (Fredrickson & Joiner, 2002). Specifically, the frequency of
positive relative to negative emotional experience predicts overall happiness (Diener et al.,
1991; Fredrickson & Losada, 2005) and individuals trained to seek out the positive may
build natural tendencies to approach environmental rewards. Training attention may serve as
one key to enhancing emotion regulation, which in turn influences not only affect but also
downstream behavior.

As discussed in the model above, one of the most promising strategies of regulating
attention to improve emotional functioning comes from different focused attention and open
monitoring meditative interventions that teach individuals to refocus and refine many
concurrent attentional processes. These attentional interventions may most effectively target
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all three types of attentional networks, thus yielding potentially large downstream effects.

To train ourselves to become most effective at regulating our own emotional states, we may
first have to adjust the source of our focus. Social and personality psychologists interested in
improving general emotional functioning and eliciting more positive emotional states may
benefit from considering this contemplative process of attending to attention itself. Although
traditionally outside the realm of social-psychological research, the optimal attention-based
training method available to improve emotion regulation may turn out to be meditative
interventions.

Acknowledgments
This work was supported by NIH Grant R01AG026323 to Derek M. Isaacowitz.

The authors wish to express their gratitude to Jennifer Stanley and Eric Allard, as well as the two anonymous
reviewers, for their helpful suggestions on earlier versions of this manuscript.

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Figure 1.
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Relationship between attention training interventions, attentional processes as emotion


regulation strategies, and emotion regulation outcomes.
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Table 1
Empirical Studies Linking Attention Training Interventions to Improved Emotion Regulation

Study N Participant Type Mean Age % Male Control Group Affective Dependent Variables

Dot-probe Training Methods

MacLeod et al. (2002) Study 1 64 Undergraduate students 19 38 Matched neutral task Self-reported anxiety and depressiona
MacLeod et al. (2002) Study 2 64 Undergraduate students 19 50 Matched neutral task Self-reported anxiety and depressiona
Wadlinger and Isaacowitz

Amir et al. (2008) 94 Undergraduate students 19 51 Matched neutral task STAIb


Goetz et al. (2008) 39 Undergraduates -- 38 Matched neutral task c Self-reported mood markers

Wadlinger & Isaacowitz (2008) 47 Undergraduate students 19 36 Matched neutral task d Gaze to negative images

Amir et al. (2009) 29 Individuals with GADe 26 50 Matched neutral task STAI, BDI-IIf, WDQg, PSWQh, HRSAi, HAMDj
Johnson (2009) 109 Undergraduate Students 19 39 Matched neutral task STAI, Self-reported state frustration and anxiety scores
Schmidt et al. (2009) 36 SADk patients 22 67 Matched neutral task LSASl, BSPSm, SPAIn, STAI-T, BDI-II

Visual Search Training Methods

Dandeneau et al. (2008) Study 2b 147 Undergraduate students -- 33 Matched neutral task VPTo, POMSp, RSESq
Dandeneau et al. (2008) Study 3a 25 Undergraduate students -- 12 Matched neutral task PSSr, RSES, STAI-S, Self-reported stress, FIOSs
Dandeneau et al. (2008) Study 3b 23 Telemarketers -- 61 Matched neutral task PSS, Salivary cortisol

Clinical Auditory Training Tasks

Wells (1990) 1 Panic disorder patients 40 0 None Self-reported anxietyt, STAI-S


Wells et al. (1997) 3 Anxiety patients -- -- None Self-reported anxiety, STAI-S
Papageorgiou & Wells (1998) 3 Hypochondriac patients 70 0 None BAIu, GDSv
Papageorgiou & Wells (2000) 4 Major depressive disorder patients 36 25 None

Pers Soc Psychol Rev. Author manuscript; available in PMC 2012 February 1.
BDIw, BAI, MCQx

Siegle, Ghinassi, & Thase (2007)* 31 Adults with unipolar depression -- -- Treatment as usual BDI, NHRSQy
Watson & Purdon (2008) 108 Undergraduates 18.99 37 Several conditions DASS-21z

Meditative Practices

Mindfulness-Based Stress Reduction


Shapiro et al. (1998) 73 Premed and med students -- 44 Waitlist ECRSaa, SCL-90bb, STAI
Davidson et al. (2003) 41 Corporate employees 36 29 Waitlist STAI, PANAScc
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Study N Participant Type Mean Age % Male Control Group Affective Dependent Variables

Rosenzweig et al. (2003) 302 Med Students -- -- Didactic seminar POMS


Carlson et al. (2004) 59 Cancer patients 42 26 None POMS, EORTC-QLQ-C30dd, SOSIee
Chang et al. (2004) 43 Continuing education students 47 43 None PSOMff, PSS
Ramel et al. (2004) 23 Veterans 51 65 Waitlist BDI, STAI
Anderson et al. (2007) 72 Community adults -- -- Waitlist PANAS, BDI, BAI, ASIgg, NAIhh, ARSii, PSWQ
Carmody & Baer (2008) 174 Adults in stressful circumstances 47 37 None
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BSIjj, PSS, PWBkk

Shapiro et al. (2008)** 44 Undergraduate students 18 20 Waitlist PSS, RRQll


Farb et al. (2010) 20 Adults 45.55 33 Waitlist BDI-II, BAI, SCL-90-Rmm, Self- rated level of sadness
Loving-Kindness Meditation
Fredrickson et al. (2008) 139 Working adults 41 35 Waitlist LOTnn, Ego- Resilienceoo, PWB, SWLSpp, CES-Dqq,
mDESrr
Hutcherson et al. (2008) 93 Young adults 24 43 Neutral imagery task Positive and negative mood composites
Integrative Mind Body Training
Tang et al. (2007) 80 Undergraduates 21.8 55 Relaxation training POMS
Vipassana Meditation (Insight Meditation)
Chambers et al. (2008) 40 Non-clincial adults 33.70 55 Waitlist RRSss, BDI, BAI, PANAS

Mindfulness Intervention***
Erisman & Roemer (2010) 30 Adults w/emotion regulation difficulty 24.10 50 Neutral Information PANAS, DERS-Stt

Mindfulness-based Mind Fitness Training****


Jha et al. (2010) 29 Marine Corps Reservists 30 100 Military & civilian control PANAS

Note. All studies appear in chronological order by training type. Participant number, age, and sex were reported for the experimental or intervention condition when possible; if these values were not reported
by condition, these columns indicate the overall numbers across all conditions.

Pers Soc Psychol Rev. Author manuscript; available in PMC 2012 February 1.
*
Also used Paced Auditory Serial Addition Task (PASAT) training method.
**
Also used the Eight Point Program (Easwaran, 1991).
***
10-minute in laboratory intervention drawn from work by Segal, Williams, & Teasdale, 2002.
****
8-week course modified from the MBSR protocol for military populations.
a
Data was analyzed from analogue mood scales presented electronically during stress task.
b
STAI = State-Trait Anxiety Inventory (Spielberger, Gorsuch, & Lushene, 1970). STAI-S = State anxiety scale; STAI-T = Trait anxiety scale.
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c
See Tamir, Robinson, & Clore, 2002.
d
Assessed by eye tracking.
e
Generalized anxiety disorder.
f
BDI-II = Beck Depression Inventory-II (Beck, Steer, & Brown, 1996).
g
WDQ = Worry Domains Questionnaire (Tallis, Eysenck, & Mathews,1992).
h
PSWQ = Penn State Worry Questionnaire (Meyer, Miller, Metzger, & Borkovec, 1990).
i
Wadlinger and Isaacowitz

HRSA = Hamilton Rating Scale for Anxiety (Hamilton, 1959).


j
HAMD = Hamilton Rating Scale for Depression (Hamilton, 1960).
k
SAD = Seasonal affective disorder.
l
LSAS = Liebowitz Social Anxiety Scale (Liebowitz, 1987).
m
BSPS = Brief Social Phobia Scale (Davidson, Potts, Richichi, Ford, Krishnan, Smith, et al., 1991).
n
SPAI = Social Phobia and Anxiety Inventory (Turner, Johnson, Beidel, Heiser, & Lydiard, 2003).
o
VPT = Visual Probe Task which measured attention bias towards threatening social information.
p
POMS = Profile of Mood States (McNair et al., 1971).
q
RSES = Rosenberg Self-Esteem Scale (Rosenberg, 1965).
r
PSS = Perceived Stress Scale (Cohen, Kamarck, & Mermelstein, 1983).
s
FIOS = Feelings of Inadequacy Scale, a subscale of School Abilities Scale (Fleming & Courtney, 1984).
t
Self-reported anxiety was rated immediately following each treatment session.
u
BAI = Beck Anxiety Inventory (Beck, Epstein, Brown, & Steer, 1988).

Pers Soc Psychol Rev. Author manuscript; available in PMC 2012 February 1.
v
GDS = Geriatric Depression Scale (Yesavage et al., 1983).
w
BDI = Beck Depression Inventory (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961).
x
MCQ = Meta-Cognitions Questionnaire (Cartwright-Hatton & Wells, 1997).
y
NHRSQ = Nolen-Hoeksema’s Response Style’s Questionnaire (Nolen-Hoeksema, Morrow, & Fredrickson, 1993).
z
DASS-21 = Depression, Anxiety, Stress Scales-21 (Lovibond & Lovibond, 1995).
aa
ECRS = Empathy Construct Rating Scale (La Monica, 1981).
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bb
SCL-90 = Hopkins Symptom Checklist 90 – Revised, Subscale 4 Depression (Derogatis, 1977).
cc
PANAS = Positive and Negative Affect Scale (Watson, Clark, & Tellegen, 1988).
dd
EORTC-QLQ-C30 = European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (Aaronson et al., 1993).
ee
SOSI = Symptoms of Stress Inventory (Leckie & Thompson, 1979).
ff
4PSOM = Positive States of Mind questionnaire (Horowitz, Adler, & Kegeles, 1988).
gg
ASI = Anxiety Sensitivity Index (Reiss, Peterson, Gursky, & McNally, 1986).
hh
Wadlinger and Isaacowitz

NAI = Novaco Anger Inventory (Novaco, 1975).


ii
ARS = Anger Rumination Scale (Sukhodolsky, Golub, & Cromwell, 2001).
jj
BSI = Brief Symptom Inventory for psychological symptoms and somatic complaints (Derogatis, 1992).
kk
PWB = Psychological Well-Being Scales (Ryff & Keyes, 1995).
ll
RRQ = Rumination and Reflection Questionnaire (Trapnell & Campbell, 1999).
mm
SCL-90-R = The Symptom Checklist 90 Revised (Derogatis, 1994).
nn
LOT = Life Orientation Test - Revised (Scheier, Carver, & Bridges, 1994).
oo
Ego-Resilience Measure (Block & Kremen, 1996).
pp
SWLS = Satisfaction with Life Scale (Diener, Emmons, Larsen, & Griffin, 1985).
qq
CES-D = Center for Epidemiological Studies – Depression Measure (Radloff, 1977).
rr
mDES = Modified Differential Emotions Scale (Fredrickson, Tugade, Waugh, & Larkin, 2003).
ss
RRS = Ruminative Responses Scale [subscale of Response Styles Questionnaire (Nolen-Hoeksema & Morrow, 1991)].
tt
DERS-S = State Difficulties in Emotion Regulation Scale (McLaughlin, Mennin, & Farach, 2007).

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Table 2
A Model of Attention Training Methods: Integrating Emotion Regulation Strategies and Attentional Networks
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Attentional Training Methodologies1 Emotion Regulation Strategies

Concentration Meditationa (C) Sustained Selective attention to object Disengage


attention on object distracters; reengage
object
Higher
Insight Meditationb (C) Sustained --- Disengage
awareness w/out distracters; non-
focus reactive labeling of
distracters

Loving-Kindness Meditationc (R/C) Sustained Selective attention to positive Disengage


attention to emotion distracters; reengage
positive emotion object
Moderate
ATTd (D/C) Vigilance for Selective attention to neutral sound Alternate attention
neutral sound b/w sounds; Attend
to multiple sounds
Dot-Probe Training (D) Vigilance for Selective visual attention to Disengage negative
positive positive information and neutral
information information
Lower
Visual Search Training (D) Vigilance for Selective visual attention to Avoidance of
positive positive information negative
information information
NIH-PA Author Manuscript

Attentional2 Network Alerting Orienting Executive

Effort (to execute) Similar Constructs3 Awareness, Scanning, selective attention Selective, focused,
alertness, alternating, and
vigilance, divided attention
sustained attention

Cognitive Effort (to acquire)4 Lower Moderate Higher

Note.
1
Within the model training types can be categorized as reflecting Gross’s (1998) attentional deployment emotion regulation strategies of
concentration (C), distraction (D), and rumination (R).
2
This model focuses on the primary attentional network/s recruited, although components of all networks may be recruited during training tasks
(see Posner & Petersen, 1990).
3
Delineates additional nomenclature corresponding to the alerting, orienting, and executive networks (see Raz & Buhle, 2006).
4
Cognitive effort to acquire refers to effort required to learn a new strategy while effort to execute refers to effort required to employ a learned
strategy.
a
NIH-PA Author Manuscript

Also known as Shamatha or Focused Attention Meditation. The object of meditation is most commonly one’s breath.
b
Also known as Vipassana or Open Monitoring Meditation.
c
Also known as Metta Meditation.
d
Auditory attention training derived from clinical psychology

Pers Soc Psychol Rev. Author manuscript; available in PMC 2012 February 1.

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