Emotion regulation and mental health across cultures: a systematic review and meta-analysis

Emotion regulation (ER) plays a central role in mental health, but the effect differs across cultures. Here, expanding from extant literature's focus on Western-Eastern dichotomy or individualism-collectivism, this meta-analysis synthesized evidence on the associations between the two most-studied ER strategies (cognitive reappraisal and expressive suppression) and two mental health outcomes (psychopathology and positive functioning) and investigated the moderating roles of several cultural dimensions: Hofstede's national cultures dimensions, education, industrialization, richness and democracy (EIRDness), and sample demographics. A comprehensive literature search was conducted using electronic databases (CINAHL, Scopus, Web of Science, PsycINFO and MEDLINE) to identify eligible studies reporting relationships between ER and mental health outcomes (PROSPERO: CRD42021258190, 249 articles, n = 150,474, 861 effect sizes, 37 countries/regions). For Hofstede's national cultures and EIRDness, multimodel inference revealed that greater reappraisal propensity was more adaptive in more short-term-oriented, uncertainty-tolerant and competition-driven cultures, whereas greater suppression propensity was more maladaptive in more indulgent and competition-driven cultures. For demographics, greater reappraisal propensity was more adaptive for samples with more female (B = -0.19, 95% confidence interval (CI) -0.29 to -0.09) and more racial minority participants (B = -0.32, 95% CI -0.51 to -0.13), whereas greater suppression propensity was more maladaptive in younger samples (B = -0.004, 95% CI -0.005 to -0.002). These findings elucidate how cultures are associated with the function of ER and suggests ways in which future studies can integrate cultural characteristics when examining ER and psychological adjustment.