Negative affect and peripheral inflammation: The role of cognitive reappraisal and expressive suppression

The association between global negative affect and inflammation is inconsistently observed in healthy, community samples.

Identifying person-level characteristics that influence this association may help clarify how negative affect confers risk of morbidity and mortality and which individuals may benefit from early intervention. One such characteristic that may influence the negative affect-inflammation association includes the use of emotion regulation strategies. Here, we examined whether regular use of emotion regulation strategies, namely reappraisal and suppression, moderated the association between global negative affect and peripheral inflammation.

Proinflammatory biomarkers (interleukin-6 [IL-6] and C-reactive protein) and self-reported negative affect and emotion regulation usage were assessed at the baseline visit of three study cohorts completed between 2008 and 2021. Age, sex, body mass index, and education were included as covariates in multiple regression models.

In a healthy sample of midlife adults (N = 1,033), expressive suppression (p = .049) and cognitive reappraisal (p = .044) moderated the association between negative affect and IL-6, such that negative affect was positively associated with IL-6 levels only among adults who reported more frequent use of expressive suppression or cognitive reappraisal. Patterns remained consistent after controlling for perceived stress and negative life events and excluding participants based on immune-related medical history. No significant associations were observed with C-reactive protein.

Findings suggest that, among otherwise healthy adults, the more frequent-and possibly contextually invariant-use of suppression or reappraisal may partly influence the variable coupling between negative affect and IL-6. (PsycInfo Database Record (c) 2026 APA, all rights reserved).