Flexible emotion regulatory selection when coping with COVID-19-related threats during quarantine

The COVID-19 pandemic poses significant emotional challenges that individuals need to select how to regulate. The present study directly examined how during the pandemic, healthy individuals select between regulatory strategies to cope with varying COVID-19-related threats, and whether an adaptive flexible regulatory selection pattern will emerge in this unique threatening global context. Accordingly, this two-study investigation tested how healthy individuals during a strict state issued quarantine, behaviorally select to regulate COVID-19-related threats varying in their intensity. Study 1 created and validated an ecologically relevant set of low and high intensity sentences covering major COVID-19 facets that include experiencing physical symptoms, infection threats, and social and economic consequences. Study 2 examined the influence of the intensity of these COVID-19-related threats, on behavioral regulatory selection choices between disengagement via attentional distraction and engagement via reappraisal. Confirming a flexible regulatory selection conception, healthy individuals showed strong choice preference for engagement reappraisal when regulating low intensity COVID-19-related threats, but showed strong choice preference for disengagement distraction when regulating high intensity COVID-19-related threats. These findings support the importance of regulatory selection flexibility for psychological resilience during a major global crisis.

Providing the first evidence for flexible behavioral regulatory selection patterns when facing COVID-19-related high and low intensity threats, and consistent with prior regulatory selection findings 1 , we found that participants' preference for distraction over reappraisal increased as emotional intensity increased from low to high intensity  These findings show that all of the reported analyses in the main manuscript were uninfluenced by the exclusion of participants.

Complementary analyses using non-parametric tests
The Wilcoxon signed-rank test is appropriate when there is a non-normal distribution and the data is paired 2 . Below we report the relevant analyses using Wilcoxon signed-rank test, showing that results are left unchanged.

Study 1:
Consistent with our predictions, high intensity sentences were rated as more negative, compared to low intensity sentences (W = 465.00, p > .001). We also tested whether differences in negative ratings between high and low intensity sentences are evident for each pair of sentences, across participants. In all pairs, the high intensity sentence was significantly higher in negative experience ratings than the corresponding low intensity sentence (all W's ≥ 325.00, p's > .001).

Study 2:
Consistent with our predictions, we found that participants' preference for distraction over reappraisal increased as emotional intensity increased from low to high intensity (W = 3885.00, p < .001). To provide further evidence for the robustness of our effects, we examined whether differences in regulatory selection between high and low intensity sentences are evident for each pair of sentences, across participants. In 93.33% (14/15) of the pairs, distraction over reappraisal preference increased significantly as emotional intensity increased from low to high intensity (all W's ≥ 570.00, p's ≤ .01).
Furthermore, we examined whether participants' preference for distraction in high intensity (Med = 60%) and for reappraisal in low intensity (Med = 80%) differ from a 50% no preference rate. Indeed, both the preference for choosing distraction in high intensity (W = 2,977.50, p = .001) and the preference for choosing reappraisal in low intensity (W = 365.00, p < .001) significantly differed from a 50% no preference rate.

Study 2: Explanation of why negative emotional experience ratings following regulatory selection and implementation were not analyzed
Negative emotional experience ratings following regulatory selection and implementation were not analyzed because they are un-interpretable in Regulatory Selection Tasks 1 . First, since participants freely choose their preferred strategy, and tend to strongly prefer distraction versus reappraisal in high versus low intensity, the number of trials in which participants eventually implemented each strategy in each emotional intensity is uneven. Second, and more importantly, inferences about differential effectiveness of distraction versus reappraisal require equating stimuli's intensity level for each of these conditions. This is not possible in Regulatory Selection Tasks because participants tend to choose distraction over reappraisal as emotional intensity increases 1 . Therefore, distracted sentences are presumably more intense than reappraised sentences from the outset and are thus incomparable.  The PSQI is a self-report questionnaire assessing sleep quality over a 1-month time period 4 . The PSQI values presented in the table represent the averaged sum of the seven sleep quality component scores, across participants. The STAI-s is a 6-item self-report scale designed to measure feelings of worry, tension, apprehension, and nervousness individuals are currently experiencing (i.e., state anxiety) 5 . For Study 2, we adapted this scale for our purposes by adding the suffix "during the COVID-19 period" to each item (e.g., "I feel at ease during the COVID-19 period"). The STAI values presented in the table represent the averaged sum of these 6 items, across participants.

High intensity Low intensity
Over the last day, your body temperature has risen to 103.5°F.
Over the last day, your body temperature has risen to 99.1°F.

1
A man in the seat next to you on the bus had a persistent cough.
A man in a seat far away from you on the bus had a mild cough .
During the last few hours, you have experienced severe difficulty breathing.
During the last few hours, you have experienced minor difficulty breathing .

3
Your primary physician who treated you two days ago has COVID-19 .
Your primary physician who treated you two months ago has COVID-19 .

4
A COVID-19 patient sat at the same restaurant table as you did an hour before your visit.
A COVID-19 patient sat at the same restaurant table as you did a month before your visit.

5
The delivery person who brought your groceries has COVID-19.
The delivery person who brought your neighbor's groceries has COVID-19 .

6
Your blood type was found to be highly associated with severe COVID-19 symptoms .
Your blood type was found to be minimally associated with severe COVID-19 symptoms.

7
Your uncle is hospitalized due to a critical COVID-19 health condition.
Your uncle is staying in a quarantine site* due to a minor COVID-19 health condition.

8
Experts estimate that a mutation of the COVID-19 virus will be lethal.
Experts estimate that a mutation of the COVID-19 virus will be non-lethal.

9
Experts estimate that the transmission rate will not decrease in the coming year.
Experts estimate that the transmission rate will decrease significantly in the coming month.
Hospitals predict that the healthcare system will collapse due to the load.
Hospitals predict that the healthcare system will be minimally affected due to the load.

11
You have been updated that you need to undergo a COVID-19 test out of a valid concern that you have been infected .
You have been updated that you need to undergo a COVID-19 test as part of a random sample.
Last night you woke up many times due to a very serious cough.
Last night you woke up once because of a very mild cough.
*During the COVID-19 crisis in Israel, people who had COVID-19 but did not show severe symptoms or a need for hospitalization could choose to spend their isolation time in designated "quarantine sites" like special hotels.
**Note that translating from Hebrew (the language the experiment was administed) to English requires certain necessary changes in length and wording in order to preserve the original meaning.