Nolen Hoeksema 2012

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Susan Nolen-Hoeksema
Department of Psychology, Yale University, New Haven, Connecticut 06520;
email: susan.nolen-hoeksema@yale.edu
Annu. Rev. Clin. Psychol. 2012. 8:161–87 Keywords

First published online as a Review in Advance on gender differences, depression, anxiety, alcohol, strategies
October 24, 2011
The Annual Review of Clinical Psychology is online Abstract

at clinpsy.annualreviews.org
This review addresses three questions regarding the relationships
This article’s doi: among gender, emotion regulation, and psychopathology: (a) are there
doi: 10.1146/annurev-clinpsy-032511-143109
gender differences in emotion regulation strategies, (b) are emotion
Copyright c 2012 by Annual Reviews. regulation strategies similarly related to psychopathology in men and
All rights reserved
women, and (c) do gender differences in emotion regulation strategies
1548-5943/12/0427-0161$20.00 account for gender differences in psychopathology? Women report us-
ing most emotion regulation strategies more than men do, and emotion
regulation strategies are similarly related to psychopathology in women
and men. More rumination in women compared to men partially ac-
counts for greater depression and anxiety in women compared to men,
while a greater tendency to use alcohol to cope partially accounts for
more alcohol misuse in men compared to women. The literature on
emotion regulation is likely missing vital information on how men reg-
ulate their emotions. I discuss lessons learned and questions raised about
the relationships between gender differences in emotion regulation and
gender differences in psychopathology.
161
Contents 1. How Do We Understand the

INTRODUCTION. . . . . . . . . . . . . . 162 Lack of Substantial
EMOTION REGULATION Relationships Between
AND Putatively Adaptive Emotion
PSYCHOPATHOLOGY . . . . . 163 Regulation Strategies and
GENDER, EMOTION Psychopathology? . . . . . . . . . . 174
REGULATION, AND 2. Greater Self-Reports of
PSYCHOPATHOLOGY . . . . . 165 Emotion Regulation in
Gender Differences in Women Compared to Men
Tendencies to Use Specific May Also Be Due to Their
Emotion Regulation Greater Attention to and

Strategies . . . . . . . . . . . . . . . . . . 165 Involvement in Their
Gender Differences in the Emotional Lives. But Is This

Relationships Between a Good Thing? . . . . . . . . . . . . . 175
Emotion Regulation and 3. It’s Time to Stop Assuming
Psychopathology . . . . . . . . . . . 167 That Men Are Just
Gender Differences in Emotion Suppressing or Denying
Regulation Accounting for Their Emotions . . . . . . . . . . . . 176
Gender Differences in 4. Are Men Really on Mars and
Psychopathology . . . . . . . . . . . 168 Women on Venus When It
Why Do Women Report Comes to Emotion
Engaging in More Emotion Regulation? . . . . . . . . . . . . . . . . 176
Regulation Strategies Than 5. How Much Does Emotion
Men Do? . . . . . . . . . . . . . . . . . . 169 Regulation Have to Do with
What Are Men Doing with Psychopathologies More
Their Emotions Other Than Common in Men Than
Drinking? . . . . . . . . . . . . . . . . . . 171 Women (i.e., More
LESSONS LEARNED AND “Externalizing”
QUESTIONS RAISED . . . . . . . 174 Disorders)? . . . . . . . . . . . . . . . . 177
CONCLUSIONS . . . . . . . . . . . . . . . . 178
INTRODUCTION 1990, Polivy & Herman 2002), and alcohol

abuse (Sher & Grekin 2007, Tice et al. 2001).
Emotion dysregulation is increasingly be-
Each of the disorders in which deficits
ing viewed as central to several types of
in emotion regulation are implicated shows
psychopathology (see chapters in Gross &
substantial gender differences in prevalence.
Thompson 2007, Kring & Sloan 2010).
Specifically, women are significantly more
Emotion regulation: Disturbances in emotion regulation have been
likely than men to be diagnosed with unipolar
activities that allow an implicated in depression and anxiety disorders
individual to monitor, depression (Kessler et al. 2007), all of the
(Campbell-Sills & Barlow 2007, Gross &
evaluate, and modify anxiety disorders except obsessive-compulsive
Munoz 1995, Mennin et al. 2007, Nolen-
the nature and course disorder (McLean & Anderson 2009), border-
Hoeksema et al. 2008), borderline personality
of an emotional line personality disorder (Lenzenweger 2008),
response disorder (Linehan 1993, Lynch et al. 2007), eat-
and eating disorders (Striegel-Moore et al.
ing disorders (Fairburn et al. 1995, McCarthy
162 Nolen-Hoeksema
2003). Men are more likely than women to individual, such as the sudden appearance of
be diagnosed with alcohol-related disorders a dangerous snake (LeDoux 2000), or inter-
(Keyes et al. 2008). nal, in the form of memories, imagined sce-
Reappraisal: finding
In turn, gender differences have been doc- narios, predictions about the future, interpre- benign or positive
umented in a number of emotion-related pro- tations, or beliefs (Williams 2010). Goals may attributions or
cesses, including in specific emotion regulation be either immediate (e.g., avoiding being bit- interpretations of an
strategies (Feingold 1994, Hall 1978, McClure ten by the snake) or long term (fulfilling ca- event to prevent or
reduce negative mood
2000, Nolen-Hoeksema & Aldao 2011, Nolen- reer aspirations). Theorists differ as to whether
about the event
Hoeksema et al. 2008, Tamres et al. 2002). they view emotion regulation as distinct from
Acceptance:
Some theorists have suggested that gender dif- emotion generation or emotional reactivity,
acknowledging one’s
ferences in emotion regulation may contribute with some defining emotion regulation as sep- emotions without
to the gender differences in certain types of arate from the process of emotion generation judging them
psychopathology (Hyde et al. 2008, Nolen- (Eisenberg et al. 2007, Gross & Thompson Problem-solving:
Hoeksema 1991, Zahn-Waxler et al. 2008). 2007, Rottenberg & Gross 2003) and oth- active attempts to
Below I briefly review theories of emotion ers arguing that an experienced emotion and overcome or prevent a
regulation and evidence that specific regulatory its regulation are in many ways indistinguish- problem to reduce
distress
strategies are linked to psychopathology. Then able (see Campos et al. 2004, Derryberry &
I address three questions regarding the relation- Rothbart 1997, Lewis et al. 2010). For the Attentional
redeployment:
ships among gender, emotion regulation, and bulk of this review, I discuss emotion regula-
diverting one’s
psychopathology: (a) are there gender differ- tion strategies as distinct from the experience attention to positive or
ences in the tendencies to use certain strategies; of emotion, but I eventually return to a discus- benign stimuli to
(b) are emotion regulation strategies similarly sion of the interrelatedness of the experience change one’s mood
related to psychopathology in men and women; and regulation of emotion (see also the review
and (c) do gender differences in emotion regula- by Gross & Barrett 2011).
tion strategies account for gender differences in Over the years, different theoretical models
certain psychopathologies (particularly depres- have highlighted different specific strategies
sion, anxiety, and alcohol abuse)? Finally, I dis- as adaptive or maladaptive (for a full review,
cuss lessons learned and questions raised about see Aldao et al. 2010). A number of theories
the relationships between gender differences in suggest that psychopathology can result from
emotion regulation and gender differences in the inability to downregulate negative emo-
psychopathology. I also explicate how exami- tions through strategies such as reappraisal,
nation of gender differences in emotion regu- acceptance, problem-solving, or attentional
lation informs general theories and research on redeployment. Reappraisal involves finding
the nature of emotion regulation and its rela- benign or positive attributions or interpreta-
tionship to psychopathology. tions of an event to prevent or reduce negative
mood about the event (Gross 1998). Accep-
tance involves acknowledging one’s emotions
EMOTION REGULATION AND without judging them (Hayes et al. 1996).
PSYCHOPATHOLOGY Problem-solving involves active attempts to
The term “emotion regulation” has been used overcome or prevent a problem (Billings
to refer to the range of activities that allow an & Moos 1981). Attentional redeployment
individual to monitor, evaluate, and modify the involves diverting one’s attention to positive
nature and course of an emotional response, in or benign stimuli to change one’s mood (e.g.,
order to pursue his or her goals and appropri- averting one’s gaze from a frightening scene;
ately respond to environmental demands (Cole Eisenberg et al. 2007, Gross 1998, Kochanska
et al. 2004, Eisenberg & Spinrad 2004, Gross et al. 2000, Rothbart & Bates 2006). Emotion
1998, Johnson et al. 2010, Thompson 1994). regulation theories of psychopathology argue
Emotion-eliciting events may be external to the that the inability to use these strategies to
www.annualreviews.org • Gender, Emotion, and Psychopathology 163

downregulate leads to negative emotions that from their aversive self-awareness (Heatherton
are more uncontrollable, severe, and chronic & Baumeister 1991), rumination also prospec-
and likely develop into psychopathology tively predicts increases in substance abuse
Rumination: a
perseverative focus on (Campbell-Sills & Barlow 2007, Gross & John (Caselli et al. 2008, 2010; Nolen-Hoeksema
one’s negative 2003, Linehan 1993, Mennin et al. 2005). & Harrell 2002; Nolen-Hoeksema et al. 2007;
emotions and the Consistent with these theories, difficulties Skitch & Abela 2008) and eating disorders
causes and in reappraisal, acceptance, problem-solving, or (Holm-Denoma & Hankin 2010, Nolen-
consequences of them,
attentional redeployment have all been shown Hoeksema et al. 2007, Rawal et al. 2010).
without engaging in
problem-solving to be related to elevated levels of depression, Psychopathology can also result from the
anxiety, or borderline personality disorder excessive attempts to downregulate negative
Suppression:
consciously or symptoms (see Aldao et al. 2010, Campbell-Sills emotions through strategies such as suppres-
nonconsciously trying & Barlow 2007, Lynch et al. 2007, McLaughlin sion or avoidance (Gross 1998, Hayes et al.
to push negative et al. 2007, Roemer et al. 2008). The inability to 1996). Various forms of suppression and avoid-
thoughts and feelings deploy these strategies to downregulate nega- ance have been implicated in psychopathology,
from awareness
tive affect may also lead individuals to engage in including suppression of emotional expression
Avoidance: maladaptive behaviors, such as binge eating or (Gross 1998) and suppression of unwanted
behavioral or cognitive
binge drinking; some studies have found rela- thoughts (Wenzlaff & Wegner 2000). Hayes
attempts to get away
from distressing tionships between eating disorders or alcohol- and colleagues (1999) used the term “experi-
thoughts or situations related disorders and difficulties in acceptance ential avoidance” to refer to the suppression
(Breslin et al. 2002, Kristeller et al. 2006, or avoidance of an array of psychological
Marlatt et al. 2004) and problem-solving experiences, including thoughts, emotions,
(Cooper et al. 1992, Van Boven & Espelage sensations, memories, and urges. Finally,
2006). behavioral avoidance of emotionally evocative
Some people do not simply fail to down- situations has a long history of study in psychol-
regulate negative emotions but also engage in ogy (Mowrer 1947). Studies have confirmed
processes that exacerbate and prolong these that people who chronically suppress or avoid
emotions. Rumination, defined as a persever- their emotions are at increased risk for depres-
ative focus on one’s negative emotions and sion (Wenzlaff & Wegner 2000) and anxiety
the causes and consequences of them, without disorders, such as panic disorder (Barlow et al.
engaging in problem-solving, prospectively 1989, Lissek et al. 2009), posttraumatic stress
predicts symptoms and diagnoses of major disorder (Foa & Kozak 1986), specific phobia
depression (see meta-analyses by Aldao et al. (Merckelbach et al. 1996), and social phobia
2010, Mor & Winquist 2002, Rood et al. (Kashdan & Breen 2007).
2009, Watkins 2008). Rumination has also Some people may engage in potentially dan-
been shown to predict symptoms of anxiety gerous behaviors, such as binge drinking or
(Clohessy & Ehlers 1999, Fresco et al. 2002, binge eating, in attempts to suppress or avoid
Harrington & Blankenship 2002, Mayou their emotions, leading to disorders such as
et al. 2002, Nolen-Hoeksema 2000, Nolen- substance abuse (Cooper et al. 1988) or eating
Hoeksema & Morrow 1991, Schwartz & disorders (Polivy & Herman 2002, Tice et al.
Koenig 1996, Segerstrom et al. 2000). Among 2001). Indeed, chronic avoidance and suppres-
the specific anxiety disorders, rumination is sion are associated with increased risk for eat-
associated with an increased risk for social ing disorders (Engler et al. 2006) and substance
phobia (Mellings & Alden 2000), posttraumatic abuse (Sher & Grekin 2007).
stress disorder (Clohessy & Ehlers 1999, Ehlers A meta-analysis examining the relationships
et al. 1998, Mayou et al. 2002, Murray et al. of reappraisal, problem-solving, acceptance,
2002), and generalized anxiety (McLaughlin rumination, suppression, and avoidance to
& Nolen-Hoeksema 2011, Watkins 2009). psychopathology (i.e., depression, anxiety,
Perhaps because people are trying to escape substance abuse, and eating disorders) found
164 Nolen-Hoeksema
a large effect size for rumination; medium to accounting for gender differences in emotion
large for avoidance, problem solving, and sup- regulation significantly reduces observed
pression; and small to medium for reappraisal gender differences in psychopathology.
and acceptance (Aldao et al. 2010). Depression
and anxiety were more consistently related to
emotion regulation deficits than were substance Gender Differences in
abuse and eating disorders. These results were Tendencies to Use Specific
found in both community samples and com- Emotion Regulation Strategies
parisons of clinical to nonclinical samples, with Women are widely viewed as the “more
larger effects found in studies including clinical emotional sex,” with greater tendencies to ex-
samples. Thus, there is substantial evidence that perience, express, and dwell on their emotions
difficulties in emotion regulation, particularly (Barrett & Bliss-Moreau 2009, Brody 1993,
the tendencies to use rumination, avoidance, Deaux & Major 1987, Fabes & Martin 1991,
or suppression and failures to use problem- Fischer & Manstead 2000, LaFrance & Banaji
solving, are associated with psychopathology, 1992, Shields 1987). Men, on the other hand,
particularly depression and anxiety.1 are viewed as tending to suppress or avoid both
the experience and expression of emotions.
Further, people tend to make dispositional
GENDER, EMOTION attributions for women’s expressions of emo-
REGULATION, AND tion, seeing them as the result of something
PSYCHOPATHOLOGY deep, meaningful, and stable about women, but
As noted, at least three key questions can be tend to attribute men’s expressions of emotion
asked about the relationships among gender, to the situations they are facing (Barrett &
emotion regulation, and psychopathology. The Bliss-Moreau 2009).
first is whether there are gender differences Consistent with these views of the emotional
in the tendencies to use certain emotion lives of women and men, some gender role the-
regulation strategies. Answering this question ories suggest that women use more internally
involves examining mean differences between focused, passive responses to their emotions,
men and women in endorsement of strategies. such as rumination, while men are more likely
The second question is whether emotion reg- to engage in suppression or avoidance, includ-
ulation strategies are similarly related to psy- ing turning to substances to avoid (for a review
chopathology in men and women. Answering see Tamres et al. 2002). Because men’s gender
this question involves examining gender dif- role is to be more active and agentic, they may
ferences in the relationships between emotion also be more likely than women to engage in
regulation strategies and psychopathology. The problem-solving and reappraisal in attempts to
third question is whether gender differences in control or change the situations that they be-
emotion regulation strategies account for gen- lieve are driving their emotions (Tamres et al.
der differences in certain psychopathologies. 2002).
Answering this question involves mediational The emotion regulation strategy for which
analyses to determine whether statistically gender differences have been most consistently
found is rumination. A meta-analysis of 10 stud-
ies with a combined sample of over 2,000 par-
1
Aldao et al. (2010) did not examine the relationship between ticipants found that women scored significantly
emotion regulation strategies and borderline personality dis-
order in their meta-analysis because there is a lack of empir- higher than men on self-report measures of the
ical studies on this topic, despite the centrality of emotion tendency to ruminate when distressed (Tamres
regulation deficits in Linehan’s (1993) theory of borderline et al. 2002). Studies subsequent to this meta-
personality disorder. As a result, I do not address borderline
personality disorder in this review either. Clearly, however, analysis have continued to find that women and
this is an important area for future research. girls score higher on rumination scales than

men and boys do (Broderick & Korteland 2002, large (n >1,300) community sample of women
Cox et al. 2010, Hampel & Petermann 2005, and men ranging from 25 to 75 years of age
Jose & Brown 2008, Lopez et al. 2009, Mezulis (Nolen-Hoeksema & Aldao 2011). Women
Effortful control:
the ability to exert et al. 2002, Peled & Moretti 2007). reported using rumination, seeking social
voluntary control over In an effort to obtain observational data on support, reappraisal, problem-solving, and
emotional reactions women’s and men’s tendencies to ruminate acceptance significantly more than men. No
and one’s urges and when in distress, Butler & Nolen-Hoeksema gender differences were found in suppression
impulses to act
(1994) induced a sad mood or neutral mood in of emotion.
a sample of female and male college students, The greater tendency for women to report
then gave them a choice of a task that required engaging in putatively adaptive emotion regu-
them to focus on and analyze their current lation strategies more than men parallels find-
emotional states or a task that was not emotion ings on effortful control in children. Effortful
focused. They found that the overwhelming control is considered a fundamental dimension
majority of women chose the emotion-focusing of temperament characterized by the ability to

task whether they were in a sad mood or a exert voluntary control over emotional reac-
neutral mood. In contrast, only about half tions and one’s urges and impulses to act (see
the men chose the emotion-focusing task in Eisenberg et al. 2007, Kochanska et al. 2000,
either mood. Thus, there is evidence from Rothbart & Bates 2006). Effortful control in-
both self-report and observational studies that cludes cognitive strategies, such as attentional
women choose to focus on and analyze their redeployment, planning, or reappraisal, as well
emotions when in sad moods. as behavioral responses, such as withdrawal and
Perhaps surprisingly, the meta-analysis by direct action. Studies of children consistently
Tamres et al. (2002) found that women were find girls show greater effortful control abilities
more likely than men to report engaging in than boys, with large effect sizes for gender (see
most types of emotion regulation, specifically meta-analysis by Else-Quest et al. 2006).
11 out of 17 strategies examined. Some of these One consequence of low effortful control
differences were in line with gender role the- may be that males are more likely to engage
ories. Women were significantly more likely in impulsive, reward-seeking behaviors in re-
than men to report engaging in wishful think- sponse to negative emotions. Some studies sug-
ing, which may be akin to rumination. Women gest that the relationship between depressive
also reported seeking social support and turn- affect and later alcohol use is stronger for men
ing to religion, which are in line with evidence than women (Carney et al. 2000, Hussong et al.
that women express emotions more than men 2001, Swendsen et al. 2000), suggesting that
do (Brody 1993) and are more interpersonally men may be more likely than women to seek the
oriented than men are (Feingold 1994, Hyde rewarding effects of alcohol in response to neg-
et al. 2008). ative emotions. Indeed, studies of adults show
Women were also more likely than men to that men consistently score higher on mea-
report using reappraisal and problem-focused sures of “drinking to cope” compared to women
coping, however, which was not expected based (Cooper et al. 1992, 1995; Frone et al. 1994;
on gender role theories (Tamres et al. 2002). Nolen-Hoeksema & Harrell 2002; Park &
Moreover, women were more likely than men Levenson 2002; Ratliff & Burkhart 1984).
to report engaging in efforts to avoid or distract On the other hand, in laboratory studies, re-
themselves from distressing situations. There searchers find that women expect alcohol to
were no emotion regulation strategies that men interfere with their ability to cope with dif-
reported engaging in more often than women ficult situations and avoid alcohol when they
did. must deal with stressful situations (Abrams &
Similarly, we found gender differences in a Wilson 1979, Sutker et al. 1982). More recent
wide range of emotion regulation strategies in a studies show that women do not experience the
166 Nolen-Hoeksema
dampening of emotional arousal due to intake are robustly related to depression and anxiety
of alcohol that men do (Udo et al. 2009), which and also related to substance abuse (Aldao &
may reduce their tendencies to turn to alcohol Nolen-Hoeksema 2010). Similarly, drinking
to cope with negative mood. to cope with distress predicts increases in
In summary, women report using more of alcohol-related problems for men and for
almost all types of emotion regulation strate- women in our community study and in other
gies compared to men, including rumina- studies (Cooper et al. 1997, Nolen-Hoeksema
tion, reappraisal, problem-solving, acceptance, & Harrell 2002, Rutledge & Sher 2001, Timko
distraction, and seeking social support (or re- et al. 2005). Unfortunately, in our community
ligion). This is consistent with studies of chil- study (Nolen-Hoeksema & Aldao 2011), the
dren showing that girls are higher on effortful strategies theorized to be adaptive, including
control than boys. Men report using alcohol to reappraisal, problem-solving, acceptance,
cope more often than women do. and seeking emotional support, were not
significantly associated with lower levels of de-

pression, anxiety, or alcohol problems in either
Gender Differences in the women or men. This is generally consistent
Relationships Between Emotion with our earlier meta-analysis, which found that
Regulation and Psychopathology reappraisal and acceptance had relatively small
A greater tendency to use a particular emotion relationships to psychopathology, although
regulation strategy in one gender compared problem-solving had a moderate relationship
to another would not be consequential if to psychopathology (Aldao et al. 2010).
that strategy was not associated with psy- Aldao & Nolen-Hoeksema (2011) argued,
chopathology in the gender more prone to however, that adaptive strategies may only
use it. For example, women could report using predict psychopathology in the presence of
more reappraisal than men, but if reappraisal maladaptive strategies, suggesting that they
doesn’t predict lower levels of psychopathol- have compensatory effects among people prone
ogy in women, then the gender difference to maladaptive strategies not seen when exam-
in reappraisal is inconsequential for gender ined alone. Indeed, Aldao & Nolen-Hoeksema
differences in psychopathology. Or it could be (2011) found an interaction between com-
that emotion regulation strategies are similarly posite indices of adaptive and maladaptive
related to psychopathology in men and women, strategies in the prediction of a composite
so a greater tendency for one gender to use a psychopathology index of depression, anxiety,
certain strategy could have consequences for and alcohol use problems.3 Adaptive strategies
gender differences in psychopathology. predicted lower levels of psychopathology only
In our large community study (Nolen- among people with high levels of maladaptive
Hoeksema & Aldao 2011), higher rumination strategies, consistent with a compensatory
scores and higher suppression scores were effect (similar results were obtained when the
significantly related to higher depression dependent variables were depression/anxiety
and anxiety scores, and more problems due to alone or alcohol problems alone).
alcohol use, in men and in women.2 This is con- For this review I examined whether there
sistent with our previous meta-analysis showing were gender differences in these compensatory
that rumination and suppression/avoidance
2 3
In Nolen-Hoeksema & Aldao (2011), we report only anal- Aldao & Nolen-Hoeksema (2011) included reappraisal and
yses of the relationships between strategies and depression. acceptance in their adaptive strategies composite and in-
We conducted analyses of the relationships between the same cluded rumination, suppression, denial, and behavioral dis-
strategies and self-reported anxiety (Beck & Steer 1990) and engagement in their maladaptive strategies composite. The
problems due to alcohol use (First et al. 1997) for this review. gender analyses reported in this section used those composite
These results are available from the author. indices.

effects and found there were. Among women, Women’s greater levels of rumination sig-
the interaction between adaptive and maladap- nificantly mediated the relationship between
tive strategies significantly predicted a compos- gender and depression on both the BDI and
BDI: Beck
Depression Inventory ite psychopathology index (depression, anxiety, the SCID symptom count (Sobel test p’s <
and alcohol problems); subsequent analyses 0.01). Rumination fully mediated the relation-
SCID: Structured
Clinical Interview for showed that among women, adaptive strategies ship between gender and SCID symptoms, but
DSM-IV predicted these psychopathologies only among only partially mediated the relationship be-
those with high levels of maladaptive strategies. tween gender and BDI scores (i.e., the rela-
Among men, the interaction between adaptive tionship between gender and BDI scores was
and maladaptive strategies was not a significant still significant at p < 0.05). These results were
predictor of psychopathology.4 Thus it appears consistent using both the full rumination scale
that there are some gender differences in the and the brooding subscale of rumination, from
relationships between emotion regulation which items overlapping with depression symp-
strategies and psychopathology. Specifically, toms have been removed (Treynor et al. 2003).
for women, adaptive strategies appear to have Similarly, both the full rumination scale and
some compensatory effects among those with the brooding subscale were partial mediators
higher levels of maladaptive strategies, but of the gender difference in self-reported anxiety
adaptive strategies do not have such compen- ( p’s < 0.05), but the gender difference in anxiety
satory effects against maladaptive strategies for still remained significant. Thus, we have some
men (for similar gender results in adolescents, evidence that mean gender differences in rumi-
see Sontag & Graber 2010). nation account at least partially for the gender
differences in depression and anxiety.
Gender Differences in Emotion I also examined whether women’s greater
Regulation Accounting for Gender tendency to engage in reappraisal, problem-
Differences in Psychopathology solving, acceptance, or seeking emotional sup-
port compared to men might mitigate the gen-
Using the data from our community study
der differences in depression or anxiety. That
(Nolen-Hoeksema & Aldao 2011), I also tested
is, the fact that women engage in these adaptive
whether gender differences in mean levels of
strategies more often than men may result in
emotion regulation strategies statistically ac-
the gender difference in depression or anxiety
counted for gender differences in symptoms of
being smaller than it might otherwise be. The
depression, anxiety, and alcohol abuse. Women
only indication of such an effect was in the re-
did score higher than men ( p < 0.05) on our
lationship between seeking emotional support
two measures of depression, the Beck Depres-
and gender differences in BDI scores. Seeking
sion Inventory (BDI; Beck & Beck 1972) and
emotional support was associated with lower
the total number of symptoms on a clinician
BDI scores, and when social support was added
administered Structured Clinical Interview for
to the equation predicting BDI scores, the co-
DSM-IV (SCID; First et al. 1997; see Aldao
efficient for the gender difference in BDI scores
& Nolen-Hoeksema 2011 for information on
increased significantly ( p < 0.05). This suggests
this index), as well as our self-report measure of
that women’s greater tendency to seek social
anxiety (Beck Anxiety Inventory; Beck & Steer
support may mitigate the gender difference in
1990). Men scored higher than women ( p <
depression somewhat; this result must be inter-
0.001) on our measure of alcohol abuse, a count
preted cautiously, however, because it was not
of symptoms on a clinician-administered SCID
replicated with SCID symptom count scores.
(see Aldao & Nolen-Hoeksema 2011).
Using our community sample, I tested
whether men’s greater tendency to use alcohol
to cope with stress accounted for their greater
4
Results available from author. rates of alcohol-related problems and found
168 Nolen-Hoeksema
a significant mediational effect (Sobel’s test women are more emotionally reactive to neg-
p < 0.01). The relationship between gender and ative events than men are because they ap-
alcohol problems was still significant, however, praise these events as more stressful (Ge et al.
when using alcohol to cope was in the model 2001, Hyde et al. 2008, Rudolph & Hammen
( p < 0.001), suggesting that men’s greater ten- 1999). Women also report greater affect inten-
dency to cope by drinking only partially me- sity than men do, meaning they report both
diates the gender differences in alcohol-related more intense positive and more intense nega-
problems. I also tested whether the greater de- tive emotions in their daily lives (Fujita et al.
gree of adaptive strategies reported by women 1991, Gohm 2003). However, fewer gender
compared to men (i.e., reappraisal, acceptance, differences have been found in moment-by-
seeking social support, and active coping) con- moment emotional experiences (Barrett et al.
tributed to the gender differences in alcohol 1998, Kring & Gordon 1998, Robinson et al.
problems and found that it did not. 1998), suggesting that gender differences in
Thus, in general, there are similar relation- self-reports of global emotionality are strongly
ships between the emotion regulation strategies influenced by gender role expectations. Still,
of rumination, reappraisal, problem-solving, gender differences in self-reports of emotion
seeking emotional support, and acceptance and regulation may be influenced by gender dif-
the psychopathologies of depression, anxiety, or ferences in self-perceptions of emotionality
alcohol problems in women and men, with one and perceptions of the stressfulness of the
exception. Among women but not among men, environment.
putatively adaptive strategies are significantly In their meta-analysis, Tamres et al. (2002)
associated with psychopathology only among tested whether gender differences in emotion
those who also use maladaptive strategies, sug- regulation strategies were found only in studies
gesting that the adaptive strategies may have that also found gender differences in appraisals
some compensatory effects in women (but not of stressors. They found that for problem-
men) prone to maladaptive strategies. solving, avoidance, and positive reappraisal,
Do gender differences in emotion regulation women reported using the strategy more than
account for gender differences in psychopathol- men did only in studies in which women ap-
ogy? There were two significant, consistent praised the stressor as more severe than men
findings. Women’s greater tendency to engage did, suggesting that gender differences in these
in rumination compared to men was a signif- strategies could be the result of gender differ-
icant mediator of women’s greater levels of ences in stressor appraisal. In contrast, the gen-
depression and anxiety compared to men. On der differences in rumination and social support
the other hand, men’s greater tendency to turn seeking were found across studies.
to alcohol to cope compared to women was a In our community study (Nolen-Hoeksema
significant mediator of men’s greater alcohol & Aldao 2011), we were able to directly test
problems compared to women. whether gender differences in emotion reg-
ulation strategies were significant even when
controlling for gender differences in depres-
Why Do Women Report Engaging in sive symptoms. We found that all the gender
More Emotion Regulation Strategies differences (i.e., in rumination, seeking social
Than Men Do? support, reappraisal, problem-solving, and ac-
Why would women report more frequently us- ceptance) remained significant after controlling
ing most emotion regulation strategies except for depression, suggesting they are not simply a
drinking to cope, compared to men? Women reflection of women’s greater tendency toward
may report using more emotion regulation be- depression compared to men.
cause they have more distressing emotions to Still, it may be that, compared to men,
regulate. Several theorists have suggested that women are more aware of and attentive to

their emotions and more likely to engage in Greater emotional awareness and under-
concerted efforts to change their emotions. standing may facilitate adaptive emotion reg-
Women show more awareness of their own ulation in most women. Indeed, most women
and others’ emotions and pay more attention do not suffer from significant depression or
to these emotions compared to men on both anxiety, even when they live in stressful envi-
self-report and performance-based measures ronments, suggesting that they have emotion
(Brody & Hall 1993, Ciarrochi et al. 2005, regulation repertoires that make them resilient
Joseph & Newman 2010). On measures of (Nolen-Hoeksema & Hilt 2009). As noted
emotional understanding, which present above, our community study found that among
participants with a variety of scenarios, women women, adaptive strategies compensate some-
show greater understanding of what emotions what for the presence of maladaptive strategies.
they or others would feel across different For some women, however, this attention
contexts and what the sources of these emo- to and engagement with emotions may become
tions would be (Barrett et al. 2000, Joseph & maladaptive, in the form of a ruminative focus
Newman 2010). Moreover, women show more on emotions (Barrett et al. 2000, Zahn-Waxler
complex and differentiated conceptualizations et al. 2008). These women may become exces-
of emotion than men do, even when accounting sively engaged in understanding their emotions
for gender differences in verbal intelligence and the causes of their emotions and may be-
(Barrett et al. 2000). Women encode events gin to feel trapped in analyzing their emotions,
and recall memories more in terms of their as in rumination. Further, a greater tendency
emotional content than men do (Davis 1999, to see their emotions as the result of some-
Seidlitz & Diener 1998) and have more elab- thing in themselves rather than something in
orated memories of autobiographical events their situations (Barrett & Bliss-Moreau 2009)
than men do (Davis 1999). Women are more may lead some women to blame themselves
likely than men to see their emotions as pro- for their emotions or to believe their emotions
viding useful information that it is important to are out of control. Nolen-Hoeksema & Jackson
analyze (Gohm 2003). Finally, whereas people (2001) found that women were more likely than
tend to view men’s emotions as the result of ex- men to believe that negative emotions are un-
ternal situations, they view women’s emotions controllable, and this gender difference in be-
as more likely due to internal, dispositional liefs partially mediated the gender difference in
characteristics, seeing them as meaningful in- rumination.
formation to analyze (Barrett & Bliss-Moreau Women are also more aware of and con-
2009, Brescoll & Uhlmann 2008). cerned with the emotions of others than men
This greater attention to, use of, and un- are (Brody & Hall 1993, McClure 2000). This
derstanding of emotion may lead women to en- may facilitate women’s ability to empathize
gage in more attempts to modify their emotions with and relate to others. Being able to con-
to meet environmental demands or to pursue nect with others also likely builds social sup-
their goals, i.e., to engage in emotion regulation port, and we found in our community study that
strategies of a variety of kinds. Indeed, women women’s ability to solicit emotional support
outscore men on performance-based measures from others protected them somewhat against
of the knowledge of what emotion regulation being more depressed. But some women may
strategies would be most effective across a va- become too concerned with or affected by the
riety of contexts ( Joseph & Newman 2010). emotions of others (Gilligan 1982, Helgeson
These tendencies appear to start early. Girls 1994, Jack 1991, Miller 1976), and this may also
show greater attention to and understanding contribute to rumination. Nolen-Hoeksema &
of emotions than boys from an early age (see Jackson (2001) found that women scored higher
reviews by McClure 2000, Zahn-Waxler et al. than men on a measure of “excessive interper-
2008). sonal orientation” (e.g., “For me to be happy,
170 Nolen-Hoeksema
I need others to be happy”; Fritz & Helgeson range of activities to regulate their emotions but
1998), and this gender difference in excessive not labeling them as emotion regulation strate-
interpersonal orientation partially mediated the gies. Barrett and colleagues (2000) suggest that
gender difference in rumination. men may be more likely to engage in automatic,
Finally, it is important to note that although nonconscious emotion regulation compared to
women may have a larger repertoire of emotion the more conscious, linguistically based emo-
regulation strategies, including adaptive strate- tion regulation of women. People clearly do
gies, that they endorse compared to men, the regulate their emotions even when they are
context in which they use these strategies is not conscious of having emotions or engag-
an important determinant of their effectiveness ing in regulation (Bargh & Williams 2007).
(Bonanno et al. 2004). Indeed, Aldao & Nolen- Evidence shows that people automatically cor-
Hoeksema (2010) argued that one reason adap- rect both positive and negative moods toward
tive strategies are not as strongly related to psy- a neutral baseline (Forgas & Ciarrochi 2002,
chopathology as maladaptive strategies is that Larsen & Prizmic 2008), particularly if they are
the effects of adaptive strategies are more con- “action-oriented” instead of “state-oriented”
text dependent than the effects of maladap- ( Jostmann et al. 2005), as men may be.
tive strategies. For example, reappraisal may As for specific emotion regulation strategies,
be adaptive in some situations, but maladap- there is evidence that people engage in au-
tive in others, as in an abusive relationship. In tomatic reappraisal, for example, strategically
contrast, maladaptive strategies such as rumi- comparing themselves with others in order to
nation may have detrimental effects in a wider improve their sense of well-being (Aspinwall &
range of circumstances. An important question Taylor 1993). Moreover, nonconscious reap-
for future research is whether women are more praisal works to reduce reactivity to negative
likely than men to try to internally manage stimuli. Williams and colleagues (2009) first
their emotions in difficult situations or to con- induced anxiety in participants, then either
tinue to problem-solve (particularly around in- nonconsciously primed participants to reap-
terpersonal problems) even when they become praise the situation or explicitly instructed them
intractable, rather than abandoning impossible to reappraise. Participants who underwent
situations. the nonconscious reappraisal prime showed
reductions in physiological activity equal to
those of the participants explicitly instructed
What Are Men Doing with Their to reappraise, and both of these groups showed
Emotions Other Than Drinking? greater physiological recovery than a control
The only emotion regulation strategy that group given no prime or instructions. In a
men consistently report doing more often than second study, Williams and colleagues (2009)
women is drinking to cope. We know that men found that the effects of the nonconscious
are experiencing emotions as much as women reappraisal prime were even stronger among
are—again, experience-sampling studies and people who scored low on a self-report measure
laboratory emotion-induction paradigms show of the tendency to engage in reappraisal. The
few consistent gender differences in online researchers suggest that nonconscious emotion
emotional reports (Barrett et al. 1998). Per- regulation is more efficient and less susceptible
haps men’s relative lack of attention to, or to interference from cognitive load (e.g., due
understanding of, their emotions leads them to distraction, fatigue, competing demands)
to engage in fewer attempts to regulate these than explicit, conscious emotion regulation
emotions. is (see also Mauss et al. 2006). Thus, to the
extent that men are more likely than women to
Automatic emotion regulation. It is highly engage nonconsciously in emotion regulation
likely, however, that men are engaging in a strategies such as reappraisal, they may be able

to use such strategies to regulate their moods through self-disclosure. Males may not endorse
across a wider variety of circumstances. such items but still frequently seek support from
McRae and colleagues (2008) found evi- male friends through shared activities.
dence that men may engage in reappraisal more Engaging in shared activities with friends
automatically and with less effort than women. could help to positively regulate emotions in
They instructed participants either to look at several ways (see Zarbatany et al. 2000). The
or to reappraise negative photos and found that emotional closeness created by shared activities
men and women reported equal reductions in could affirm a male’s self-worth and sense of
self-reported distress when using reappraisal belonging. The activity could act as a positive
relative to just looking. Men, however, showed distraction and an instrumental behavior, up-
less prefrontal cortex activity as well as a greater regulating positive affect, much as with behav-
decline in amygdala activity when reappraising ioral activation assignments in psychotherapy

than women did. This suggests that men had ( Jacobson et al. 2001). And while engaging in
to exert less executive control to get a greater activity, the individual may reveal some of what
reduction in amygdala activity than women did, is causing him distress to his friend, resulting in
perhaps because reappraisal is more automatic expressions of concern or validation, or offers
and less effortful for men than for women. of help. Thus, when distressed, males may seek
Men also showed more evidence of positive support from friends by engaging in shared ac-
implicit attitudes toward emotion regulation, tivities, never registering this as support seeking
which have been linked in a previous study to or emotion regulation but nonetheless gaining
more automatic emotion regulation but not to regulatory benefits.
greater self-reports of conscious emotion regu- Studies suggest that social support may be
lation (Mauss et al. 2006). especially effective in reducing distress and in-
There is a great deal more work to be done creasing well-being when it is “invisible,” that
to determine if men engage in more automatic is, when the provider does not make it obvi-
emotion regulation than do women. If so, it ous that he or she is providing support and/or
will be important to determine if they engage the recipient is not consciously aware that he
in both more adaptive and maladaptive emo- or she is receiving support (Bolger & Amarel
tion regulation and what the implications are 2007). Howland & Simpson (2010) found that
for gender differences in psychopathology. the beneficial effects of invisible emotional and
practical support are even stronger for men
Social support, male style. Another type of than for women. They conjectured that invisi-
emotion regulation men may engage in more ble support allows men to maintain their sense
than women, but may not label as emotion of agency and independence while receiving
regulation, is seeking social support and lift- affirmation and practical help.
ing their moods through activities with friends. In contrast to male same-sex friendships, fe-
Compared to females, males’ interactions with male same-sex friendships tend to involve more
friends tend to be more activity based (e.g., self-disclosure (e.g., Rose 2002, Zarbatany
Furman & Buhrmester 1985, Parker & Asher et al. 2000). Unfortunately, the self-disclosure
1993, Rose 2002, Zarbatany et al. 2000). characteristic of female close relationships
Further, studies of children suggest that there can backfire when it leads to co-rumination,
is a stronger link between shared activities with defined as excessively discussing personal prob-
friends (e.g., sports) and emotional closeness in lems within a dyadic relationship (Haggard
boys than in girls (e.g., Camarena et al. 1990, et al. 2011; Rose 2002, 2007; Rose et al. 2007).
Zarbatany et al. 2000). Self-report measures of Co-rumination is characterized by discussing
coping or emotion regulation tend to ask more the same problem repeatedly, mutual encour-
about a female style of social support seeking, agement of discussing problems, speculating
namely, seeking emotional support from others about problems, and focusing on negative
172 Nolen-Hoeksema
feelings (Rose 2002, Rose et al. 2007). Al- became more angry and had more angry
though bouts of co-rumination appear to lead thoughts compared to individuals distracted
to increased intimacy with friends, they are also after an anger induction. In experimental stud-
associated with increases in depressive symp- ies, Bushman (2002) found that participants
toms in girls and women (Calmes & Roberts provoked into anger then induced to ruminate
2008, Rose et al. 2007). Co-rumination may showed more aggressive behavior compared
have effects similar to those of rumination, to participants who were provoked but then
rehearsing negative interpretations of events, distracted. Further, Bushman and colleagues
interfering with problem-solving, and imped- (2005) found that participants induced to
ing instrumental behavior. The self-disclosure ruminate after a provocation showed more
that occurs in co-rumination also leaves an displaced anger in a mildly annoying situation
individual vulnerable to relational aggression, unrelated to the original anger provocation,

that is, a friend revealing sensitive information even when this annoying situation happened
about the individual to others (Rose 2002). eight hours after the original provocation.
The danger of co-rumination when females Verona (2005) examined the relationship
seek social support may help to explain why between self-report measures of the tendency
social support is not consistently or strongly to ruminate and aggressive behavior in an ex-
related to improvements in mood in women periment in which participants were to deliver
(Nolen-Hoeksema & Aldao 2011). On the electric shocks to a confederate when the con-
other hand, the fact that self-report measures federate made mistakes on a task. She found
of seeking social support describe it in terms that both men and women who scored high on
that may not match men’s style of using support a rumination questionnaire gave more shocks to
from friends may explain why social support is the confederate than those scoring low on ru-
not consistently or strongly related to improve- mination in a context in which their attention
ments in mood in men (Nolen-Hoeksema & was directed solely at the confederate’s perfor-
Aldao 2011). mance. In another condition in which the par-
ticipants were distracted from the confederate’s
Anger rumination and aggressive behavior performance, women who scored high on rumi-
in males. One emotion regulation activity that nation did not deliver more shocks than those
may be linked to greater aggression in males, low on rumination, but men who scored high
but that has been relatively understudied, is on rumination still delivered more shocks than
anger rumination. Although women ruminate those low on rumination, suggesting that the
more in response to sadness or anxiety, men association between rumination and aggression
appear to ruminate more in response to anger. is less context dependent in men than women.
In two studies using different mood inductions, Finally, self-reported anger rumination is asso-
Rusting & Nolen-Hoeksema (1998) found that ciated with higher scores on measures of physi-
women induced into an angry mood were sub- cal and verbal aggression and hostility in adults
sequently more likely to choose a nonemotion- (Anestis et al. 2009) and adolescents (Peled &
focusing task than an emotion-focusing task, Moretti 2007).
whereas men were more likely to choose to fo- Thus, men appear to engage in angry ru-
cus on their angry emotions (see also Knobloch- mination more than women. Anger rumination
Westerwick & Alter 2006, Sukhodolsky et al. is associated with an increase in angry feelings
2001). and thoughts and more aggressive behavior in
In turn, anger rumination is associated with laboratory settings and higher self-reports of
increases in angry feelings and thoughts and aggression and hostility.
more aggressive behavior. Rusting & Nolen-
Hoeksema (1998) found that individuals Summary. In summary, I suggest that the lit-
induced to ruminate after an anger provocation erature is missing vital information on how men

regulate their emotions because we are not cur- regulation strategies does not seem to be do-
rently asking the right questions to reveal some ing them much good, however, in that the
of men’s typical emotion regulation strategies. putatively adaptive strategies endorsed more
For example, much of men’s emotion regula- by women are at best weakly related to psy-
tion may be automatic and nonconscious and chopathology in the analyses of our community
therefore not measurable with self-report ques- sample (Nolen-Hoeksema & Aldao 2011) and
tionnaires. In addition, the way men use social in our meta-analysis (Aldao et al. 2010). The
support to regulate their emotions may be one exception was that among women high in
different from the way women do, and not cap- maladaptive strategies, a composite of adaptive
tured by current measures. Finally, men may strategies was significantly related to lower psy-
not be as likely as women to ruminate when sad chopathology. How do we reconcile these find-
or anxious but may be more likely than women ings with the several theories that argue that
to ruminate when angry, contributing to their strategies such as reappraisal and acceptance are
higher rates of aggressive or antisocial activity. critical in protecting against psychopathology

There are likely other ways men cope or (e.g., Gross 1998, Hayes et al. 1999), the thera-
regulate their emotions that are to be discov- pies that teach these strategies and show reduc-
ered. The focus of the field on voluntary strate- tions in psychopathology (e.g., Beck et al. 1979,
gies, such as reappraisal and suppression, that Hayes et al. 2011), and the experimental evi-
were described several decades ago by the orig- dence that inducing people to engage in reap-
inal stress and coping theorists (Carver et al. praisal or acceptance lowers subjective distress
1989, Folkman & Lazarus 1980) has obscured (e.g., Kuehner et al. 2009, McRae et al. 2008)?
our investigation of other types of adaptive and As noted above, Aldao and colleagues (2010,
maladaptive strategies that might characterize Aldao & Nolen-Hoeksema 2011) suggested
men’s (or women’s) emotion regulation. that the effectiveness of adaptive strategies may
be more context dependent than the effective-
ness of maladaptive strategies. For example,
LESSONS LEARNED AND ruminating in an abstract, self-evaluative way
QUESTIONS RAISED when one is distressed may lead to more distress
This examination of the gender differences regardless of the context, while the appropriate-
in emotion regulation and their relationship ness of reappraisal or acceptance may depend
to gender differences in psychopathology on the situation. Thus, women’s tendencies
has suggested some important lessons and toward more maladaptive strategies may be
raised some interesting questions. These more frequently harmful than their tendencies
lessons and questions pertain to theories of the toward more adaptive strategies are beneficial.
relationships between emotion regulation and The present review also suggests that some
psychopathology generally and to the role of individuals who say they are not engaging
gender differences in these relationships. in reappraisal, acceptance, or problem-solving
may actually be doing so but may not be con-
scious of it. For these individuals, engaging
1. How Do We Understand the Lack in these adaptive emotion regulation strategies
of Substantial Relationships Between may be so automatic that they are not aware
Putatively Adaptive Emotion that they are regulating their emotions, and
Regulation Strategies and thus they score low on self-report measures of
Psychopathology? adaptive emotion regulation strategies (McRae
Women reported engaging in more of all types et al. 2008). Further, this type of automatic,
of emotion regulation compared to men, ex- nonconscious engagement in emotion regula-
cept drinking alcohol to cope. Women’s greater tion may be more efficient and effective in re-
repertoire of consciously chosen emotion ducing emotion arousal than conscious emotion
174 Nolen-Hoeksema
regulation (Mauss et al. 2006, Williams et al. may be engaging in more explicit, conscious
2009). So, to the extent that men are especially emotion regulation because they acknowledge
likely to engage in nonconscious emotion reg- when they are distressed and take that distress as
ulation more than women, they may be bene- meaningful rather than ignoring or dismissing
fiting from strategies such as reappraisal even it.
more than women. Some emotion regulation theories suggest
We need more research on gender dif- that emotional awareness and understanding
ferences in nonconscious emotion regulation are critical first steps to adaptive emotion
to determine whether men truly are engag- regulation (e.g., Hayes et al. 1999, Mennin &
ing in more automatic emotion regulation than Fresco 2010, Roemer et al. 2008, Saarni 2007,
women and whether this contributes to men’s Salovey et al. 1995). Indeed, people scoring
lower rates of disorders such as depression and high on measures of emotional clarity, defined
anxiety compared to women. More generally, as the ability to identify, understand, and
we need more research on nonconscious emo- distinguish one’s own emotional experiences
tion regulation to understand its effects and (Gohm & Clore 2000, 2002; Salovey et al.
how people can increase positive nonconscious 1995), show better emotion regulation and
strategies and reduce negative nonconscious lower levels of depression and anxiety (Gohm
strategies. & Clore 2000, 2002; Mennin et al. 2007).
Furthermore, the discrepancies between Emotional awareness and understanding can
the results of self-report questionnaire research have costs, however (Mauss et al. 2006). A
and experimental research on the effects of recent study showed that individuals higher
strategies such as reappraisal point to the on emotional clarity showed more prolonged
obvious importance of not relying only on self- distress reactions to negative films (Vine &
reports in studies of emotion regulation. These Nolen-Hoeksema 2011), presumably because
self-reports can be affected by mood, such that they were more aware of the emotions the
people in more distress report engaging in more films aroused and were more engaged in think-
of all types of emotion regulation (see Nolen- ing about them. Moreover, as suggested above,
Hoeksema et al. 2008). They may also be awareness and analysis of one’s emotions can
affected by gender role expectations and stereo- become maladaptive when individuals cannot
types, leading women to endorse engaging in find some understanding of their emotions or
more emotion regulation than men because disengage from them if they are becoming un-
this fits the expectation that women are more controllable or if the context demands (Nolen-
“emotional” (Barrett & Bliss-Moreau 2009). Hoeksema et al. 2008). Thus, women’s greater
tendency to engage in rumination may be due
in part to their greater attention to their emo-
2. Greater Self-Reports of Emotion tions and tendencies to see their emotions as
Regulation in Women Compared to meaningful.
Men May Also Be Due to Their The evidence that people make more
Greater Attention to and Involvement dispositional attributions for women’s emo-
in Their Emotional Lives. But Is This tions but more situational attributions for
a Good Thing? men’s emotions (Barrett & Bliss-Moreau
Women’s greater self-reports of emotion reg- 2009) also suggests that as they are analyzing
ulation strategies compared to men may not their emotions, women may be likely to make
just be due to their conforming to gender role attributions to stable, internal features of them-
expectations. They may also reflect a greater selves rather than to situational factors. This
awareness, understanding, and analysis of emo- may reduce their tendencies to take action to
tions in women compared to men (see also change situations that truly are contributing to
Barrett & Bliss-Moreau 2009). Thus, women distress.

These speculations about the implications of do not show up on coping or emotion regula-
gender differences in reports of emotion regu- tion questionnaires. This calls for research on
lation, and in emotional awareness and under- the potential differences in the ways men and
standing, are another example of how paying women seek support from friends and intimates
attention to gender leads us to ask critical ques- and what kinds of support they find useful.
tions not only about gender but also about basic
processes.
4. Are Men Really on Mars and
Women on Venus When It Comes to
3. It’s Time to Stop Assuming That Emotion Regulation?
Men Are Just Suppressing or Denying Clearly not. The mean gender differences in
Their Emotions emotion regulation are small even when they

The literature on gender and emotion has been are statistically significant (Nolen-Hoeksema &
replete with claims that men ignore, deny, or Aldao 2011, Tamres et al. 2002). So the simi-
suppress their emotions, compared to women larities between men and women in emotion
(Baron-Cohen 2003, Brody & Hall 1993, Gray regulation are greater than the differences.
1992). Our analyses of gender differences in Still, the gender differences in engagement
self-reports of emotion regulation found no in emotion, self-perceptions of emotion regula-
differences in reported suppression of emotion (as indexed by self-reported emotion reg-
tion, despite a large sample size ranging in ulation), and gender role expectations for emo-
age from 25 to 75 years (Nolen-Hoeksema tions discussed here raise interesting questions
& Aldao 2011). The meta-analyses by Tam- about whether men and women may respond
res and colleagues (2002) found that women differently to certain interventions to improve
were more likely than men to report engaging emotion regulation problems. Williams and
in distraction and avoidance as coping strate- colleagues (2009) found that implicitly prim-
gies. Although we know of no work specifically ing reappraisal goals was more effective in par-
on gender differences in automatic suppression ticipants who scored low on self-reports of the
of emotion, studies using momentary assess- use of reappraisal. This raises the question of
ments of emotions generally find no differences whether implicit instruction in reappraisal as is
in men’s and women’s responses to emotion- done in interpretation retraining (MacLeod &
eliciting stimuli or in everyday emotional expe- Mathews 2012) may be more effective in men
riences, suggesting that men are just as aware than in women since men tend to self-report
of their emotions from moment to moment as low use of reappraisal. Similarly, if men do re-
women are (for reviews, see Barrett & Bliss- spond even more than women to invisible social
Moreau 2009, Barrett et al. 2000). Thus, the support, as the study by Howland & Simpson
widespread belief that men’s modus operandi (2010) indicates, this suggests that helping dis-
when it comes to emotion regulation is denial tressed men’s support providers be more skill-
and suppression is not supported by the existing ful in providing support surreptitiously may be
evidence. a useful intervention.
Assumptions that men deny or suppress On the other hand, women’s endorsement
their emotions have likely obscured the search of the use of a wide range of emotion regulation
for ways, both adaptive and maladaptive, that strategies suggests that therapies that attempt
men do regulate their emotions. This review to shore up their adaptive strategies (e.g.,
suggests that men may engage in more noncon- reappraisal and acceptance) while diminishing
scious emotion regulation, which calls for more their use of maladaptive strategies (e.g., rumi-
work using implicit measures of emotion regu- nation) would be especially attractive to them.
lation. I also suggest that men may seek social Rumination-focused cognitive behavioral
support in different ways from women, which therapy (Watkins et al. 2007, 2011) directly
176 Nolen-Hoeksema
addresses the tendency to ruminate and teaches alcohol to cope with distress more often than
alternative strategies for managing mood females do.
and negative cognition (i.e., mindfulness, Low effortful control has parallels with the
reappraisal). kinds of emotion regulation strategies that have
been discussed in this review (see Eisenberg
et al. 2010) and indeed may contribute to the
5. How Much Does Emotion use of maladaptive strategies such as rumination
Regulation Have to Do with (Henry & Moffitt 1997, Joormann 2010). It is
Psychopathologies More Common in not clear, however, whether individuals low on
Men Than Women (i.e., More effortful control engage in antisocial or aggres-
“Externalizing” Disorders)? sive behavior, or drink alcohol, because they are
Most of the discussion of psychopathology in unable to regulate an emotion or because they

this review, and in the literature on emotion are unable to control an impulse or motivation
regulation, has focused on depression and anx- to behave inappropriately. Although the ability
iety, two disorders in which emotional distur- to regulate emotions and the ability to regu-
bances are at the core. The meta-analysis by late motivations and impulses are clearly related
Aldao and colleagues (2010) found that emo- conceptually and empirically, the distinctions
tion regulation strategies were more strongly between them are often ignored, sometimes re-
related to depression or anxiety symptoms than sulting in assumptions that men who are act-
to alcohol problems, suggesting that emotion ing aggressively, or have alcohol use problems,
regulation plays a stronger role in “internal- are “actually depressed” (see Nolen-Hoeksema
izing” disorders, which are more prevalent in 2008). This can lead to inappropriate treatment
women than men, than in “externalizing” dis- strategies that target mood disorders presumed
orders, which are more prevalent in men than to underpin externalizing behavior in men but
women. Similarly, analyses of our community tend to be ineffective in reducing externalizing
study found that the only variable that helped behaviors (Schuckit 1995).
to explain men’s higher rates of alcohol prob- Thus, the links between emotion regulation
lems was “drinking to cope.” These trends raise and externalizing disorders, which are more
questions about whether most emotion regula- common in men, are not clear. Again, it may
tion deficits really do play much of a role in be that we have not been measuring the kind of
psychopathologies more common in men than emotion regulation deficits that are more com-
women, namely externalizing disorders such as mon in men and can contribute to externalizing
alcohol use problems and aggressiveness. disorders. For example, I suggested above that
The literature on effortful control may be anger rumination may play a role in men’s ag-
taken as evidence that emotion dysregulation gressiveness, but this remains to be shown.
contributes to externalizing disorders in males. It may also be that emotion regulation
Low effortful control has been linked to deficits tend not to lead to alcohol problems
aggressiveness and antisociality in studies of or antisociality directly but rather only when in
children (Bongers et al. 2003; Eisenberg et al. interaction with important moderators. For ex-
2001, 2005; Moffitt & Caspi 2001). Several ample, people differ in how rewarding they find
theorists have suggested that the greater rates substances (Newlin & Thomson 1990, Sher
of low effortful control in boys versus girls et al. 2005), and higher self-reported reward
may account for the greater rates of aggression sensitivity is related to a number of indicators
and antisociality seen in boys than girls (see of alcohol misuse (Loxton & Dawe 2001, Pardo
Baron-Cohen 2002; Else-Quest et al. 2006; et al. 2007, Zisserson & Palfai 2007). Emo-
Mullin & Hinshaw 2007; Zahn-Waxler et al. tion regulation deficits may interact with indi-
2006, 2008). Further, as suggested above, low viduals’ sensitivity to the rewarding aspects of
effortful control may lead males to turn to substances like alcohol, determining whether

they will develop alcohol abuse (Aldao et al. to men partially accounted for the greater level
2010, Carver et al. 2008, Nolen-Hoeksema & of depression and anxiety in women compared
Watkins 2011). Men have more positive ex- to men. Thus, when treating depressed or anx-
pectancies for the effects of alcohol than women ious women, clinicians may need to be particu-
(see review by Nolen-Hoeksema & Hilt 2006), larly attentive to whether they are prone to ru-
which may indicate a greater perception of al- minate and to use interventions to reduce that
cohol as rewarding. Thus, men may carry this tendency, such as rumination-focused CBT
moderator more often than women. (Watkins et al. 2007, 2011). We also found that
The social environment also influences how men’s greater tendency to use alcohol to cope
much reward, or punishment, individuals re- compared to women partially accounted for
ceive for externalizing behaviors. For exam- their higher rates of alcohol use problems. This
ple, individuals, particularly youth, with high suggests that interventions addressing drinking
levels of exposure to, and reinforcement for, to cope (e.g., Marlatt & Witkiewitz 2010) are
alcohol use or aggression are more likely to particularly indicated for men.
see these behaviors as normative and appropri- This review of the gender differences in
ate ways to respond to distress, including the emotion regulation and its links to psy-
distress caused by emotion regulation deficits chopathology also raised some critical ques-
(Wills & Cleary 1999, Wood et al. 2004). On tions about common assumptions or assertions
the other hand, individuals with emotion regu- in the general literature on emotion regula-
lation deficits whose environments discourage tion. The fact that emotion regulation strate-
or prohibit the use of alcohol or aggression gies such as reappraisal and acceptance, which
may be less likely to do so (Nolen-Hoeksema are central to theories and treatments for de-
& Watkins 2011). Males receive more expo- pression and anxiety (Beck et al. 1979, Gross
sure to positive peer and adult models, and 1998, Hayes et al. 1999), are endorsed more by
less punishment, for alcohol use and aggres- members of the gender who suffer these dis-
sion than do females (Huselid & Cooper 1992, orders most often (i.e., women), and are not
White & Huselid 1997). Thus, gender-related consistently strongly related to symptoms of de-
social factors may be important moderators of pression and anxiety, raises questions about how
whether emotion dysregulation leads to exter- we view and measure these strategies. Similarly,
nalizing disorders. the fact that men do not report more suppres-
sion, avoidance, or denial than women, and that
use of these strategies does not account for any
CONCLUSIONS of the variance in the gender difference in al-
The gender differences in emotion regulation cohol use disorders, raises questions about the
and their links to gender differences in psy- role of these strategies in these disorders and
chopathology are important because they can whether emotion regulation has much at all to
provide clues as to the sources of problems that do with externalizing disorders.
are more common in women or in men. To I suggested that some of these questions may
the extent that a gender difference in a par- be resolved by more research on nonconscious
ticular emotion regulation strategy significantly forms of emotion regulation and by broadening
accounts for the gender difference in a form of our conceptualization of emotion regulation to
psychopathology, this suggests that intervening include forms that may be more idiosyncratic to
at the level of that emotion regulation strategy men versus women. Overall, gender has proven
may help to reduce the psychopathology in the a useful lens through which to examine the liter-
gender in which it is most prominent. ature on emotion regulation and psychopathol-
In this review, we found that the greater ten- ogy and to identify holes and quandaries in that
dency toward rumination in women compared literature.
178 Nolen-Hoeksema
SUMMARY POINTS
1. Women report using more of almost all types of emotion regulation strategies compared
to men, including rumination, reappraisal, problem solving, acceptance, distraction, and
seeking social support (or religion). This is consistent with studies of children showing
that girls are higher on effortful control than boys. Men report using alcohol to cope
more often than women do.
2. Emotion regulation strategies are similarly related to psychopathology in women and
men, with one exception: For women, adaptive strategies appear to have some com-
pensatory effects among those with higher levels of maladaptive strategies, but adaptive
strategies do not have such compensatory effects against maladaptive strategies for men.
3. More rumination in women compared to men partially accounts for greater depression
and anxiety in women compared to men, whereas a greater tendency to use alcohol to
cope partially accounts for more alcohol misuse in men compared to women.
4. The literature on emotion regulation is likely missing vital information on how men
regulate their emotions. I suggest that men may engage in more automatic, nonconscious
emotion regulation, and the types of social support men provide to one another may be
different from those that women provide. In addition, men may engage in more anger
rumination than women do.
FUTURE ISSUES
1. We need more research on automatic, nonconscious emotion regulation to determine if
it is more common in men than women and its relationship to psychopathology. Also,
research should rely less on self-reports of emotion regulation.
2. Emotional awareness and understanding seem greater in women than men, but we do
not know if this is an asset or a liability for women, so more research is needed.
3. Future research should avoid the assumption that men suppress, deny, or avoid their
emotions and look for ways men regulate their emotions that are not currently obvious.
4. Understanding whether emotion regulation plays any role in forms of psychopathology
more common in men than women is a priority.
DISCLOSURE STATEMENT
The author is unaware of any affiliation, funding, or financial holdings that might be perceived as
affecting the objectivity of this review.
LITERATURE CITED
Abrams DB, Wilson GT. 1979. Effects of alcohol on social anxiety in women: cognitive versus physiological
processes. J. Abnorm. Psychol. 88:161–73
Aldao A, Nolen-Hoeksema S. 2010. Specificity of cognitive emotion regulation strategies: a transdiagnostic
examination. Behav. Res. Ther. 48:947–83

Aldao A, Nolen-Hoeksema S. 2011. When are adaptive strategies most predictive of psychopathology?
J. Abnorm. Psychol. In press
Aldao A, Nolen-Hoeksema S, Schweizer S. 2010. Emotion regulation strategies across psychopathology: a
meta-analytic review. Clin. Psychol. Rev. 30:217–37
Anestis M, Anestis J, Selby E, Joiner T. 2009. Anger rumination across forms of aggression. Personal. Individ.
Differ. 46:192–96
Aspinwall LG, Taylor SE. 1993. Effects of social comparison direction, threat, and self-esteem on affect,
self-evaluation, and expected success. J. Personal. Soc. Psychol. 64:708–22
Bargh JA, Williams LE. 2007. The nonconscious regulation of emotion. See Gross 2007, pp. 429–45
Barlow DH, Craske MG, Cerny JA, Klosko JS. 1989. Behavioral treatment of panic disorder. Behav. Ther.
20:261–82
Baron-Cohen S. 2002. The extreme male brain theory of autism. Trends Cogn. Sci. 6:248–54
Baron-Cohen S. 2003. The Essential Difference: The Truth About the Male and Female Brain. New York: Basic
Books. 271 pp.
Barrett L, Bliss-Moreau E. 2009. She’s emotional. He’s having a bad day: attributional explanations for emotion
stereotypes. Emotion 9:648–58
Barrett L, Lane RD, Sechrest L, Schwartz GE. 2000. Sex differences in emotional awareness. Personal. Soc.
Psychol. Bull. 26:1027–35
Barrett L, Robin L, Pietromonaco PR, Eyssell KM. 1998. Are women the “more emotional sex”? Evidence
from emotional experiences in social context. Cogn. Emot. 12:555–78
Beck AT, Rush AJ, Shaw BF, Emery G. 1979. Cognitive Therapy of Depression. New York: Guilford
Beck AT, Beck RW. 1972. Screening depressed patients in family practice: a rapid technique. Postgrad. Med.
52:81–85
Beck AT, Steer RA. 1990. Manual for the Revised Beck Anxiety Inventory. San Antonio, TX: Psychol. Corp.
Billings AG, Moos RH. 1981. The role of coping responses and social resources in attenuating the stress of
life events. J. Behav. Med. 4:139–57
Bolger N, Amarel D. 2007. Effects of social support visibility on adjustment to stress: experimental evidence.
J. Personal. Soc. Psychol. 92:458–75
Bonanno GA, Papa A, O’Neill K, Westphal M, Coifman K. 2004. The importance of being flexible: the ability
to both enhance and suppress emotional expression predicts long-term adjustment. Psychol. Sci. 15:482–87
Bongers IL, Koot HM, van der Ende J, Verhulst FC. 2003. The normative development of child and adolescent
problem behavior. J. Abnorm. Psychol. 112:179–92
Brescoll VL, Uhlmann EL. 2008. Can an angry woman get ahead? Status conferral, gender, and expression
of emotion in the workplace. Psychol. Sci. 19:268–75
Breslin FC, Zack M, McMain S. 2002. An information-processing analysis of mindfulness: implications for
relapse prevention in the treatment of substance abuse. Clin. Psychol. Sci. Pract. 9:275–99
Broderick PC, Korteland C. 2002. Coping style and depression in early adolescence: relationships to gender,
gender role, and implicit beliefs. Sex Roles 46:201–13
Brody LR. 1993. On understanding gender differences in the expression of emotion: gender roles, socialization,
and language. In Human Feelings: Explorations in Affect Development and Meaning, ed. SL Ablon, pp. 87–121.
Hillsdale, NJ: Analytic Press
Brody LR, Hall JA. 1993. Gender and emotion in context. In Handbook of Emotions, ed. M Lewis, JM Haviland,
LF Barrett, pp. 89–121. New York: Guilford
Bushman BJ. 2002. Does venting anger feed or extinguish the flame? Catharsis, rumination, distraction, anger,
and aggressive responding. Personal. Soc. Psychol. Bull. 28:724–31
Bushman BJ, Bonacci AM, Pedersen WC, Vasquez EA, Miller N. 2005. Chewing on it can chew you up:
effects of rumination on triggered displaced aggression. J. Personal. Soc. Psychol. 88:969–83
Butler LD, Nolen-Hoeksema S. 1994. Gender differences in responses to depressed mood in a college sample.
Sex Roles 30:331–46
Calmes CA, Roberts JE. 2008. Rumination in interpersonal relationships: Does co-rumination explain gender
differences in emotional distress and relationship satisfaction among college students? Cogn. Ther. Res.
32:577–90
180 Nolen-Hoeksema
Camarena PN, Sarigiani PA, Petersen AC. 1990. Gender-specific pathways to intimacy in early adolescence.
J. Youth. Adolesc. 19:19–32
Campbell-Sills L, Barlow DH. 2007. Incorporating emotion regulation into conceptualizations and treatments
of anxiety and mood disorders. See Gross 2007, pp. 542–60
Campos JJ, Frankel CB, Camras L. 2004. On the nature of emotion regulation. Child Dev. 75:377–94
Carney MA, Armeli S, Tennen H, Affleck G, O’Neil TP. 2000. Positive and negative daily events, perceived
stress, and alcohol use: a diary study. J. Consult. Clin. Psychol. 68:788–98
Carver CS, Johnson SL, Joorman J. 2008. Serotonergic function, two-mode models of self-regulation, and
vulnerability to depression: what depression has in common with impulsive aggression. Psychol. Bull.
134:912–43
Carver CS, Scheier MF, Weintraub JK. 1989. Assessing coping strategies: a theoretically based approach.
Caselli G, Bortolai C, Leoni M, Rovetto F, Spada MM. 2008. Rumination in problem drinkers. Addict. Res.
Theory 16:564–71
Caselli G, Ferretti C, Leoni M, Rebecchi D, Rovetto F, Spada MM. 2010. Rumination as a predictor of
drinking behaviour in alcohol abusers: a prospective study. Addiction 105:1041–48
Ciarrochi J, Hynes K, Crittenden N. 2005. Can men do better if they try harder: sex and motivational effects
on emotional awareness. Cogn. Emot. 19:133–41
Clohessy S, Ehlers A. 1999. PTSD symptoms, response to intrusive memories and coping in ambulance service
workers. Br. J. Clin. Psychol. 38:251–65
Cole PM, Martin SE, Dennis TA. 2004. Emotion regulation as a scientific construct: methodological chal-
lenges and directions for child development research. Child Dev. 75:317–33
Cooper ML, Frone MR, Russell M, Mudar P. 1995. Drinking to regulate positive and negative emotions: a
motivational model of alcohol use. J. Personal. Soc. Psychol. 69:990–1005
Cooper ML, Frone MR, Russell M, Peirce RS. 1997. Gender, stress, coping, and alcohol use. In Gender and
Alcohol: Individual and Social Perspectives, ed. RW Wilsnack, SC Wilsnack, pp. 199–224. Piscataway, NJ:
Rutgers Cent. Alcohol Stud.
Cooper ML, Russell M, George WH. 1988. Coping, expectancies, and alcohol abuse: a test of social learning
formulations. J. Abnorm. Psychol. 97:218–30
Cooper ML, Russell M, Skinner JB, Frone MR, Mudar P. 1992. Stress and alcohol use: moderating effects of
gender, coping, and alcohol expectancies. J. Abnorm. Psychol. 101:139–52
Cox SJ, Mezulis AH, Hyde JS. 2010. The influence of child gender role and maternal feedback to child stress on
the emergence of the gender difference in depressive rumination in adolescence. Dev. Psychol. 46:842–52
Davis PJ. 1999. Gender differences in autobiographical memory for childhood emotional experiences.
Deaux K, Major B. 1987. Putting gender into context: an interactive model of gender-related behavior. Psychol.
Rev. 94:369–89
Derryberry D, Rothbart MK. 1997. Reactive and effortful processes in the organization of temperament. Dev.
Psychopathol. 9:633–52
Ehlers A, Mayou RA, Bryant B. 1998. Psychological predictors of chronic posttraumatic stress disorder after
motor vehicle accidents. J. Abnorm. Psychol. 107:508–19
Eisenberg N, Cumberland A, Spinrad TL, Fabes RA, Shepard SA, et al. 2001. The relations of regulation and
emotionality to children’s externalizing and internalizing problem behavior. Child Dev. 72:1112–34
Eisenberg N, Hofer C, Vaughan J. 2007. Effortful control and its socioemotional consequences. See Gross
2007, pp. 287–306
Eisenberg N, Spinrad TL. 2004. Emotion-related regulation: sharpening the definition. Child Dev. 75:334–39
Eisenberg N, Spinrad TL, Eggum ND. 2010. Emotion-related regulation and its relation to children’s mal-
adjustment. Annu. Rev. Clin. Psychol. 6:495–525
Eisenberg N, Zhou Q, Spinrad TL, Valiente C, Fabes RA, Liew J. 2005. Relations among positive parent-
ing, children’s effortful control, and externalizing problems: a three-wave longitudinal study. Child Dev.
76:1055–71
Else-Quest NM, Hyde JS, Goldsmith HH, Van Hulle CA. 2006. Gender differences in temperament: a
meta-analysis. Psychol. Bull. 132:33–72

Engler PA, Crowther JH, Dalton G, Sanftner JL. 2006. Predicting eating disorder group membership: an
examination and extension of the sociocultural model. Behav. Ther. 37:69–79
Fabes RA, Martin CL. 1991. Gender and age stereotypes of emotionality. Personal. Soc. Psychol. Bull. 17:532–40
Fairburn CG, Normal PA, Welch SL, O’Connor MR, Doll HA, Peveler RC. 1995. A prospective study
of outcome in bulimia nervosa and the long-term effects of three psychological treatments. Arch. Gen.
Psychiatry 52:304–12
Feingold A. 1994. Gender differences in personality: a meta-analysis. Psychol. Bull. 116:429–56
First MB, Spitzer RL, Gibbon M, Williams JBW. 1997. Structured Clinical Interview for DSM-IV Axis I
Disorders–Patient Edition. New York: N.Y. State Psychiatr. Inst.
Fischer AH, Manstead ASR. 2000. The relation between gender and emotions in different cultures. In Gender
and Emotion: Social Psychological Perspectives, ed. AH Fischer, pp. 71–94. New York: Cambridge Univ.
Press
Foa EB, Kozak MJ. 1986. Emotional processing of fear: exposure to corrective information. Psychol. Bull.
99:20–35
Folkman S, Lazarus RS. 1980. An analysis of coping in a middle-aged community sample. J. Health Soc. Behav.
21:219–39
Forgas JP, Ciarrochi JV. 2002. On managing moods: evidence for the role of homeostatic cognitive strategies
in affect regulation. Personal. Soc. Psychol. Bull. 28:336–45
Fresco DM, Frankel AN, Mennin DS, Turk CL, Heimberg RG. 2002. Distinct and overlapping features of
rumination and worry: the relationship of cognitive production to negative affective states. Cogn. Ther.
Res. 26:179–88
Fritz HL, Helgeson VS. 1998. Distinctions of unmitigated communion from communion: self-neglect and
overinvolvement with other. J. Personal. Soc. Psychol. 71:121–40
Frone MR, Cooper ML, Russell M. 1994. Stressful life events, gender, and substance use: an application of
tobit regression. Psychol. Addict. Behav. 8:59–69
Fujita R, Diener E, Sandvik E. 1991. Gender differences in negative affect and well-being: the case for emotional
intensity. J. Personal. Soc. Psychol. 41:427–34
Furman W, Buhrmester D. 1985. Children’s perceptions of the personal relationships in their social networks.
Dev. Psychol. 21:1016–24
Ge X, Conger RD, Elder GH Jr. 2001. Pubertal transition, stressful life events, and the emergence of gender
differences in adolescent depressive symptoms. Dev. Psychol. 37:404–17
Gilligan C. 1982. In a Different Voice: Psychological Theory and Women’s Development. Cambridge, MA: Harvard
Univ. Press
Gohm CL. 2003. Mood regulation and emotional intelligence: individual differences. J. Personal. Soc. Psychol.
84:594–607
Gohm CL, Clore GL. 2000. Individual differences in emotional experience: mapping available scales to
processes. Personal. Soc. Psychol. Bull. 26:679–97
Gohm CL, Clore GL. 2002. Four latent traits of emotional experience and their involvement in well-being,
coping, and attributional style. Cogn. Emot. 16:495–518
Gray J. 1992. Men Are from Mars, Women Are from Venus: A Practical Guide for Improving Communication and
Getting What You Want in Your Relationships. New York: Harper Collins
Gross JJ. 1998. The emerging field of emotion regulation: an integrative review. Rev. Gen. Psychol. 2:271–99
Gross JJ, ed. 2007. Handbook of Emotion Regulation. New York: Guilford
Gross JJ, Feldman Barrett L. 2011. Emotion generation and emotion regulation: one or two depends on your
point of view. Emot. Rev. 3:8–16
Gross JJ, John OP. 2003. Individual differences in two emotion regulation processes: implications for affect,
relationships, and well-being. J. Personal. Soc. Psychol. 85:348–62
Gross JJ, Munoz RF. 1995. Emotion regulation and mental health. Clin. Psychol. Sci. Pract. 2:151–64
Gross JJ, Thompson RA. 2007. Emotion regulation: conceptual foundations. See Gross 2007, pp. 3–24
Haggard DL, Robert C, Rose AJ. 2011. Co-rumination in the workplace: adjustment trade-offs for men and
women who engage in excessive discussions of workplace problems. J. Bus. Psychol. 26:27–40
Hall JA. 1978. Gender effects in decoding nonverbal cues. Psychol. Bull. 85:845–57
182 Nolen-Hoeksema
Hampel P, Petermann F. 2005. Age and gender effects on coping in children and adolescents. J. Youth Adolesc.
34:73–83
Harrington JA, Blankenship V. 2002. Ruminative thoughts and their relation to depression and anxiety.
J. Appl. Soc. Psychol. 32:465–85
Hayes SC, Strosahl KD, Wilson KG. 1999. Acceptance and Commitment Therapy: An Experiential Approach to
Behavior Change. New York: Guilford
Hayes SC, Villatte M, Levin M, Hildebrandt M. 2011. Open, aware, and active: contextual approaches as an
emerging trend in the behavioral and cognitive therapies. Annu. Rev. Clin. Psychol. 7:141–68
Hayes SC, Wilson KG, Gifford EV, Follette VM, Strosahl KD. 1996. Experiential avoidance and behavioral
disorders: a functional dimensional approach to diagnosis and treatment. J. Consult. Clin. Psychol. 64:1152–
68
Heatherton TF, Baumeister RF. 1991. Binge eating as escape from self-awareness. Psychol. Bull. 110:86–108
Helgeson VS. 1994. Relation of agency and communion to well-being: evidence and potential explanations.
Henry B, Moffitt TE. 1997. Neuropsychological and neuroimaging studies of juvenile delinquency and adult
criminal behavior. In Handbook of Antisocial Behavior, ed. DM Stoff, J Breiling, JD Maser, pp. 280–88.
Hoboken, NJ: Wiley
Holm-Denoma JM, Hankin BL. 2010. Perceived physical appearance mediates the rumination and bulimic
symptom link in adolescent girls. J. Clin. Child Adolesc. 39:537–44
Howland M, Simpson JA. 2010. Getting in under the radar: a dyadic view of invisible support. Psychol. Sci.
21:1878–85
Huselid RF, Cooper ML. 1992. Gender roles as mediators of sex differences in adolescent alcohol use and
abuse. J. Health Soc. Behav. 33:348–52
Hussong AM, Hicks RE, Levy SA, Curran PJ. 2001. Specifying the relations between affect and heavy alcohol
use among young adults. J. Abnorm. Psychol. 110:449–66
Hyde JS, Mezulis AH, Abramson LY. 2008. The ABCs of depression: integrating affective, biological, and
cognitive models to explain the emergence of the gender difference in depression. Psychol. Rev. 115:291–
313
Jack DC. 1991. Silencing the Self. New York: Harper Perennial
Jacobson NS, Martell CR, Dimidjian S. 2001. Behavioral activation treatment for depression: returning to
contextual roots. Clin. Psychol. Sci. Pract. 8:255–70
Johnson SL, Carver CS, Fulford D. 2010. Goal dysregulation in the affective disorders. In Emotion Regulation
and Psychopathology: A Transdiagnostic Approach to Etiology and Treatment, ed. AM Kring, DM Sloan,
pp. 204–28. New York: Guilford
Joormann J. 2010. Cognitive inhibition and emotion regulation in depression. Curr. Dir. Psychol. Sci. 19:161–
66
Jose PE, Brown I. 2008. When does the gender difference in rumination begin? Gender and age differences
in the use of rumination by adolescents. J. Youth Adolesc. 37:18–192
Joseph DL, Newman DA. 2010. Emotional intelligence: an integrative meta-analysis and cascading model.
J. Appl. Psychol. 95:54–78
Jostmann N, Koole SL, Van der Wulp N, Fockenberg D. 2005. Subliminal affect regulation: the moderating
role of action versus state orientation. Eur. Psychol. 10:209–17
Kashdan TB, Breen WE. 2007. Materialism and diminished well-being: experiential avoidance as a mediating
mechanism. J. Soc. Clin. Psychol. 26:521–39
Kessler RC, Merikangas KR, Wang PS. 2007. Prevalence, comorbidity, and service utilization for mood
disorders in the United States at the beginning of the twenty-first century. Annu. Rev. Clin. Psychol.
3:137–58
Keyes KM, Grant BF, Hasin DS. 2008. Evidence for a closing gender gap in the alcohol use, abuse, and
dependence in the United States population. Drug Alcohol Depend. 93:21–29
Knobloch-Westerwick S, Alter S. 2006. Mood adjustment to social situations through mass media use: how
men ruminate and women dissipate angry moods. Hum. Commun. Res. 32:58–73
Kochanska G, Murray KT, Harlan ET. 2000. Effortful control in early childhood: continuity and change,
antecedents, and implications for social development. Dev. Psychol. 36:220–32

Kring AM, Gordon AH. 1998. Sex differences in emotion: expression, experience, and physiology. J. Personal.
Soc. Psychol. 74:686–703
Kring AM, Sloan DM, eds. 2010. Emotion Regulation and Psychopathology: A Transdiagnostic Approach to Etiology
and Treatment. New York: Guilford
Kristeller J, Baer RA, Quillian-Wolever R. 2006. Mindfulness-based approaches to eating disorders. In
Mindfulness-Based Treatment Approaches, ed. RA Baer, pp. 75–91. San Diego, CA: Elsevier
Kuehner C, Huffziger S, Liebsch K. 2009. Rumination, distraction, and mindful self-focus: effects on mood,
dysfunctional attitudes and cortisol stress response. Psychol. Med. 39:219–29
LaFrance M, Banaji M. 1992. Toward a reconsideration of the gender-emotion relationship. In Emotion and
Social Behavior, ed. MS Clark, pp. 178–201. Newbury Park, CA: Sage
Larsen RJ, Prizmic Z. 2008. The science of subjective well being. In The Science of Subjective Well-Being, ed.
M Eid, RJ Larsen, pp. 258–89. New York: Guilford
LeDoux JE. 2000. Emotion circuits in the brain. Annu. Rev. Neurosci. 23:155–84
Lenzenweger MF. 2008. Epidemiology of personality disorders. Psychiatr. Clin. North Am. 31:395–403
Lewis AR, Zinbarg RE, Durbin CE. 2010. Advances, problems, and challenges in the study of emotion
regulation: a commentary. J. Psychopathol. Behav. 32:83–91
Linehan MM. 1993. Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York: Guilford
Lissek S, Rabin SJ, McDowell DJ, Dvir S, Bradford DE, et al. 2009. Impaired discriminative fear-conditioning
resulting from elevated fear responding to learned safety cues among individuals with panic disorder.
Behav. Res. Ther. 47:111–18
Lopez CM, Driscoll KA, Kistner JA. 2009. Sex differences and response styles: subtypes of rumination and
associations with depressive symptoms. J. Clin. Child Adolesc. 38:27–35
Loxton NJ, Dawe S. 2001. Alcohol abuse and dysfunctional eating in adolescent girls: the influence of individual
difference in sensitivity to reward. Int. J. Eat. Disord. 29:455–62
Lynch TR, Trost WT, Salsman N, Linehan MM. 2007. Dialectical behavior therapy for borderline personality
disorder. Annu. Rev. Clin. Psychol. 3:181–205
MacLeod C, Mathews A. 2012. Cognitive bias modification approaches to anxiety. Annu. Rev. Clin. Psychol.
8:In press
Marlatt GA, Witkiewitz K. 2010. Update on harm-reduction policy and intervention research. Annu. Rev.
Clin. Psychol. 6:591–606
Marlatt GA, Witkiewitz K, Dillworth TM, Bowen SW, Parks GA, et al. 2004. Vipassana meditation as a
treatment for alcohol and drug use disorders. In Mindfulness and Acceptance: Expanding the Cognitive-
Behavioral Tradition, ed. SC Hayes, VM Folette, MM Linehan, pp. 261–87. New York: Guilford
Mauss IB, Evers C, Wilhelm FH, Gross JJ. 2006. How to bite your tongue without blowing your top: Implicit
evaluation of emotion regulation predicts affective responding to anger provocation. Personal. Soc. Psychol.
Bull. 32:589–602
Mayou RA, Ehlers A, Bryant B. 2002. Posttraumatic stress disorder after motor vehicle accidents: 3-year
follow-up of a prospective longitudinal study. Behav. Res. Ther. 40:665–75
McCarthy M. 1990. The thin ideal, depression, and eating disorders in women. Behav. Res. Ther. 28:205–15
McClure EB. 2000. A meta-analytic review of sex differences in facial expression processing and their devel-
opment in infants, children, and adolescents. Psychol. Bull. 126:424–53
McLaughlin KA, Mennin DS, Farach FJ. 2007. The contributory role of worry in emotion generation and
dysregulation in generalized anxiety disorder. Behav. Res. Ther. 45:1735–52
McLaughlin KA, Nolen-Hoeksema S. 2011. Rumination as a transdiagnostic factor in depression and anxiety.
Behav. Res. Ther. 49:186–93
McLean CP, Anderson ER. 2009. Brave men and timid women? A review of the gender differences in fear
and anxiety. Clin. Psychol. Rev. 29:496–505
McRae K, Ochsner KN, Mauss IB, Gabrieli JJD, Gross JJ. 2008. Gender differences in emotion regulation:
an fMRI study of cognitive reappraisal. Group Process. Intergroup Relat. 11:143–62
Mellings TMB, Alden LE. 2000. Cognitive processes in social anxiety: the effects of self-focus, rumination,
and anticipatory processing. Behav. Res. Ther. 38:243–57
Mennin D, Holaway R, Fresco D, Moore M, Heimberg R. 2007. Delineating components of emotion and its
dysregulation in anxiety and mood psychopathology. Behav. Ther. 38:284–302
184 Nolen-Hoeksema
Mennin DS, Fresco DM. 2010. Emotion regulation as an integrative framework for understanding and treat-
ing psychopathology. In Emotion Regulation and Psychopathology, ed. AM Kring, DM Sloan, pp. 356–79.
New York: Guilford
Mennin DS, Heimberg RG, Turk CL, Fresco DM. 2005. Preliminary evidence for an emotion dysregulation
model of generalized anxiety disorders. Behav. Res. Ther. 43:1281–310
Merckelbach H, de Jong PJ, Muris P, van den Hout MA. 1996. The etiology of specific phobias: a review.
Clin. Psychol. Rev. 16:337–61
Mezulis AH, Abramson LY, Hyde JS. 2002. Domain specificity of gender differences in rumination. J. Cogn.
Psychother. 16:421–34
Miller JB. 1976. Toward a New Psychology of Women. Boston, MA: Beacon
Moffitt TE, Caspi A. 2001. Childhood predictors differentiate life-course persistent and adolescence-limited
antisocial pathways among males and females. Dev. Psychopathol. 13:355–75
Mor N, Winquist J. 2002. Self-focused attention and negative affect: a meta-analysis. Psychol. Bull. 128:638–62
Mowrer OH. 1947. On the dual nature of learning—a re-interpretation of “conditioning” and “problem-
solving.” Harv. Educ. Rev. 17:102–48

Mullin BC, Hinshaw SP. 2007. Emotion regulation and externalizing disorders in children and adolescents.
See Gross 2007, pp. 523–41
Murray J, Ehlers A, Mayou RA. 2002. Dissociation and post-traumatic stress disorder: two prospective studies
of road traffic accident survivors. Br. J. Psychiatry 180:363–68
Newlin DB, Thomson JB. 1990. Alcohol challenge with sons of alcoholics: a critical review and analysis.
Nolen-Hoeksema S. 1991. Responses to depression and their effects on the duration of depressive episodes.
J. Abnorm. Psychol. 100:569–82
Nolen-Hoeksema S. 2000. The role of rumination in depressive disorders and mixed anxiety/depressive symp-
toms. J. Abnorm. Psychol. 109:504–11
Nolen-Hoeksema S. 2008. It’s not what you have, it’s what you do with it: support for Addis’s Gendered
Responding Framework. Clin. Psychol. Sci. Pract. 15:178–81
Nolen-Hoeksema S, Aldao A. 2011. Gender and age differences in emotion regulation strategies and their
relationship to depressive symptoms. Personal. Individ. Differ. 51:704–8
Nolen-Hoeksema S, Harrell ZA. 2002. Rumination, depression, and alcohol use: tests of gender differences.
J. Cogn. Psychother. 16:391–403
Nolen-Hoeksema S, Hilt LM. 2006. Possible contributors to the gender differences in alcohol use and prob-
lems. J. Gen. Psychol. 133:357–74
Nolen-Hoeksema S, Hilt LM. 2009. Gender differences in depression. In Handbook of Depression, ed. IH
Gotlib, CL Hammen, pp. 386–404. New York: Guilford
Nolen-Hoeksema S, Jackson B. 2001. Mediators of the gender difference in rumination. Psychol. Women Q.
25:37–47
Nolen-Hoeksema S, Morrow J. 1991. A prospective study of depression and posttraumatic stress symptoms
after a natural disaster—the 1989 Loma-Prieta Earthquake. J. Personal. Soc. Psychol. 61:115–21
Nolen-Hoeksema S, Stice E, Wade E, Bohon C. 2007. Reciprocal relations between rumination and bulimic,
substance abuse, and depressive symptoms in female adolescents. J. Abnorm. Psychol. 116:198–207
Nolen-Hoeksema S, Watkins ER. 2011. A heuristic for developing transdiagnostic models of psychopathology:
explaining multifinality and divergent trajectories. Perspect. Psychol. Sci. 6:589–609
Nolen-Hoeksema S, Wisco BE, Lyubomisky S. 2008. Rethinking rumination. Perspect. Psychol. Sci. 3:400–24
Pardo Y, Aguilar R, Molinuevo B, Torrubia R. 2007. Alcohol use as a behavioural sign of disinhibition: evidence
from J. A. Gray’s model of personality. Addict. Behav. 32:2398–403
Park CL, Levenson M. 2002. Drinking to cope among college students: prevalence, problems, and coping
processes. J. Stud. Alcohol. 63:486–97
Parker JG, Asher SR. 1993. Friendship and friendship quality in middle childhood: links with peer group
acceptance and feelings of loneliness and social dissatisfaction. Dev. Psychol. 29:611–21
Peled M, Moretti MM. 2007. Rumination on anger and sadness in adolescence: fueling of fury and deepening
of despair. J. Clin. Child Adolesc. 36:66–75

Polivy J, Herman CP. 2002. Causes of eating disorders. Annu. Rev. Psychol. 53:187–214
Ratliff KG, Burkhart BR. 1984. Sex differences in motivations for and effects of drinking among college
students. J. Stud. Alcohol. 45:26–32
Rawal A, Park RJ, Williams JMG. 2010. Rumination, experiential avoidance, and dysfunctional thinking in
eating disorders. Behav. Res. Ther. 48:851–59
Robinson MD, Johnson JT, Shields SA. 1998. The gender heuristic and the database: factors affecting the
perception of gender-related differences in the experience and display of emotions. Basic Appl. Soc. Psychol.
20:205–19
Roemer L, Orsillo SM, Salters-Pedneault K. 2008. Efficacy of an acceptance-based behavior therapy for
generalized anxiety disorder: evaluation in a randomized controlled trial. J. Consult. Clin. Psychol. 76:1083–
89
Rood L, Roelofs J, Bogels SM, Nolen-Hoeksema S, Schouten E. 2009. The influence of emotion-focused
rumination and distraction on depressive symptoms in non-clinical youth: a meta-analytic review. Clin.
Psychol. Rev. 29:607–16
Rose AJ. 2002. Co-rumination in the friendships of girls and boys. Child Dev. 73:1830–43
Rose AJ. 2007. Structure, content, and socioemotional correlates of girls’ and boys’ friendships. Merrill-Palmer
Q. 53:489–506
Rose AJ, Carlson W, Waller EM. 2007. Prospective associations of co-rumination with friendship and emo-
tional adjustment: considering the socioemotional trade-offs of corumination. Dev. Psychol. 43:1019–31
Rothbart MK, Bates JE. 2006. Temperament. In Handbook of Child Psychology: Vol. 3. Social, Emotional and
Personality Development, ed. W Damon, N Eisenberg, pp. 105–76. New York: Wiley
Rottenberg J, Gross JJ. 2003. When emotion goes wrong: realizing the promise of affective science. Clin.
Psychol. Sci. Pract. 10:227–32
Rudolph KD, Hammen C. 1999. Age and gender as determinants of stress exposure, generation, and reactions
in youngsters: a transactional perspective. Child Dev. 70:660–77
Rusting C, Nolen-Hoeksema S. 1998. Regulating responses to anger: effects of rumination and distraction on
angry mood. J. Personal. Soc. Psychol. 74:790–803
Rutledge PC, Sher KJ. 2001. Heavy drinking from the freshman year into early young adulthood: the roles of
stress, tension-reduction drinking motives, gender and personality. J. Stud. Alcohol 62:457–66
Saarni C. 2007. The development of emotional competence: pathways for helping children to become emo-
tionally intelligent. In Educating People To Be Emotionally Intelligent, ed. R Bar-On, K Maree, MJ Elias,
pp. 15–35. Westport, CT: Praeger/Greenwood
Salovey P, Mayer JD, Goldman SL, Turvey C, Palfai TP. 1995. Emotional attention, clarity, and repair:
exploring emotional intelligence using the trait meta-mood scale. In Emotion, Disclosure, and Health, ed.
JW Pennebaker, pp. 125–54. Washington, DC: Am. Psychol. Assoc.
Schuckit MA. 1995. Drug and Alcohol Abuse: A Clinical Guide to Diagnosis and Treatment. New York: Plenum
Med.
Schwartz JAJ, Koenig LJ. 1996. Response styles and negative affect among adolescents. Cogn. Ther. Res.
20:13–36
Segerstrom SC, Tsao JCI, Alden LE, Craske MG. 2000. Worry and rumination: repetitive thought as a
concomitant and predictor of negative mood. Cogn. Ther. Res. 24:671–88
Seidlitz L, Diener E. 1998. Sex differences in the recall of affective experiences. J. Personal. Soc. Psychol.
74:262–71
Sher KJ, Grekin ER. 2007. Alcohol and affect regulation. See Gross 2007, pp. 560–80
Sher KJ, Grekin ER, Williams NA. 2005. The development of alcohol use disorders. Annu. Rev. Clin. Psychol.
1:493–523
Shields SA. 1987. Women, men, and the dilemma of emotion. In Sex and Gender: Review of Personality and
Social Psychology, ed. P Shaver, C Hendrick, pp. 229–50. Thousand Oaks, CA: Sage
Skitch S, Abela JRZ. 2008. Rumination in response to stress as a common vulnerability factor to depression
and substance misuse in adolescence. J. Abnorm. Child Psychol. 36:1029–45
Sontag LM, Graber JA. 2010. Coping with perceived peer stress: gender-specific and common pathways to
symptoms of psychopathology. Dev. Psychol. 46:1605–20
186 Nolen-Hoeksema
Striegel-Moore R, Seeley JR, Lewinsohn PM. 2003. Psychosocial adjustment in young adulthood of women
who experienced an eating disorder during adolescence. J. Am. Acad. Child Adolesc. Psychiatry 42:587–93
Sukhodolsky DG, Golub A, Cromwell EN. 2001. Development and validation of the anger rumination scale.
Personal. Individ. Differ. 31:689–700
Sutker PB, Allain AN, Brantley PJ, Randall CL. 1982. Acute alcohol intoxication, negative affect, and auto-
nomic arousal in women and men. Addict. Behav. 7:17–25
Swendsen JD, Tennen H, Carney MA, Affleck G, Willard A, Hromi A. 2000. Mood and alcohol consumption:
an experience sampling test of the self-medication hypothesis. J. Abnorm. Psychol. 109:198–204
Tamres LK, Janicki D, Helgeson VS. 2002. Sex differences in coping behavior: a meta-analytic review and an
examination of relative coping. Personal. Soc. Psychol. Rev. 6:2–30
Thompson RA. 1994. Emotion regulation: a theme in search of definition. Monogr. Soc. Res. Child Dev. 59:25–52
Tice DM, Bratslavsky E, Baumeister RF. 2001. Emotional distress regulation takes precedence over impulse
control: If you feel bad, do it! J. Personal. Soc. Psychol. 80:53–67

Timko C, Finney JW, Moos RH. 2005. The 8-year course of alcohol abuse: gender differences in social context
and coping. Alcohol. Clin. Exp. Res. 29:612–21
Treynor W, Gonzalez R, Nolen-Hoeksema S. 2003. Rumination reconsidered: a psychometric analysis. Cogn.

Ther. Res. 27:247–59
Udo T, Bates ME, Mun EY, Vaschillo EG, Vaschillo B, et al. 2009. Gender differences in acute alcohol effects
on self-regulation of arousal in response to emotional and alcohol-related picture cues. Psychol. Addict.
Behav. 23:196–204
Van Boven AM, Espelage DL. 2006. Depressive symptoms, coping strategies, and disordered eating among
college women. J. Couns. Dev. 84:341–48
Verona E. 2005. Moderating effects of rumination and gender on context-specific aggression. Aggress. Behav.
31:420–36
Vine V, Nolen-Hoeksema S. 2011. State emotional clarity: relationships to trait emotional clarity and affect
recovery. Manuscript under review
Watkins ER. 2008. Constructive and unconstructive repetitive thought. Psychol. Bull. 134:163–206
Watkins ER. 2009. Depressive rumination and co-morbidity: evidence for brooding as a transdiagnostic
process. J. Ration. Emot. Cogn. Behav. Ther. 27:160–75
Watkins ER, Scott J, Wingrove J, Rimes K, Bathurst N, et al. 2007. Rumination-focused cognitive-behaviour
therapy for residual depression: a case series. Behav. Res. Ther. 45:2144–54
Watkins ER, Mullan EG, Wingrove J, Rimes K, Steiner H, et al. 2011. Rumination-focused cognitive be-
haviour therapy for residual depression: phase II randomized controlled trial. Br. J. Psychiatry. 199:317–22
Wenzlaff RM, Wegner DM. 2000. Thought suppression. Annu. Rev. Psychol. 51:59–91
White HR, Huselid RF. 1997. Gender differences in alcohol use during adolescence. In Gender and Alcohol,
ed. RM Wilsnack, SC Wilsnack, pp. 176–98. New Brunswick, NJ: Rutgers Cent. Alcohol Stud.
Williams JMG. 2010. Mindfulness and psychological process. Emotion 10:1–7
Williams LE, Bargh JA, Nocera CC, Gray JR. 2009. The unconscious regulation of emotion: nonconscious
reappraisal goals modulate emotional reactivity. Emotion 9:847–54
Wills TA, Cleary SD. 1999. Peer and adolescent substance use among 6th–9th graders: latent growth analyses
of influence versus selection mechanisms. Health Psychol. 18:453–63
Wood MD, Read JP, Mitchell RE, Brand NH. 2004. Do parents still matter? Parent and peer influences on
alcohol involvement among recent high school graduates. Psychol. Addict. Behav. 18:19–30
Zahn-Waxler C, Crick NR, Shirtcliff EA, Woods KE. 2006. The origins and development of psychopathology
in females and males. In Handbook of Developmental Psychopathology, ed. D Cicchetti, D Cohen, pp. 76–139.
Hoboken, NJ: Wiley
Zahn-Waxler C, Shirtcliff EA, Marceau K. 2008. Disorders of childhood and adolescence: gender and psy-
chopathology. Annu. Rev. Clin. Psychol. 4:275–303
Zarbatany L, McDougall P, Hymel S. 2000. Gender-differentiated experience in the peer culture: links to
intimacy in preadolescence. Soc. Dev. 9:62–79
Zisserson RN, Palfai TP. 2007. Behavioral activation system (BAS) sensitivity and reactivity to alcohol cues
among hazardous drinkers. Addict. Behav. 32:2178–86

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Contents
On the History and Future Study of Personality and Its Disorders

Theodore Millon p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 1
A “SMART” Design for Building Individualized Treatment Sequences

H. Lei, I. Nahum-Shani, K. Lynch, D. Oslin, and S.A. Murphy p p p p p p p p p p p p p p p p p p p p p p p p p21
Default Mode Network Activity and Connectivity in Psychopathology
Susan Whitfield-Gabrieli and Judith M. Ford p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p49
Current Issues in the Diagnosis of Attention Deficit Hyperactivity
Disorder, Oppositional Defiant Disorder, and Conduct Disorder
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Psychiatric Diagnosis: Lessons from the DSM-IV Past
and Cautions for the DSM-5 Future
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American Indian and Alaska Native Mental Health:
Diverse Perspectives on Enduring Disparities
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Emotion Regulation and Psychopathology: The Role of Gender
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Cognitive Bias Modification Approaches to Anxiety
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Diagnosis and Assessment of Hoarding Disorder
Randy O. Frost, Gail Steketee, and David F. Tolin p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 219
The Behavioral Activation System and Mania
Sheri L. Johnson, Michael D. Edge, M. Kathleen Holmes,
and Charles S. Carver p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 243
Prediction and Prevention of Psychosis in Youth at Clinical High Risk
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From Dysfunction to Adaptation: An Interactionist
Model of Dependency
Robert F. Bornstein p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 291
vi
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Personality Disorders in DSM-5

Andrew E. Skodol p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 317
Development, Evaluation, and Multinational Dissemination
of the Triple P-Positive Parenting Program
Matthew R. Sanders p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 345
Empirical Classification of Eating Disorders
Pamela K. Keel, Tiffany A. Brown, Lauren A. Holland, and Lindsay P. Bodell p p p p p p p p 381
Obesity and Public Policy
Ashley N. Gearhardt, Marie A. Bragg, Rebecca L. Pearl, Natasha A. Schvey,
Christina A. Roberto, and Kelly D. Brownell p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 405

Cognition in the Vegetative State

Martin M. Monti p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 431
Coping with Chronic Illness in Childhood and Adolescence
Bruce E. Compas, Sarah S. Jaser, Madeleine J. Dunn, and Erin M. Rodriguez p p p p p p p 455
Indexes
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Cumulative Index of Chapter Titles, Volumes 1–8 p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 484
Errata
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