2.3 Emotion regulation task
Participants completed an adapted emotion regulation
task43,44 during fMRI scanning. During the task
(Figure 1 ), participants viewed distress-inducing stimuli and
rated their current emotional distress after each trial. Participants
rated their distress on a 1-6 visual analog scale (VAS; 1=“No distress
at all”, 6=“Worst possible distress”) using an adapted version of the
FACES scale.45,46 Task stimuli consisted of ten
validated 30 s video clip vignettes depicting various realistic, salient
stressors (e.g., child receiving an injection) that have been shown to
induce transient distress in children.47 Negative
stimuli were used to test for differences in brain response to
distress-inducing stimuli. Participants were explicitly instructed to
pay attention to the movie as if it were real, pretend they were the
child in the movie, and react as if they were in that situation. Prior
to each video clip, participants were given instructions for one of four
conditions: (1) focused attention to breath, BREATH, (2) mindful
acceptance, ACCEPT, (3) distraction, DISTRACT, or (4) passive viewing,
LOOK (Supplemental Methods 1.2). Participants were cued using the text
and visual cue during the task in the fMRI scanner. Each trial lasted 30
s, and included a 2 s instruction slide, a 30 s video clip, and a 5 s
emotion rating period (Figure 1 ). The inter-trial interval (2
s) was a “RELAX” screen. There were 5 trials of each of the 4
conditions, for a total of 20 trials (total time=13 min, 21 sec). Video
clips were counterbalanced across conditions. Presentation software
(Neurobehavioral Systems, Inc.) was used for stimulus presentation and
behavioral data acquisition. The task was displayed on a back-projection
screen affixed to the head coil and behavioral responses were registered
using a 2x2 MR-compatible response device.