Oxazepam and cognitive reappraisal: A randomised experiment

PLoS One. 2021 Apr 22;16(4):e0249065. doi: 10.1371/journal.pone.0249065. eCollection 2021.

Abstract

Background: Cognitive reappraisal is a strategy for emotional regulation, important in the context of anxiety disorders. It is not known whether anxiolytic effects of benzodiazepines affect cognitive reappraisal.

Aims: We aimed to investigate the effect of 25 mg oxazepam on cognitive reappraisal.

Methods: In a preliminary investigation, 33 healthy male volunteers were randomised to oxazepam or placebo, and then underwent an experiment where they were asked to use cognitive reappraisal to upregulate or downregulate their emotional response to images with negative or neutral emotional valence. We recorded unpleasantness ratings, skin conductance, superciliary corrugator muscle activity, and heart rate. Participants completed rating scales measuring empathy (Interpersonal Reactivity Index, IRI), anxiety (State-Trait Anxiety Inventory, STAI), alexithymia (Toronto Alexithymia Scale-20, TAS-20), and psychopathy (Psychopathy Personality Inventory-Revised, PPI-R).

Results: Upregulation to negative-valence images in the cognitive reappraisal task caused increased unpleasantness ratings, corrugator activity, and heart rate compared to downregulation. Upregulation to both negative- and neutral-valence images caused increased skin conductance responses. Oxazepam caused lower unpleasantness ratings to negative-valence stimuli, but did not interact with reappraisal instruction on any outcome. Self-rated trait empathy was associated with stronger responses to negative-valence stimuli, whereas self-rated psychopathic traits were associated with weaker responses to negative-valence stimuli.

Conclusions: While 25 mg oxazepam caused lower unpleasantness ratings in response to negative-valence images, we did not observe an effect of 25 mg oxazepam on cognitive reappraisal.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anti-Anxiety Agents / adverse effects*
  • Anti-Anxiety Agents / pharmacology
  • Cognition / drug effects*
  • Emotional Regulation / drug effects*
  • Humans
  • Male
  • Oxazepam / adverse effects*
  • Oxazepam / pharmacology
  • Visual Perception

Substances

  • Anti-Anxiety Agents
  • Oxazepam

Grants and funding

This work was supported by the Swedish Society for Medicine and the Osher Center for Integrative Medicine. he funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.