Posttraumatic Stress Disorder (PTSD) is associated with emotion regulation difficulties and cognitive control deficits, which may exacerbate symptoms and negatively affect treatment outcomes. Cognitive emotion regulation strategies, such as cognitive reappraisal, can be especially challenging for individuals with PTSD due to heightened attentional bias toward negatively arousing stimuli and limited cognitive resources needed to regulate their emotional response. Therefore, it is crucial to identify alternative strategies that target both emotion regulation and cognitive control in PTSD. Aerobic exercise has emerged as a promising alternative intervention to target emotion regulation and cognitive control. However, research on the acute effects of exercise on these mechanisms in PTSD populations is limited. This study investigated the acute effects of a single bout of moderate-intensity aerobic exercise on subjective (e.g., self-reported emotional arousal) and neural (e.g., LPP) indices of emotion regulation, as well as behavioral (e.g., flanker task accuracy and reaction time) and neural (e.g., P300 and ERN) indices of cognitive control in individuals with clinically significant PTSD symptoms. Using a within-subject, pre- to post-test crossover design, 67 female participants completed a 20-minute moderate-intensity aerobic exercise session and a 20-minute time-matched sitting control session. Prior to and following each experimental session, participants completed an emotion regulation task and a letter flanker task to measure emotion regulation and cognitive control, respectively. I hypothesized that exercise would 1) enhance cognitive control – evidenced by increased P300, decreased ERN, and improved behavioral performance; and 2) improve emotion regulation – evidenced by decreased LPP and perceived emotional arousal during cognitive reappraisal. Lastly, I predicted improvements in cognitive control would mediate the effect of exercise on cognitive reappraisal success. Contrary to predictions, exercise did not lead to significant changes in P300 or ERN amplitudes during the flanker task, relative to sitting. Behaviorally, although no significant difference in response accuracy was observed, following exercise, participants demonstrated a greater reduction in reaction time relative to sitting, indicating more efficient performance. For the emotion regulation task, exercise led to a significant increase in the early and late LPP during cognitive reappraisal trials relative to view-negative trials. However, this effect appeared primarily driven by a significant decrease in LPP during view-negative trials from pre- to post-test. Exercise also did not lead to a significant change in perceived emotional arousal relative to sitting. However, exercise led to a significant decrease in perceived effort using cognitive reappraisal. Lastly, results from the mediation analysis did not support my hypothesis that exercise-induced improvements in cognitive control mediate the effect of exercise on cognitive reappraisal success. Overall, while acute aerobic exercise did not enhance neural markers of cognitive control and cognitive reappraisal success, reductions in LPP during view-negative and decreased perceived effort during cognitive reappraisal suggest that aerobic exercise may positively influence cognitive emotion regulation processes. These findings provide preliminary support for the use of exercise to enhance emotion regulation processes in PTSD. Future research is needed to further investigate the acute and long-term effects of exercise on emotion regulation and cognitive control in PTSD, as these insights may inform future research on exercise-augmented treatments for PTSD to enhance treatment outcomes.
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