Common and distinct neurofunctional signatures of emotion regulation strategies and their clinical translation in dynamic naturalistic contexts

Adaptive emotion regulation (ER) is essential for mental health. Reappraisal and acceptance are effective ER strategies that form the basis of therapeutic interventions, yet their common and distinct neural signatures - and the translational potential of these signatures - remain unclear. Here, we combined naturalistic fMRI with multivariate predictive modeling to develop neurofunctional signatures that accurately and comprehensively characterize negative affect and its regulation via acceptance and reappraisal in dynamic, immersive contexts (n=59). These signatures demonstrated process-specificity and generalization across cohorts, cultures, and modalities (n=33, n=358, n=33). ER strategies were encoded in distributed, distinguishable neural representations, with shared contributions from the default mode network and strategy-specific contributions from the amygdala, somatomotor and attention (acceptance), and the frontoparietal control (reappraisal) networks. The neuromarkers precisely identified strategy-specific ER impairments in cannabis users (nhealthy_controls=48, ncannabis_users=49), underscoring their translational relevance. We provide comprehensive, clinically-relevant brain models of emotion regulation and dysregulation in naturalistic contexts.