In their target article, Kalisch et al. offer both a parsimonious theoretical approach to understanding the basic mechanism underlying resilience and a wide-ranging body of evidence in support of this position. A cornerstone of the paper is the theory of positive appraisal style as the key mechanism that buffers individuals from developing detrimental effects of stressors. Appraisal style is broken down into a set of three cognitive processes: (1) positive situation classification, (2) reappraisal, and (3) interference inhibition. The attempt to analyze resilient factors in terms of some simpler, underlying mechanisms is worthwhile and captures a portion of the variance in the measurement of resilience. We see two major problems in this approach, however, as it underestimates the role of emotional factors, on the one hand, and on the other, it overestimates the role of appraisal and reappraisal as the best and fundamental mechanisms in establishing resilience.

Appraisal theories rely on the simplistic assumption that events generate first appraisals and then emotional reactions, an assumption not supported by several neuroscientific studies of affect (see Panksepp & Biven Reference Panksepp and Biven2012 for a discussion). Kalisch et al. downplay the role of basic emotional reactivity and regulation as important factors leading to resilience and readily jump to the “cognitive” side of resilience (appraisal and reappraisal mechanisms). Emotion, however, has a neurobiological primacy over cognition in terms of temporal dynamics (information is first received by subcortical emotional structures; see LeDoux Reference LeDoux1998) and anatomical circuitry (direct links between perceptual systems and emotional structures; see Panksepp & Biven Reference Panksepp and Biven2012).

From a developmental point of view (of great relevance when considering resilient mechanisms), it is now a matter of fact that early in infant development, all animals are more dependent on the functions of lower emotional rather than higher cognitive brain structures (Chugani Reference Chugani1998). Early perturbations of such primary processes lead to their sensitization (Panksepp & Biven Reference Panksepp and Biven2012) and late mental health problems (Heim et al. Reference Heim, Shugart, Craighead and Nemeroff2010), before cognition can have any (protective) role over the development of stress responses. These and other data point toward the direction of studying very basic emotional processes and basic (rather than high-level cognitive) regulation. Without a clear understanding of emotional reactivity and regulation, we can easily lose the focus of what really matters in terms of creating resilience.

Kalisch et al. claim that “reappraisal processes are particularly important in strongly aversive situations” (sect. 4.2.8, para. 3). Behavioral and neuroscientific evidence supports the idea that this strategy in the laboratory setting is effective in reducing psychological and physiological indexes of emotional reactions (Grecucci et al. Reference Grecucci, Giorgetta, van Wout, Bonini and Sanfey2013; Ochsner & Gross Reference Ochsner and Gross2005). Extending these findings outside the laboratory, it was found that the frequency of use of reappraisal correlates with well-being and positive emotions (Gross & John Reference Gross and John2003). This claim is in line with another set of observations coming from the clinical field, according to which there is a negative correlation between reappraisal and psychological disorders (Martin & Dahlen Reference Martin and Dahlen2005). Such a pattern leads Kalisch et al. to propose that reappraisal is the key to wellness; however, such a conclusion simply is not justified by the available evidence. Not only does a correlation not mean causation, but at least three lines of evidence contradict this conclusion.

First, experiments in emotion-regulation choice, an emergent field that aims at understanding how we choose which strategy to adopt in a given situation (Sheppes et al. Reference Sheppes, Scheibe, Suri and Gross2011), undermine the importance of reappraisal as a resilient mechanism. Sheppes and colleagues (Reference Sheppes, Scheibe, Suri and Gross2011) demonstrate that participants used reappraisal to regulate only low-intensity emotional stimuli, and used distraction for high-intensity stimuli. This result casts doubts on the use of reappraisal during stressful events that are by nature highly emotional. From a neurobiological point of view, experimental studies show a decrease in BOLD signal during induced emotional states in regions such as the prefrontal cortex (known to implement regulatory strategies) (Mayberg et al. Reference Mayberg, Liotti, Brannan, McGinnis, Mahurin, Jerabek, Silva, Tekell, Martin, Lancaster and Fox1999). Other studies demonstrate an inhibition of prefrontal cortex activity for emotional stimuli (Dolcos & McCarthy Reference Dolcos and McCarthy2006). Hence, it may be unlikely that during highly emotional events reappraisal-based strategies may be fully available for regulating the experienced emotion.

Last but not least, from a developmental point of view, the evidence for the successful use of reappraisal as a regulation strategy is scant in children (DeCicco et al. Reference DeCicco, O'Toole and Dennis2014) and nonexistent in infants (for obvious reasons of immaturity of prefrontal regions necessary for reappraisal to happen). It follows that other protective emotion-regulation strategies may guarantee resilience in the face of early stressors.

Emotional reactivity and regulatory mechanisms (cognitive, but also experiential; see Grecucci et al. Reference Grecucci, Theuninck, Frederickson, Job and Bryant2015) are keys to understand both pathological and resilient processes (Kring & Werner Reference Kring, Werner, Philippot and Feldman2004; Tracy et al. Reference Tracy, Klonsky and Proudfit2014; Troy & Mauss Reference Troy, Mauss, Southwick, Litz, Charney and Friedman2011). We are very far, however, from a complete taxonomy of emotion-regulation strategies and from a sufficient knowledge of their efficacy, optimal frequency before becoming detrimental, short- and long-term effects, and other relevant variables.

To this end, a critical distinction should be made between functional and dysfunctional emotion-regulation strategies (F/DERS). DERS may be related to psychopathology; however, as pointed out by Alado and colleagues (2010), the relationship between emotion-regulation strategies and psychopathology is not linear, and varies as a function of type of strategies and type of psychopathology. When an emotion is elicited, self-regulatory mechanisms spontaneously reduce the emotional response. A failure in such regulation may be due not necessarily to the lack of FERS, but instead to the intervention of DERS that leads to emotional dysregulation (Grecucci et al. Reference Grecucci, Theuninck, Frederickson, Job and Bryant2015).

Our view is that Kalisch et al.'s proposal, to be viable, should take into account the role of basic emotional reactivity, self-regulatory mechanisms, and DERS. We believe that just as a genetic profile can be predictive of developing a physical disease, the creation of an “emotional profile” rather than an “appraisal profile” may be useful as a predictor of resilience.