Let it be: Mindful-acceptance down-regulates pain and negative emotion. Author: Kober H1, Buhle J2, Weber J1, Ochsner KN1, Wager TD3 Affiliation: <sup>1</sup>Columbia University, Department of Psychology. <sup>2</sup>Yale University, Departments of Psychiatry &amp; Psychology. <sup>3</sup>University of Colorado Boulder, Department of Psychology and Neuroscience. Conference/Journal: Soc Cogn Affect Neurosci. Date published: 2020 Jan 27 Other: Pages: nsz104 , Special Notes: doi: 10.1093/scan/nsz104. [Epub ahead of print] , Word Count: 195 Mindfulness training ameliorates clinical and self-report measures of depression and chronic pain, but its use as an emotion regulation strategy - in individuals who do not meditate - remains understudied. As such, whether it (a) down-regulates early affective brain processes and (b) depends on cognitive control systems remains unclear. We exposed meditation-naïve participants to two kinds of stimuli: negative vs. neutral images and painful vs. warm temperatures. On alternating blocks, we asked participants to either react naturally or exercise mindful-acceptance. Emotion regulation using mindful-acceptance was associated with reductions in reported pain and negative affect, reduced amygdala responses to negative images, and reduced heat-evoked responses in medial and lateral pain systems. Critically, mindful-acceptance significantly reduced activity in a distributed, a-priori neurologic signature that is sensitive and specific to experimentally-induced pain. In addition, these changes occurred in the absence of detectable increases in prefrontal control systems. The findings support the idea that momentary mindful-acceptance regulates emotional intensity by changing initial appraisals of the affective significance of stimuli, which has consequences for clinical treatment of pain and emotion. © The Author(s) 2020. Published by Oxford University Press. KEYWORDS: Acceptance; Emotion regulation; Mindfulness; Pain; fMRI PMID: 31989171 DOI: 10.1093/scan/nsz104