The primary goal of this clinical trial is to evaluate the unique neural and behavioral effects of a one-session training combining emotion regulation skills training, with excitatory repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral prefrontal cortex (dlPFC). The secondary aim is to identify key changes in the emotion regulation neural network following the combined intervention versus each of the components alone. The third aim is to explore personalized biomarkers for response to emotion regulation training. Participants will undergo brain imaging while engaging in an emotional regulation task. Participants will be randomly assigned to learn one of two emotion regulation skills. Participants will be reminded of recent stressors and will undergo different types of neurostimulation, targeted using fMRI (functional MRI) results. Participants who may practice their emotion regulation skills during neurostimulation in a one-time session. Following this training, participants will undergo another fMRI and an exit interview to assess for immediate neural and behavioral changes. Measures of emotion regulation will be assessed at a one week and a one month follow up visit.
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High Frequency Heart Rate Variability (HF-HRV) during regulation blocks during the neurostimulation day
Timeframe: Within a month of the initial assessment
Time to return to Heart Rate (HR) baseline measured during regulation period
Timeframe: Within a month of the initial assessment
Change in the ventrolateral prefrontal cortex (vlPFC) for the [restructure-flow_negative] contrast
Timeframe: baseline Neuroimaging Scan vs post Neuroimaging scan (1 week follow-up post neurostimulation)
Change in the dorsomedial prefrontal cortex (dmPFC) for the [restructure-flow_negative] contrast
Timeframe: baseline Neuroimaging Scan, post Neuroimaging Scan (1 week follow-up post neurostimulation)
Change in the ventromedial prefrontal cortex (vmPFC) for the [restructure-flow_negative] contrast
Timeframe: baseline Neuroimaging Scan, post Neuroimaging Scan (1 week follow-up post neurostimulation)
Change in the insular cortex for the [restructure-flow_negative] contrast
Timeframe: baseline Neuroimaging Scan, post Neuroimaging Scan (1 week follow-up post neurostimulation)
Change in dorsolateral prefrontal cortex (dlPFC)-insula connectivity during [restructure - flow_negative]
Timeframe: baseline Neuroimaging Scan, post Neuroimaging Scan (1 week follow-up post neurostimulation)
Change in dorsolateral prefrontal cortex (dlPFC)-amygdala connectivity during [restructure - flow_negative]
Timeframe: baseline Neuroimaging Scan, post Neuroimaging Scan (1 week follow-up post neurostimulation)