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Neurobiological and Psychological Reaction Patterns in Response to Social Rejection in BPD

Subject Area Clinical Psychiatry, Psychotherapy, Child and Adolescent Psychiatry
Term from 2011 to 2019
Project identifier Deutsche Forschungsgemeinschaft (DFG) - Project number 190034061
 
Final Report Year 2019

Final Report Abstract

Feelings of loneliness, of being different from others, as well as fear of abandonment and social rejection are core features of BPD. In the present project, we investigated impairments in the sense of belonging by self-report questionnaires and experimental approaches. BPD patients characterize themselves in self-report questionnaires as experiencing extremely high levels of loneliness, i.e. of a strong discrepancy between desired and actually existing social connectedness. While the social networks of BPD patients are indeed smaller and less diverse as those of healthy individuals, experimental studies suggest that in standardised social interaction situations BPD patients feel less included and expect less social acceptance. We identified cognitive biases in different experimental settings. All of these suggest that BPD patients process social cues in a biased way when they are signaling a willingness of others to form affiliations: they expect to be rejected in theoretical scenarios as well as following standardised social situations, they judge happiness in facial expressions as less intense, they fail to integrate positive information about people into their judgements when provided by others, and they feel less confident in their own ability to assess such cues. While these alterations may lead to deficits in appreciating positive social encounters, they also affect the patients’ behaviour. Linked to increasing levels of loneliness, we observed a reduction in basal affiliative behaviours such as behavioural imitation in BPD. Moreover, the violation of negative expectations by positive social feedback regarding the acceptance by others led to a reduction of cooperative behaviour. This was particularly true when the social partner behaved – according to general norms – fair. Altered norms about fairness may together with increased concerns about injustice contribute to these alterations. In line with the reduced sense of belonging in BPD, our findings suggest consistently that impairments of social cognition are most prominent for the processing of positive social signals. By their effects on behaviour, these biases may contribute to interpersonal impairments and the stabilisation of subjectively perceived as well as objectively existing social isolation, i.e. in a vicious circle of loneliness. Building on these findings, we designed a computer-assisted social-cognitive trainings program for which first findings suggest that it improves the detection and appreciation of positive social cues as prerequisite to break through loneliness.

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