Belief updating in depression is not related to increased sensitivity to unexpectedly negative information

Depressive symptoms and the processing of unexpected social feedback: Differences in surprise levels, feedback acceptance, and "immunizing" cognition

Negative social expectations are a key symptom of depression. It has been suggested that individuals with depressive symptoms tend to maintain these expectations by devaluing new experiences that do not fit prior expectations. However, our understanding of the role of such "immunizing" cognition in response to unexpected social feedback in depression, as well as the cognitive mechanisms involved, remains limited. This study investigated the association between depressive symptoms and the cognitive processing of unexpected positive or negative social feedback using a novel, video-based approach featuring naturalistic social stimuli in a subclinical online sample (N = 155). We also examined how surprise levels, feedback acceptance and immunizing cognition relate to other cognitive processes, such as attributional style and rumination, using cross-sectional network analyses. Robust multiple linear regression analyses revealed that depressive symptoms were associated with higher surprise levels (R2adj. = .27), lower feedback acceptance (R2adj. = .19), and higher levels of immunizing cognition (R2adj. = .09) in response to unexpected positive social feedback, but only partially to unexpected negative social feedback. The network analysis suggested that self-efficacy expectations for coping with negative feelings and acceptance of positive social feedback had the strongest expected influence on the different cognitive processes. Our study highlights the challenges that individuals with depressive symptoms face in utilizing positive social feedback to modify negative expectations. For clinicians, our findings suggest the importance of promoting acceptance of positive social feedback, while simultaneously inhibiting immunizing cognition and avoiding the use of overly positive feedback.

Are depressive symptoms linked to a reduced pupillary response to novel positive information?-An eye tracking proof-of-concept study

Introduction

Depressive symptoms have been linked to difficulties in revising established negative beliefs in response to novel positive information. Recent predictive processing accounts have suggested that this bias in belief updating may be related to a blunted processing of positive prediction errors at the neural level. In this proof-of-concept study, pupil dilation in response to unexpected positive emotional information was examined as a psychophysiological marker of an attenuated processing of positive prediction errors associated with depressive symptoms.

Methods

Participants (N = 34) completed a modified version of the emotional Bias Against Disconfirmatory Evidence (BADE) task in which scenarios initially suggest negative interpretations that are later either confirmed or disconfirmed by additional information. Pupil dilation in response to the confirmatory and disconfirmatory information was recorded.

Results

Behavioral results showed that depressive symptoms were related to difficulties in revising negative interpretations despite disconfirmatory positive information. The eye tracking results pointed to a reduced pupil response to unexpected positive information among people with elevated depressive symptoms.

Discussion

Altogether, the present study demonstrates that the adapted emotional BADE task can be appropriate for examining psychophysiological aspects such as changes in pupil size along with behavioral responses. Furthermore, the results suggest that depression may be characterized by deviations in both behavioral (i.e., reduced updating of negative beliefs) and psychophysiological (i.e., decreased pupil dilation) responses to unexpected positive information. Future work should focus on a larger sample including clinically depressed patients to further explore these findings.

Better than expected? Predictors of coping with expectation violations in the communication about death and dying

Background

End-of-life (EOL) communication is often avoided, especially among young adults. Negative expectations concerning EOL conversations with relatives or significant others are one major reason.

Objective

To investigate how best to violate negative expectations concerning EOL conversations by identifying predictors of coping with expectation violations in this context.

Methods

Vignettes describing expectation violations in the context of EOL communication were presented to a sample of 261 university students. In a first experiment, the credibility of the expectation-disconfirming information was manipulated. In a second experiment, the valence of the disconfirming evidence was manipulated. As outcome measures, the subjective likelihood of two different responses to the expectation violation was assessed: (1) ignoring the disconfirming evidence (immunization) and (2) changing expectations (accommodation).

Results

Overall, participants experiencing a worse-than-expected event showed more immunization [F(1, 257) = 12.15, p < 0.001, ηp = 0.05], while participants experiencing a better-than-expected event showed more accommodation [F(1, 257) = 30.98, p < 0.001, ηp = 0.11]. Participants with higher fear of death [F(1, 257) = 12.24, p < 0.001, ηp = 0.05] as well as higher death avoidance tendencies [F(1, 257) = 17.16, p < 0.001, ηp = 0.06] showed less accommodation in response to a better-than-expected event.

Conclusion

In general, young adults appear to update their expectations quickly in response to unexpectedly positive experiences in the context of EOL communication. However, individuals with higher fear of death and higher death avoidance tendencies appear to be at higher risk of maintaining negative expectations despite disconfirming evidence.

Noninvasive modulation of predictive coding in humans: causal evidence for frequency-specific temporal dynamics

Increasing evidence indicates that the brain predicts sensory input based on past experiences, importantly constraining how we experience the world. Despite a growing interest on this framework, known as predictive coding, most of such approaches to multiple psychological domains continue to be theoretical or primarily provide correlational evidence. We here explored the neural basis of predictive processing using noninvasive brain stimulation and provide causal evidence of frequency-specific modulations in humans. Participants received 20 Hz (associated with top-down/predictions), 50 Hz (associated with bottom-up/prediction errors), or sham transcranial alternating current stimulation on the left dorsolateral prefrontal cortex while performing a social perception task in which facial expression predictions were induced and subsequently confirmed or violated. Left prefrontal 20 Hz stimulation reinforced stereotypical predictions. In contrast, 50 Hz and sham stimulation failed to yield any significant behavioral effects. Moreover, the frequency-specific effect observed was further supported by electroencephalography data, which showed a boost of brain activity at the stimulated frequency band. These observations provide causal evidence for how predictive processing may be enabled in the human brain, setting up a needed framework to understand how it may be disrupted across brain-related conditions and potentially restored through noninvasive methods.

How negative mood hinders belief updating in depression: results from two experimental studies

BACKGROUND

In two experimental studies, we tested the hypothesis that negative mood would hinder the revision of negative beliefs in response to unexpectedly positive information in depression, whereas positive mood was expected to enhance belief updating.

METHODS

In study 1 (N = 101), we used a subclinical sample to compare the film-based induction of sad v. happy mood with a distraction control group. Subsequently, participants underwent a well-established paradigm to examine intra-individual changes in performance-related expectations after unexpectedly positive performance feedback. In study 2, we applied the belief-updating task from study 1 to an inpatient sample (N = 81) and induced sad v. happy mood via film-clips v. recall of autobiographic events.

RESULTS

The results of study 1 showed no significant group differences in belief updating; the severity of depressive symptoms was a negative predictor of belief revision, though, and there was a non-significant trend suggesting that the presence of sad mood hindered belief updating in the subgroup of participants with a diagnosed depressive episode. Study 2 revealed that participants updated their expectations significantly less in line with positive feedback when they underwent the induction of negative mood prior to feedback, relative to positive mood.

CONCLUSIONS

By indicating that the presence of negative mood can hinder the revision of negative beliefs in clinically depressed people, our findings suggest that learning from new experiences can be hampered if state negative mood is activated. Thus, interventions relying on learning from novel positive experiences should aim at reducing state negative mood in depression.

Evaluation of Early Ketamine Effects on Belief-Updating Biases in Patients With Treatment-Resistant Depression

IMPORTANCE

Clinical research has shown that persistent negative beliefs maintain depression and that subanesthetic ketamine infusions induce rapid antidepressant responses.

OBJECTIVE

To evaluate whether ketamine alters belief updating and how such cognitive effects are associated with the clinical effects of ketamine.

DESIGN, SETTING, AND PARTICIPANTS

This study used an observational case-control protocol with a mixed-effects design that nested 2 groups by 2 testing time points. Observers were not blinded. Patients with treatment-resistant depression (TRD) and healthy volunteer participants aged 34 to 68 years were included. Patients with TRD were diagnosed with major depressive disorder or bipolar depression, had a Montgomery-Åsberg Depression Rating Scale score greater than 20, a Maudsley Staging Method score greater than 7, and failed to respond to at least 2 prior antidepressant trials. Exclusion criteria were any other psychiatric, neurological, or neurosurgical comorbidities, substance use or addictive disorders, and recreational ketamine consumption. Data were collected from January to February 2019 and from May to December 2019, and data were analyzed from January 2020 to July 2021.

EXPOSURES

Patients with TRD were observed 24 hours before single ketamine infusion, 4 hours after the infusion, and 4 hours after the third infusion, which was 1 week after the first infusion. Healthy control participants were observed twice 1 week apart without ketamine exposure.

MAIN OUTCOMES AND MEASURES

Montgomery-Åsberg Depression Rating Scale score and belief updating after belief updating when patients received good news and bad news measured by a cognitive belief-updating task and mathematically formalized by a computational reinforcement learning model.

RESULTS

Of 56 included participants, 29 (52%) were male, and the mean (SEM) age was 52.3 (1.2) years. A total of 26 patients with TRD and 30 control participants were included. A significant group × testing time point × news valence interaction showed that patients with TRD updated their beliefs more after good than bad news following a single ketamine infusion (controlled for age and education: β = -0.91; 95% CI, -1.58 to -0.24; t216 = -2.67; P = .008) than controls. Computational modeling showed that this effect was associated with asymmetrical learning rates (LRs) after ketamine treatment (good news LRs after ketamine, 0.51 [SEM, 0.04]; bad news LRs after ketamine 0.36 [SEM, 0.03], t25 = 3.8; P < .001) and partially mediated early antidepressant responses (path a*b: β = -1.00 [SEM, 0.66]; t26 = -1.53; z = -1.98; P = .04).

CONCLUSIONS AND RELEVANCE

These findings provide novel insights into the cognitive mechanisms of the action of ketamine in patients with TRD, with promising perspectives for augmented psychotherapy for individuals with mood disorders.

Testing Bayesian models of belief updating in the context of depressive symptomatology

OBJECTIVES

Predictive processing approaches to belief updating in depression propose that depression is related to more negative and more precise priors. Also, belief updating is assumed be negatively biased in comparison to normative Bayesian updating. There is a lack of efficient methods to mathematically model belief updating in depression.

METHODS

We validated a novel performance belief updating paradigm in a nonclinical sample (N = 133). Participants repeatedly participated in a non-self-related emotion recognition task and received false feedback. Effects of the feedback manipulation and differences in depressive symptoms on belief updating were analysed in Bayesian multilevel analyses.

RESULTS

Beliefs were successfully manipulated through the feedback provided. Depressive symptoms were associated with more negative updating than normative Bayesian updating but results were influenced by few cases. No evidence of biased change in beliefs or overly precise priors was found. Depressive symptoms were associated with more negative updating of generalised performance beliefs.

CONCLUSIONS

There was cautious support for negatively biased belief updating associated with depressive symptoms, especially for generalised beliefs. The content of the task may not be self-relevant enough to cause strong biases. Further explication of Bayesian models of depression and replication in clinical samples is needed.

Predictors of Coping with Health-related Expectation Violations among University Students

Objectives: Individuals often experience expectation violations related to the consumption of healthy food and physical activity and they may cope with expectation-disconfirming information by (1) ignoring the discrepancy (immunization), (2) increasing efforts to fulfill them (assimilation), or (3) changing their expectations (accommodation). We investigated whether valence, discrepancy magnitude, and controllability of the expectation disconfirming event predicted coping with expectation violations. Methods: A 2 (valence: positive vs negative) x 2 (discrepancy: larger vs smaller) x 2 (controllability: control vs no control) experimental design was implemented. Overall, we presented 297 university students with vignettes describing expectation violations and present different combinations of predictor levels. Results: Regarding physical activity, participants showed significantly higher accommodation when experiencing a better-than-expected event and showed significantly higher immunization when experiencing a worse-than-expected event. Regarding food consumption and physical activity, individuals experiencing lower discrepancy showed significantly higher immunization; individuals with control over the source of expectation disconfirmation showed significantly higher assimilation; and individuals without control over the source of expectation disconfirmation showed significantly higher accommodation.Conclusions: To promote the maintenance of healthy expectations, despite expectation violations, interventions could foster the perception of control as well as assimilative behavior.

Predictive processing in depression: Increased prediction error following negative valence contexts and influence of recent mood-congruent yet irrelevant experiences

BACKGROUND

Novel theoretical models of depression have recently emerged based on an influential new perspective in neuroscience known as predictive processing. In these models, depression may be understood as an imbalance of predictive signals in the brain; more specifically, a dominance of predictions leading to a relative insensitivity to prediction error. Despite these important theoretical advances, empirical evidence remains limited, and how expectations are generated and used dynamically in individuals with depression remains largely unexplored.

METHODS

In this study, we induced facial expression predictions using emotion contexts in 34 individuals with depression and 34 healthy controls.

RESULTS

Compared to controls, individuals with depression perceived displayed facial expressions as less similar to their expectations (i.e., increased difference between expectations and actual sensory input) following contexts evoking negative valence emotions, indicating that depressed individuals have increased prediction error in such contexts. This effect was amplified by recent mood-congruent yet irrelevant experiences.

LIMITATIONS

The clinical sample included participants with comorbid psychopathology and taking medication. Additionally, the two groups were not evaluated in the same setting, and only three emotion categories (fear, sadness, and happiness) were explored.

CONCLUSIONS

Our results shed light on potential mechanisms underlying processing abnormalities regarding negative information, which has been consistently reported in depression, and may be a relevant point of departure for exploring transdiagnostic vulnerability to mental illness. Our data also has the potential to improve clinical practice through the implementation of novel diagnostic and therapeutic tools based on the assessment and modulation of predictive signals.

Is depression associated with reduced optimistic belief updating?

When asked to evaluate their probability of experiencing a negative life event, healthy individuals update their beliefs more following good news than bad. This is referred to as optimistic belief updating. By contrast, individuals with depression update their beliefs by a similar amount, showing reduced optimism. We conducted the first independent replication of this effect and extended this work to examine whether reduced optimistic belief updating in depression also occurs for positive life events. Replicating previous research, healthy and depression groups differed in belief updating for negative events (β = 0.71, 95% CI: 0.24, 1.18). Whereas healthy participants updated their beliefs more following good news than bad, individuals experiencing depression lacked this bias. However, our findings for positive events were inconclusive. While we did not find statistical evidence that patterns of belief updating between groups varied by valence (β = -0.51, 95% CI: -1.16, 0.15), mean update scores suggested that both groups showed largely similar updating for positive life events. Our results add confidence to previous findings that depression is characterized by negative future expectations maintained by reduced updating in response to good news. However, further research is required to understand the specificity of this to negative events, and into refining methods for quantifying belief updating in clinical and non-clinical research.

Response to unexpected social inclusion: A study using the cyberball paradigm

BACKGROUND

Dysfunctional expectations are considered core characteristics of Major Depressive Disorder (MDD) and should be focused in psychotherapy. Dysfunctional expectations are especially pronounced in the interpersonal area (social expectations). In the present study, we examine the effect of unexpected social inclusion (expectation violation) on the change of generalized and specific depression-typical social expectations.

METHOD

We conducted an online study to investigate the impact of social inclusion after a period of social exclusion (unexpected social inclusion) on social expectation change (sample size 144) in a non-clinical sample. Depressive symptoms were assessed via self-reporting. Participants took part in two rounds of the online ball-game Cyberball. In the first round, all participants were socially excluded by their two co-players (acquisition of negative social expectations). In the second round, participants were either once more excluded (expectation confirmation) or included equally (expectation violation) by the same co-players. Specific and generalized social expectations were assessed after each round.

RESULTS

Specific and generalized social expectations increased following expectation violation. Even though depressive symptoms were related to lower levels of social expectations, we found that depressive symptoms did not moderate expectation change after positive expectation violations.

CONCLUSIONS

In the present experimental setup including the use of the online ball-game Cyberball, the establishment and change of social expectations can be experimentally manipulated. Under the given circumstances and in a non-clinical sample, negative expectations can be updated after unexpected positive experiences regardless of the number of depressive symptoms. The results are discussed in the context of current models of Major Depressive Disorder (MDD), expectation change, and cognitive behavioral therapy.

No Evidence for the Involvement of Cognitive Immunisation in Updating Beliefs About the Self in Three Non-Clinical Samples

BACKGROUND

Cognitive immunisation against disconfirmatory evidence (i.e., devaluing expectation-disconfirming information through cognitive mechanisms) has recently been discussed as an obstacle to the revision of dysfunctional beliefs in mental disorders such as depression. Yet, it is unclear whether cognitive immunisation is also involved in belief updating in non-clinical samples.

METHODS

Using a three-group modulation protocol (promotion vs. inhibition of cognitive immunisation vs. control group), we examined how cognitive immunisation influences belief updating in response to performance feedback in three non-clinical samples. In Experiments 1 (N = 99) and 2 (N = 93), participants received unexpectedly negative feedback, whereas participants from Experiment 3 (N = 118) received unexpectedly positive feedback. Depressive symptoms and dispositional optimism were examined as additional predictors of belief updating.

RESULTS

In all experiments, participants adjusted their expectations in line with the feedback received, but this effect was not influenced by the cognitive immunisation manipulation. In Experiment 3, expectation change remained stable over 2 weeks. Depressive symptoms were associated with a reduced integration of positive feedback, but not with an increased sensitivity to negative feedback.

CONCLUSIONS

Whereas previous research has shown that cognitive immunisation contributes to persistent beliefs in clinical populations, the present findings suggest that it does not affect belief updating in non-clinical samples.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10608-021-10256-y.

[Belief updating and mood congruence in depressive disorder]

Depressive disorder is characterized by a polymorphic symptomatology associating emotional, cognitive and behavioral disturbances. One of the most specific symptoms is negative beliefs, called congruent to mood. Despite the importance of these beliefs in the development, the maintenance, and the recurrence of depressive episodes, little is known about the processes underlying the generation of depressive beliefs. In this paper, we detail the link between belief updating mechanisms and the genesis of depressive beliefs. We show how depression alters information processing, generating cognitive immunization when processing positive information, affective updating bias related to the valence of belief and prediction error, and difficultie to disengage from negative information. We suggest that disruption of belief-updating mechanisms forms the basis of belief-mood congruence in depression.

Dispositional and situational predictors of coping with violated achievement expectations

Most students experience expectation violations during their academic career, such as unexpected failed tests. However, contradictory evidence does not always result in expectation change (accommodation). Expectations often persist through stronger efforts to fulfil the expectation (assimilation) or ignoring the discrepancy (immunisation). Our study addresses possible situational and dispositional predictors that may be decisive influences on the use of the three coping strategies. We conducted an experimental study with n = 439 students who experienced an expectation violation in an achievement test. Dispositional coping tendencies, valence of expectation violation, and the interaction of valence and degree of expectation violation were found to predict situational coping. Furthermore, higher need for cognitive closure predicted stronger accommodation, and a large degree of expectation violation predicted stronger immunisation. Thus, our study provides initial evidence on which situational and dispositional factors predict coping with expectation violations in an educational context. Expectation violation in a performance context mainly resulted in stronger efforts to protect positive achievement expectations.

How Depressive Symptoms Hinder Positive Information Processing: An Experimental Study on the Interplay of Cognitive Immunisation and Negative Mood in the Context of Expectation Adjustment

Background

People with depression maintain negative expectations despite disconfirming positive experiences by reappraising or discarding novel positive information, referred to as “cognitive immunisation”. A second body of literature suggests that negative mood can negatively affect information processing. Bridging these two lines of research, the present study examined the interplay of cognitive immunisation and negative mood in the context of expectation modification.

Methods

In a student sample (N = 152), we used a well-established experimental paradigm to examine the adjustment of performance expectations in response to positive performance feedback, and its relation to depressive symptoms. In a 2 × 2 design, participants received either a negative mood induction, a cognitive immunisation manipulation, both, or no further manipulation.

Results

Participants from all experimental groups revised their previous expectations significantly in line with positive performance feedback. However, depressive symptoms were a negative predictor of expectation adjustment, and a moderation analysis indicated that this effect was particularly pronounced if participants underwent the negative mood induction.

Conclusions

Consistent with previous work, depressive symptoms were associated with a reduced ability to integrate positive information. Furthermore, our results suggest that the activation of negative mood in people with elevated levels of depression may hamper learning from new positive experience.

“Ich denke, also sage ich vorher”: Wie “Predictive Processing-Modelle den Einsatz von Verhaltensexperimenten bei Depressionen optimieren können

Verhaltensexperimente stellen eine wichtige Interventionsform bei depressiven Störungen dar, um dysfunktionale Annahmen zu modifizieren. Häufig ist jedoch zu beobachten, dass Patient*innen trotz einer fachgerechten Durchführung von Verhaltensexperimenten weiter an negativen Annahmen festhalten. Vor diesem Hintergrund diskutieren wir in diesem Artikel, wie der Einsatz von Verhaltensexperimenten bei Depressionen optimiert werden kann und beziehen uns dabei auf ein neues Störungsmodell, das interessante Implikationen hierzu liefern könnte. Dieses Störungsmodell aus der neurowissenschaftlichen Forschung zu “Predictive Processing” geht davon aus, dass depressive Störungen durch zwei Kernaspekte gekennzeichnet sind: (1) stark negative Erwartungen, die im Sinne von selbsterfüllenden Pro­phezeiungen zu negativen Erlebnissen führen und zuneh­mend “immun” gegen gegenteilige Erfahrungen machen; (2) das Fehlen von positiven Erwartungen, wodurch die Wahr­scheinlichkeit von positiven Erlebnissen reduziert wird. Darauf aufbauend beschreiben wir zunächst, dass zur Modifikation negativer Erwartungen in einer ausführlichen Vorbesprechung erarbeitet werden sollte, welche möglichen positiven Erfahrungen aus dem Verhaltensexperiment die Patient*innen als glaubwürdig betrachten und zur Veränderung ihrer negativen Erwartungen nutzen würden. Auf diese sollte bei der Durchführung besonders geachtet werden, damit positive Erwartungsverletzungen auch als solche wahrgenommen werden. Zum anderen stellen wir dar, dass es nicht ausreichend ist, nur negative Erwartungen zu redu­zieren, sondern auch explizit positive Erwartungen durch weitere Verhaltensexperimente gefördert werden sollten.

When Beliefs Face Reality: An Integrative Review of Belief Updating in Mental Health and Illness

Belief updating is a relatively nascent field of research that examines how people adjust their beliefs in light of new evidence. So far, belief updating has been investigated in partly unrelated lines of research from different psychological disciplines. In this article, we aim to integrate these disparate lines of research. After presenting some prominent theoretical frameworks and experimental designs that have been used for the study of belief updating, we review how healthy people and people with mental disorders update their beliefs after receiving new information that supports or challenges their views. Available evidence suggests that both healthy people and people with particular mental disorders are prone to certain biases when updating their beliefs, although the nature of the respective biases varies considerably and depends on several factors. Anomalies in belief updating are discussed in terms of both new insights into the psychopathology of various mental disorders and societal implications, such as irreconcilable political and societal controversies due to the failure to take information into account that disconfirms one’s own view. We conclude by proposing a novel integrative model of belief updating and derive directions for future research.

Design and Validation of the Adaptation to Change Questionnaire: New Realities in Times of COVID-19

Emotional and cognitive-behavioral factors influence people's adaptability to change. Based on this premise, the objective of this study was to develop, evaluate and validate the Adaptation to Change Questionnaire (ADAPTA-10) for identifying those who show poor adaptability to adverse situations, such as those caused by COVID-19. This study was carried out in a sample of 1160 adults and produced a 10-item instrument with good reliability and validity indices. It is an effective tool useful in research and in clinical practice. Calculation tables are provided for the general Spanish population and by sex to evaluate adaptability to change. The two-dimensional structure proposed in the original model was confirmed. This instrument will enable the needs for adaptation to the new reality associated with COVID-19 to be detected and also other situations in which the subject becomes immersed which demand adaptation strategies in the new situation lived in.

No1LikesU! - A Pilot Study on an Ecologically Valid and Highly Standardised Experimental Paradigm to Investigate Social Rejection Expectations and Their Modification

Background

Dysfunctional expectations have been suggested as core features in the development and maintenance of mental disorders. Thus, preventing development and promoting modification of dysfunctional expectations through intervention might improve clinical treatment. While there are well-established experimental procedures to investigate the acquisition and modification of dysfunctional performance expectations in major depression, paradigms for investigating other important types of dysfunctional expectations (e.g. social rejection expectations) are currently lacking. We introduce an innovative associative learning paradigm, which can be used to investigate the development, maintenance, and modification of social rejection expectations.

Method

A pilot sample of 28 healthy participants experienced manipulated social feedback after answering personal questions in supposed webcam conferences. While participants repeatedly received social rejection feedback in a first phase, differential feedback was given in a second phase (social rejection vs. social appreciation). In a third phase, explicit social feedback was omitted.

Results

Participants developed social rejection expectations in the first phase. For the second phase, we found an interaction effect of experimental condition; i.e. participants adjusted their expectations according to the differential social feedback. In the third phase, learned social expectations remained stable in accordance to the social feedback in the second phase.

Conclusion

Results indicate that the paradigm can be used to investigate the development, maintenance, and modification of social rejection expectations in healthy participants. This offers broad applications to explore the differential acquisition and modification of social rejection expectations in healthy vs. clinical samples. Further, the paradigm might be used to investigate therapeutic strategies to facilitate expectation change.