Rejection Sensitivity and the Defensive Motivational System: Insights From the Startle Response to Rejection Cues

Maternal Depressive Symptoms and Offspring Internalizing Problems: A Cross-Lagged Panel Network Analysis in Late Childhood and Early Adolescence

The present study investigated the relations between maternal depressive symptoms and internalizing problems in offspring during late childhood and early adolescence, examining sex differences using symptom network analysis. A total of 885 Chinese youths in late childhood (n = 497, 38.6% girls; age = 9.58 years, SD = 0.24) and early adolescence (n = 388, 48.5% girls; age = 11.30 years, SD = 0.24) and their mothers (Mage = 37.34 years, SD = 5.42) were recruited. Cross-lagged panel network (CLPN) analysis was used to explore bridge symptoms (i.e., symptoms connecting two or more mental disorders) and identify transmission pathways between maternal depressive symptoms and offspring's internalizing problems at these two developmental stages. The CLPN results revealed that in late childhood, the bridge connections in the network model were boys feeling worried to mothers feeling distractible, and girls feeling worried to mothers feeling powerless. In early adolescence, the bridge connections were boys experiencing depressed mood to mothers feeling powerless, and mothers feeling bad to girls experiencing depressed mood. These findings highlight the network-level relations between maternal depressive symptoms and offspring internalizing problems. They provide insights into the developmental differences and similarities in symptoms during these periods and suggest ways to break the vicious cycle of psychopathology between mothers and their children.

Why rejection sensitivity leads to adolescents' loneliness: Differential exposure, reactivity, and exposure-reactivity models

INTRODUCTION

Rejection sensitivity is considered a risk factor for loneliness; however, the underlying mechanisms remain unknown. Adopting the constructs of exposure, reactivity, and exposure-reactivity from the personality framework, this study investigated three models of rejection sensitivity, bullying victimization, and loneliness to reveal why rejection sensitivity leads to loneliness among Chinese early adolescents.

METHODS

Using a longitudinal design, three-wave data were obtained (with approximately 6-month intervals) from 2381 Chinese early adolescents (51.2% boys at Time 1, Mage = 13.38, SD = 0.59) from 7 secondary schools. Students reported on their rejection sensitivity at Time 1, bullying victimization at Times 1 and 2, and their loneliness at Times 2 and 3. A longitudinal moderated mediation model was conducted to analyze the association between variables.

RESULTS

Path analyses demonstrated that rejection sensitivity was associated with greater loneliness for adolescents in which association was mediated by bullying victimization. High levels of rejection sensitivity exacerbate the adverse effect of bullying victimization on loneliness. Furthermore, in line with the differential exposure-reactivity model, the effect of rejection sensitivity on loneliness mediated by bullying victimization only existed for high rejection-sensitive adolescents.

CONCLUSIONS

The findings emphasize the dual role of rejection sensitivity in the development process of adolescents' loneliness and highlight the importance of identifying rejection-sensitive adolescents for intervention and prevention efforts.

Hooked on a thought: Associations between rumination and neural responses to social rejection in adolescent girls

Rumination is a significant risk factor for psychopathology in adolescent girls and is associated with heightened and prolonged physiological arousal following social rejection. However, no study has examined how rumination relates to neural responses to social rejection in adolescent girls; thus, the current study aimed to address this gap. Adolescent girls (N = 116; ages 16.95-19.09) self-reported on their rumination tendency and completed a social evaluation fMRI task where they received fictitious feedback (acceptance, rejection) from peers they liked or disliked. Rejection-related neural activity and subgenual anterior cingulate cortex (sgACC) connectivity were regressed on rumination, controlling for rejection sensitivity and depressive symptoms. Rumination was associated with distinctive neural responses following rejection from liked peers including increased neural activity in the precuneus, inferior parietal gyrus, dorsolateral prefrontal cortex, and supplementary motor area (SMA) and reduced sgACC connectivity with multiple regions including medial prefrontal cortex, precuneus and ventrolateral prefrontal cortex. Greater precuneus and SMA activity mediated the effect of rumination on slower response time to report emotional state after receiving rejection from liked peers. These findings provide clues for distinctive cognitive processes (e.g., mentalizing, conflict processing, memory encoding) following the receipt of rejection in girls with high levels of rumination.

A daily diary study on stressors, hurt feelings, aggression, and somatic symptoms: The role of rejection sensitivity and negative emotion differentiation

The current study adopted a daily diary design to examine associations of daily stressors and hurt feelings to three unfavorable daily outcomes, including verbal aggression, physical aggression, and somatic symptoms and the moderation of rejection sensitivity and negative emotion regulation on the relations between these daily variables. A total of 248 college students participated in the daily diary study in which they responded to the assessment on a daily basis for 7 consecutive days. The results indicated that daily stressors predicted daily verbal aggression; daily stressors, daily hurt feelings, and rejection sensitivity predicted somatic symptoms. Negative emotion regulation moderated the association between stressors and verbal aggression such that more stressors and high negative emotion regulation predicted more frequent daily verbal aggression. Rejection sensitivity moderated the association of hurt feelings to verbal and physical aggression. Perception of hurt feelings and high rejection sensitivity predicted more verbal aggression but less physical aggression. Rejection sensitivity also moderated the association of stressors to somatic symptoms such that more stressors and high rejection sensitivity predicted more somatic symptoms. The findings collectively highlight the importance of supporting individuals with high rejection sensitivity to encode social cues in a healthy way. It is imperative to provide emotion regulation skills to cope with negative emotions derived from social interactions.

Childhood psychological abuse and relational aggression among adolescents: A moderated chain mediation model

Introduction

Adolescents are in a period when a marked upward trend of adolescents relational aggression. Even though previous studies have found that childhood psychological abuse experience is an important factor influencing adolescent relational aggression, it is unclear when and under what circumstances childhood psychological abuse impacts adolescent relational aggression. This study constructed a moderated chain mediation model to investigate the influence of childhood psychological abuse on relational aggression among Chinese adolescents and its internal mechanism.

Methods

Data from 1868 (923 male and 945 female, M = 14.31, SD = 1.60) Chinese adolescents in two full-time middle schools in Guangzhou were collected via a cross-sectional survey in 2020. Adolescents reported on childhood psychological abuse, relational aggression, rejection sensitivity relational victimization and cognitive reappraisal.

Results

The results demonstrated that: (1) childhood psychological abuse was significantly positively related to relational aggression; (2) childhood psychological abuse was significantly linked with adolescents' relational aggression through the separate mediating effects of rejection sensitivity and relational victimization, as well as through the chain mediating effects of rejection sensitivity and relational victimization; (3) the chain mediated effect of childhood psychological abuse on relational aggression through rejection sensitivity and relational victimization was moderated by cognitive reappraisal.

Conclusion

These findings indicate that childhood psychological abuse, as a kind of poor parenting style, has influence on adolescents' internal personality (rejection sensitivity) and external behavior development (relational victimization and relational aggression). This study is helpful to demonstrate the protective effect of cognitive reappraisal and reveal the internal mechanism of childhood psychological abuse on relational aggression.

Does Self-Silencing Behavior Mediate the Relation Between Rejection Sensitivity and Sexual Violence Victimization?

Previous research reveals that rejection sensitivity is associated with both sexual violence victimization and self-silencing behavior, yet the association among these variables has not been examined. As the foundation for this study, we propose a theoretical model that integrates these constructs. Using mediational analyses with bootstrapping, the results from a sample of 241 heterosexual college women revealed that consistent with the proposed model, self-silencing mediated the link between rejection sensitivity and reports of unwanted sexual contact and rape. The implications of the findings for the prevention of victimization/revictimization and interventions with victimized women are discussed.

Rejection sensitivity mediates the interparental conflict and adolescent Internet addiction: School connectedness as a moderator

Internet addiction (IA) is a growing social problem with negative mental and social outcomes; the present study examined whether rejection sensitivity mediates the relationship between interparental conflict and adolescent IA and the moderating role of school connectedness. One thousand and seven adolescents (51.84% females; Mean_age = 13.17; SD = 0.69) anonymously completed questionnaires to assess interparental conflict, school connectedness, rejection sensitivity, IA, and demographic information. The model results showed that: (1) the positive association between interparental conflict and adolescent IA was partially mediated by rejection sensitivity; (2) this indirect link was moderated by the school connectedness and was stronger for adolescents with high school connectedness. The results provide support for the attachment theory that high interparental conflict could increase adolescents’ rejection sensitivity, and high school connectedness plays a double-edged role that adolescents show more rejection sensitivity while reporting high interparental conflict and high school connectedness.

Rejection Sensitivity and Sexual Minority Men's Social Anxiety Disorder: The Moderating Role of Sexual Identity Strength

Although gay-related rejection sensitivity (RS) is associated with social anxiety among sexual minority men, little attention has been given to the validity of gay-related RS measures and to individual differences that might moderate the association between gay-related RS and social anxiety. In a population-based sample of sexual minority men, Study 1 (N = 114) investigated the incremental validity of gay-related RS and showed that gay-related RS scores significantly added to the prediction of social anxiety symptoms, even after controlling for personal RS scores. In a clinical sample of sexual minority men, Study 2 (N = 254) examined interrelationships among gay-related RS, sexual identity strength, and current social anxiety symptoms and disorder diagnosis. Results revealed that the expected count of current social anxiety symptoms and the odds of social anxiety disorder diagnosis, as assessed with a structured diagnostic interview, increased as a function of gay-related RS scores. Sexual identity strength moderated these relationships, such that the associations between gay-related RS scores and interviewer-assessed social anxiety symptoms and disorder were only significant for those high, but not low, in sexual identity strength. Together, results from the present studies lend support to the incremental validity of gay-related RS scales in predicting social anxiety symptoms and suggest that sexual minority men who consider their sexual orientation to be self-defining might be particularly vulnerable to the mental health correlates of gay-related RS.

The Higher the Life Satisfaction, the Better the Psychological Capital? Life Satisfaction and Psychological Capital: A Moderated Mediation Model

This study investigates the mediator role of attachment avoidance and the moderator role of rejection sensitivity on the links between life satisfaction and psychological capital (PsyCap). This study uses the Experiences in Close Relationship Scale, Rejection Sensitive Scale, Positive Psychological Capital Scale, and Life Satisfaction Scale among 999 Chinese young adults as subjects. The results presented that life satisfaction had a significant positive predictive effect on PsyCap. Mediation analysis of this study shows that attachment avoidance mediated the association between life satisfaction and PsyCap. Furthermore, moderated mediation analysis indicated that rejection sensitivity moderates the link between life satisfaction and attachment avoidance (first-stage moderation). Compared with individuals with low rejection sensitivity, individuals with high rejection sensitivity show more attachment avoidance under low life satisfaction. This study helps understand the relationship between life satisfaction and PsyCap from the perspective of rejection sensitivity theory and attachment theory and has implications for guiding college students toward strengthening PsyCap and weakening rejection sensitivity.

Examining the Effects of Stuttering and Social Anxiety on Interpretations of Ambiguous Social Scenarios Among Adolescents

PURPOSE

The proclivity to construe ambiguous information in a negative way is known as interpretation bias, which has been implicated in the onset and/or maintenance of social anxiety. The purpose of this study was to examine group and individual differences in interpretation bias among young people who stutter and their typically fluent peers during the adolescent years when social fears and worries tend to escalate.

METHODS

A total of 99 adolescents (13 to 19 years old) participated, including 48 adolescents who stutter (67% male) and 51 typically fluent controls (68% male). They completed a computerized vignette-based interpretation bias task in which they first read 14 short ambiguous social scenarios (half including a verbal interaction, half including a non-verbal interaction). They were then presented with four possible interpretations of each scenario including two negative interpretations (one target, one foil) and two positive interpretations (one target, one foil). Participants used a 4-point Likert scale to rate how similar in meaning each interpretation was to the original scenario. Participants also completed self-report measures of social and general anxiety, and provided a speech sample for stuttering analysis.

RESULTS

There was no effect of stuttering on interpretations; the adolescents who stutter rated interpretations across both verbal and non-verbal scenarios comparably to the controls, and stuttering severity did not affect interpretation ratings. However, across groups, there was a significant effect of social anxiety such that higher social anxiety was associated with more negative interpretations, and lower social anxiety was associated with more positive interpretations.

DISCUSSION

This study provides preliminary evidence that social anxiety may affect how adolescents interpret ambiguous social cues in verbal and non-verbal scenarios more than stuttering, although more research into how people who stutter process social information is warranted.

Social anxiety, rejection sensitivity, and theory of mind decoding ability

OBJECTIVES

Recent initiatives have highlighted the importance of investigating clinically relevant variations in social processes that contribute to mental illness. Surprisingly little research has examined the associations between socially and clinically relevant transdiagnostic factors, such as social anxity (SA) and rejection sensitvity (RS), on theory of mind (ToM) decoding ability.

METHODS

The Reading the Mind in the Eyes Task and self-report measures of SA and RS were completed by 199 adult participants.

RESULTS

Linear regression analyses suggest a specific difficulty decoding positive emotion associated with SA and global decrements in ToM associated with RS that may reflect a negative interpretation bias.

CONCLUSIONS

These findings may have important implications for understanding how those with SA and RS perceive and navigate social interactions, which may contribute to the maintenance of symptoms and decreased psychosocial functioning.

Longitudinal associations between justice sensitivity, nonsuicidal self-injury, substance use, and victimization by peers

Justice sensitivity (JS), the tendency to perceive and negatively respond to alleged injustice, has been associated with a range of internalizing and externalizing problems and peer victimization; however, it remains unclear if it has an association with self-victimization. Participants (N = 769) reported on their JS longitudinally at 9-19 (T1), 11-21 (T2), and 14-22 years of age (T3). They further reported on nonsuicidal self-injury (NSSI) and illegal substance use as indicators of self-victimization as well as victimization by peers at T2 and T3. A cross-lagged latent model revealed that victim JS at T1 was positively associated with NSSI, substance use, and peer victimization at T2, and victim JS at T2 was positively associated with substance use at T3. Higher observer JS at T2 predicted higher illegal substance use at T3 and higher illegal substance use at T2 predicted higher observer JS at T3. Finally, higher peer victimization at T2 predicted less perpetrator JS at T3 in the total group. Multigroup models further revealed sex-specific effects. Our findings highlight that being sensitive to injustice, particularly the tendency to feel unfairly treated or being taken advantage of, contributes to individuals' vulnerability to both engaging in behaviors reflecting self-victimization and being a target of peer victimization, which in turn have influences on JS.

The borderline interpersonal-affective systems (BIAS) model: Extending understanding of the interpersonal context of borderline personality disorder

Prominent explanatory models for borderline personality disorder (BPD) are intrapersonal in nature and hold that it is an emotional disorder. However, the empirical support for emotional models of BPD is mixed. Refinements to BPD explanatory models are needed to increase the precision with which BPD can be understood and treated. Drawing on existing theoretical and empirical research in BPD, this manuscript presents the Borderline Interpersonal-Affective Systems (BIAS) model. The BIAS model purports that harmful early life relationships and subsequent conflictual relationships lead individuals with BPD to develop a sensitivity to interpersonal threat in the form of attentional and appraisal biases. Individuals with BPD are posited to 1) experience heightened emotional reactivity specifically to perceived interpersonal threat and 2) engage in destructive behaviors both to regulate increasing emotion and to meet interpersonal needs. We review the empirical support for each component of the BIAS model, along with the role of the cognitions, emotions, and behaviors of significant others in influencing BIAS model processes in individuals with BPD over time. The BIAS model highlights a novel way of understanding and integrating interpersonal and emotional components of the disorder. Key directives for future research and clinical implications are discussed.

Borderline Personality Features, Anger, and Intimate Partner Violence: An Experimental Manipulation of Rejection

Individuals with borderline personality features may be susceptible to react to situational stressors with negative and interpersonally maladaptive emotionality (e.g., anger) and aggression. The current study attempted to test two moderated mediation models to investigate dispositional risk factors associated with borderline personality features and intimate partner violence (IPV). Results from an experimental rejection induction paradigm were examined using moderated regression to observe contextual reactions to imagined romantic rejection from a current romantic partner among individuals with borderline personality features. An ethnically diverse sample of 218 undergraduates at a large public university in the southwestern United States was recruited. Participants responded to demographic questions and self-report measures, and engaged in an experimental rejection induction paradigm. Borderline personality features was positively associated with rejection sensitivity, physical assault, and psychological aggression. Contrary to initial hypotheses, rejection sensitivity did not serve as a mediator of the relations between borderline personality features and physical assault and psychological aggression. However, trait anger mediated the relation between borderline personality features and psychological aggression. As such, trait anger may be an important explanatory variable in the relation between borderline personality features and psychological aggression specifically. Results of the rejection induction paradigm indicated that, for individuals who were asked to imagine an ambiguous rejection, the relation between borderline personality features and state anger post-rejection was strengthened. For individuals who imagined a critical rejection, there was no significant relation between borderline personality features and state anger post-rejection. Findings suggest that trait anger may be an important dispositional factor in the link between borderline personality features and IPV. In addition, contextual factors, such as ambiguous rejection by an intimate partner, may be especially relevant in activating anger or aggression in individuals with borderline personality features.

The effectiveness of cognitive analytic therapy for borderline personality disorder: Utilizing a withdrawal experimental design to improve sensitivity to abandonment

OBJECTIVES

A primary methodological weakness of the single-case experimental design (SCED) outcome studies conducted of the treatment of personality disorder with cognitive analytic therapy (CAT) is that they have failed to employ a withdrawal phase or cross-over design and so are deemed quasi-experimental. This study sought to implement a withdrawal design, in order to improve the internal validity of the study to make it a true SCED, and also in order to enable the patient to explore abandonment dynamics.

DESIGN

The study employed an A¹ /B¹ /A² /B² with extended follow-up SCED with a female patient treated with CAT meeting diagnostic criteria for borderline personality disorder (BPD). Following the 6-week baseline period 'A¹ ', treatment occurred in two phases (21 sessions 'B¹ ' and 24 sessions 'B² ') sandwiching a 12-week treatment withdrawal phase ('A² ') and a 24-week structured follow-up phase. Seven idiographic daily measures were collected that created a N = 698 day timeline. Nomothetic outcome measures were collected at baseline and at the end of each phase of the study, and the Session Impact Scale was completed after each treatment session.

RESULTS

There was a significant increase in the task focus of treatment sessions. Ideographically, CAT was an effective treatment for improving the participant's self-to-self relationship, as their self-hate reduced and their sense-of-self increased. There was a broad pattern of deterioration during the second treatment phase (B² ) and follow-up phase across the ideographic measures, and CAT was ineffective for BPD ideographic emotional or self-to-other measures. Reliable change occurred on the primary BPD nomothetic outcome measure from baseline to end of first treatment phase.

CONCLUSIONS

The study suggests that the CAT intervention was partially successful and that it is possible to integrate good research practice with clinical innovation. The methodological strengths and limitations of the design and the clinical implications of the results are discussed.

PRACTITIONER POINTS

Cognitive analytic therapy was partially effective in the treatment of BPD in a case that had been unresponsive to other psychological interventions. Therapists need to complete lengthy and structured follow-up to capture any emerging relapse. Therapists need to discuss the patient's thoughts and feelings about termination regularly in a relationally informed manner.

Associations Between Rejection Sensitivity, Aggression, and Victimization: A Meta-Analytic Review

BACKGROUND

Rejection sensitivity (RS) is a personality disposition characterized by oversensitivity to social rejection; individuals who are sensitive to social rejection tend to anxiously or angrily expect, readily perceive, and overreact to it. The associations between (a) RS and aggression and (b) RS and victimization have been studied in recent years. However, the strength of these associations varied considerably between studies. This review aimed to synthesize the primary literature to improve our insight into these associations.

METHOD

A comprehensive literature search yielded 52 studies (with a total of 66,405 participants and producing 203 effect sizes) on the RS-aggression and RS-victimization associations. Three-level meta-analytic models were used to synthesize effect sizes and to examine potential moderators of the RS-aggression association and the RS-victimization association, respectively.

RESULTS

There was a small but significant association between RS and aggression (pooled r = .183; p < .001) and a slightly below moderate and significant association between RS and victimization (pooled r = .298; p < .001). The RS-aggression association was stronger for angry RS than for anxious RS and stronger for reactive aggression than for proactive aggression. Similar results were obtained in analyzing the longitudinal associations only.

CONCLUSIONS

RS is significantly associated with aggression and victimization. The implications of the results for clinical practice as well as directions for future research are discussed.

Negative bias and reduced visual information processing of socio-emotional context in borderline Personality Disorder: A support for the hypersensitivity hypothesis

BACKGROUND AND OBJECTIVES

Current studies on emotional dysregulation in BPD suggest that it might be manifested by altered appraisal and biased attentional mechanisms, rather than by hyperreactivity. The aim of this study was to acquire more evidence on this topic by testing the hypothesis that BPD patients are characterized by a negative evaluation bias and reduced visual exploration in response to socio-emotional content. Moreover, the association between the previous conceptualizations and typical dysfunctional processes in BPD were evaluated.

METHODS

Fifty-four socio-emotional pictures were administered to 20 female BPD patients and 20 healthy controls (HCs) divided into three blocks characterized by different stimulus durations (500 ms, 3s, 18s). Self-reported and eye-tracking data were collected during the experiment.

RESULTS

BPD patients showed lower valence ratings and reduced visual exploration of socio-emotional pictures compared to HCs. Visual exploration in BPD was affected by exposure time with reduced exploration in response to prolonged stimuli presentation. Dysfunctional features and pre-task negative affectivity level in BPD were correlated with self-reported evaluations and eye-tracking data.

LIMITATIONS

Possible effects of gender on emotional responsivity could not be addressed given the female composition of our sample. Moreover, the role of psychiatric symptoms and medications should be addressed in future research.

CONCLUSIONS

This study presented evidence on dysfunctional mechanisms sustaining emotional dysregulation in BPD. This construct seemed supported by a well-established negative bias towards emotional stimuli together with a reduced processing of social information as manifestations of emotional hypersensitivity.

Frontline Staff Characteristics and Capacity for Trauma-Informed Care: Implications for the Child Welfare Workforce

BACKGROUND

Improved understanding of the lasting ways trauma can impact self-regulatory and relational capacities have increased calls for Trauma-Informed Care (TIC) for child welfare-involved families. Little is known, however, about how the attitudes and characteristics of frontline workers impact the implementation of TIC and job retention. This work fills an important gap in knowledge regarding the relationship between staff relational capacities, the implementation of TIC and staff retention.

OBJECTIVE

To understand the relationship between staff characteristics, endorsement of TIC and intent to turnover.

PARTICIPANTS AND SETTING

Three child and family serving agencies surveyed 271 staff from a populous Northeastern state.

METHODS

Regression analyses were used to examine the relationship between staff characteristics, Attitudes Related to Trauma Informed Care (ARTIC) score, and intent to turnover.

RESULTS

Higher levels of staff rejection sensitivity was associated with lower endorsement of Principles of Trauma-Informed Care (p < .05). Lower staff alignment with principles of TIC was associated with higher levels of intention to turnover and leave their organization (p < .05).

CONCLUSION

Staff histories of relational loss and trauma may impact both workforce buy-in and readiness to implement TIC. Therefore, identifying staff sensitivity to rejection in the hiring process or after hire, and providing specific supports, such as reflective supervision, may enhance both service delivery and staff experiences' of their work. Additionally, using the ARTIC scale in the hiring process may also reduce staff turnover and burnout. Attending to staff relational characteristics is a critical component of promoting worker resilience.

Selective suppression of rapid eye movement sleep increases next-day negative affect and amygdala responses to social exclusion

Healthy sleep, positive general affect, and the ability to regulate emotional experiences are fundamental for well-being. In contrast, various mental disorders are associated with altered rapid eye movement (REM) sleep, negative affect, and diminished emotion regulation abilities. However, the neural processes mediating the relationship between these different phenomena are still not fully understood. In the present study of 42 healthy volunteers, we investigated the effects of selective REM sleep suppression (REMS) on general affect, as well as on feelings of social exclusion, cognitive reappraisal (CRA) of emotions, and their neural underpinnings. Using functional magnetic resonance imaging we show that, on the morning following sleep suppression, REMS increases general negative affect, enhances amygdala responses and alters its functional connectivity with anterior cingulate cortex during passively experienced experimental social exclusion. However, we did not find effects of REMS on subjective emotional ratings in response to social exclusion, their regulation using CRA, nor on functional amygdala connectivity while participants employed CRA. Our study supports the notion that REM sleep is important for affective processes, but emphasizes the need for future research to systematically investigate how REMS impacts different domains of affective experience and their neural correlates, in both healthy and (sub-)clinical populations.

The Rejection Sensitivity Model as a Framework for Understanding Sexual Minority Mental Health

Sexual minorities are disproportionately affected by mental health problems (e.g., depression, anxiety, substance use disorders, suicidality). Minority stress theory and the psychological mediation framework have become the predominant conceptual models used to explain these disparities, and they have led to substantial advances in research on stigma-related stress and mental health. However, the field's reliance on these models has limited the extent to which other theories have been considered as potential frameworks for further advancing our understanding of sexual minority mental health. In this article, I discuss how the rejection sensitivity (RS) model can be used to complement and extend minority stress theory and the psychological mediation framework by: (1) emphasizing the role of perception in stigma-related experiences; (2) acknowledging the unique consequences of different anticipatory emotions; (3) describing additional mechanisms linking proximal minority stressors to mental health; and (4) further specifying the temporal order of these processes. I conclude by discussing the importance of attending to developmental processes in research on sexual orientation-related RS and describing important directions for future research.

The vicious circle of social exclusion and psychopathology: a systematic review of experimental ostracism research in psychiatric disorders

Social exclusion (ostracism) is a major psychosocial factor contributing to the development and persistence of psychiatric disorders and is also related to their social stigma. However, its specific role in different disorders is not evident, and comprehensive social psychology research on ostracism has rather focused on healthy individuals and less on psychiatric patients. Here, we systematically review experimental studies investigating psychological and physiological reactions to ostracism in different responses of psychiatric disorders. Moreover, we propose a theoretical model of the interplay between psychiatric symptoms and ostracism. A systematic MEDLINE and PsycINFO search was conducted including 52 relevant studies in various disorders (some of which evaluated more than one disorder): borderline personality disorder (21 studies); major depressive disorder (11 studies); anxiety (7 studies); autism spectrum disorder (6 studies); schizophrenia (6 studies); substance use disorders (4 studies); and eating disorders (2 studies). Psychological and physiological effects of ostracism were assessed with various experimental paradigms: e.g., virtual real-time interactions (Cyberball), social feedback and imagined scenarios. We critically review the main results of these studies and propose the overall concept of a vicious cycle where psychiatric symptoms increase the chance of being ostracized, and ostracism consolidates or even aggravates psychopathology. However, the specificity and stability of reactions to ostracism, their neurobiological underpinnings, determinants, and moderators (e.g., attachment style, childhood trauma, and rejection sensitivity) remain elusive.

Rejection Sensitivity Mediates the Relationship Between Social-Interpersonal Stressors and Depressive Symptoms in Military Context

BACKGROUND

Depression is pervasive in the military context and is likely to elicit lasting negative effects on health. Based on interpersonal models, social-interpersonal stressors are significantly associated with the development and maintenance of depression. However, little is known about the mechanisms by which these stressors increase the risk of depression in terms of social relationships. Rejection sensitivity, which refers to people who are sensitive to social rejection and tend to anxiously expect, readily perceive, and overreact to it, may play an underlying role in this process, as it is formed through social-interpersonal stressors and then aggravates further symptoms of depression.

OBJECTIVES

The current study aimed to examine the mediating effects on the relationship between social-interpersonal stressors and depressive symptoms in the military context.

METHODS

This study recruited 600 soldiers aged from 17 to 36 (M = 21.80; SD = 2.99; 100% males) with a cluster sampling method who completed Social-Interpersonal Stressors subscale, Rejection Sensitivity Questionnaire (RSQ), and Self-Rating Depression Scale (SDS). Mediation analyses examined the underlying mechanism between social-interpersonal stressors and depressive symptoms.

RESULTS

The results support the hypothesis and indicate that rejection sensitivity mediates the association between social-interpersonal stressors and depressive symptoms (B indirect = 0.02, p < 0.001, 95% CI= 0.005 to 0.044).

CONCLUSIONS

The findings suggest that interventions designed to desensitize individuals' high levels of rejection sensitivity may help to decrease their risk of depressive symptoms in the military environment. Rejection sensitivity is an important mechanism underpinning the development of depressive symptoms. Other theoretical and applied implications for prevention of depressive symptoms in the military context are discussed.

Justice sensitivity and rejection sensitivity as predictors and outcomes of eating disorder pathology: A 5-year longitudinal study

OBJECTIVE

Rejection sensitivity and justice sensitivity are personality traits that are characterized by frequent perceptions and intense adverse responses to negative social cues. Whereas there is good evidence for associations between rejection sensitivity, justice sensitivity, and internalizing problems, no longitudinal studies have investigated their association with eating disorder (ED) pathology so far. Thus, the present study examined longitudinal relations between rejection sensitivity, justice sensitivity, and ED pathology.

METHOD

Participants (N = 769) reported on their rejection sensitivity, justice sensitivity, and ED pathology at 9-19 (T1), 11-21 (T2), and 14-22 years of age (T3).

RESULTS

Latent cross-lagged models showed longitudinal associations between ED pathology and anxious rejection sensitivity, observer and victim justice sensitivity. T1 and T2 ED pathology predicted higher T2 and T3 anxious rejection sensitivity, respectively. In turn, T2 anxious rejection sensitivity predicted more T3 ED pathology. T1 observer justice sensitivity predicted more T2 ED pathology, which predicted higher T3 observer justice sensitivity. Furthermore, T1 ED pathology predicted higher T2 victim justice sensitivity.

DISCUSSION

Rejection sensitivity-particularly anxious rejection sensitivity-and justice sensitivity may be involved in the maintenance or worsening of ED pathology and should be considered by future research and in prevention and treatment of ED pathology. Also, mental health problems may increase rejection sensitivity and justice sensitivity traits in the long term.

Longitudinal association between low self-esteem and depression in early adolescents: The role of rejection sensitivity and loneliness

OBJECTIVES

Although the relation between low self-esteem and depression has been well established, little is known about the possible psychological mechanisms that account for the relation between them. Based on Beck's cognitive theory of depression, the main aim of this study was to explore the notion that rejection sensitivity and loneliness serve as mediators of the relation between low self-esteem and depression among early adolescents.

DESIGN

Using a longitudinal design, we evaluated the hypothesized model with a sample of 866 Chinese early adolescents (51% females) between 11 and 15 years old who completed questionnaires on three occasions at 1-year intervals.

RESULTS

Structural equation modelling showed that: (1) low self-esteem at Time 1 positively predicted depression at Time 3; (2) rejection sensitivity at Time 2 partially mediated the relation between low self-esteem at Time 1 and depression at Time 3; (3) low self-esteem at Time 1 demonstrated partial indirect effects on depression at Time 3 successively via rejection sensitivity and loneliness at Time 2; and (4) rejection sensitivity predicted an increase in loneliness but not vice versa, and depression accounted for later loneliness, but not for rejection sensitivity.

CONCLUSIONS

The associations between low self-esteem and depression among early adolescents may be explained by rejection sensitivity and loneliness. These results suggest implications for effective interventions for depression in early adolescents.

PRACTITIONER POINTS

Low self-esteem is a risk factor for depression in early adolescents, and rejection sensitivity and loneliness help explain the vulnerability model. Implementing empirically based intervention plans to overcome low self-esteem may be helpful in efforts to reduce depression in early adolescents. Effective interventions should likely include efforts to decrease rejection sensitivity and loneliness and their effects, such as training to interpret verbal and behavioural cues in social interactions more accurately and to develop more effective social skills to enhance social confidence.

Rejection Sensitivity, Self-Compassion, and Aggressive Behavior: The Role of Borderline Features as a Mediator

This study used mediation analyses to examine the assumption that the presence of borderline personality features mediates the relationship between rejection sensitivity (RS), self-compassion, and aggressive behavior. Sixty adults consisting of 31 participants diagnosed with borderline personality disorder and 29 participants with no diagnosis of borderline personality disorder were assessed for RS, self-compassion, aggressive behavior, and borderline personality features. Mediation was found for the total aggression score, anger score, and hostility score regarding both self-compassion and RS. Mediation was also found regarding RS and verbal and physical aggression, and regarding self-compassion and verbal and physical aggression. These findings provide evidence that the presence of borderline personality features is an important factor in explaining the associations linking RS and self-compassion to aggressive behavior. High RS and low self-compassion are associated with greater borderline personality features, which in turn relate to increased aggressive behavior.

The Sting of Rejection: Deferring Blood Donors due to Low Hemoglobin Values Reduces Future Returns

Background

Roughly one quarter of short-term temporary deferrals (STTD) of blood donors are low-hemoglobin deferrals (LHD), i.e. STTD due to a hemoglobin (Hb) value falling below a cutoff of 125 g/L for female and 135 g/L for male donors. Since voluntarily donating blood is a prosocial activity, donors may perceive deferral as social exclusion, which can cause social pain, decrease self-esteem, and lead to antisocial behavior. However, little is known about the causal impacts of LHD on donor return.

Study Design and Methods

We conducted a quasi-experiment with 80,060 donors invited to blood drives in the canton of Zurich, Switzerland, between 2009 and 2014. Within a narrow window of Hb values around the predetermined cutoff, the rate of LHD jumps discontinuously. This discontinuous jump allows us to quantify the causal effects of LHD on donor return, as it is uncorrelated with other unobserved factors that may also affect donor return.

Results

We found different behavioral reactions to LHD for female and male donors. Female donors do not react to the first LHD. However, after any repeated LHD, they are 13.53 percentage points (p <0.001) less likely to make at least 1 donation attempt within the next 18 months and make 0.389 fewer donation attempts (p <0.001). Male donors react to the first LHD. They are 5.32 percentage points (p = 0.139) less likely to make at least 1 donation attempt over the next 18 months and make 0.227 (p = 0.018) fewer donation attempts. After any repeated LHD, male donors are 13.30 percentage points (p = 0.004) less likely to make at least 1 donation attempt and make 0.152 (p = 0.308) fewer donation attempts.

Conclusion

LHD have detrimental impacts on donor return, especially if they occur repeatedly - suggesting that avoiding false LHD and helping donors to better cope with them helps to maintain the pool of prospective donors.

The link between rejection sensitivity and borderline personality disorder: A systematic review and meta-analysis

OBJECTIVE

People with Borderline Personality Disorder (BPD) may experience heightened rejection sensitivity (RS), a disposition developing from repeated childhood rejecting experiences. It is not known whether the full RS model accounts for the cognitive-affective experiences common in BPD. This systematic review extends upon previous reviews, firstly by assessing the link between childhood rejecting experiences and adult RS, and secondly by considering the link between BPD and RS in both non-clinical and clinical samples.

METHOD

Two research questions were devised, and searches based on predetermined criteria were conducted using PsycNET, PubMed, SCOPUS, and Web of Science. Data were extracted by one researcher and 20% was inter-rated, with high levels of agreement. Forty-three papers were systematically reviewed, and 31 included in meta-analysis and meta-regression.

RESULTS

Studies assessing the link between childhood rejection and RS are limited; however, emotional abuse and neglect appears linked with RS. Pooled effect sizes suggest RS is linked with BPD (r = .326), with strong effect sizes when comparing clinical and control samples (r = .655). Qualitative synthesis suggests this may be mediated by executive control, although further research is required. The small number of studies considering the full RS model with regard to BPD suggests the interaction between emotional abuse and neglect affects rejection sensitivity; however, outcomes are inconsistent.

CONCLUSIONS

Childhood rejection, particularly emotional abuse and neglect, appears to be linked to rejection sensitivity, and rejection sensitivity is linked to BPD. However, this may not be linear. Implications for clinical practice and research are discussed.

PRACTITIONER POINTS

Rejection sensitivity is consistently linked with BPD, in clinical and non-clinical samples. Supporting mentalization or improved theory of mind may offer a therapeutic target for this disposition. Considering the causes and effects of rejection sensitivity may offer a non-blaming explanation of interpersonal difficulties in BPD and could be utilized as part of formulation and the therapeutic relationship. However, the possible interaction between emotional abuse and neglect and rejection sensitivity suggests rejection sensitivity is not always apparent for people with BPD. Idiosyncratic formulation should consider this. The literature included in the review is limited to Western populations with a high proportion of females, which may limit generalizability. Measures of rejection sensitivity included in the review were restricted to self-report, which may be subject to bias. Furthermore, measures of childhood rejection were retrospective in nature due to the exclusion of child samples. Further research should consider longitudinal and observational study designs.

Trustworthiness appraisal deficits in borderline personality disorder are associated with prefrontal cortex, not amygdala, impairment

BACKGROUND

Borderline Personality Disorder (BPD) is associated with sensitivity to signals of interpersonal threats and misplaced trust in others. The amygdala, an integral part of the threat evaluation and response network, responds to both fear- and trust-related stimuli in non-clinical samples, and is more sensitive to emotional stimuli in BPD compared to controls. However, it is unknown whether the amygdalar response can account for deficits of trust and elevated sensitivity to interpersonal threat in BPD.

METHODS

Facial stimuli were presented to 16 medication-free women with BPD and 17 demographically-matched healthy controls (total n = 33). Participants appraised fearfulness or trustworthiness of the stimuli while BOLD fMRI was obtained.

RESULTS

Though BPD participants judged stimuli as less trustworthy compared to controls, trustworthiness did not correlate with amygdalar activity in either group. Trustworthiness correlated with prefrontal regional activity in the insula and lateral prefrontal cortex. Prefrontal BOLD activity while appraising trustworthiness was smaller in BPD compared to controls, and the size of the reduction was proportional to each participant's response bias.

CONCLUSIONS

Neural substrates of trustworthiness appraisal are associated with the lateral prefrontal cortex and insula, not amygdala, suggesting that untrustworthy stimuli do not elicit a subcortical threat response. Current models of BPD and its treatment may need to include a focus on improving impairments in frontally mediated trustworthiness appraisal in addition to amygdala- driven emotional hyper-reactivity.

Social Cognition and Borderline Personality Disorder: Splitting and Trust Impairment Findings

The Borderline personality disorder (BPD) diagnosis has its origins in the concept of borderline personality organization (BPO). BPO is rooted in psychoanalytic object relations theory (ORT) which conceptualizes BPD and BPO to exhibit a propensity to view significant others as either idealized or persecutory (splitting) and a trait-like paranoid view of interpersonal relations. From the ORT model, those with BPD think that they will ultimately be betrayed, abandoned, or neglected by significant others, despite periodic idealizations. This article synthesizes the extant literature splitting and trust impairments in BPD, identifies avenues for further investigation, and discusses the relative promise of different methods to evaluate these clinical processes.

Rejection sensitivity and borderline personality disorder features: A mediation model of effortful control and intolerance of ambiguity

Although past research suggests that borderline personality disorder (BPD) patients' rejection hypersensitivity may be an important factor underlying these patients' interpersonal problems, the role of cognitive factors in this association is still not well understood. The present study examined whether cognitive factors such as effortful control and intolerance of ambiguity mediated the association between rejection sensitivity and BPD features. A sample of 256 young adults completed self-report questionnaires assessing rejection sensitivity, effortful control, intolerance of ambiguity, and BPD features. Results showed that effortful control and intolerance of ambiguity mediated the association between rejection sensitivity and BPD features. The present study showed the role of cognitive aspects including both effortful control and intolerance of ambiguity in the relationship between rejection sensitivity and BPD features. However, there is a need for further research to experimentally investigate how rejection sensitivity may impact cognitive capacities in interpersonal contexts among individuals with BPD features.

Modulation of brain response to peer rejection by rejection sensitivity: An exploratory study

A number of studies have explored how rejection sensitivity (RS) affects the neural and physiological responses to stimuli with implicit rejection clues. Peer rejection during social interaction conveys explicit rejection feedback. The current event-related potentials (ERP) study using Chatroom task aimed to test to what extent RS modulated individuals' psychological and neural response to explicit rejection feedback. The subjective ratings mainly demonstrated that RS modulated ostracism distress and negative mood following rejection feedback. The ERP results showed that compared with low RS individuals, both the parietal P3 and left frontal LPP responses towards rejection feedback were enhanced in high RS individuals, indicating that high RS individuals exhibit attentional bias, intense anger experience and lower emotion regulation towards rejection suggested by their neural responses. The current study provides a new insight into neural correlates of RS in the high ecological experimental context.

Borderline Personality Disorder Features and Sensitivity to Injustice

Hypersensitivity to injustice has been proposed to contribute to interpersonal dysfunction in borderline personality disorder (BPD). We investigated whether BPD features are related to sensitivity to injustice and whether justice sensitivity mediates the relationship between BPD features and aggressive behavior. In an online survey, subjects reported justice sensitivity from the perspective of a victim, an observer, a beneficiary, and a perpetrator as well as BPD features and their own aggressive behavior. Justice sensitivity was higher in participants with a clinically relevant degree of BPD features when they evaluated injustice from the perspective of a victim or an observer. Victim sensitivity partially mediated the relationship between BPD features and the frequency of aggressive behavior. The present study provides first data on the important role of sensitivity to injustice in those with marked BPD features. Particularly, victim sensitivity with its close link to angry reactions may contribute to interpersonal problems in BPD.

Fear of Being Laughed at in Borderline Personality Disorder

Building on the assumption of a possible link between biases in social information processing frequently associated with borderline personality disorder (BPD) and the occurrence of gelotophobia (i.e., a fear of being laughed at), the present study aimed at evaluating the prevalence rate of gelotophobia among BPD patients. Using the Geloph<15> , a questionnaire that allows a standardized assessment of the presence and severity of gelotophobia symptoms, rates of gelotophobia were assessed in a group of 30 female BPD patients and compared to data gathered in clinical and non-clinical reference groups. Results indicate a high prevalence of gelotophobia among BPD patients with 87% of BPD patients meeting the Geloph<15> criterion for being classified as gelotophobic. Compared to other clinical and non-clinical reference groups, the rate of gelotophobia among BPD patients appears to be remarkably high, far exceeding the numbers reported for other groups in the literature to date, with 30% of BPD patients reaching extreme levels, 37% pronounced levels, and 20% slight levels of gelotophobia.

Can Memories of Traumatic Experiences or Addiction Be Erased or Modified? A Critical Review of Research on the Disruption of Memory Reconsolidation and Its Applications

Recent research suggests that the mere act of retrieving a memory can temporarily make that memory vulnerable to disruption. This process of "reconsolidation" will typically restabilize the neural representation of the memory and foster its long-term storage. However, the process of reconsolidating the memory takes time to complete, and during this limited time window, the original memory may be modified either by the presentation of new information or with pharmacological agents. Such findings have prompted rising interest in using disruption during reconsolidation as a clinical intervention for anxiety, posttraumatic stress, and substance use disorders. However, "boundary conditions" on memory reconsolidation may pose significant obstacles to clinical translation. The aim of this article is to critically examine the nature of these boundary conditions, their neurobiological substrates, and the potential effect they may have on disruption of reconsolidation as a clinical intervention. These boundary conditions also highlight potential constraints on the reconsolidation phenomenon and suggest a limited role for memory updating consistent with evolutionary accounts of associative learning for threat and reward. We conclude with suggestions for future research needed to elucidate the precise conditions under which reconsolidation disruption may be clinically useful.