Rapid heartbeat, but dry palms: reactions of heart rate and skin conductance levels to social rejection

Comparing multimodal physiological responses to social and physical pain in healthy participants

Background

Previous physiology-driven pain studies focused on examining the presence or intensity of physical pain. However, people experience various types of pain, including social pain, which induces negative mood; emotional distress; and neural activities associated with physical pain. In particular, comparison of autonomic nervous system (ANS) responses between social and physical pain in healthy adults has not been well demonstrated.

Methods

We explored the ANS responses induced by two types of pain-social pain, associated with a loss of social ties; and physical pain, caused by a pressure cuff-based on multimodal physiological signals. Seventy-three healthy individuals (46 women; mean age = 20.67 ± 3.27 years) participated. Behavioral responses were assessed to determine their sensitivity to pain stimuli. Electrocardiogram, electrodermal activity, photoplethysmogram, respiration, and finger temperature (FT) were measured, and 12 features were extracted from these signals.

Results

Social pain induced increased heart rate (HR) and skin conductance (SC) and decreased blood volume pulse (BVP), pulse transit time (PTT), respiration rate (RR), and FT, suggesting a heterogeneous pattern of sympathetic-parasympathetic coactivation. Moreover, physical pain induced increased heart rate variability (HRV) and SC, decreased BVP and PTT, and resulted in no change in FT, indicating sympathetic-adrenal-medullary activation and peripheral vasoconstriction.

Conclusion

These results suggest that changes in HR, HRV indices, RR, and FT can serve as markers for differentiating physiological responses to social and physical pain stimuli.

Evidence of deviant parasympathetic response to social exclusion in women with borderline personality disorder

Stressful social situations like social exclusion are particularly challenging for patients with borderline personality disorder (BPD) and often lead to dysfunctional reactive behaviour of aggression and withdrawal. The autonomous signature of these core symptoms of BPD remains poorly understood. The present study investigated the parasympathetic response to social exclusion in women with BPD (n = 62) and healthy controls (HC; n = 87). In a between-subjects design, participants experienced objective social exclusion or overinclusion in the Cyberball task, a virtual ball-tossing game. Need threat scores served as individual measures of perceived exclusion and the resulting frustration of cognitive-emotional needs. Five-minute measurements of high-frequency heart rate variability (HF-HRV) at three time points (before, during, after Cyberball) indicated parasympathetic tone and regulation. We observed a trend towards lowered baseline HF-HRV in BPD vs. HC in line with previous findings. Interestingly, the parasympathetic response of patients with BPD to objective and perceived social exclusion fundamentally differed from HC: higher exclusion was associated with increased parasympathetic activation in HC, while this autonomic response was reversed and blunted in BPD. Our findings suggest that during social stress, the parasympathetic nervous system fails to display an adaptive regulation in patients with BPD, but not HC. Understanding the autonomous signature of the stress response in BPD allows the formulation of clinically relevant and biologically plausible interventions to counteract parasympathetic dysregulation in this clinical group.

Poverty, Somatisation Tendency and Potency in Low-Income Adolescent Groups of India and Israel: Explorations from the Field

Poverty increases vulnerability towards somatisation and influences the sense of mastery and well-being. The present study on adolescents living in relative poverty in a high-income group country (Israel) and a low-middle-income group country (India) explored the nature of somatisation tendency (ST) and its relationship with potency and perception of poverty (PP). Potency, a buffer against stress-induced negative health effects, was hypothesized to be negatively related to ST and mediate the link between PP and ST. Purposive sampling was used to collect questionnaire-based data from community youth (12-16 years) of two metropolitan cities-Kolkata (India, N = 200) and Tel-Aviv (Israel, N = 208). The nature of ST, PP and potency was analysed using descriptive and inferential statistics and correlation-regression statistics and mediation analysis were used to understand the relationship among them. A clinically significant level of ST was reported by both Indian and Israeli youth experiencing 5-7 somatic symptoms on average. Potency was found to be a significant predictor of ST in both countries (p < 0.05) and emerged as a significant mediator (p < 0.001) in the PP and ST relationship among Indian adolescents. The present study highlights potency as a protective buffer in economically vulnerable community adolescents and re-establishes a high prevalence of ST among them, irrespective of their country's global economic position.

Watching with Argus eyes: Characterization of emotional and physiological responding in adults exposed to childhood maltreatment and/or recent adversity

Exposure to adverse experiences is a well-established major risk factor for affective psychopathology. The vulnerability of deleterious sequelae is assumed in maladaptive processes of the defensive system, particularly in emotional processing. More specifically, childhood maltreatment has been suggested to be associated with the recruitment of specific and distinct defensive response profiles. To date, it remains unclear whether these are specific or generalizable to recent adversity in adulthood. This pre-registered study aimed to investigate the impact of exposure to childhood and recent adversity on emotional processing in 685 healthy adults with the "Affective Startle Modulation" Paradigm (ASM). First, we replicated higher trait anxiety and depression levels in individuals exposed to both types of adversity. Second, we observed increased general skin conductance reactivity in individuals exposed to recent adversity. Third, individuals exposed to childhood maltreatment showed reduced, while individuals exposed to recent adversity showed increased discrimination between pictures of negative and neutral valence, compared with non-exposed individuals in SCR. No association between exposure to adversity and fear potentiated startle was observed. Furthermore, explorative analyses revealed moderate dimensional and categorical agreement between two childhood maltreatment questionnaires and provide insight into potential adversity-type specific effects. Our results support experience-dependent plasticity in sympathetic nervous system reactivity and suggest distinct response profiles in affective modulation in individuals exposed to early versus recent adversity. We emphasize the need to further explore distinct adversity profiles to further our understanding on specific psychophysiological profiles and their potential implication for prevention and intervention.

Wearables in sociodrama: An embodied mixed-methods study of expressiveness in social interactions

This mixed-methods study investigates the use of wearable technology in embodied psychology research and explores the potential of incorporating bio-signals to focus on the bodily impact of the social experience. The study relies on scientifically established psychological methods of studying social issues, collective relationships and emotional overloads, such as sociodrama, in combination with participant observation to qualitatively detect and observe verbal and nonverbal aspects of social behavior. We evaluate the proposed method through a pilot sociodrama session and reflect on the outcomes. By utilizing an experimental setting that combines video cameras, microphones, and wearable sensors measuring physiological signals, specifically, heart rate, we explore how the synchronization and analysis of the different signals and annotations enables a mixed-method that combines qualitative and quantitative instruments in studying embodied expressiveness and social interaction.

Spontaneous Breathing Rate Variations Linked to Social Exclusion and Emotion Self-assessment

The emotional reactions to social exclusion can be associated with physiological responses that could allow researchers to estimate the valence and intensity of the ongoing affective state. In this work, respiratory activity was analysed to verify whether breathing rate variations can be considered as predictive factors of subsequent positive and negative affect after inclusion and exclusion in young women. A standard Cyberball task was implemented and manipulated information was provided to the participants to create both conditions. The participants were socially excluded by limiting their participation to 6% of the total number of passes among three teammates and providing negative feedback about them. The results suggest that breathing rate can be a good option to infer subjective feelings during social interactions and a promising feature to incorporate into modern emotion monitoring systems as an alternative to other physiological measures. Furthermore, the interaction between metaemotion and physiology was studied by recording breathing rate while completing the Positive and Negative Affect Schedule, evidencing a breathing rate increase during the emotion self-assessment only after exclusion.

Targeted Memory Reactivation During REM Sleep in Patients With Social Anxiety Disorder

BACKGROUND

Social anxiety disorder (SAD) is characterized by a significant amount of fear when confronted to social situations. Exposure therapy, which is based on fear extinction, does not often lead to full remission. Here, based on evidence showing that rapid eye movement (REM) sleep promotes the consolidation of extinction memory, we used targeted memory reactivation (TMR) during REM sleep to enhance extinction learning in SAD.

METHODS

Forty-eight subjects with SAD were randomly assigned to two groups: control or TMR group. All patients had two successive exposure therapy sessions in a virtual reality (VR) environment, where they were asked to give a public talk in front of a virtual jury. At the end of each session, and only in the TMR group (N = 24), a sound was paired to the positive feedback phase of therapy (i.e., approval of their performance), which represented the memory to be strengthened during REM sleep. All participants slept at home with a wearable headband device which automatically identified sleep stages and administered the sound during REM sleep. Participants' anxiety level was assessed using measures of parasympathetic (root mean square of successive differences between normal heartbeats, RMSSD) and sympathetic (non-specific skin conductance responses, ns-SCRs) activity, and subjective measures (Subjective Units of Distress Scale, SUDS), during the preparation phase of their talks before (T1) and after (T2) one full-night's sleep and after 1 week at home (T3). Participants also filled in a dream diary.

RESULTS

We observed an effect of time on subjective measures of anxiety (SUDS). We did not find any difference in the anxiety levels of the two groups after 1 week of TMR at home. Importantly, the longer the total duration of REM sleep and the more stimulations the TMR group had at home, the less anxious (increased RMSSD) these participants were. Finally, fear in dreams correlated positively with ns-SCRs and SUDS at T3 in the TMR group.

CONCLUSION

TMR during REM sleep did not significantly modulate the beneficial effect of therapy on subjective anxiety. Yet, our results support that REM sleep can contribute to extinction processes and substantiate strong links between emotions in dreams and waking stress levels in these patients.

Autonomic changes as reaction to experimental social stress in an inpatient psychosomatic cohort

OBJECTIVES

Patients with psychosomatic disorders suffer from social isolation that might further lead to destabilization and exacerbation of bodily symptoms via autonomic pathways. We aimed to investigate the influence of controlled social stress (model of social ostracism) on the autonomic nerve system (ANS) in an inpatient cohort with psychosomatic disorders.

METHODS

We examined heart rate variability (HRV), skin conductance (SC) and skin temperature (ST) as well as ECG-derived respiration rate (EDR) and subjective reports on stress during exposure to experimental social stress (cyberball game). Data were collected from 123 participants (f:m = 88:35, 42.01 ± 13.54 years) on admission and upon discharge from the university psychosomatic clinic. All data were recorded during baseline, inclusion and exclusion phases of the cyberball game as well as during the recovery phase.

RESULTS

We found significant changes between admission and discharge with a decline in parasympathetic-related HRV parameters (SDRR -3.20 ± 1.30 ms, p = 0.026; RMSSD: -3.77 ± 1.28 ms, p = 0.007) as well as a decrease in SC (-0.04 ± 0.17 μS, p = 0.019) and EDR (-0.01 ± 0.01 Hz, p = 0.007), suggesting a drop in sympathetic tonus, with no changes in ST (p = 0.089) and subjective stress levels (p = 0.322). HRV parameters decreased during the cyberball game (SDRR p = 0.026; RMSSD p = 0.002; lnHF p < 0.001). In contrast, both SC (p < 0.001) and EDR (p < 0.001) increased during the game with SC being slightly lower during the exclusion phase. This can point toward a stimulation of sympathetic nervous system during game participation, which was concordant with the rise in subjective stress values (p < 0.001). ST showed a continuous, unspecific rise over time (p < 0.001).

CONCLUSION

Our data demonstrate the decrease of ANS parameters during experimental social stress when data upon discharge were compared to those upon admission. These results are partially contradictory to previous studies that showed a rise in HRV in a psychiatric cohort over the course of (outpatient) treatment. Further research is required to help attributing these differences to effects of treatment or acute states relating to admission to or discharge from a psychosomatic department.

The Paradox of Fiction Revisited-Improvised Fictional and Real-Life Social Rejections Evoke Associated and Relatively Similar Psychophysiological Responses

Theatre-based practices, such as improvisation, are frequently applied to simulate everyday social interactions. Although the improvisational context is acknowledged as fictional, realistic emotions may emerge, a phenomenon labelled the 'paradox of fiction'. This study investigated how manipulating the context (real-life versus fictional) modulates psychophysiological reactivity to social rejection during dyadic interactions. We measured psychophysiological responses elicited during real-life (interview) and fictional (improvisation exercises) social rejections. We analysed the heart rate (HR), skin conductance, facial muscle activity, and electrocortical activity (electroencephalographic (EEG) alpha asymmetry) of student teachers (N = 39) during various social rejections (devaluing, interrupting, nonverbal rejection). All social rejections evoked negative EEG alpha asymmetry, a measure reflecting behavioural withdrawal motivation. Psychophysiological responses during real-life and fictional rejections correlated, and rejection type modified the responses. When comparing responses across all rejection types, facial muscle activity and EEG alpha asymmetry did not differ between real-life and fictional rejections, whereas HR decelerated and skin conductance increased during fictional rejections. These findings demonstrate that regardless of cognitive awareness of fictionality, relatively subtle social rejections elicited psychophysiological reactivity indicating emotional arousal and negative valence. These findings provide novel, biological evidence for the application of theatre-based improvisation to studying experientially everyday social encounters.

Numbers (but not words) make math anxious individuals sweat: Physiological evidence

The study aimed to determine the specificity of math anxiety by measuring physiological arousal to the presentation of numerical and non-numerical stimuli. It also investigated whether math and trait anxieties share similar behavioral and physiological manifestations. Fifty-two female university students performed an experimental task including simple or complex arithmetical equations and math-related or neutral words. Participants' electrodermal activity (skin conductance response) was monitored during the task. Math and trait anxieties were measured using common explicit questionnaires. Results showed math anxiety levels were significantly related to physiological arousal during the performance of complex numerical tasks. Importantly, math anxiety significantly mediated the links between trait anxiety and physiological arousal in complex numerical tasks. The findings support previous work finding relations between math and trait anxieties, but also show math anxiety is a unique phenomenon with specific behavioral and physiological manifestations, especially during the processing of complex numerical information.

Cardiac parasympathetic activity in female patients with borderline personality disorder predicts approach/avoidance behavior towards angry faces

Among other features, Borderline Personality Disorder (BPD) is characterized by difficulties in regulating affiliative behavior. Here, we examined the association of heart rate variability (HRV) with approach/avoidance behavior in BPD. Accordingly, HRV parameters (RMSSD and HF-HRV) were measured in 42 female patients with BPD and 50 controls before performing an Approach Avoidance Task (AAT). Half of participants were previously exposed to social exclusion in a virtual ball-tossing game. Overall, HRV was lower in patients with BPD compared to controls. Moreover, low HRV was associated with attenuated approach for angry faces with an averted gaze. Following social exclusion, the BPD group showed the largest approach to happy faces and the least approach for angry faces, a pattern which differed from controls and patients in the control condition. Our findings indicate an association of cardiac parasympathetic activity with social behavior. Moreover, social exclusion may foster avoidance of angry faces in BPD patients.

Distress and retaliatory aggression in response to witnessing intergroup exclusion are greater on higher levels of collective narcissism

The negative consequences of personal exclusion have been demonstrated by multiple studies. Less is known about the consequences of witnessing one's own group being excluded by other groups, although studies suggest exclusion can be experienced vicariously and negatively affects members of the excluded group. Results of the present lab‐based experiment (N = 153) indicate, in line with our predictions, that witnessing intergroup exclusion (a national majority excluded by a minority, manipulated by an adapted intergroup Cyberball paradigm) produced a sense of personal exclusion. It also increased self‐reported distress and behavioral aggression measured in the Taylor Aggression Paradigm), especially among participants high on collective narcissism: a belief that the exaggerated greatness of the in‐group is not sufficiently appreciated by others. Contrary to expectations, a short mindful decentration intervention (instructing participants to observe thoughts and emotions as transient mental products without engaging with them) delivered while participants were witnessing intergroup exclusion (vs. inclusion) produced changes in heart rate variability reactivity indicative of emotional arousal, especially among collective narcissists. We concluded that collective narcissism is associated with distress in the face of intergroup exclusion, aggressive retaliation, and in consequence, it is a risk‐factor predisposing group members to stress‐related health and psychosocial problems. Furthermore, a mindful decentration, despite being an effective strategy to reduce maladaptive stress in most people, may be counterproductive in addressing high collective narcissists' responses to threat to the in‐group's image.

This study demonstrated that mindfulness‐based interventions may not mitigate, but rather exacerbate the distressing effects of observed intergroup exclusion in individuals scoring high on collective narcissism. The finding was observed on the psychophysiological level (HF HRV), but not on the psychological level (self‐reported distress), indicating that individuals high in collective narcissism may not consciously perceive, or choose to report their stronger reactions occurring after a mindfulness‐based intervention.

Healthcare Workers and COVID-19-Related Moral Injury: An Interpersonally-Focused Approach Informed by PTSD

The COVID-19 pandemic has resulted in a still-unfolding series of novel, potentially traumatic moral and ethical challenges that place many healthcare workers at risk of developing moral injury. Moral injury is a type of psychological response that may arise when one transgresses or witnesses another transgress deeply held moral values, or when one feels that an individual or institution that has a duty to provide care has failed to do so. Despite knowledge of this widespread exposure, to date, empirical data are scarce as to how to prevent and, where necessary, treat COVID-19-related moral injury in healthcare workers. Given the relation between moral injury and post-traumatic stress disorder (PTSD), we point here to social and interpersonal factors as critical moderators of PTSD symptomology and consider how this knowledge may translate to interventions for COVID-19-related moral injury. Specifically, we first review alterations in social cognitive functioning observed among individuals with PTSD that may give rise to interpersonal difficulties. Drawing on Nietlisbach and Maercker's 2009 work on interpersonal factors relevant to survivors of trauma with PTSD, we then review the role of perceived social support, social acknowledgment and social exclusion in relation to potential areas of targeted intervention for COVID-19-related moral injury in healthcare workers. Finally, building on existing literature (e.g., Phoenix Australia-Centre for Posttraumatic Mental Health and the Canadian Centre of Excellence-PTSD, 2020) we conclude with individual and organizational considerations to bolster against the development of moral injury in healthcare workers during the pandemic.

Investigating Reflexive Responses to Explicit and Implicit Forms of Social Exclusion Using Immersive Virtual Environment Technology

Humans are strongly affected by social exclusion, a multifaceted and complex phenomenon of social life. However, individuals tend to respond differently depending on a multitude of individual and contextual factors. Firstly, with a view to increasing the ecological validity and experimental control of an exclusion manipulation in the laboratory setting, we made use of immersive virtual environment technology (IVET; an Oculus Rift Virtual Reality headset) to create a new exclusion paradigm. Secondly, given that a recent meta-analytic report on reflexive responses (i.e., affect and physiology) to manipulations of exclusion in the laboratory setting cites inconsistencies across findings (Blackhart et al., 2009), we focused on the form of exclusion manipulated to illustrate how this factor may help to explain the divergences in responses. We thus investigated how explicit and implicit forms of social exclusion may have a differential impact on self-reported affect, as well as on electrodermal and cardiovascular activity. Results from this laboratory study conducted with a varied sample of the local population made salient the affordances of IVET as a tool in exclusion research. They also helped to reconcile the conflicting findings in the literature relating to differences in the level of negative affect generated and shed light on physiological arousal in the wake of being excluded in different ways.

Understanding loneliness in the twenty-first century: an update on correlates, risk factors, and potential solutions

PURPOSE

Loneliness is increasingly recognised as the next critical public health issue. A plausible reason for this concern may be related to emerging societal trends affecting the way we relate, communicate, and function in our social environment. In 2006, a prominent review of the clinical significance of loneliness was published. However, there has not been a comprehensive update on known and emerging risk factors and correlates of loneliness since then. Furthermore, there is no conceptual model that has been developed to better account for the complexity of loneliness and to inform the development of evidence-based solutions as we challenge the issues of the twenty-first century.

METHODS

We reviewed the current literature to identify either known or emerging risk factors and correlates of loneliness since 2006. This includes new or known evidence on: (1) demography; (2) health, including physical health; mental health; cognitive health; brain, biology, and genetics; and (3) socio-environmental factors including digital communication and the workplace.

RESULTS

We synthesized the literature according to a new proposed conceptual model of loneliness which showed the interplay between known and emerging correlates and risk factors from demography, health, to socio-environmental factors. In the conceptual model of loneliness, we illustrated how solutions can be delivered and tailored to an individual based on their life circumstances and preferences.

CONCLUSION

We concluded by making specific recommendations in advancing our scientific understanding of loneliness. Our knowledge can only be deepened if we increase scientific rigour via accounting for confounding variables and using longitudinal, multi-disciplinary, and multiple methodologies in research. We also call for the rigorous evaluation of programs targeting loneliness.

Bodily sensations in social scenarios: Where in the body?

Bodily states are fundamental to emotions’ emergence and are believed to constitute the first step in the chain of events that culminate in emotional awareness. Recent works have shown that distinct topographical maps can be derived to describe how basic and more complex emotions are represented in the body. However, it is still unclear whether these bodily maps can also extend to emotions experienced specifically within social interactions and how these representations relate to basic emotions. To address this issue, we used the emBODY tool to obtain high-resolution bodily maps that describe the body activation and deactivation experienced by healthy participants when presented with social scenarios depicting establishment or loss of social bonds. We observed patterns of activation/deactivation for each single social scenario depending on the valence, but also a common activation of head, chest and deactivation of limbs for positive and negative social scenarios, respectively. Furthermore, we show that these maps are comparable to those obtained when taking the perspective of a third person, suggesting the existence of common body representation of social emotions for the self and other person evaluation. Finally, we showed that maps related to complex social scenarios are strongly correlated with bodily states experienced in basic emotions, suggesting that the patterns of body activation/deactivation observed for social scenarios might arise from a complex interaction of the basic emotions that these experiences elicit.

Does perceived ostracism contribute to mental health concerns among veterans who have been deployed?

Posttraumatic stress-negative psychological experiences as a result of traumatic stressors-can hinder military veterans' reintegration into society and cause various mental health problems. Veterans need quality social relationships to facilitate reintegration and to cope with posttraumatic stress and related mental health problems; discrimination or other forms of interpersonal rejection can exacerbate these veterans' problems. Ostracism (i.e., being ignored and excluded) is a painful and psychologically distressing experience that may be one factor that contributes to the problems of veterans who are dealing with posttraumatic stress. To our knowledge, this connection has yet to be tested empirically. Thus, we investigated the correlation between posttraumatic stress, perceived ostracism, and other theoretically relevant variables (i.e., mental health problems, perceived social support, psychological need satisfaction) in a sample of veterans who have had at least one deployment. Our results provide preliminary empirical evidence suggesting that perceived ostracism may contribute to veteran' deployment-related psychological problems. Veterans' perceived ostracism correlated with psychological problems (i.e., posttraumatic stress symptoms, anxiety and psychological distress), and it explained additional variance in posttraumatic stress symptoms above and beyond common predictors of these symptoms (i.e., deployment stress, perceived military and civilian-based social support). Finally, perceived ostracism emerged as the most important predictor of posttraumatic stress symptoms in a relative weights analysis.

Attachment buffers the physiological impact of social exclusion

Attachment systems facilitate coping with stress, with previous studies demonstrating attachment figures diminishing subjective, behavioral and neural responses to social pain. Yet little is known about the physiological mechanisms governing this benefit in the context of social exclusion. This study investigated the impact of attachment (vs non-attachment) priming on affective and cardiovascular responses to social exclusion induced by the computerized “Cyberball” ball-tossing game, and the moderating influence of individual differences in attachment style, rejection sensitivity and self-construal. No significant change in high frequency heart rate variability (HF-HRV)–an index of parasympathetic activity and cardiovagal balance–was observed across the time course in the attachment priming condition, whereas the non-attachment condition showed significant fluctuation in HF-HRV–increasing during Cyberball and decreasing relative to baseline during recovery. Moreover, the benefit afforded by attachment priming on was enhanced amongst participants with lower rejection sensitivity and higher collectivistic self-construal, and those with higher anxious attachment style in the non-attachment prime group showed a trend towards increased HF-HRV during the Cyberball. Results are consistent with Social Baseline Theory, which argues that social proximity–particularly from attachment figures–protects against the metabolic costs associated with strong reactions to stress, including the preservation of cardiovagal homeostasis in this instance. Social attachments may provide an important mechanism to increase adaptive responding to the distressing experience of social exclusion.

Don't judge me: Psychophysiological evidence of gender differences to social evaluative feedback

Human beings have a basic need for esteemed social connections, and receiving negative self-evaluative feedback induces emotional distress. The aim of the current study is to measure eye movements (a physiological marker of attention allocation) and pupillary responses (a physiological marker of cognitive and emotional processing) as online and objective indices of participants' reaction to positive/negative social evaluations from the same or opposite sex. Following the paradigm, subjective mood ratings and heart rate variability (HRV) - as an objective index of regulatory effort- were measured. Results demonstrate clear gender-specific results in all measures. Eye-movements demonstrate that male participants respond more with other-focused attention (and specifically to male participants), whereas women respond more with self-focused attention following negative social evaluative feedback. Pupillary responses show that social evaluative feedback is specifically eliciting cognitive/affective processes in male participants to regulate emotional responses when provided by the opposite gender. Finally, following the paradigm, female (as compared to male) participants were more subjectively reactive to the paradigm (i.e., self-reports), and were less able to engage contextual- and goal related regulatory control of emotional responses (reduced HRV). Although the current study focused on psychiatrically healthy young adults, results may contribute to our understanding of sex differences in internalizing mental problems, such as rumination.

Examining HIV-Related stigma in relation to pain interference and psychological inflexibility among persons living with HIV/AIDS: The role of anxiety sensitivity

Pain is highly prevalent among people living with HIV (PLHIV). Although the association between stigma and pain among stigmatized individuals has been well-established in the non- HIV chronic pain literature, little is known about the association between stigma and pain among PLHIV and the mechanisms that underlie this association. The present study examined the indirect effect of HIV stigma and pain via anxiety sensitivity (fear of anxiety symptoms). The sample included 97 PLHIV (60.2% male, M_age = 48.40, SD = 7.75). Results indicated significant and medium-sized indirect effects of HIV stigma on pain severity, pain interference, and psychological inflexibility in pain via anxiety sensitivity. Alternative models did not yield significant indirect effects. The results suggest anxiety sensitivity may explain the association between stigma and pain among PLHIV. These findings provide novel empirical insight into the nature of stigma-pain relation among PLHIV and could be used to guide pain-based intervention development for this population.

Parasympathetic cardio-regulation during social interactions in individuals with obesity-The influence of negative body image

Individuals with obesity in Western societies often face weight-related stigmatization and social exclusion. Recurrent exposure to prejudice and negative social feedback alters one's behavior in future social interactions. In this study, we aimed to investigate autonomic nervous system and affective responses to social interactions in individuals with obesity. Women and men with (n = 56) and without (n = 56) obesity participated in episodes of social inclusion and social exclusion using a virtual ball-tossing game. During the experiment, heart rate was measured and parasympathetic activity (overall high-frequency power and event-related cardiac slowing) was analyzed. Our results show that in novel social interactions, women with obesity, relative to the other groups, exhibited the strongest increase in parasympathetic activity. Furthermore, parasympathetic activity was related to a more negative body image in individuals with obesity, but not in lean individuals. Additionally, women with obesity reported a stronger decrease in mood after social exclusion than did the other participants. Our results demonstrate influences of objective and subjective bodily characteristics on parasympathetic cardio-regulation during social interactions. In particular, they show behavioral and physiological alterations during social interactions in women with obesity.

Reduced Cortisol Output during Public Speaking Stress in Ostracized Women

Ostracism (being excluded or ignored) is experienced as unpleasant and distressing. In previous studies, an immediate pre-stress experience of ostracism induced by Cyberball, a virtual ball-tossing game, was found to inhibit cortisol reactivity to public speaking stress in female students. The present study examines whether the effect will persist when a 15-min time gap between the Cyberball experience and subsequent psychological stress is introduced. N = 84 women were randomly assigned to Cyberball ostracism vs. inclusion. 15 min after playing Cyberball, all women were subjected to public speaking stress. Salivary cortisol and mood were repeatedly assessed during the course of the experiment. These are the main findings of the study: Repeated measures ANCOVA revealed that public speaking stress resulted in a significant increase of cortisol in both groups (inclusion vs. ostracism). However, cortisol levels were significantly lower in the ostracism group. In earlier studies when Cyberball was played immediately before public speaking stress, the cortisol response to public speaking was completely suppressed in ostracized women. By introducing a waiting period between Cyberball and public speaking stress in the present study, the main effect of an ostracism induced reduction of cortisol remained, although both groups showed an increase of cortisol as a response to public speaking. These results again suggest that the experience of ostracism might inhibit hypothalamic-pituitary-adrenal (HPA) axis activity, thereby confirming previous results. The formerly observed total suppression of HPA axis responsiveness to public speaking, however, seems to be a rather short-term effect.

To be spurned no more: The affective and behavioral consequences of social and nonsocial rejection

Social pain is often associated with social rejection and shares neural correlates with the bothersome aspect of physical pain, which may also indicate an overlap in function. Pain has been described as a motivational signal to respond to the source of the pain in an adaptive way, such as by altering behavior. We tested whether social pain causes similarly adaptive alterations in behavior. Participants played computerized ball-tossing tasks with putative players-one who passed to and one who excluded the participant from play-in both a social and nonsocial version. We assessed the behavioral consequences of social pain by comparing the number of throws to each stimulus (social rejector vs. nonsocial rejector) over the course of the task. Posttask questionnaires assessed subjective feelings of social pain. A decrease in throws to the rejecting stimulus was only observed in the social version, indicating that rejection that is social in nature leads to change in behavior. Moreover, participants reported more negative feelings toward the rejecting stimulus in the social than in the nonsocial version. These subjective feelings of social pain mediated the effect of version of the game (social vs. nonsocial) on changes in behavior, indicating that social pain from social rejection causes changes in behavior.

fMRI Study of Social Anxiety during Social Ostracism with and without Emotional Support

Social anxiety is characterized by an excessive fear of being embarrassed in social interactions or social performance situations. Emotional support can help to decrease or diminish social distress. Such support may play an important role at different points of social interaction. However, it is unclear how the beneficial effects of social support are represented in the brains of socially anxious individuals. To explore this, we used the same paradigm previously used to examine the effects of emotional support on social pain caused by exclusion. Undergraduates (n = 46) showing a wide range of social anxiety scores underwent functional magnetic resonance imaging (fMRI) while participating in a Cyberball game. Participants were initially included and later excluded from the game. In the latter half of the session in which participants were excluded, they were provided with supportive messages. In line with our previous work, we found that social exclusion led to increased anterior cingulate cortex (ACC) activity, whereas emotional support led to increased left dorsolateral prefrontal cortex (DLPFC) activity. Despite validation of the paradigm, social anxiety was not associated with increased ACC activity during social exclusion, or during perceived emotional support. Instead, fear of negative evaluation as assessed by the Brief Fear of Negative Evaluation (BFNE) scale showed positive associations with left DLPFC activation while receiving emotional support, compared to while being socially excluded. The more socially anxious an individual was, the greater was the left DLPFC activity increased during receipt of messages. This suggests that highly socially anxious people still have the ability to perceive social support, but that they are nevertheless susceptible to negative evaluation by others.

Effects of social exclusion on emotions and oxytocin and cortisol levels in patients with chronic depression

OBJECTIVE

Patients with chronic depression (CD) experience a high burden of disease, severe co-morbidity, and increased mortality. Although interpersonal dysfunction is a hallmark of CD, the underlying mechanisms are largely unexplored. Oxytocin (OT) has been proposed to play a crucial role in the social deficits of mental disorders and has been found to be dysregulated after social exclusion (ostracism) in patients with borderline personality disorder. This study investigated how social exclusion affects emotions, OT levels, and cortisol (CT) levels in CD patients.

METHOD

Twenty-one patients diagnosed with CD and 21 healthy controls (HC) matched for gender, age, and education underwent repeated neuroendocrine measurements in a standardized laboratory setting while playing Cyberball, a virtual ball-tossing game that mimics a social exclusion situation. Emotional reactions, plasma OT and cortisol levels were assessed at baseline and 5, 15, and 40 min after Cyberball.

RESULTS

At baseline, there were no group differences in OT levels. Immediately after playing Cyberball, plasma OT levels showed divergent changes in CD patients and HC; the difference in direction of change was significant with a reduction in CD patients compared to HC (p = .035*); CT levels did not differ between groups at any time point, but decreased over time. Patients showed more threatened emotional needs and increased negative emotions, especially anger and resentment, and showed higher sensitivity to ambiguous threat of social exclusion than healthy controls.

CONCLUSIONS

CD patients react to ostracism with pronounced negative emotions. The reduction in OT levels in CD patients after social exclusion may contribute to their interpersonal dysfunction and their difficulty in coping adequately with aversive social cues.