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

人们认为，BPD患者普遍存在的社会排斥体验会导致严重的人际关系问题。在第一个资助期，IP1调查了该患者群体中社会排斥经历的潜在机制和行为后果。研究结果表明，在我们的样本中看到的人际关系问题主要与处理真实拒绝的改变无关，而是与处理积极的社会信号有关，特别是在社会包容和归属感领域。BPD患者经历的积极社会暗示似乎不那么强烈；对评估这些线索缺乏信心；感觉在积极和中立的社交接触中被排斥；期望从社交伙伴那里得到的积极反馈较少；不能调整自己的期望，尤其是在得到积极反馈的情况下；并且对之前被社会伙伴包括在内的陌生人的合作行为有所减少。许多这些反应的严重程度受到排斥敏感性的影响，排斥敏感性是一种认知情感倾向，在BPD患者中更高，即使在急性BPD症状缓解后也是如此。这些明显的适应不良机制可能导致普遍的归属感破坏，感觉不同和与他人分离，以及孤独感。在第二个资助期，IP1将侧重于两个目标：a)将资助期1的实验结果应用于将在随机对照试验中进行评估的基于计算机的培训干预；b)进一步研究BPD中减弱关联的病理机制。我们假设在BPD中存在基础附属过程的损伤，例如行为匹配（即模仿和同步动作）。我们将研究它们与对社会奖励的敏感性和对事件的改变预期之间的相互作用。效果将通过显性行为、心理生理参数（心率和肌电图）和神经相关（fMRI）来测量。

The pervasive experience of social exclusion in BPD is assumed to contribute to severe interpersonal problems. In the first funding period, IP1 investigated potential mechanisms and behavioral consequences of the experience of social exclusion in this patient population. The findings suggest that the interpersonal problems seen in our sample were primarily linked to alterations not in the processing of real rejection, but rather to the processing of positive valent social signals, particularly in the domain of social inclusion and the sense of belonging. It appears that BPD patients are experiencing positive social cues as less intense; are less confident in evaluating such cues; feel less included in positive and neutral social encounters; expected less positive feedback from social co-players; fail to adjust their expectancies, particularly in the case of positive feedback; and react with a decrease in cooperative behavior to unknown others when previously included by social partners. The severity of many of these reactions was influenced by rejection sensitivity, which is a cognitive-affective disposition that is higher in individuals with BPD, even after remission of acute BPD symptoms. These distinct maladaptive mechanisms may result in a pervasive disruption of the sense of belonging, in feeling different and separated from others, and in feelings of loneliness. In the second funding period, IP1 will focus on two aims: a) applying the experimental findings of funding period 1 to a computer-based training intervention that will be evaluated in a randomized controlled trial; and b) further investigation of the patho-mechanisms of attenuated affiliation in BPD. We hypothesize that in BPD there is an impairment of basal affiliative processes such as behavioral matching (i.e., mimicry and synchronized action). We will study their interplay with sensitivity to social reward and altered expectations of events. Effects will be measured by means of overt behaviors, psychophysiological parameters (heart rate and electromyography), and neural correlates (fMRI).