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

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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).