Neurobiological and Psychological Reaction Patterns in Response to Social Rejection in BPD
Final Report Abstract
Feelings of loneliness, of being different from others, as well as fear of abandonment and social rejection are core features of BPD. In the present project, we investigated impairments in the sense of belonging by self-report questionnaires and experimental approaches. BPD patients characterize themselves in self-report questionnaires as experiencing extremely high levels of loneliness, i.e. of a strong discrepancy between desired and actually existing social connectedness. While the social networks of BPD patients are indeed smaller and less diverse as those of healthy individuals, experimental studies suggest that in standardised social interaction situations BPD patients feel less included and expect less social acceptance. We identified cognitive biases in different experimental settings. All of these suggest that BPD patients process social cues in a biased way when they are signaling a willingness of others to form affiliations: they expect to be rejected in theoretical scenarios as well as following standardised social situations, they judge happiness in facial expressions as less intense, they fail to integrate positive information about people into their judgements when provided by others, and they feel less confident in their own ability to assess such cues. While these alterations may lead to deficits in appreciating positive social encounters, they also affect the patients’ behaviour. Linked to increasing levels of loneliness, we observed a reduction in basal affiliative behaviours such as behavioural imitation in BPD. Moreover, the violation of negative expectations by positive social feedback regarding the acceptance by others led to a reduction of cooperative behaviour. This was particularly true when the social partner behaved – according to general norms – fair. Altered norms about fairness may together with increased concerns about injustice contribute to these alterations. In line with the reduced sense of belonging in BPD, our findings suggest consistently that impairments of social cognition are most prominent for the processing of positive social signals. By their effects on behaviour, these biases may contribute to interpersonal impairments and the stabilisation of subjectively perceived as well as objectively existing social isolation, i.e. in a vicious circle of loneliness. Building on these findings, we designed a computer-assisted social-cognitive trainings program for which first findings suggest that it improves the detection and appreciation of positive social cues as prerequisite to break through loneliness.
Publications
- (2013). Cerebral processing of social rejection in patients with borderline personality disorder. Social Cognitive and Affective Neuroscience, 9(11), 1789-1797
Domsalla, M., Koppe, G., Niedtfeld, I., Vollstädt-Klein, S., Schmahl, C., Bohus, M., & Lis, S.
(See online at https://doi.org/10.1093/scan/nst176) - (2013). Social interaction in borderline personality disorder. Current Psychiatry Reports, 15(2), 338
Lis, S., & Bohus, M.
(See online at https://doi.org/10.1007/s11920-012-0338-z) - (2014). Mechanisms of disturbed emotion processing and social interaction in borderline personality disorder: State of knowledge and research agenda of the German Clinical Research Unit. Borderline Personality Disorder and Emotion Dysregulation, 1(1), 12
Schmahl, C., Herpertz, S. C., Bertsch, K., Ende, G., Flor, H., Kirsch, P., . . . Bohus, M.
(See online at https://doi.org/10.1186/2051-6673-1-12) - (2015). Negative evaluation bias for positive self-referential information in borderline personality disorder. PLOS ONE, 10(1), e0117083
Winter, D., Herbert, C., Koplin, K., Schmahl, C., Bohus, M., & Lis, S.
(See online at https://doi.org/10.1371/journal.pone.0117083) - (2015). Pain processing after social exclusion and its relation to rejection sensitivity in borderline personality disorder. PLOS ONE, 10(8), e0133693
Bungert, M., Koppe, G., Niedtfeld, I., Vollstädt-Klein, S., Schmahl, C., Lis, S., & Bohus, M.
(See online at https://doi.org/10.1371/journal.pone.0133693) - (2015). Rejection sensitivity and symptom severity in patients with borderline personality disorder: Effects of childhood maltreatment and self-esteem. Borderline Personality Disorder and Emotion Dysregulation, 2(1), 4
Bungert, M., Liebke, L., Thome, J., Haeussler, K., Bohus, M., & Lis, S.
(See online at https://doi.org/10.1186/s40479-015-0025-x) - (2016). Confidence in facial emotion recognition in borderline personality disorder. Personality Disorders: Theory, Research, and Treatment, 7(2), 159-168
Thome, J., Liebke, L., Bungert, M., Schmahl, C., Domes, G., Bohus, M., & Lis, S.
(See online at https://doi.org/10.1037/per0000142) - (2016). Evaluation and memory of social events in borderline personality disorder: Effects of valence and self-referential context. Psychiatry Research, 240, 19-25
Winter, D., Koplin, K., Schmahl, C., Bohus, M., & Lis, S.
(See online at https://doi.org/10.1016/j.psychres.2016.03.042) - (2016). Neuroeconomic approaches in mental disorders. In M. Reuter & C. Montag (Eds.), Neuroeconomics (pp. 311-330). Berlin, Heidelberg: Springer
Lis, S., & Kirsch, P.
(See online at https://doi.org/10.1007/978-3-642-35923-1_16) - (2017). Borderline personality disorder features and sensitivity to injustice. Journal of Personality Disorders, 32(2), 192-206
Lis, S., Schaedler, A., Liebke, L., Hauschild, S., Thome, J., Schmahl, C., . . . Bohus, M.
(See online at https://doi.org/10.1521/pedi_2017_31_292) - (2017). Loneliness, social networks, and social functioning in borderline personality disorder. Personality Disorders: Theory, Research, and Treatment, 8(4), 349-356
Liebke, L., Bungert, M., Thome, J., Hauschild, S., Gescher, D. M., Schmahl, C., . . . Lis, S.
(See online at https://doi.org/10.1037/per0000208) - (2017). Understanding negative self-evaluations in borderline personality disorder—A review of self-related cognitions, emotions, and motives. Current Psychiatry Reports, 19(3), 17
Winter, D., Bohus, M., & Lis, S.
(See online at https://doi.org/10.1007/s11920-017-0771-0) - (2018). Behavioural mimicry and loneliness in borderline personality disorder. Comprehensive Psychiatry, 82, 30-36
Hauschild, S., Winter, D., Thome, J., Liebke, L., Schmahl, C., Bohus, M., & Lis, S.
(See online at https://doi.org/10.1016/j.comppsych.2018.01.005) - (2018). Difficulties with being socially accepted: An experimental study in borderline personality disorder. Journal of Abnormal Psychology, 127(7), 670-682
Liebke, L., Koppe, G., Bungert, M., Thome, J., Hauschild, S., Defiebre, N., . . . Lis, S.
(See online at https://doi.org/10.1037/abn0000373) - (2018). Lower self-positivity and its association with self-esteem in women with borderline personality disorder. Behaviour Research and Therapy, 109, 84-93
Winter, D., Steeb, L., Herbert, C., Sedikides, C., Schmahl, C., Bohus, M., & Lis, S.
(See online at https://doi.org/10.1016/j.brat.2018.07.008)
