Rejection sensitivity and social interaction problems in psychiatric patients with childhood maltreatment – a transdiagnostic study on psychological and neurobiological mechanisms

• Applicant: Privatdozentin Dr. Andrea Jobst-Heel
• Subject Area: Clinical Psychiatry, Psychotherapy, Child and Adolescent Psychiatry ; Biological Psychology and Cognitive Neuroscience ; Cognitive, Systems and Behavioural Neurobiology
• Term: since 2023
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 520999366

Childhood maltreatment (CM) as a form of adverse experience in the spectrum of Early Adversity and Trauma (EAT) has been widely confirmed as core risk factor for the development of severe mental health problems. Around 25% of patients with psychiatric disorders report CM, and this subpopulation transdiagnostically characterizes by more complex psychopathology, more pronounced functional impairment and chronic courses of disease. Another common clinical feature of mental disorders with high prevalence of CM, such as borderline personality disorder (BPD), persistent depressive disorder (PDD) or complex posttraumatic stress disorder (cPTSD), are serious problems of social interaction (e.g. in maintaining relationships and repairing broken cooperation), that particularly impact long-time psychosocial functioning and may even hamper psychotherapy. Rejection Sensitivity (RS), i.e. the personality disposition to anxiously expect, readily perceive and intensely react to social reaction, can easily reinforce the vicious circle of withdrawal and rejection. In turn, high RS has been associated with several negative mental health outcomes and has been rooted to infant attachment violation and CM including experiences of parental rejection and different forms of abuse (emotional, physical, sexual). The proposed study aims to establish a novel transdiagnostic approach and investigates the association between distinct clusters/cumulative risk of CM and RS as central transdiagnostic determinant for psychopathology. For this purpose, we will follow the current "TRANSD"iagnostic research recommendations in psychiatry and intend to demonstrate the transdiagnostic construct (CMxRS) in an across-diagnoses sample including four mental disorders (BPD, PDD, cPTSD, episodic depression) and non-clinical controls. To study the different components of RS, a standardized experimental setting will be used and altered reactions and impaired interpersonal coping strategies to experimentally induced social rejection/exclusion will be assessed. By a broad set of concomitant psychometric, endogene (peripheral oxytocin and cortisol), neurophysiological (skin conductance levels, heart rates) and neurogenetic (epigenetic modifications and genetic variations in the oxytocin system) measurements, underlying neurobiological processes will be investigated. A deeper understanding of the ethiopathology of social interaction problems could set the path to identify novel target points for developing mechanism-based interventions in order to improve psychotherapy in patients with CM.

• DFG Programme: Research Grants
• Co-Investigator: Professor Dr. Frank J. Padberg