Differential Neural Processing of Social Exclusion and Inclusion in Adolescents with Non-Suicidal Self-Injury and Young Adults with Borderline Personality Disorder

Abstract

IntroductionNon-suicidal self-injury (NSSI) is a symptom of borderline personality disorder (BPD). However, NSSI often occurs independently of BPD. Altered neural processing of social exclusion has been shown in adolescents with NSSI and adults with BPD with additional alterations during social inclusion in BPD patients. Aims of this study were to investigate differences in neural processing of social inclusion and exclusion situations between adolescents with NSSI and young adults with BPD and NSSI.MethodsUsing fMRI, neural processing of positive and negative social situations (paradigm: “Cyberball”) was explored. Participants were 14 adolescents with NSSI, but without BPD (Mage = 15.4; SD = 1.9), 15 adults with BPD and NSSI (Mage = 23.3; SD = 4.1), as well as 15 healthy adolescents (Mage = 14.5; SD = 1.7), and 16 healthy adults (Mage = 23.2; SD = 4.4).ResultsBehavioral results showed enhanced feelings of social exclusion in both patient groups as compared to healthy controls but only the NSSI group showed enhanced activation during social exclusion versus inclusion compared to the other groups. While both NSSI and BPD groups showed enhanced activation in the ventral anterior cingulate cortex during social exclusion as compared to their age-matched controls, enhanced activation during social inclusion as compared to a passive watching condition was mainly observed in the BPD group in the dorsolateral and dorsomedial prefrontal cortex, and the anterior insula.DiscussionWhile neural processing of social exclusion was pronounced in adolescents with NSSI, BPD patients also showed increased activity in a per se positive social situation. These results might point toward a higher responsiveness to social exclusion in adolescents with NSSI, which might then develop into a generalized increased sensitivity to all kinds of social situations in adults with BPD.

Cerebral responses to self-initiated action during social interactions

“…Social exclusion engaged the insula, dorsal anterior cingulate cortex, and other prefrontal cortical regions, as well as the posterior cingulate cortex (Eisenberger et al, 2003;Kross, Egner, Ochsner, Hirsch, & Downey, 2007;Lieberman & Eisenberger, 2009;DeWall et al, 2010;Bolling et al, 2011;Sebastian et al, 2011;Moor et al, 2012; see Rotge et al, 2014 andWang, Braun, &Enck, 2017 for a review). In contrast, fewer studies focused on social inclusion and the reported neural responses appeared less consistent (Brown et al, 2017;van der Meulen et al, 2017).…”

Are you laughing at me? Neural correlates of social intent attribution to auditory and visual laughter

“…In social anxiety, fears concerning negative evaluation and social rejection represent even the core symptom of the disorder (Trower & Gilbert, ). Altered processing of social acceptance, however, has been recently described for adolescent (Brown et al, ) and adult patients (Malejko et al, ) with borderline personality disorder calling for a better characterization of the neural correlates of social acceptance also in healthy participants. The current limitation of knowledge is not due to a lack of data, but a lack of analyses tackling this scientific question as most researchers who employ the Cyberball paradigm exclusively report activations to social exclusion versus fair play, but not the reverse contrast.…”

“…In social anxiety, fears concerning negative evaluation and social rejection represent even the core symptom of the disorder (Trower & Gilbert, 1989). Altered processing of social acceptance, however, has been recently described for adolescent (Brown et al, 2017) and adult patients (Malejko et al, 2018) with borderline personality disorder calling for a better characterization of the neural correlates of social acceptance also in healthy participants.…”

Neuronale Korrelate von sozialem Ausschluss bei psychischen Erkrankungen

“…Neuronale Korrelate von sozialem Ausschluss bei BPS wurden in mehreren Arbeiten untersucht (30)(31)(32)(33)(34)(35)(36). Eine der ersten Studien zur Untersuchung neuronaler Korrelate von sozialem Ausschluss bei Patienten mit BPS wurde mit funktioneller Infrarotspektroskopie und dem Cyberball-Experiment durchgeführt.…”

“…Die zugrunde liegenden neuronalen Mechanismen der verstärkten emotionalen Reaktion auf sozialen Ausschluss wurde bei Patienten mit NSSV nur in einer Studie untersucht (30…”