In present society, mental illness is looked at as a guilty secret that you should keep to yourself or quietly seek therapy. Many people with a mental illness are embarrassed to speak out about their disorder due to the fear of being socially rejected or labeled as different. Which leads me into the topic I was most interested in studying. I wanted to research a personality disorder, specifically Borderline Personality Disorder (BPD). Defined by the DSM-V, Borderline Personality Disorder is a mental illness marked by an ongoing pattern of varying moods, self-image, and impulsive behavior (https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml) . The symptoms of BPD often are followed with impulsive behaviors, instability of interpersonal relationships, and poor self-image. People living with BPD will feel intense emotions for an extended period of time, and it is difficult for them to bounce back to a stable state of mind. People with MPD tend to view things with an extreme perception. Their thoughts and ideas of people or things change quickly. While reading about BPD’s criteria it raised the question: “How would a person with BPD adjust in society?”. I wanted to know the difficulties of being socially accepted or socially rejected while living with an erratic disorder.
Social scientist at Heidelberg University did an experimental study on patients with BPD and how they would react to being socially accepted. The American Psychiatric Association said there is an anxious preoccupation with real or imaged abandonment is a key feature of dysfunctional interpersonal behavior in BPD (CITATION). The social scientist at Heidelberg University found in recent studies that research suggest that people with BPD do not show as much emotional sensitivity to rejection, but instead they experience intense emotions when feeling others are including them in social aspects.
EFFECTS OF SOCIAL ACCEPTANCE AND REJECTION
The reduced sense of belonging has indirectly been linked to altered cognitive processing, particularly in response to being socially included, this gives someone with BPD a false expectation of the behavior of social partners. This correlates with other studies that did find that anxious expectations of being rejected does identify these people (CITATION). Even though people with BPD do have a tendency to have erratic episodes, some information can be formulated as bias. Assumptions of altered expectations relies either on self-reports in hypothetical social scenarios, which can be asses with questionnaires or indirect measures, such as social interactions (CITATION). Due to the bias factor, it is hard to measure whether patients with BPD adjust their expectations based on negative or positive feedback.
The social scientist at Heidelberg University noted how social behaviors, such as cooperation and trustfulness are shaped by one’s interaction with others (CITATION). Although there are irregularities in social behavior following social acceptance and rejection in BPD. Behavior such as extreme rage, to feelings of being rejected are correlated with BPD and antisocial behavior. Which suggest that there is an inability to cope with social rejection. Social rejection and aggressive behavior rely on the perception the patient is having to a social situation. These findings suggested that that reduced feelings of being accepted may intensify alterations in social interactions behavior in individuals with BPD (CITATION). The point of the above study was to explore the social expectations patients with BPD hold and how they would adjust following experiences of social acceptance or rejection. The social scientist then hypothesized that patients with BPD would first, lower expectations of being accepted by others. Next, they hypothesized that patients with BPD would fail to adjust these expectations to positive social feedback. They were interested in learning more about whether social acceptance or rejection affect social behavior in patients with BPD and healthy participants. They also hypothesized that patients with BPD would not be as cooperative and become more aggressive then compared to the healthy controls. In other words, patients with BPD already have a false negative evaluation bias during social encounters, they feel more rejected then socially accepted (CITATION). Lastly, they hypothesized that social rejection increases the negative affects in patients with BPD and also in the healthy control group, although when social acceptance increases the negative affect only in individuals with BPD.
EXPERIMENTAL PROCEDURES
The scientist developed the Manheim Virtual Group Interaction Paradigm (MVGIP) to study the dynamics of social rejection and acceptance, while including reality-based situations. In order to enact the MVGIP they need participants to be involved. The patient group consisted of 56 female patients diagnosed with Borderline Personality Disorder. The participants in the group where alike in age, and education. Same criteria were met for the healthy control group. Participants were told that the goal of the study was to test a newly developed virtual communication program. While participants were led to believe that the other participants of the meeting were real participants, modeled by avatars, the avatars behavior was computer-controlled to ensure a comparable social setting for all participants (CITATION). The experimental procedure consisted of a sequence of different paradigms. During phase I, participants were given the opportunity to become acquainted with what they believed were the other participants. Moving on to the second phase, they evaluated their liking of every member of the virtual group. In phase III, participants than received feedback about the evaluation by the others in six feedback rounds with feedback signaling either social acceptance or rejection (CITATION). During each round, both BPD participants and he healthy control group were asked about their expectations of the next round of feedback before it was given.
During the MVGIP there was a “becoming acquainted” phase, which is where six participants met six avatars or whom they thought to be other participants. In order to not give away any real implications of the study participants followed standardized protocol. They answered six questions based on relationship closeness. Following the “becoming acquainted” phase, participants were asked to evaluate the six other virtual participants by answering constructed standardized questions. The introduction of social acceptance or rejection was implemented in the feedback phase outside the virtual reality meeting to enable a preceding assessment of how participants evaluated their coplayers (CITATION). Expectations of social acceptance was assessed in six rounds in a manipulated order with induction of social acceptance or rejection by evaluating the feedback. In each of the six rounds, participants were asked about their expectations first. They answered these questions using a six-point scale, zero representing “nobody” to six which represents “everybody”. After each participant gave an expectation rating, feedback was then provided by the presentation of six schematic faces. Relative the acceptance condition, feedback varied between four and six positive faces and zero to two negative faces per round.
RESULTS: MANHEIM VIRTUAL GROUP INTERACTION PARADIGM
Expectations of social acceptance was measured during the initial feedback phase of the MVGIP. The expectations differed between BPD and the healthy control group, depending on whether the feedback was represented by acceptance or rejection. In response to the two feedback conditions, it revealed that there were differential changes of social acceptance and of social rejection. Adjustments to feedback are stronger in the healthy control group than in patients with BPD. Post study, comparisons revealed that after acceptance, only the healthy control group adjusted their expectations toward more positive feedback, whereas in the participants with BPD, they did not change (CITATION). In contrast to their findings of social acceptance or rejection both groups adjusted their expectations toward being rejected by more members of the virtual meeting after rejection feedback. In addition, patients with BPD expected less positive feedback than the healthy control group across the board.
During the experimental study they did investigate the emotional responses to social acceptance and rejection. They reported that patients with BPD showed an increase in anger than the healthy control group, and that anger increased following feedback in patients with BPD (CITATION). Arousal showed a factor during the study but differentiated during feedback conditions. Arousal decreased after being accepted, but it increased after being rejected.
RESULTS: GENERAL
During the study, the social scientist of Heidelberg University investigated explicit expectations of social acceptance in BPD after a standardized social encounter (CITATION). They were interested in whether expectations of acceptance were lower in the patient’s with BPD compared to the healthy control group. They also wanted to discover whether patients with BPD would be different from the healthy control group in how experimentally induced social acceptance and rejection affected these expectations (CITATION). They found that not only did the patients with BPD fail to adjust their expectations to positive feedback but were less cooperative toward social partners in a different social context after feedback of social acceptance (CITATION).