Gutz, Renneberg, Roepke, and Niedeggen (2015) investigated how three populations respond to being included and then rejected. Along with healthy controls, or average people for comparison, their experiment included people in treatment for Social Anxiety Disorder (SAD) and a separate group in treatment for Borderline Personality Disorder (BPD).
Individuals with Social Anxiety Disorder are terrified that they are going to come across as awkward losers when they interact with others. This fear comes from a distorted perception that other people are more negative and judgmental than they really are, which leads to avoiding social situations and having very few social connections. When these situations cannot be avoided, people with SAD are hardest on themselves after the fact: they go over what happened in their minds and imagine how their behaviors left bad impressions.
People with Borderline Personality Disorder have an intense fear of being rejected and also view others as more negative and judgmental than they really are. This is complicated for people with BPD because they lack a solid sense of self and tend to derive some identity through the attention given to them in relationships. At the start of relationships they treat people as if they can do no wrong, but as they grow closer this bond becomes a risk - they might lose their source of self! Based on a distorted perception of reality and motivated by fear they turn against the people closest to them: accusing and blaming; projecting their own faults; exploding with over-the-top emotional reactions; or making threats of self-harm. These behaviors are scary and hurtful to receive from somebody who used to treat you so well, so eventually many of these relationships end. This further reinforces a fear of rejection.
Gutz et al. were interested in how the three groups would react to being included and being excluded. To provoke these situations they used a rigged video game called Cyberball: in this game you can "toss" a ball to two other players and they can choose to "toss" the ball to you. The participants are tested individually and they believe that they are playing online against two other people. However, they are actually just playing with a computer program and what occurs in the game is not by accident. In the first trial the program sends the ball to the participant and the two pretend players equally (33%) of the time; this should give participants a feeling of being included. In the second trial the program sends the ball to the participant less (16%) of the time compared to the pretend players; this should give participants a feeling of being excluded or rejected.
In addition to participants' ratings of their fear, expectation, and experience of rejection, the authors collected biological data in the form of brain activity during both trials. This was measured by electrical changes on the scalp known as an "event related brain potential" or ERP. The ERP of interest was P3b: this change occurs when a person has to reevaluate a situation - when something unexpected happens (and should not be confused with the dehydrated peanut butter PB2). In prior studies using Cyberball, average people exhibited this electrical change when they received the ball in the exclusion trial because this is an unexpected event.
The results of the present experiment confirmed differences between the healthy controls and the two clinical populations: overall the healthy controls rated themselves as lower in anxiety about being rejected and on expectations of rejection. In the exclusion trial, all three groups felt left out but the two clinical groups felt more threatened by this than did the healthy controls. This is evidence that rejection is felt more strongly by people diagnosed with SAD and BPD.
Differences between the clinical groups also occurred: Borderline participants rated themselves as higher in rejection expectancy than did the participants with Social Anxiety Disorder. Likewise, while there was little difference between healthy controls and participants with SAD, the participants in treatment for BPD always reported a higher experience of being left out, even in the inclusion trial. In fact, whereas the other two groups were accurate, at all times participants with BPD underestimated how many times the ball was tossed to them: they overestimated how much they were left out.
P3b activity confirmed these self-reports: only the participants with Borderline Personality Disorder demonstrated a P3b event, in fact a large P3b change, during the inclusion trial. Because this is associated with unexpected events, this means that these participants were expecting to be left out even when they were being included. Further evidence can be found in a statistical analysis: self-reports of rejection expectancy explain the largest difference in the P3b changes between the three groups.
Gutz et al. explain the significance of these findings:
...this negative perception bias might cause situation-inappropriate overreactions in daily life, and consequently prompt expectation-confirming rejection behavior by others. A recent study indicated that it is the negative perception of others that triggers elevated negative affect and quarrelsome behavior in patients with BPD (p. 428).
If Overly Attached Girlfriend struggles with BPD she may assume that any relationship puts her at risk for abandonment. An evening hanging out with her partner would not be interpreted as being accepted, but instead as a situation of likely rejection. The meme is funny because we can see the distortion in her thinking. In real life it would not be any fun: instead it might start a fight or even lead to a break-up.
Further Reading:
The Gutz et al. (2015) article can be accessed through your local college library.
If you or somebody you care about are dealing with anxiety or personality disorders, you can find helpful resources on the National Alliance on Mental Illness website.
Dr. Marsha Linehan, who created a therapy for Borderline Personality Disorder, made news by announcing that she, too, struggles with this psychological problem. Read the New York Times article about her "coming out."
Dr. Kipling Williams, one of the originators of the Cyberball game, has an updated version available on his website. This site also includes a gif that shows an image that is similar to what is seen when participating in Cyberball experiments.
BONUS: None of us would need to fear rejection if Ryan Gosling were our partner (or lab partner). Enjoy the statistics humor!
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