On the borderline of rejection

Nobody likes to feel left out; it hurts and you might wonder if you did something wrong or if you will always be rejected. On the other hand, imagine being included and feeling a sense of impending abandonment. In this week's meme Overly Attached Girlfriend is exhibiting that problem as she spends time with her partner:

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!

Cats and Depression

Some suggest that the first popular Internet memes starred cute cats with sayings like "I can has cheezburger?." So it was natural that I chose a cat as this blog's icon and not surprising that this week's meme features a cat:

The humor comes from relating typical cat behaviors to the very serious symptoms of human depression. Specifically the DSM-V includes "changes in sleep, appetite, and decreased interest in activities" as indicators of Major Depressive Disorder and Depressive Episodes in human beings.

On the other hand, there is an old adage that pets and their owners resemble each other. Maybe this trend applies not only to physical traits but also to psychological traits? We can ask the question: is their a relationship between cat ownership and depression?

On one hand we have research findings that lead us to believe that having a cat, or any pet, could be protective against depression. For example, McConnell, Brown, Shoda, Stayton, and Marton (2011) conducted an experiment to determine if pets can serve as social support and reduce the sting of rejection. In their somewhat disturbingly named paper, "Friends with benefits: on the positive consequences of pet ownership," they included a study of 97 undergraduate students, who were also pet owners (76 dogs, 20 cats, one horse). The participants either wrote a detailed report about a time that they were rejected (experimental condition) or what they had done earlier that day (control). Thus the experimental condition triggered feelings of rejection whereas the control condition did not; this was verified by participants' scores on a 17 question Social Needs Scale.

Next, the participants were either instructed to write about why they like their pets, why they like their best friends (human, that is), or to draw maps of their college campus. Past research demonstrated that thinking of your best friend serves as a reminder of social support, so the researchers were curious if thinking of a pet would have the same effect. Drawing a map was a neutral experience that would not be related to social support.

Indeed, when they completed a second check of their emotional states the participants who had felt rejected and then thought about their pets or best friends had rebounded and now felt that their social needs were satisfied. Although the difference did not reach statistical significance, the students who thought about their pets actually had a slightly higher emotional boost than the students who thought about their best friends!

Things were worse for the participants who had felt rejection and then drew maps of their campus: their social needs scores continued to plummet. Drawing the map was associated with feeling even more rejected as the study progressed! So if you are feeling low, thinking about your cat might make you feel better, but just thinking about random things to distract yourself might make you feel worse.

Before you start to believe that cats are the key to avoiding depression, these findings are tempered by an earlier study also found in the McConnell et al. (2011) article. When they compared 167 pet owners and 50 non-pet owners in the university community, the pet owners were slightly less lonely and had better self-esteem, but they did not differ significantly from the non-owners on actual measures of depression.

Another possibility is that the positive social support that cats provide may be undercut by a negative biological factor: Toxoplasma gondii. This protozoan can only complete its reproductive cycle inside a cat's digestive tract and can infect humans who have contact with cat poop that contaminates their food. A recent review by Hsu, Groer, and Beckie (2014) reports that 23% of the U.S. population shows no physical symptoms yet tests positive for this type of infection!

New T. gondii infections that are acquired during pregnancy can cause miscarriage, but an ongoing, undetected infection is associated with, "...mental and behavioral disorders such as schizophrenia, depression and suicide attempts" (p. 632). This is likely because the infection causes inflammation or cysts in the brain, and both could disrupt neurotransmitters such as serotonin, dopamine, and tryptophan. However, cat ownership is not considered to be a high risk factor for infection for most people: raw meat consumption or contamination from unwashed kitchen utensils are more common modes of infection.

So go ahead and hug your cat to thank your pet for the social support - but, to be safe, wash your hands well after cleaning out the litter box. For all of us, if you are not a cat and find yourself sleeping too much, eating too much or too little, and you have lost all motivation it is important that you seek treatment for depression.

Further reading:

You can access the McConnell et al. (2011) article at your local college library. A copy of the Hsu et al. (2014) article is available online.

Depression is a serious illness. The National Suicide Prevention Lifeline (1-800-273-8255) can help if you are feeling hopeless. Their website also has good information for people who would like to volunteer or donate to help others.

A really fun read for anyone who likes cats: a link to Shreve, K.R., & Udell, M.A.R. (2015). What's inside your cat's head? A review of cat (Felis Silvestris catus) cognition research past, present and future. Animal Cognition, in press.

BONUS: Imagine if your friends acted like cats and dogs...or watch it here and it will make you smile: