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. 2021 Nov 18;8(1):28.
doi: 10.1186/s40479-021-00169-3.

Autonomic vulnerability to biased perception of social inclusion in borderline personality disorder

Maria Lidia Gerra  1 , Martina Ardizzi  2 , Silvia Martorana  2 , Veronica Leoni  2 , Paolo Riva  3 , Emanuele Preti  3 , Barbara Francesca Marta Marino  3 , Paolo Ossola  2 , Carlo Marchesi  2 , Vittorio Gallese  2 , Chiara De Panfilis  2
Affiliations

Autonomic vulnerability to biased perception of social inclusion in borderline personality disorder

Maria Lidia Gerra et al. Borderline Personal Disord Emot Dysregul. .

Erratum in

Abstract

Background: Individuals with Borderline Personality Disorder (BPD) feel rejected even when socially included. The pathophysiological mechanisms of this rejection bias are still unknown. Using the Cyberball paradigm, we investigated whether patients with BPD, display altered physiological responses to social inclusion and ostracism, as assessed by changes in Respiratory Sinus Arrhythmia (RSA).

Methods: The sample comprised 30 patients with BPD, 30 with remitted Major Depressive Disorder (rMDD) and 30 Healthy Controls (HC). Self-report ratings of threats toward one's fundamental need to belong and RSA reactivity were measured immediately after each Cyberball condition.

Results: Participants with BPD showed lower RSA at rest than HC. Only patients with BPD, reported higher threats to fundamental needs and exhibited a further decline in RSA after the Inclusion condition.

Conclusions: Individuals with BPD experience a biased appraisal of social inclusion both at the subjective and physiological level, showing higher feelings of ostracism and a breakdown of autonomic regulation to including social scenarios.

Keywords: Cyberball paradigm; Polyvagal theory; Rejection bias; Respiratory sinus arrhythmia.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Experimental procedure
Fig. 2
Fig. 2
NTS scores (Panel A) and RSA levels (Panel B) across test conditions. Note: NTS = Need Threat Scale (higher scores represent greater satisfaction with basic needs); RSA = Respiratory Sinus Arrhythmia. Error bars depict standard error. * = p < .05. In Panel A the satisfaction with basic need (NTS, Y axis) across conditions (Inclusion, Ostracism and Reflective stage, X axis) in the three groups. After the Inclusion condition, BPD patients experienced lesser satisfaction with basic needs than HC and rMDD. Furthermore, their level of satisfaction with basic needs did not improve moving from the ostracism condition to the reflective stage. In Panel B Respiratory Sinus Arrhythmia (RSA, Y axis) across conditions (Baseline, Inclusion, Ostracism and Reflective stage, X axis) in the three groups. RSA decreased from Baseline to Inclusion in BPD patients, but did not vary in HC nor rMDD patients across the experimental conditions
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