It will (never) stop hurting: Do repeated or chronic experiences of exclusion lead to hyper- or hyposensitive psychological responses?

Unlike one-time lab manipulations of exclusion, in real life, many people experience exclusion, from others and from groups, over extended periods, raising the question of whether individuals could, over time, develop hypo- or hypersensitive responses to chronic exclusion. In Study 1, we subjected participants to repeated experiences of inclusion or exclusion (three Cyberball games, time lag of three days, N = 194; 659 observations). We find that repeatedly excluded individuals become hypersensitive to inclusion, but not to exclusion. Study 2 (N = 183) tested whether individuals with chronic experiences of real-world exclusion show hypo- or hypersensitive responses to a novel episode of exclusion. In line with Study 1, exclusion hurt to the same extent regardless of baseline levels of chronic exclusion in daily life. However, chronically excluded individuals show more psychological distress in general. We discuss theoretical and practical implications for dealing with chronically excluded individuals and groups.

Exploring the peer status prototypes: A large-scale latent profile analysis on high-school students from four European countries.

Peer status - the regard other group members have of an individual - is fundamental for youth development. Different research traditions developed independent theoretical frameworks conceiving the dimensions underlying social status, and this led to identifying a variety of peer status prototypes. In this work, we explored whether a classification based on the four dimensions of popularity, aggression, dislike, and victimization could integrate the scattered peer status profiles found in the different traditions. A latent profile analysis on 16,224 European students identified the peer status prototypes of popular, bullies, disliked, victims, and average students. Both the peer- and self-reported correlates supported that the five profiles accounted for the large variety of the students' profiles in the literature. These findings suggest that the adoption of a multidimensional approach supported by advanced statistical procedures could identify students' peer status profiles more effectively, replacing classifications based on cutoffs, and leading to a unified students' classification.

Does being involved by doctors satisfy patients' fundamental psychological needs? A study on a large European sample.

The present work was aimed at investigating whether the patients' involvement by their healthcare providers may satisfy patients' fundamental psychological needs (i.e. self-esteem, belonging, control, meaningful existence), which in turn, can impact their psychological well-being. Based on the European Quality of Life Survey data, the sample included 10,427 European adults who, in the last 12 months, visited GP/family doctors and hospital/medical specialists. Among them, 51.3% declared to have a chronic disease. Results showed that the experience of being involved by GP/family doctors and hospital/medical specialists had a positive effect on psychological well-being and that this effect was mediated by the satisfaction of all four needs. Moreover, the results of the moderated mediation model showed that the indirect effect of the involvement by GP/family doctors and hospital/medical specialists on psychological well-being through belonging was moderated by the presence or absence of a chronic condition. The study provides a novel contribution in investigating the positive effects of the patient's involvement, emphasizing its importance for patient's needs satisfaction, and its role appears particularly beneficial for the ones living with a chronic condition.

Being liked or not being liked: A study on social-media exclusion in a preadolescent population.

INTRODUCTION: Social-media can contribute to building up adolescents' relationships, but they might also bring negative exclusionary experiences. Being excluded is a subtle yet hurtful form of relational aggression, which affects people's psychological wellbeing, especially during developmental stages. In this study, we (1) analyzed the effects of social-media exclusion adapting the Ostracism Online paradigm to a cohort of Italian preadolescents (Mage = 11.47, 53% girls) and (2) tested the efficacy of two potential recovery strategies (i.e., social bonds vs. social surrogate). METHOD: Inclusionary status was manipulated through the number of "likes" participants received on a fictitious online social network. In the exclusion condition, participants received fewer likes than everyone else. In the inclusion condition, participants received a similar number of likes of other users. Then, all participants were asked to think of a significant positive relationship with a family member (social bonds), a celebrity (social surrogate), their present moment thoughts (control). RESULTS: Preadolescents who received fewer likes than others reported higher levels of need threat (i.e., belong, self-esteem, meaningful existence, but not control) and negative emotions. Moreover, the social-bonds strategy generally brought a faster psychological recovery from social-media exclusion than the control condition. The efficacy of social-surrogates strategy was greater for boys than for girls, probably due to different choices in their favorite celebrities. CONCLUSION: These findings show how offline life offers compensatory opportunities for adolescents' online life. When the lack of "Likes" signal exclusion on social-media, thinking of an existing social relationship help adolescents to cope with this negative experience.

Selective changes in moral judgment by noninvasive brain stimulation of the medial prefrontal cortex.

Multiple cortical networks intervene in moral judgment, among which the dorsolateral prefrontal cortex (DLPFC) and the medial prefrontal structures (medial PFC) emerged as two major territories, which have been traditionally attributed, respectively, to cognitive control and affective reactions. However, some recent theoretical and empirical accounts disputed this dualistic approach to moral evaluation. In the present study, to further assess the functional contribution of the medial PFC in moral judgment, we modulated its cortical excitability by means of transcranial direct current stimulation (tDCS) and tracked the change in response to different types of moral dilemmas, including switch-like and footbridge-like moral dilemmas, with and without personal involvement. One hundred participants (50 males) completed a questionnaire to assess the baseline levels of deontology. Next, participants were randomly assigned to receive anodal, sham, or cathodal tDCS over the medial prefrontal structures and then were asked to address a series of dilemmas. The results showed that participants who received anodal stimulation over the medial PFC provided more utilitarian responses to switch-like (but not footbridge-like) dilemmas than those who received cathodal tDCS. We also found that neurostimulation modulated the influence that deontology has on moral choices. Specifically, in the anodal tDCS group, participants' decisions were less likely to be influenced by their baseline levels of deontology compared with the sham or cathodal groups. Overall, our results seem to refute a functional role of the medial prefrontal structures purely restricted to affective reactions for moral dilemmas, providing new insights on the functional contribution of the medial PFC in moral judgment.

Lonely hearts and angry minds: Online dating rejection increases male (but not female) hostility.

The present work explores the hostile tendencies elicited by romantic rejection in the increasingly common context of online dating. To empirically investigate this issue, we created an ad hoc online dating platform in which fictitious online dating partners romantically rejected heterosexual male and female participants. Results revealed that male-but not female-participants who were rejected by desired dating partners displayed increased hostility. This pattern of findings was consistent across different measures, which considered both aggressive tendencies against the rejecting partners and hostile attitudes against the opposite gender. Further, increased feelings of anger explained the relationship between online romantic rejection and increased male hostility. Our work and its findings have both theoretical and methodological implications for the understanding of interpersonal processes in online interactions and the growing body of literature on online dating.

Connecting with a Slot Machine: Social Exclusion and Anthropomorphization Increase Gambling.

Two studies tested whether social exclusion can increase gambling behavior. In Study 1, participants were asked to relive a socially painful instance, a physically painful instance or a control condition and were then presented with a real online gambling device (i.e., a slot machine). The results revealed that participants who relived a socially painful instance played longer on the gambling device. In Study 2, we induced actual feelings of social disconnection and manipulated slot machine anthropomorphization. The results revealed a significant interaction between inclusionary status and anthropomorphism in predicting gambling. More specifically, excluded participants gambled longer when presented with an anthropomorphized slot machine. However, the gambling behavior of excluded and included participants was no different when participants were reminded that slot machines are inanimate objects. Finally, positive and negative game experience mediated the influence of both inclusionary status and anthropomorphism on gambling. Overall, this research identifies another potential vulnerability produced by experiences of social exclusion, namely, gambling behavior. Implications for pathological gambling and future research directions are outlined.

The lone gamer: Social exclusion predicts violent video game preferences and fuels aggressive inclinations in adolescent players.

Violent video game playing has been linked to a wide range of negative outcomes, especially in adolescents. In the present research, we focused on a potential determinant of adolescents' willingness to play violent video games: social exclusion. We also tested whether exclusion can predict increased aggressiveness following violent video game playing. In two experiments, we predicted that exclusion could increase adolescents' preferences for violent video games and interact with violent game playing fostering adolescents' aggressive inclinations. In Study 1, 121 adolescents (aged 10-18 years) were randomly assigned to a manipulation of social exclusion. Then, they evaluated the violent content of nine different video games (violent, nonviolent, or prosocial) and reported their willingness to play each presented video game. The results showed that excluded participants expressed a greater willingness to play violent games than nonviolent or prosocial games. No such effect was found for included participants. In Study 2, both inclusionary status and video game contents were manipulated. After a manipulation of inclusionary status, 113 adolescents (aged 11-16 years) were randomly assigned to play either a violent or a nonviolent video game. Then, they were given an opportunity to express their aggressive inclinations toward the excluders. Results showed that excluded participants who played a violent game displayed the highest level of aggressive inclinations than participants who were assigned to the other experimental conditions. Overall, these findings suggest that exclusion increases preferences for violent games and that the combination of exclusion and violent game playing fuels aggressive inclinations.

Neuromodulation can reduce aggressive behavior elicited by violent video games.

Research has shown that exposure to violent media increases aggression. However, the neural underpinnings of violent-media-related aggression are poorly understood. Additionally, few experiments have tested hypotheses concerning how to reduce violent-media-related aggression. In this experiment, we focused on a brain area involved in the regulation of aggressive impulses-the right ventrolateral prefrontal cortex (rVLPFC). We tested the hypothesis that brain polarization through anodal transcranial direct current stimulation (tDCS) over rVLPFC reduces aggression related to violent video games. Participants (N = 79) were randomly assigned to play a violent or a nonviolent video game while receiving anodal or sham stimulation. Afterward, participants aggressed against an ostensible partner using the Taylor aggression paradigm (Taylor Journal of Personality, 35, 297-310, 1967), which measures both unprovoked and provoked aggression. Among those who received sham stimulation, unprovoked aggression was significantly higher for violent-game players than for nonviolent-game players. Among those who received anodal stimulation, unprovoked aggression did not differ for violent- and nonviolent-game players. Thus, anodal stimulation reduced unprovoked aggression in violent-game players. No significant effects were found for provoked aggression, suggesting tit-for-tat responding. This experiment sheds light on one possible neural underpinning of violent-media-related aggression-the rVLPFC, a brain area involved in regulating negative feelings and aggressive impulses.

Grand Theft Auto is a "Sandbox" Game, but There are Weapons, Criminals, and Prostitutes in the Sandbox: Response to Ferguson and Donnellan (2017).

In this issue, (Ferguson, C. J., & Donnellan, B. D., Journal of Youth and and Adolescence, published online 21 June 2017) criticize one of our studies (Gabbiadini, A., Riva, P., Andrighetto, L., Volpato, C., & Bushman, B. J., PLoS ONE, 11: 1-14, 2016) that found violent sexist video games can reduce empathy for female violence victims in male players who identify with violent male game characters, and do so by increasing masculine beliefs. Their main criticism is a "straw person" argument built on a claim that we never made (i.e., a direct effect of sexist-violent video games on empathy). They also made several other criticisms of our article. We appreciate the opportunity to respond to their criticisms in this article. We also point out some flaws in their reanalysis. Despite their criticisms, the core contributions of our original article remain intact.

Orders to shoot (a camera): effects of ostracism on obedience.

Research suggests that ostracism increases susceptibility to indirect forms of social influence (e.g., conformity). Yet, no study to date has explored whether the effects of ostracism extend to the most direct form of social influence--obedience. We investigated whether ostracized individuals would be more likely to obey a direct command to do something effortful in uncomfortable conditions. Participants (N = 62) were randomly assigned to be included or ostracized in Cyberball, or assigned to a control condition. They were then approached by the experimenter and commanded to go outside when temperatures were below 30 degrees F and take 39 unique and creative photographs in the cold of winter. Ostracized participants were more likely to obey the experimenter's command to be creative when taking photographs. No differences in obedience emerged between the inclusion and the control condition. We provided evidence completing the social influence "trifecta": ostracism increases susceptibility to conformity, compliance, and now, obedience.

Associations between social isolation and parenting stress during the first wave of COVID-19 in Italian children with special educational needs.

The parents of 413 children with typical development (TD) or special educational needs (SEN) filled in an online survey to investigate the associations between the restrictions introduced to face COVID-19 and parenting stress and parental disciplinary practices. The parents of children with SEN showed a significantly higher stress level than TD children's parents. However, they showed a lower inclination to overreact. In both groups, the parents who feel less supported, feel their needs threatened, and report having a child with more difficulties were more likely to exhibit parenting stress. Data on the associations between COVID-19 restrictions and the stress perceived by parents could help to focus the attention of the public health system on their parents' needs, leading to practices aimed to prevent parenting stress and burnout.

Should I trust you? Investigating trustworthiness judgements of painful facial expressions.

Past research indicates that patients' reports of pain are often met with skepticism and that observers tend to underestimate patients' pain. The mechanisms behind these biases are not yet fully understood. One relevant domain of inquiry is the interaction between the emotional valence of a stranger's expression and the onlooker's trustworthiness judgment. The emotion overgeneralization hypothesis posits that when facial cues of valence are clear, individuals displaying negative expressions (e.g., disgust) are perceived as less trustworthy than those showing positive facial expressions (e.g., happiness). Accordingly, we hypothesized that facial expressions of pain (like disgust) would be judged more untrustworthy than facial expressions of happiness. In two separate studies, we measured trustworthiness judgments of four different facial expressions (i.e., neutral, happiness, pain, and disgust), displayed by both computer-generated and real faces, via both explicit self-reported ratings (Study 1) and implicit motor trajectories in a trustworthiness categorization task (Study 2). Ratings and categorization findings partly support our hypotheses. Our results reveal for the first time that when judging strangers' facial expressions, both negative expressions were perceived as more untrustworthy than happy expressions. They also indicate that facial expressions of pain are perceived as untrustworthy as disgust expressions, at least for computer-generated faces. These findings are relevant to the clinical setting because they highlight how overgeneralization of emotional facial expressions may subtend an early perceptual bias exerted by the patient's emotional facial cues onto the clinician's cognitive appraisal process.

On the lowest rung of the ladder: How social exclusion, perceived economic inequality and stigma increase homeless people's resignation.

Despite the relevance of social exclusion and economic inequality for homelessness, empirical studies investigating how these issues relate to homeless people's psychological well-being are scarce. We aimed to fill this gap by conducting two quasi-experimental studies on homeless and non-homeless groups. The first study (N = 200) showed that homeless (vs. non-homeless) people presented higher levels of resignation, characterized by depression, alienation, helplessness, and unworthiness (Williams, 2009). The second study (N = 183) replicated the findings from Study 1 and showed that perceived economic inequality could increase homeless people's resignation by emphasizing perceptions of social exclusion. Additional analyses found that identification with the stigmatized homeless group could mediate the relationship between perceived inequality and social exclusion, increasing the resignation. Overall, the results showed that chronic social exclusion of homeless people is associated with higher levels of resignation. Moreover, they showed the role of perceived economic inequality and homeless group stigmatized identification as group-specific mechanisms favouring social exclusion and ultimately worsening psychological well-being.

Divergent emotional and autonomic responses to Cyberball in patients with opioid use disorder on opioid agonist treatment.

The perception of social exclusion among patients with opioid use disorder (OUD) could be affected by long-term opioid use. This study explores the emotional and cardiac autonomic responses to an experience of ostracism in a sample of participants with OUD on opioid agonist treatment (OAT). Twenty patients with OUD and twenty healthy controls (HC) performed a ball-tossing game (Cyberball) with two conditions: Inclusion and Ostracism. We measured self-reported ratings of perceived threat towards one's fundamental needs and respiratory sinus arrhythmia (RSA) immediately after the game and 10 min after Ostracism (Reflective stage). Following ostracism, participants with OUD self-reported blunted feelings of threat to the fundamental need to belong. RSA levels were significantly suppressed immediately after ostracism and during the Reflective stage in comparison with HC, indicating an autonomic alteration in response to threatening social situations. Finally, only among HC higher perceived threats towards fundamental needs predicted increases in RSA levels, suggesting an adaptive vagal regulation in response to a perceived threat. Conversely, among patients with OUD the subjective response to ostracism was not associated with the autonomic reaction. OAT may have a protective effect against negative feelings of ostracism. However patients with OUD on OAT present poor autonomic regulation in response to social threats, which could reflect their trait hypersensitivity to social rejection.

Social influences in the digital era: When do people conform more to a human being or an artificial intelligence?

The spread of artificial intelligence (AI) technologies in ever-widening domains (e.g., virtual assistants) increases the chances of daily interactions between humans and AI. But can non-human agents influence human beings and perhaps even surpass the power of the influence of another human being? This research investigated whether people faced with different tasks (objective vs. subjective) could be more influenced by the information provided by another human being or an AI. We expected greater AI (vs. other humans) influence in objective tasks (i.e., based on a count and only one possible correct answer). By contrast, we expected greater human (vs. AI) influence in subjective tasks (based on attributing meaning to evocative images). In Study 1, participants (N = 156) completed a series of trials of an objective task to provide numerical estimates of the number of white dots pictured on black backgrounds. Results showed that participants conformed more with the AI's responses than the human ones. In Study 2, participants (N = 102) in a series of subjective tasks observed evocative images associated with two concepts ostensibly provided, again, by an AI or a human. Then, they rated how each concept described the images appropriately. Unlike the objective task, in the subjective one, participants conformed more with the human than the AI's responses. Overall, our findings show that under some circumstances, AI can influence people above and beyond the influence of other humans, offering new insights into social influence processes in the digital era.

Conflicting representations of pain: a qualitative analysis of health care professionals' discourse.

INTRODUCTION: Studies regarding health care professionals' representations of pain indicate that doctors and nurses tend to concentrate on the organic origin of pain, and to view pain as subordinate to diagnosis and treatment of the disease; they also tend to underestimate the psychological and psychosocial components of pain, which means that they generally view the patient's subjective experience as secondary. This leads to an underestimation of pain. OBJECTIVE: The objective of this study was to analyze the representations of pain held by doctors, head nurses, and nurses in two Italian hospitals, focusing on how these representations are shaped according to the local culture in which they are constructed and negotiated. METHODS: Our study is based on a socio-constructionist approach, drawing on semi-structured, in-depth interviews with 26 health care professionals. RESULTS: The results show similarities and differences in how health care professionals construct their representations of pain. Three main issues emerged. First, the contents of these representations are strictly related to participants' job position and professional training; second, the representation of pain is significantly influenced by the values and meanings associated with the different professions; and third, there are two conflicting representations of pain, focusing on the objectivity vs the subjectivity of pain, respectively. CONCLUSIONS: To promote significant change regarding pain management within hospital organizations, it is essential to construct shared representations of the problem and its implications, particularly as regards relations with the patient. This change should take place at the educational as well as the socio-organizational level, and it should take into account ideas and proposals from the subjects involved.

Surrendering to social emptiness: Chronic social exclusion longitudinally predicts resignation in asylum seekers.

The current knowledge of the long-term consequences of social exclusion mostly relies on theoretical assumptions. (Williams, 2009, Adv. Exp. Soc. Psychol., 41, 275) hypothesized that chronic ostracism drives individuals into a stage of resignation (depression, alienation, unworthiness, helplessness). We focused on asylum seekers (N = 112) as a social group at risk of experiencing prolonged instances of exclusion. Applying a three-wave longitudinal design with a three-month interval between each wave, we sought to advance the knowledge of the temporal development of chronic social exclusion. Cross-lagged panel analyses showed that social exclusion influenced the development of feelings of resignation in the long term, from baseline to six months and between three and six months. In the same time frame, the perception of social exclusion became stable and chronic. These findings provide empirical evidence that chronic exclusion predicts resignation and shed light on the temporal development of the detrimental impact that pervasive exclusion can have on people belonging to marginalized social groups.

Forced Social Isolation and Mental Health: A Study on 1,006 Italians Under COVID-19 Lockdown.

Most countries have been struggling with the spread of the COVID-19 pandemic imposing social isolation on their citizens. However, this measure carried risks for people's mental health. This study evaluated the psychological repercussions of objective isolation in 1,006 Italians during the first, especially strict, lockdown in spring 2020. Although varying for the regional spread-rate of the contagion, results showed that the longer the isolation and the less adequate the physical space where people were isolated, the worse the mental health (e.g., depression). Offline social contacts buffered the association between social isolation and mental health. However, when offline contacts were limited, online contacts seemed crucial in protecting mental health. The findings inform about the potential downsides of the massive social isolation imposed by COVID-19 spread, highlighting possible risk factors and resources to account for implementing such isolation measures. Specifically, besides some known factors such as physical space availability, the local contagion rate is critical in moderating the link between social isolation and mental health issues, supporting national policies implementing regional tiers of restriction severity.

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

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.