Preexposure to one social threat alters responses to another social threat: Behavioral and electrophysiological evidence.

A recent Cyberball study has indicated that the experience of loss of control can affect how people process subsequent social exclusion. This "preexposure effect" supports the idea of a common cognitive system involved in the processing of different types of social threats. To test the validity of this assumption in the current study, we reversed the sequence of the preexposure setup. We measured the effects of social exclusion on the subsequent processing of loss of control utilizing event-related brain potentials (ERPs) and self-reports. In the control group (CG, n = 26), the transition to loss of control elicited significant increases in both the P3 amplitude and the self-reported negative mood. Replicating the results of the previous preexposure study, these effects were significantly reduced by the preexposure to an independent social threat (here: social exclusion). In contrast to previous findings, these effects were not modulated by the discontinuation (EG1disc, n = 25) or continuation (EG2cont, n = 24) of the preexposure threat. Given that the P3 effect is related to the violation of subjective expectations, these results support the notion that preexposure to a specific social threat has widespread effects on the individuals' expectancy of upcoming social participation and control.

Evidence of deviant parasympathetic response to social exclusion in women with borderline personality disorder.

Stressful social situations like social exclusion are particularly challenging for patients with borderline personality disorder (BPD) and often lead to dysfunctional reactive behaviour of aggression and withdrawal. The autonomous signature of these core symptoms of BPD remains poorly understood. The present study investigated the parasympathetic response to social exclusion in women with BPD (n = 62) and healthy controls (HC; n = 87). In a between-subjects design, participants experienced objective social exclusion or overinclusion in the Cyberball task, a virtual ball-tossing game. Need threat scores served as individual measures of perceived exclusion and the resulting frustration of cognitive-emotional needs. Five-minute measurements of high-frequency heart rate variability (HF-HRV) at three time points (before, during, after Cyberball) indicated parasympathetic tone and regulation. We observed a trend towards lowered baseline HF-HRV in BPD vs. HC in line with previous findings. Interestingly, the parasympathetic response of patients with BPD to objective and perceived social exclusion fundamentally differed from HC: higher exclusion was associated with increased parasympathetic activation in HC, while this autonomic response was reversed and blunted in BPD. Our findings suggest that during social stress, the parasympathetic nervous system fails to display an adaptive regulation in patients with BPD, but not HC. Understanding the autonomous signature of the stress response in BPD allows the formulation of clinically relevant and biologically plausible interventions to counteract parasympathetic dysregulation in this clinical group.

Compensatory prosocial behavior in high-risk adolescents observing social exclusion: The effects of emotion feedback.

Although exposure to violence has been consistently associated with deficits in prosocial behavior among adolescents, effective methods of mitigating these deficits have yet to be identified. The current investigation tested whether prosocial behavior could be promoted by providing adolescents with feedback about the emotional states of others and whether the effects of feedback varied between adolescents who had versus had not experienced violence in the home or in the community. Adolescents aged 8 to 17 years with (n = 87) and without (n = 61) histories of violence exposure completed a virtual social exclusion ball-tossing paradigm in which information about an excluded peer's emotions (sad, angry, or neutral) was experimentally manipulated. Among adolescents with histories of violence exposure, those who received feedback that the peer was sad due to being excluded compensated by throwing the ball more often to that peer. In contrast, adolescents without histories of violence exposure did not engage in compensatory prosocial behavior, instead maintaining a relatively even number of tosses to all players. Findings offer new insight into simple potential methods of eliciting prosocial behavior in adolescents for whom such responding may be compromised and may provide a potential starting point for interventions.

1 plus 1 is more than 2: mental health problems, financial difficulties, and social exclusion in a cross-sectional study of 28,047 general-population adults.

BACKGROUND: Mental health problems and financial difficulties each increase the risk of social exclusion. However, few large studies representing a broad age range have investigated the combined social effect of having both difficulties. The purpose of this cross-sectional study was to examine associations of mental health problems, financial difficulties, and the combination of both with social exclusion. METHODS: This analysis was based on responses from 28,047 adults (age > 18 years) from the general population participating in The Norwegian Counties Public Health Survey 2019. Respondents answered questions about their financial situation, mental health problems, and social exclusion. Social exclusion was measured as a lack of social support, low participation in organized social activities, low participation in other activities, missing someone to be with, feeling excluded, and feeling isolated. Adjustments for sex and age were made in multivariable logistic regression analyses. RESULTS: Having mental health problems or financial difficulties was associated with various measures of social exclusion (odds ratios [ORs] with 95% confidence intervals [CIs]: 1.33 [1.23-1.43] to 12.63 [10.90-14.64]). However, the odds of social exclusion strongly increased for respondents who reported a combination of mental health problems and financial difficulties compared with those who did not report either (ORs [CIs]: 2.08 [1.90-2.27] to 29.46 [25.32-34.27]). CONCLUSIONS: Having the combination of mental health problems and financial difficulties is strongly associated with increased risk for social exclusion, far beyond the effect of either factor alone.

Mitigating the affective and cognitive consequences of social exclusion: an integrative data analysis of seven social disconnection interventions.

BACKGROUND: Being socially excluded has detrimental effects, with prolonged exclusion linked to loneliness and social isolation. Social disconnection interventions that do not require direct support actions (e.g., "how can I help?") offer promise in mitigating the affective and cognitive consequences of social exclusion. We examine how various social disconnection interventions involving friends and unknown peers might mitigate social exclusion by buffering (intervening before) and by promoting recovery (intervening after). METHODS: We present an integrative data analysis (IDA) of five studies (N = 664) that systematically exposed participants to exclusion (vs. inclusion) social dynamics. Using a well-validated paradigm, participants had a virtual interaction with two other people. Unbeknownst to participants, the other people's behavior was programmed to either behave inclusively toward the participant or for one to behave exclusively. Critically, our social disconnection interventions experimentally manipulated whether a friend was present (vs. an unknown peer vs. being alone), the nature of interpersonal engagement (having a face-to-face conversation vs. a reminder of an upcoming interaction vs. mere presence), and the timing of the intervention in relation to the social dynamic (before vs. during vs. after). We then assessed participants' in-the-moment affective and cognitive responses, which included mood, feelings of belonging, sense of control, and social comfort. RESULTS: Experiencing exclusion (vs. inclusion) led to negative affective and cognitive consequences. However, engaging in a face-to-face conversation with a friend before the exclusion lessened its impact (p < .001). Moreover, a face-to-face conversation with a friend after exclusion, and even a reminder of an upcoming interaction with a friend, sped-up recovery (ps < .001). There was less conclusive evidence that a face-to-face conversation with an unknown peer, or that the mere presence of a friend or unknown peer, conferred protective benefits. CONCLUSIONS: The findings provide support for the effectiveness of social disconnection interventions that involve actual (i.e., face-to-face) or symbolic (i.e., reminders) interactions with friends. These interventions target momentary vulnerabilities that arise from social exclusion by addressing negative affect and cognitions before or after they emerge. As such, they offer a promising approach to primary prevention prior to the onset of loneliness and social isolation.

Social exclusion as a major outcome domain of psychotic disorders: early predictors, and associations with non-recovery and clinical staging 21 years after a first episode of psychosis.

PURPOSE: People with psychotic disorders have high levels of social exclusion; however, little is known about its early predictors. We present a long-term observational cohort study aimed at examining early risk factors for later social exclusion. METHODS: A total of 243 subjects were assessed at their first psychotic episode for early risk factors including sociodemographic variables, familial risk of major mental disorders, perinatal complications, childhood factors, and adolescent factors and re-assessed after a mean follow-up of 21 years for 12 social exclusion domains: leisure activities, housing, work, income, neighborhood deprivation, educational attainment, physical and mental health, family and social support, legal competence, and discrimination. The ability of risk factors to predict social exclusion was examined using hierarchical linear regression. RESULTS: Overall social exclusion was independently predicted by low parental socio-economic status, length of follow-up, familial risk of schizophrenia, obstetric complications, neurodevelopmental delay, poor childhood adjustment, childhood adversity, poor adolescent social networks, poor adolescent adjustment, and low premorbid IQ. The model explained 58.2% of the variance in total social exclusion score. Each social exclusion domain was predicted by a different set of variables, which explained between 17.8 and 57.0% of their variance, although low socio-economic status, familial risk of schizophrenia, obstetric complications, childhood adversity, and poor social networks predicted most of the social exclusion domains. CONCLUSION: Early risk factors strongly predicted later social exclusion. A multifaceted approach to preventing later social exclusion is crucial in people with a first episode of psychosis and early risk factors of social exclusion.

Shaping tomorrow's support: baseline clinical characteristics predict later social functioning and quality of life in schizophrenia spectrum disorder.

PURPOSE: We aimed to explore the multidimensional nature of social inclusion (mSI) among patients diagnosed with schizophrenia spectrum disorder (SSD), and to identify the predictors of 3-year mSI and the mSI prediction using traditional and data-driven approaches. METHODS: We used the baseline and 3-year follow-up data of 1119 patients from the Genetic Risk and Outcome in Psychosis (GROUP) cohort in the Netherlands. The outcome mSI was defined as clusters derived from combined analyses of thirteen subscales from the Social Functioning Scale and the brief version of World Health Organization Quality of Life questionnaires through K-means clustering. Prediction models were built through multinomial logistic regression (ModelMLR) and random forest (ModelRF), internally validated via bootstrapping and compared by accuracy and the discriminability of mSI subgroups. RESULTS: We identified five mSI subgroups: "very low (social functioning)/very low (quality of life)" (8.58%), "low/low" (12.87%), "high/low" (49.24%), "medium/high" (18.05%), and "high/high" (11.26%). The mSI was robustly predicted by a genetic predisposition for SSD, premorbid adjustment, positive, negative, and depressive symptoms, number of met needs, and baseline satisfaction with the environment and social life. The ModelRF (61.61% [54.90%, 68.01%]; P =0.013) was cautiously considered outperform the ModelMLR (59.16% [55.75%, 62.58%]; P =0.994). CONCLUSION: We introduced and distinguished meaningful subgroups of mSI, which were modestly predictable from baseline clinical characteristics. A possibility for early prediction of mSI at the clinical stage may unlock the potential for faster and more impactful social support that is specifically tailored to the unique characteristics of the mSI subgroup to which a given patient belongs.

Measuring social exclusion and its distribution in England.

BACKGROUND: Social exclusion is a multidimensional concept referring processes which restrict the ability of individuals or groups to participate fully in society. While social exclusion has been used to explore patterns of disadvantage, it has been difficult to measure. Thus, we aimed to use population-based data to measure social exclusion and its constituent domains and to describe its distribution in England. METHODS: We used data from Understanding Society in 2009/2010 develop a multidimensional measurement approach, replicated in 2018/2019. We defined five domains of social exclusion from the literature and expert consultation: material, relational, political, digital, and structural. In both waves, we identified measures for each domain, then conducted principal component analysis to identify the components. We generated domain scores and an overall social exclusion score. We described the distribution of social exclusion and its domains by sex, region, age, and ethnicity. RESULTS: We found the level of social exclusion was higher in the youngest age group and decreased by age. We found elevated levels of overall social exclusion for ethnic minoritised groups including African, Arab, and Caribbean groups compared to White British groups. We found distinct patterns within each domain. DISCUSSION: We developed an overall measure of social exclusion with five domains, and finding distinct patterns of social exclusion by age, ethnicity, and region which varied across domain. These findings suggest that attention should be paid to the separate domains due to different population distributions. This measurement approach moves beyond conceptual discussions of social exclusion and demonstrates the utility of a quantitative measure of social exclusion for use in health and social research.

Suicidal ideation and attempt among young people living in gosiwons in South Korea.

INTRODUCTION: Young people living in gosiwons could be at high risk for suicide owing to inadequate living conditions and the social stigma towards them. However, this topic has not received adequate academic attention. Gosiwon is a type of small residence consisting of several tiny rooms densely packed together and usually does not meet minimum housing standards. However, gosiwons are favored by low-income groups, especially young people, because they are cheaper than other residences. This study aimed to examine the factors that increase the risk of suicidal ideation and attempt among young people living in gosiwons. METHODS: A sample of 300 young people aged 19-34 years living in gosiwons for over 6 months was analyzed. A set of multinomial logistic regression was conducted to examine the factors that differentiate the suicidal ideation and attempt group from the no-suicidal risk group. RESULTS: Approximately 30% of the study participants experienced suicidal ideation or attempted suicide. Among several risk factors, social exclusion and depressive symptoms distinguished the group with suicidal ideation from the no-risk group. Depressive symptoms were the only factor that differentiated the group with suicide attempts history from the no-risk group. CONCLUSION: The results emphasize the need to focus on social exclusion and depressive symptoms among young people living in poor housing conditions. Interventions to address social exclusion and depressive symptoms may help prevent suicide risk among young people exposed to housing exclusion.

Why step in? Shifting justifications for bystander behaviors through interventions with youth in the Middle East.

Research shows positive bystander intervention effectively mitigates bullying experiences. Yet, more evidence regarding bystander responses to bias-based social exclusion (BSE) is needed in intergroup contexts, especially in the majority world and in areas of intractable conflict. This study assessed the effectiveness of skills and skills + contact-based interventions for BSE among 148 Palestinian Citizens of Israel (Mage = 10.55) and 154 Jewish-Israeli (Mage = 10.54) early adolescents (Girls = 52.32%) in Tel Aviv-Yafo. Bystander responses were assessed by participants' reactions to hypothetical BSE scenarios over three time points. Repeated measures ANOVAs revealed both interventions significantly increased positive and decreased negative bystander responses, with changes maintained at the follow-up. The opposite result pattern emerged for the control group. Findings suggest that both interventions can effectively encourage youth to publicly challenge BSE, even amidst intractable conflict.

Effects of two different social exclusion paradigms on ambiguous facial emotion recognition.

Social exclusion is an emotionally painful experience that leads to various alterations in socio-emotional processing. The perceptual and emotional consequences that may arise from experiencing social exclusion can vary depending on the paradigm used to manipulate it. Exclusion paradigms can vary in terms of the severity and duration of the leading exclusion experience, thereby classifying it as either a short-term or long-term experience. The present study aimed to study the impact of exclusion on socio-emotional processing using different paradigms that caused experiencing short-term and imagining long-term exclusion. Ambiguous facial emotions were used as socio-emotional cues. In study 1, the Ostracism Online paradigm was used to manipulate short-term exclusion. In study 2, a new sample of participants imagined long-term exclusion through the future life alone paradigm. Participants of both studies then completed a facial emotion recognition task consisting of morphed ambiguous facial emotions. By means of Point of Subjective Equivalence analyses, our results indicate that the experience of short-term exclusion hinders recognising happy facial expressions. In contrast, imagining long-term exclusion causes difficulties in recognising sad facial expressions. These findings extend the current literature, suggesting that not all social exclusion paradigms affect socio-emotional processing similarly.

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.

The role of ventrolateral prefrontal cortex on voluntary emotion regulation of social pain.

The right ventrolateral prefrontal cortex (rVLPFC) is highly engaged in emotion regulation of social pain. However, there is still lack of both inhibition and excitement evidence to prove the causal relationship between this brain region and voluntary emotion regulation. This study used high-frequency (10 Hz) and low-frequency (1 Hz) repetitive transcranial magnetic stimulation (rTMS) to separately activate or inhibit the rVLPFC in two groups of participants. We recorded participants' emotion ratings as well as their social attitude and prosocial behaviors following emotion regulation. Also, we used eye tracker to record the changes of pupil diameter to measure emotional feelings objectively. A total of 108 healthy participants were randomly assigned to the activated, inhibitory or sham rTMS groups. They were required to accomplish three sequential tasks: the emotion regulation (cognitive reappraisal) task, the favorability rating task, and the donation task. Results show that the rVLPFC-inhibitory group reported more negative emotions and showed larger pupil diameter while the rVLPFC-activated group showed less negative emotions and reduced pupil diameter during emotion regulation (both compared with the sham rTMS group). In addition, the activated group gave more positive social evaluation to peers and donated more money to a public welfare activity than the rVLPFC-inhibitory group, among which the change of social attitude was mediated by regulated emotion. Taken together, these findings reveal that the rVLPFC plays a causal role in voluntary emotion regulation of social pain and can be a potential brain target in treating deficits of emotion regulation in psychiatric disorders.

The Impact of Ingroup and Outgroup Exclusion on HIV-Risk Cognitions in Sexual Minority Men.

BACKGROUND: Sexual minority men (SMM) face disproportionate rates of HIV/AIDS. Emerging evidence indicates that minority stress (e.g., discrimination) and stress from within the gay community itself (e.g., exclusion) may contribute to sexual orientation disparities in HIV prevalence and risk. PURPOSE: This study investigated the impact of sexual orientation discrimination and exclusion by the gay community on SMM's intentions to engage in HIV-risk behavior. METHODS: We conducted an experiment in which we employed an exclusion manipulation to induce (a) perceived discrimination from the outgroup and (b) perceived exclusion by the ingroup in a community sample of 194 SMM. Participants completed a baseline assessment of previous discrimination, exposure to gay community stress, and HIV-risk behavior. Two days later, participants completed an experiment in which they were randomized to one of four conditions in the game Cyberball: (a) exclusion by straight men, (b) inclusion by straight men, (c) exclusion by gay men, or (d) inclusion by gay men. Risky sex intentions were then assessed. RESULTS: Discrimination and gay community stress were positively associated with HIV-risk behaviors at baseline. Participants who were excluded (vs. included) by straight men in the experimental task reported more risky sex intentions. This effect was mediated by decreases in state self-esteem. Risky sex intentions did not differ between participants who were included versus excluded by gay men. CONCLUSIONS: This study provides the first experimental evidence that discrimination is associated with sexual risk taking in SMM, and elucidates a potential psychological mechanism through which this effect operates.

Perceived contact with friends from lower socioeconomic status reduces exclusion based on social class.

This study investigated children's and adolescents' reasoning about intergroup exclusion based on social class from educational opportunities in Türkiye. The role of children's and adolescents' perceived contact with friends from different socioeconomic backgrounds on their evaluations of exclusion and personal solutions to the exclusion was also examined. Participants (N = 270) included 142 children (8-10 years old, Mage = 9.80; SD = 0.82; 53.5% girls) and 128 adolescents (14-16 years old, Mage = 15.46; SD = 0.91, 61.7% girls) from lower (N = 144) and higher (N = 126) socioeconomic backgrounds. Results showed that while most participants viewed social class-based exclusion as wrong, adolescents were more likely to view it as wrong than were children. Adolescents from lower SES approached social class-based exclusion as less acceptable than did adolescents from higher SES who referred to expectations about conformity to authority and the status quo. Moderation analyses showed that for adolescents from higher SES, higher perceived contact with friends from lower SES was associated with decreased acceptability of exclusion and increased motivation to provide equity. RESEARCH HIGHLIGHTS: Overall, adolescents living in a country with economic instability evaluated social class-based exclusion from educational opportunities among peers as unfair and wrong. Adolescents from lower SES viewed social class-based exclusion as less acceptable than did adolescents from higher SES. Adolescents from higher SES expected that excluders' intentions were motivated by conforming to authority and supporting the status quo more frequently than did children. For adolescents from higher SES, perceived contact with friends from lower SES was associated with decreased acceptability of exclusion and increased motivation to provide equity.

Social capital and women's narratives of homelessness and multiple exclusion in northern England.

Women experiencing three or more co-occurring issues (homelessness, substance misuse, mental health) are a highly vulnerable population associated with multimorbidity. Taking women's life stories of trajectories into social exclusion in the north of England as its focus, this paper aims to explore the complexity of social contexts in which women navigate extreme health inequalities. Of the few studies that have examined women's experiences of homelessness through the lens of social capital, most have focused on network size, rather than the quality and influence of the relationships which precipitate or contextualise experiences of social exclusion. We utilise case studies to offer a theoretically-grounded analysis which illustrates the relationship between social capital and homelessness within this population. Our results illustrate how structural contexts, and specifically social capital accrual and social bonding processes particularly pertinent to women can act to both ameliorate and perpetuate social exclusion. We conclude by arguing that health inequalities cannot be tackled as single-issue processes but instead are multi-layered and complex.

How do health system factors (funding and performance) impact on access to healthcare for populations experiencing homelessness: a realist evaluation.

BACKGROUND: People experiencing long-term homelessness face significant difficulties accessing appropriate healthcare at the right time and place. This study explores how and why healthcare performance management and funding arrangements contribute to healthcare accessibility or the lack thereof using long-term homeless adults as an example of a population experiencing social exclusion. METHODS: A realist evaluation was undertaken. Thirteen realist interviews were conducted after which data were transcribed, coded, and analysed. RESULTS: Fourteen CMOCs were created based on analysis of the data collected. These were then consolidated into four higher-level CMOCs. They show that health systems characterised by fragmentation are designed to meet their own needs above the needs of patients, and they rely on practitioners with a special interest and specialised services to fill the gaps in the system. Key contexts identified in the study include: health system fragmentation; health service fragmentation; bio-medical, one problem at a time model; responsive specialised services; unresponsive mainstream services; national strategy; short health system funding cycles; and short-term goals. CONCLUSION: When health services are fragmented and complex, the needs of socially excluded populations such as those experiencing homelessness are not met. Health systems focus on their own metrics and rely on separate actors such as independent NGOs to fill gaps when certain people are not accommodated in the mainstream health system. As a result, health systems lack a comprehensive understanding of the needs of all population groups and fail to plan adequately, which maintains fragmentation. Policy makers must set policy and plan health services based on a full understanding of needs of all population groups.

Community centers for older adults and psychosocial factors: Evidence from the German Ageing Survey.

INTRODUCTION: There is a dearth of studies examining the association between the use of community centers for older adults and psychosocial factors. Thus, our aim was to examine the association between the use of community centers for older adults and psychosocial factors (in terms of loneliness, perceived social isolation, and life satisfaction; also stratified by sex)-which is important for successful aging. METHODS/DESIGN: Data were taken from a nationally representative sample-the German Ageing Survey-including older community-dwelling individuals. The De Jong Gierveld tool was used to measure loneliness, the Bude and Lantermann tool was used to measure perceived social isolation, and the Satisfaction with Life Scale was used to quantify life satisfaction. Multiple linear regressions were used to evaluate the hypothesized associations. RESULTS: In the analytical sample, n equaled 3246 individuals (mean age was 75 years, 65-97 years). After adjusting for various socioeconomic, lifestyle-related, and health-related covariates, multiple linear regressions showed that the use of community centers was associated with higher life satisfaction among men (ß = 0.12, p < 0.01), but not women. The use of community centers was not associated with loneliness or perceived social isolation for either gender. CONCLUSIONS: The use of community centers was positively associated with satisfaction with one's own life among male older adults. Thus, encouraging older men to use such services may be beneficial. This quantitative study provides an initial basis for further research in this neglected area. For example, longitudinal studies are required to confirm our present findings.

Impact of social exclusion on empathy in women with borderline personality disorder.

Unstable interpersonal relationships and fear of abandonment are core symptoms of borderline personality disorder (BPD) that often intensify during stress. Psychosocial stress, which includes components of social exclusion and increases cortisol secretion, enhances emotional empathy in healthy individuals. Women with BPD, on the contrary, react with reduced emotional empathy. The aim of the present study was to investigate the effects of perceived social exclusion without accompanying cortisol increase on empathy in women with BPD and healthy women. To induce social exclusion, we randomized 98 women with BPD and 98 healthy women to either an exclusion or an overinclusion (control) condition of Cyberball, a virtual ball game. Subsequently, participants underwent the Multifaceted Empathy Test (MET), which assesses cognitive and emotional empathy. There was no increase in cortisol release after Cyberball. Cognitive empathy did not differ between groups or conditions. Women with BPD reported lower emotional empathy for positive emotions (group by valence interaction), but not for negative emotions. Exploratory analyses suggested that this effect might be more pronounced after social exclusion. Our results confirm previous findings that cognitive empathy does not differ between women with BPD and healthy women and extend this evidence to social exclusion. Emotional empathy in women with BPD seems to be more sensitive to the effects of stress or ambiguous social situations. Specifically, emotional empathy seems to be reduced for positive emotions, and might further decline after social exclusion. Empathic reactions to emotional stimuli of different valences and to specific emotions should be further investigated.

Distinct dynamic behavioural response to social exclusion in male patients with a history of alcohol dependence.

Social exclusion contributes to alcohol consumption, whereas the development of alcohol dependence (AD) can in turn lead to the social exclusion of people with AD. Previous research observed altered neural responses to experimentally induced social exclusion (i.e., Cyberball game) in patients with AD. In addition, inflammation has been associated with both social behaviours and AD. Our study aimed to investigate the dynamic behavioural response and the inflammatory effects of social exclusion in male patients with a history of AD. To this end, we analysed dynamic changes in ball tossing during a partial exclusion Cyberball game and the cytokine interleukin (IL)-1b in saliva in 31 male patients who had a history of AD and 29 gender-matched healthy controls without AD. Participants were included in the first 2 min of the Cyberball game and then excluded by one of the two co-players in the proceeding 5 min. Saliva was collected three times: one before and two after the Cyberball game. Across groups, participants passed the ball more often to the excluder during the partial exclusion period. Analysis using piece-wise linear mixed models showed that patients rapidly increased ball tosses to the excluder upon exclusion, which lasted to the late response phase, whereas the early behavioural response to exclusion took longer for controls. There was no significant change of salivary IL-1b level to exclusion in either patients or controls. The results indicate a distinct dynamic behavioural response to social exclusion in male patients with a history of AD.