Wiesenfeller Jana, Flasbeck Vera, Brown Elliot C, Brüne Martin
Department of Psychiatry, Psychotherapy, and Preventive Medicine, Division of Social Neuropsychiatry and Evolutionary Medicine, LWL University Hospital, Ruhr-University Bochum, Bochum, Germany.
Department of Decision Neuroscience and Nutrition, German Institute of Human Nutrition, Nuthetal, Germany.
Front Behav Neurosci. 2020 Dec 1;14:588874. doi: 10.3389/fnbeh.2020.588874. eCollection 2020.
Borderline personality disorder (BPD) is portrayed by unstable relationships, fears of abandonment and heightened sensitivity to social rejection. Research has shown that these characteristics may lead to inappropriate social behavior including altered approach-avoidance behavior. However, it has remained unclear how social exclusion may affect approach-avoidance behavior in patients with BPD.
We assessed social approach-avoidance behavior and the impact of social exclusion in a sample of 38 patients with BPD and 40 healthy control participants.
We used an explicit joystick-based approach-avoidance task (AAT) after playing a virtual ball-tossing game (Cyberball), which simulates the exclusion of the participant by two other players. In the AAT, participants were required to push or pull emotional stimuli, more specifically happy and angry facial expressions, with either direct or averted gaze direction.
Patients with BPD approached happy stimuli less and showed overall less differential approach-avoidance behavior toward individuals expressing positive or negative facial emotions compared to healthy participants, who showed more approach behavior for happy compared to angry facial expressions. Moreover, borderline symptom severity correlated inversely with the AAT score for happy facial expressions and positively with subjective unpleasantness during social exclusion as well as rejection sensitivity. However, social exclusion did not influence approach-avoidance tendencies.
Patients with BPD showed altered approach-avoidance behavior, which might affect social interactions in the patient's everyday lives and may therefore impede social interaction.
边缘型人格障碍（BPD）表现为人际关系不稳定、害怕被抛弃以及对社会排斥高度敏感。研究表明，这些特征可能导致不适当的社会行为，包括改变的趋近-回避行为。然而，社会排斥如何影响BPD患者的趋近-回避行为仍不清楚。
我们评估了38例BPD患者和40名健康对照参与者样本中的社会趋近-回避行为以及社会排斥的影响。
在玩虚拟抛球游戏（Cyberball）后，我们使用了一种基于显式操纵杆的趋近-回避任务（AAT），该游戏模拟了参与者被另外两名玩家排斥的情景。在AAT中，参与者被要求用直接或回避的注视方向推动或拉动情绪刺激，更具体地说是快乐和愤怒的面部表情。
与健康参与者相比，BPD患者较少趋近快乐刺激，并且对表达正面或负面面部情绪的个体总体上表现出较少的差异趋近-回避行为，健康参与者对快乐面部表情的趋近行为比对愤怒面部表情更多。此外，边缘型症状严重程度与快乐面部表情的AAT得分呈负相关，与社会排斥期间的主观不愉快感以及拒绝敏感性呈正相关。然而，社会排斥并未影响趋近-回避倾向。
BPD患者表现出改变的趋近-回避行为，这可能会影响患者日常生活中的社交互动，因此可能会阻碍社交。
