Coughlan-Hopkins Senan, Martinelli Cristina
Department of Psychology, City St George's, University of London, London, UK.
Department of Psychology, Kingston University, London, UK.
J Eat Disord. 2025 Jul 10;13(1):134. doi: 10.1186/s40337-025-01261-7.
Social rejection sensitivity (SRS) is characterised by anxious expectations of rejection, and the increased tendency to readily perceive and react intensely to rejection-based cues. It has been suggested SRS may play a role in anorexia nervosa (AN). Our review investigates whether SRS is exhibited in AN, and the cognitive mechanisms that underly this disposition.
We included experimental studies if they used social threat or rejection-based stimuli, reported on measures related to either cognitive, emotional, and/or behavioural responses, and compared patients with a diagnosis of AN and/or those who have recovered from the illness with healthy controls.
This article identified 47 eligible studies, with risk of bias assessment indicating the research was of good quality. Main findings showed patients with AN exhibit attentional bias towards social rejection cues, negative interpretation bias during ambiguous social scenarios, and heightened negative affect during and following rejection-based experiences. Physiological blunting during and following rejection-based experiences was observed in AN with some evidence to suggest this remediates during the process of weight-restoration. demonstrating an incongruence between affective and somatic experience in active illness.
Our results suggest females with AN display a cognitive profile that could lead to a tendency to expect rejection, readily perceive rejection and react with more intense negative affect to rejection-based cues, with limited evidence to suggest this cognitive profile persists in recovery. Our results can be interpreted through theoretical models that postulate drive for thinness may partially function to cope with anticipated or experienced rejection.
社交拒绝敏感性（SRS）的特征是对拒绝的焦虑预期，以及对基于拒绝的线索易于察觉并产生强烈反应的增强倾向。有人提出，SRS可能在神经性厌食症（AN）中起作用。我们的综述调查了AN患者是否表现出SRS，以及这种倾向背后的认知机制。
如果实验研究使用了社会威胁或基于拒绝的刺激，报告了与认知、情感和/或行为反应相关的测量结果，并将诊断为AN的患者和/或从该疾病中康复的患者与健康对照进行比较，我们就将其纳入研究。
本文确定了47项符合条件的研究，偏倚风险评估表明这些研究质量良好。主要研究结果显示，AN患者对社会拒绝线索表现出注意偏向，在模棱两可的社交场景中存在消极解释偏向，并且在基于拒绝的经历期间及之后会产生更强烈的消极情绪。在AN患者中观察到基于拒绝的经历期间及之后出现生理反应迟钝，有一些证据表明这种情况在体重恢复过程中会得到改善，这表明在疾病活跃期情感体验和躯体体验之间存在不一致。
我们的结果表明，患有AN的女性表现出一种认知特征，这种特征可能导致她们倾向于预期被拒绝，容易察觉到被拒绝，并对基于拒绝的线索产生更强烈的消极情绪反应，仅有有限的证据表明这种认知特征在康复后仍然存在。我们的结果可以通过理论模型来解释，这些模型假定对瘦的追求可能部分起到应对预期或经历的拒绝的作用。
