Cognitive and affective processing of social exclusion in borderline personality disorder and social anxiety disorder

Causal attributions of social events are crucial for understanding emotional responses. Aim of the study was to identify appraisal processes in response to social exclusion in borderline personality disorder (BPD) and social anxiety disorder (SAD). Twenty-five patients with BPD, 25 patients with SAD and 25 healthy controls played Cyberball, a virtual ball-tossing paradigm that experimentally induces social exclusion. Causal attributions, subjective feelings and action tendencies in response to social exclusion were assessed. Both clinical groups showed more internal attributions and less control attributions than the control group, reported a higher increase in self-focused negative emotions, along with more escape tendencies and less intent to engage in pleasant activities. But only the BPD group reported higher hostile-intent attributions and more aggressive action tendencies compared to healthy controls.