Neuronale Korrelate von sozialem Ausschluss bei psychischen Erkrankungen

Zusammenfassung

Ablehnung in zwischenmenschlichen Situationen oder sozialer Ausschluss wird umgangssprachlich häufig als schmerzhaft beschrieben. Wissenschaftliche Untersuchungen konnten zeigen, dass sozialer Ausschluss in der Tat gleichzeitig mit der Aktivierung von neuronalen Netzwerken einhergeht, die auch bei physischem Schmerz reagieren. Unter experimentellen Bedingungen wird sozialer Ausschluss dabei vorwiegend mit dem Cyberball-Paradigma operationalisiert, das in dem vorliegenden Artikel vorgestellt wird. Da einerseits sozialer Ausschluss als Risikofaktor für die Entwicklung psychischer Erkrankungen gilt und darüber hinaus Störungen der sozialen Interaktion ein diagnoseübergreifendes Symptom darstellen, ist die Untersuchung neurofunktioneller Korrelate sozialer Zurückweisung nicht nur von grundlagenwissenschaftlichem, sondern auch von klinischem Interesse. In diesem Artikel werden Befunde zu neuronalen Korrelaten sozialer Zurückweisung bei Patienten mit psychischen Erkrankungen vorgestellt, die zumeist mit funktionell-magnetresonanztomografischer Untersuchungen erhoben wurden. Wir fokussieren dabei auf Untersuchungen von Patienten mit emotional-instabiler Persönlichkeitsstörung vom Borderline-Typ, mit nicht suizidalem selbstverletzendem Verhalten sowie mit depressiver Störung.

Summary

Social exclusion is perceived as “hurtful” and is not only described by pain words. Research has shown, that social rejection activates neural networks that also react to the experience of physical pain. Under experimental conditions, social exclusion is operationalized by the so-called cyberball-paradigm that we introduce in this article. Considering social exclusion as a risk factor for several psychiatric disorders and dysfunctional social interaction is a frequent symptom across psychiatric diagnoses, the investigation of neural correlates of social exclusion seems not only a topic of interest fo basic research but may be an issue with remarkable clinical implications. In this article, we introduce findings on neural correlates of social exclusion and summarize functional magnetic resonance imaging studies in patients with borderline personality disorder, non-suicidal self-injurious behavior and depressive disorder.

Schlüsselwörter

fMRT - sozialer Schmerz - Cyberball

Keywords

fMRI - social pain - cyberball

• Literatur

• 1 Baumeister RF, Leary MR. The Need to Belong: Desire for Interpersonal Attachments as a Fundamental Human Motivation. Psychol Bull 1995; 117 (03) 497-529.
• 2 Spitzer M, Bonenberger M. Soziale schmerzen: Warum sie auch weh tun und was daraus folgt. Nervenheilkunde 2012; (31) 761-764.
• 3 Spitzer M. Verstoßen im Scanner: Ablehnung schmerzt Editorial. Nervenheilkunde 2003; 22: 486-7.
• 4 Eisenberger NI, Lieberman MD, Williams KD. Does rejection hurt? An FMRI study of social exclusion. Science 2003; 302 (5643): 290-2.
• 5 Wager TD, Atlas LY, Lindquist MA, Roy M, Woo C-W, Kross E. An fMRI-Based Neurologic Signature of Physical Pain. N Engl J Med 2013; 368 (15) 1388-97.
• 6 Rainville P, Duncan GH, Price DD, Carrier B, Bushnell MC. Pain affect encoded in human anterior cingulate but not somatosensory cortex. Science 1997; 277 (5328): 968-71.
• 7 Peyron R, Laurent B, Garcia-Larrea L. Functional imaging of brain responses to pain. A review and meta-analysis. NeurophysiolClin 2000; 30: 263-88.
• 8 Davis KD. The neural circuitry of pain as explored with functional MRI. Neurol Res 2000; 22 (03) 313-7.
• 9 Büchel C, Bornhovd K, Quante M, Glauche V, Bromm B, Weiller C. Dissociable neural responses related to pain intensity, stimulus intensity, and stimulus awareness within the anterior cingulate cortex: a parametric single-trial laser functional magnetic resonance imaging study. J Neurosci 2002; 22 (03) 970-6.
• 10 Tan LL, Pelzer P, Heinl C, Tang W, Gangadharan V, Flor H. et al. A pathway from midcingulate cortex to posterior insula gates nociceptive hypersensitivity. Nat Neurosci 2017; 20 (11) 1591-601.
• 11 Vogt BA. Midcingulate cortex: Structure, connections, homologies, functions and diseases. 74 Journal of Chemical Neuroanatomy 2016; 28-46.
• 12 Williams KD, Cheung CK, Choi W. Cyberostracism: effects of being ignored over the Internet. J Pers Soc Psychol 2000; 79 (05) 748-62.
• 13 Rotge JY, Lemogne C, Hinfray S, Huguet P, Grynszpan O, Tartour E. et al. A meta-analysis of the anterior cingulate contribution to social pain. Soc Cogn Affect Neurosci 2015; 10 (01) 19-27.
• 14 Eisenberger NI. The Neural Bases of Social Pain. Psychosom Med 2012; 74 (02) 126-35.
• 15 Onoda K, Okamoto Y, Nakashima K, Nittono H, Ura M, Yamawaki S. Decreased ventral anterior cingulate cortex activity is associated with reduced social pain during emotional support. Soc Neurosci 2009; 04 (05) 443-54.
• 16 Kross E, Berman MG, Mischel W, Smith EE, Wager TD. Social rejection shares somatosensory representations with physical pain. Proc Natl Acad Sci 2011; 108 (15) 65720-5.
• 17 DeWall CN, MacDonald G, Webster GD, Masten CL, Baumeister RF, Powell C. et al. Acetaminophen reduces social pain: Behavioral and neural evidence. Psychol Sci 2010; 21 (07) 931-7.
• 18 Masten CL, Eisenberger NI, Borofsky LA, Pfeifer JH, McNealy K, Mazziotta JC. et al. Neural correlates of social exclusion during adolescence: Understanding the distress of peer rejection. Soc Cogn Affect Neurosci 2009; 04 (02) 143-57.
• 19 Schmälzle R, O’Donnell MBrook, Garcia JO, Cascio CN, Bayer J, Bassett DS. et al. Brain connectivity dynamics during social interaction reflect social network structure. Proc Natl Acad Sci 2017; 114 (20) 5153-5158.
• 20 Cacioppo S, Frum C, Asp E, Weiss RM, Lewis JW, Cacioppo JT. A quantitative meta-analysis of functional imaging studies of social rejection. Sci Rep 2013; 03: 2027.
• 21 Bolling DZ, Pitskel NB, Deen B, Crowley MJ, McPartland JC, Mayes LC. et al. Dissociable brain mechanisms for processing social exclusion and rule violation. Neuroimage 2011; 54 (03) 2462-71.
• 22 Powers KE, Wagner DD, Norris CJ, Heatherton TF. Socially excluded individuals fail to recruit medial prefrontal cortex for negative social scenes. Soc Cogn Affect Neurosci 2013; 08 (02) 151-7.
• 23 Beyer F, Münte TF, Krämer UM. Increased neural reactivity to socio-emotional stimuli links social exclusion and aggression. Biol Psychol 2014; 96: 102-10.
• 24 Who. Risks to mental health: An overview of vulnerabilities and risk faktors. 2012
• 25 American Psychiatric Association. DSM-V. American Journal of Psychiatry. 2013
• 26 Krause-Utz A, Winter D, Niedtfeld I, Schmahl C. The Latest Neuroimaging Findings in Borderline Personality Disorder. Curr Psychiatry Rep 2014; 16 (03) 438.
• 27 Schmahl C, Bohus M, Esposito F, Treede R-D, Di Salle F, Greffrath W. et al. Neural correlates of antinociception in borderline personality disorder. Arch Gen Psychiatry 2006; 63 (06) 659-67.
• 28 Kleindienst N, Bohus M, Ludäscher P, Limberger MF, Kuenkele K, Ebner-Priemer UW. et al. Motives for nonsuicidal self-injury among women with borderline personality disorder. J Nerv Ment Dis 2008; 196 (03) 230-6.
• 29 Shearer SL. Phenomenology of self-injury among inpatient women with boderline personality disorder. J Nerv Ment Dis 1994; 182 (09) 524-6.
• 30 Brown RC, Plener PL, Groen G, Neff D, Bonenberger M, Abler B. Differential neural processing of social exclusion and inclusion in adolescents with non-suicidal self-injury and young adults with borderline personality disorder. Front Psychiatry 2017; 08: 267.
• 31 Bungert M, Koppe G, Niedtfeld I, Vollstädt-Klein S, Schmahl C, Lis S. et al. Pain processing after social exclusion and its relation to rejection sensitivity in borderline personality disorder. PLoS One 2015; 10 (08) 1-22.
• 32 Domsalla M, Koppe G, Niedtfeld I, Vollstadt-Klein S, Schmahl C, Bohus M. et al. Cerebral processing of social rejection in patients with borderline personality disorder. Soc Cogn Affect Neurosci 2014; 09 (11) 1789-97.
• 33 Weinbrecht A, Niedeggen M, Roepke S, Renneberg B. Feeling excluded no matter what? Bias in the processing of social participation in borderline personality disorder. NeuroImage Clin 2018; 19: 343-350.
• 34 Gutz L, Renneberg B, Roepke S, Niedeggen M. Neural processing of social participation in borderline personality disorder and social anxiety disorder. J Abnorm Psychol 2015; 124 (02) 421-31.
• 35 Savage M, Lenzenweger MF. The Impact of Social Exclusion on “Reading the Mind in the Eyes” Performance in Relation to Borderline Personality Disorder Features. J Pers Disord 2018; 32 (01) 109-130.
• 36 Staebler K, Renneberg B, Stopsack M, Fiedler P, Weiler M, Roepke S. Facial emotional expression in reaction to social exclusion in borderline personality disorder. Psychol Med 2011; 41 (09) 1929-38.
• 37 Ruocco AC, Medaglia JD, Tinker JR, Ayaz H, Forman EM, Newman CF. et al. Medial prefrontal cortex hyperactivation during social exclusion in borderline personality disorder. Psychiatry Res – Neuroimaging 2010; 181 (03) 223-6.
• 38 Satpute AB, Lieberman MD. Integrating automatic and controlled processes into neurocognitive models of social cognition. Brain Res 2006; 1079 (01) 86-97.
• 39 Renneberg B, Herm K, Hahn A, Staebler K, Lammers C-H, Roepke S. Perception of Social Participation in Borderline Personality Disorder. Clin Psychol Psychother 2012; 19 (06) 473-80.
• 40 Staebler K, Helbing E, Rosenbach C, Renneberg B. Rejection sensitivity and borderline personality disorder. Clin Psychol Psychother 2011; 18 (04) 275-83.
• 41 Eisenberger NI, Lieberman MD. Why rejection hurts: A common neural alarm system for physical and social pain. Trends Cogn Sci 2004; 08 (07) 294-300.
• 42 Etkin A, Egner T, Kalisch R. Emotional processing in anterior cingulate and medial prefrontal cortex. Trends in Cognitive Sciences 2011; 15 (02) 85-93.
• 43 Ochsner KN, Knierim K, Ludlow DH, Hanelin J, Ramachandran T, Glover G. et al. Reflecting upon feelings: An fMRI study of neural systems supporting the attribution of emotion to self and other. J Cogn Neurosci 2004; 16 (10) 1746-72.
• 44 Eisenberger NI. The pain of social disconnection: Examining the shared neural underpinnings of physical and social pain. Nature Reviews Neuroscience 2012; 13 (06) 421-34.
• 45 Baer RA, Peters JR, Eisenlohr-Moul TA, Geiger PJ, Sauer SE. Emotion-related cognitive processes in borderline personality disorder: A review of the empirical literature. Clinical Psychology Review 2012; 32 (05) 359-69.
• 46 Stanford S, Jones MP. Psychological subtyping finds pathological, impulsive, and “normal” groups among adolescents who self-harm. J Child Psychol Psychiatry Allied Discip 2009; 50 (07) 807-15.
• 47 Nock MK. Self-Injury. Annu Rev Clin Psychol 2010; 06: 339-63.
• 48 Nitkowski D, Petermann F. Verhaltensdiagnostik selbstverletzenden Verhaltens. Nervenheilkunde 2009; 28 (04) 227-231.
• 49 Lloyd-Richardson EE, Perrine N, Dierker L, Kelley ML. Characteristics and functions of non-suicidal self-injury in a community sample of adolescents. Psychol Med 2007; 37 (08) 1183-92.
• 50 Brown RC, Plener PL. Non-suicidal Self-Injury in Adolescence. Curr Psychiatry Rep 2017; 19 (03) 20.
• 51 Nater UM, Bohus M, Abbruzzese E, Ditzen B, Gaab J, Kleindienst N. et al. Increased psychological and attenuated cortisol and alpha-amylase responses to acute psychosocial stress in female patients with borderline personality disorder. Psychoneuroendocrinology 2010; 35 (10) 1565-72.
• 52 Plener PL, Bubalo N, Fladung AK, Ludolph AG, Lule D. Prone to excitement: adolescent females with Non-suicidal self-injury (NSSI) show altered cortical pattern to emotional and NSS-related material. Psychiatry Res 2012; 203 (2–3|): 146-52.
• 53 Giletta M, Prinstein MJ, Abela JRZ, Gibb BE, Barrocas AL, Hankin BL. Trajectories of suicide ideation and nonsuicidal self-injury among adolescents in Mainland China: Peer predictors, joint development, and risk for suicide attempts. J Consult Clin Psychol 2015; 83 (02) 265-79.
• 54 Lereya ST, Copeland WE, Zammit S, Wolke D. Bully/victims: a longitudinal, population-based cohort study of their mental health. Eur Child Adolesc Psychiatry 2015; 24 (12) 1461-71.
• 55 Wichstrøm L. Predictors of non-suicidal self-injury versus attempted suicide: Similar or different?. Arch Suicide Res 2009; 13 (02) 105-22.
• 56 Glenn CR, Klonsky ED. Nonsuicidal self-injury disorder: an empirical investigation in adolescent psychiatric patients. J Clin Child Adolesc Psychol 2013; 42 (04) 496-507.
• 57 Seeley WW, Menon V, Schatzberg AF, Keller J, Glover GH, Kenna H. et al. Dissociable Intrinsic Connectivity Networks for Salience Processing and Executive Control. J Neurosci 2007; 27 (09) 2349-56.
• 58 In-Albon T, Ruf C, Schmid M. Proposed Diagnostic Criteria for the DSM-5 of Nonsuicidal Self-Injury in Female Adolescents: Diagnostic and Clinical Correlates. Psychiatry J 2013; 2013: 159208.
• 59 Plener PL, Kaess M, Schmahl C, Pollak S, Fegert JM, Brown RC. Nichtsuizidales selbstverletzendes Verhalten im Jugendalter. Dtsch Arztebl Int 2018; 115 (03) 23-30.
• 60 Plener PL, Schumacher TS, Munz LM, Groschwitz RC. The longitudinal course of non-suicidal selfinjury and deliberate self-harm: a systematic review of the literature. Borderline Personal Disord Emot Dysregulation 2015; 02: 2.
• 61 Distel MA, Smit JH, Spinhoven P, Penninx BWJH. Borderline personality features in depressed or anxious patients. Psychiatry Res 2016; 241: 224-31.
• 62 Liu RT, Kraines MA, Massing-Schaffer M, Alloy LB. Rejection Sensitivity and Depression: Mediation by Stress Generation. Psychiatry Interpers Biol Process 2014; 77 (01) 86-97.
• 63 Kupferberg A, Bicks L, Hasler G. Social functioning in major depressive disorder. Neuroscience and Biobehavioral Reviews 2016; 69: 313-32.
• 64 Kumar P, Waiter GD, Dubois M, Milders M, Reid I, Steele JD. Increased neural response to social rejection in major depression. Depress Anxiety 2017; 34 (11) 1049-1056.
• 65 Silk JS, Siegle GJ, Lee KH, Nelson EE, Stroud LR, Dahl RE. Increased neural response to peer rejection associated with adolescent depression and pubertal development. Soc Cogn Affect Neurosci 2014; 09 (11) 1798-807.
• 66 Harmer CJ, Cowen PJ. ‘It’s the way that you look at it’-a cognitive neuropsychological account of SSRI action in depression. Philos Trans R Soc B Biol Sci 2013; 368 (1615): 20120407.
• 67 Menon V. Salience Network. In: Brain Mapping: An Encyclopedic Reference; 2015: 597-611.
• 68 Hsu DT, Sanford BJ, Meyers KK, Love TM, Hazlett KE, Walker SJ. et al. It still hurts: Altered endogenous opioid activity in the brain during social rejection and acceptance in major depressive disorder. Mol Psychiatry 2015; 20 (02) 193-200.
• 69 Jobst A, Sabass L, Palagyi A, Bauriedl-Schmidt C, Mauer MC, Sarubin N. et al. Effects of social exclusion on emotions and oxytocin and cortisol levels in patients with chronic depression. J Psychiatr Res 2015; 60: 170-7.
• 70 Petrovic P, Kalso E, Petersson KM, Ingvar M. Placebo and opioid analgesia – Imaging a shared neuronal network. Science 2002; 295 (5560): 1737-40.
• 71 Hariri AR, Bookheimer SY, Mazziotta JC. Modulating emotional responses: Effects of a neocortical network on the limbic system. Neuroreport 2000; 11 (01) 43-8.
• 72 Small DM. Changes in brain activity related to eating chocolate: From pleasure to aversion. Brain 2001; 124 (Pt 9): 1720-33.
• 73 Leary MR, Tambor ES, Terdal SK, Downs DL. Self-Esteem as an Interpersonal Monitor: The Sociometer Hypothesis. J Pers Soc Psychol 1995; 68 (03) 518-530.
• 74 Onoda K, Okamoto Y, Nakashima K, Nittono H, Yoshimura S, Yamawaki S. et al. Does low self-esteem enhance social pain? The relationship between trait self-esteem and anterior cingulate cortex activation induced by ostracism. Soc Cogn Affect Neurosci 2010; 05 (04) 385-91.