Physiological and behavioral reactivity to social exclusion: a functional infrared thermal imaging study in patients with psoriasis

Abstract

Recent studies have shown that sympathetic nervous system (SNS) activity can be heavily impacted not only by basic threats to survival but also by threats to social bonds. In this study we explored the behavioral and physiological consequences of social exclusion/inclusion in patients with psoriasis, a disease frequently associated with the experience of being ostracized and with deficient emotion regulation skills. We employed a virtual ball-tossing game (Cyberball) to induce the experience of social exclusion/inclusion. We then used a Trust Game to measure the effects of this social modulation on trust. During Cyberball, infrared thermal imaging was used to record participants’ facial temperature and thus obtain an online measure of SNS activation. Behavioral data showed that social exclusion shifted participants’ trust toward unfamiliar players who had not previously excluded them. Physiological data indicated that in control participants, social exclusion triggered higher SNS activation than inclusion. No such effect was found in patients with psoriasis, whose SNS activity was the same during inclusion as it was during exclusion, suggesting that they benefit less from inclusive experiences than control participants. In addition, in patients but not in controls, higher SNS activation during social exclusion was linked to higher monetary investment toward unfamiliar players, a result in keeping with the social reconnection hypothesis, according to which emotions triggered by social rejection can be regulated by investing in new social interactions. We also found that an increase in periorbital temperature is accompanied by a decrease in happiness ratings after social exclusion was experienced during the Cyberball game. NEW & NOTEWORTHY Previous research on emotional processes in psoriasis has mainly employed self-report measures. In this study we used thermal imaging to obtain an online measure of the sympathetic nervous system (SNS) activity during social exclusion and tested how this experience influenced subsequent trust. We found that being included was a less positive experience for patients compared with controls and that SNS activity during exclusion had a stronger influence on subsequent trust in patients than in controls.

Emotions, Alexithymia, and Emotion Regulation in Patients With Psoriasis

“…Two subscales of the DERS, namely, emotional clarity and emotion acceptance, which are believed to measure concepts that are very close to alexithymia, also show higher scores among these patients (Innamorati et al, 2016). In agreement, in two recent studies, we showed that psoriasis patients scored higher than controls in the "Lack of Emotional Clarity" subscale of the DERS, indicating that patients have more difficulties than controls in correctly identifying their own emotions (Panasiti et al, 2019;Ponsi et al, 2019).…”

“…Our review also highlights some limitations of the approaches that have been used so far for studying emotional processes in psoriasis. First of all, only few studies (Mastrolonardo et al, 2006(Mastrolonardo et al, , 2007van Beugen et al, 2016;Panasiti et al, 2019;Ponsi et al, 2019) reported behavioral and physiological evidence. Although we acknowledge that self-report measures are important to understand the conscious evaluation that patients have of themselves, we also believe that implicit measures are crucial to understand what are the abilities that are truly compromised in these patients.…”

“…Patients suffering from stigmatization tend not to have a partner, to have lower education, to have a higher level of social inhibition, to show a type D personality (van Beugen et al, 2017), to have higher stress and pruritus intensity, and to have lower quality of life (Hrehorów et al, 2012). In a recent study (Ponsi et al, 2019), we showed that in patients with psoriasis with respect to controls, higher sympathetic system activation during an experimental paradigm designed to induce the feeling of social exclusion (i.e., cyberball paradigm) was related to a higher need for social reconnection (i.e., the need to invest in new social interactions).…”

Mutual Relationship Between Sleep Disorders, Quality of Life and Psychosocial Aspects in Patients With Psoriasis

“…On the other hand, researchers have found shortened sleep duration and worse sleep quality to be influenced by the exposure to such factors the following day ( 20 , 42 ). Studies show that the feeling of social isolation is associated with increased secretion of pro-inflammatory cytokines as well as pro-inflammatory gene expression and alterations in hormone signaling, similar to what we observe after sleep deprivation ( 4 , 28 , 43 ). Research has also revealed that social isolation may independently trigger health-damaging behaviors, for instance, smoking and alcohol abuse, which are mentioned above as contributing to sleep deprivation ( 38 ).…”

Exploring the relationship between umbilical blood cord donation and the impact of social distance on altruism and trust

“…The invested money is multiplied by three and then the trustees can decide whether to return half of the sum to the investors or to keep for themselves the entire amount. People tend to trust more their in-group vs. out-group (i.e., parochial trust), and are strongly influenced by the information regarding the reputation of the trustee (Boero, Bravo, Castellani, & Squazzoni, 2009;Ponsi, Monachesi, Panasiti, Aglioti, & Panasiti, 2019) with the lowest trust directed to strangers (i.e., people defined by non-diagnostic information, De Dreu, 2018). We hypothesized that the expectation of reciprocity (i.e., the idea that others reciprocate our generosity) would play a role in UCB donation.…”