Emotional Reactivity and Prosocial Behaviour in Response to Witnessing Social Exclusion in Adolescents with Eating Disorders and Healthy Controls

Abstract

Abstract Background Prosocial behaviour can promote positive social interactions and it is a key skill in adolescence. People with emotional problems or psychiatric disorders, such as people with eating disorders might have impairments in prosocial behaviour, due to broader documented difficulties in underlying processes (e.g., mentalizing). Method The aim of this study was to examine prosocial behaviour in adolescents with eating disorders compared to healthy controls, using a behavioural task. Adolescents with eating disorders (N = 74) and healthy adolescents (N = 65) played a four-player virtual Prosocial Cyberball Game with three pre-programmed avatars. During the task the participant witnessed the exclusion of one of the players, and subsequently had the opportunity to compensate for this by throwing the ball more often to the excluded player. Throughout the game, participants rated the level of negative affect in themselves and in the excluded player. Results Both patients and healthy controls made significantly more ball-tosses to the excluded player after witnessing the exclusion, however patients made fewer compared to healthy controls (large effect size). Patients also reported a smaller increase in negative affect after witnessing virtual exclusion (large effect size) and a smaller decrease in negative affect following the compensation round (large effect size). Patients estimated a smaller decrease in negative affect in the excluded player following the compensation round (medium effect size). There were no associations between these outcomes and eating disorder psychopathology in the patient group. Conclusions Compared to healthy adolescents, adolescent patients with eating disorders demonstrate less prosocial compensatory behaviour towards a victim of virtual exclusion. In addition, they report flatter negative affect in themselves in response to witnessing and compensating for virtual exclusion, and in the excluded player in response to compensation. If these findings are replicated, interventions to target these difficulties might contribute to improve social functioning in this patient group.