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Social Exclusion and Pain Sensitivity: Why Exclusion Sometimes Hurts and
Sometimes Numbs

Article  in  Personality and Social Psychology Bulletin · September 2011


DOI: 10.1177/0146167211422449 · Source: PubMed

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422449
ein and ClaypoolPersonality and Social Psychology Bulletin
PSPXXX10.1177/0146167211422449Bernst

Article
Personality and Social Psychology Bulletin

Social Exclusion and Pain Sensitivity: XX(X) 1­–12


© 2011 by the Society for Personality
and Social Psychology, Inc
Why Exclusion Sometimes Hurts Reprints and permission:
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and Sometimes Numbs


DOI: 10.1177/0146167211422449
http://pspb.sagepub.com

Michael J. Bernstein1 and Heather M. Claypool2

Abstract
Some research indicates that social exclusion leads to increased emotional- and physical-pain sensitivity, whereas other
work indicates that exclusion causes emotional- and physical-pain numbing. This research sought to examine what causes
these opposing outcomes. In Study 1, the paradigm used to instantiate social exclusion was found to moderate the social
exclusion-physical pain relation: Future-life exclusion led to a numbing of physical pain whereas Cyberball exclusion led to
hypersensitivity. Study 2 examined the underlying mechanism, which was hypothesized to be the severity of the “social injury.”
Participants were subjected to either the standard future-life exclusion manipulation (purported to be a highly severe social
injury) or a newly created, less-severe version. Supporting our hypothesis, the standard (highly severe) future-life exclusion
led to physical-pain numbing, whereas the less-severe future-life exclusion resulted in hypersensitivity. Implications of these
results for understanding the exclusion–pain relation and other exclusion effects are discussed.

Keywords
ostracism, exclusion, social rejection, pain sensitivity

Received May 23, 2010; revision accepted November 28, 2011

Pain can be alleviated by morphine but the pain of social Beyond facilitating basic survival and reproduction,
ostracism cannot be taken away. humans derive more proximal benefits from maintaining
stable social connections. Those with social relationships
—Derek Jarman tend to experience greater overall well-being (Baumeister,
1991), show better ability to cope with stress (Cohen,
Among the many experiences and motivations critical to Sherrod, & Clark, 1986; Cohen & Wills, 1985), and engage
human existence, the innate drive to affiliate with others is in less antisocial and criminal behavior (Sampson & Laub,
one of the most fundamental (Baumeister & Leary, 1995). 1993). Social exclusion and isolation, however, are associ-
Many characteristics of humans, such as extended develop- ated with a host of negative consequences, including increased
ment, relative physical weakness, and comparatively high anxiety (Baumeister & Tice, 1990; Mathes, Adams, &
biparental investment in offspring, are indications that the Davies, 1985), lower self-esteem (Leary, Tambor, Terdal, &
survival of the human organism requires a stable social infra- Downs, 1995), decrements in immune functioning (Kiecolt-
structure (Brewer, 2004). This line of thought is congenial Glaser et al., 1984), and elevated violence (Leary, Kowalski,
with evolutionary perspectives, which argue that group liv- Smith, & Phillips, 2003). Thus, social exclusion poses
ing is a selected characteristic of human behavior because it numerous immediate threats to physical and mental health
has acted as a solution to a variety of adaptive problems and threats to more long-term, inclusive fitness consider-
throughout our history. Specifically, the ability to establish ations. Therefore, it seems essential to human survival that
and maintain social connections has numerous survival and
reproductive benefits: Groups provide social support, access 1
Penn State Abington, Abington, PA, USA
2
to survival-relevant resources, and protection from environ- Miami University, Oxford, OH, USA
mental dangers, as well as access to potential mating partners
Corresponding Author:
(see Brewer, 2004). It should come as no surprise, then, that Michael J. Bernstein, Penn State Abington, Woodland Building, Abington,
belonging to social groups is often as motivationally relevant PA 19020
as obtaining food and water (Baumeister & Leary, 1995). Email: mjb70@psu.edu
2 Personality and Social Psychology Bulletin XX(X)

individuals are able to adapt their cognitive and behavioral threats is essential. A system for processing physical dam-
repertoires to detect and avoid threats of social exclusion and age (and its associated pain) is believed to have developed
find ways of adapting and reaffiliating postexclusion. early in the evolution of the human brain. As human civiliza-
Given the negative consequences that often ensue follow- tion advanced and social/group living became more and
ing exclusion from groups, it may come as no surprise that more crucial for survival, a parallel system for detecting
both scientists and laypeople have suggested that social social threats (and its associated pain) became necessary,
exclusion may be experienced negatively, both psychologi- and rather than developing a separate system, it co-opted
cally and physically. The quote at the start of this article, the one already in place for responding to tissue damage
suggesting that social exclusion causes a pain that cannot (MacDonald & Leary, 2005). Because of this, pain overlap
be eliminated, is one of a litany of similar quotations, poems, and social pain theories propose that both types of pain are
novels, musical compositions, and various other artistic processed with the same neurological hardware (Eisenberger
endeavors focusing on the pain experienced with social & Lieberman, 2005; MacDonald et al., 2005).
exclusion (MacDonald & Leary, 2005). From these anec- One implication of both these perspectives, therefore, is
dotal observations, it seems clear that pain and social exclu- that one’s emotional and physical reactions will coincide.
sion are inherently intertwined in humans’ phenomenological An experience that triggers physical pain should be accom-
experiences. Supportive of these assertions, there is some panied by an emotionally painful reaction, whereas physi-
scientific evidence that social exclusion may trigger physical cally numbing experiences should co-occur with emotional
pain (e.g., Eisenberger, Lieberman, & Williams, 2003). Yet numbness. Therefore, if social exclusion affects one type of
a closer examination of the literature suggests that the rela- pain, it should trigger a concomitant reaction on the other
tion between social exclusion and physical pain may be com- type as well.
plex, as some work suggests that exclusion triggers not pain, By definition, experiences of social exclusion, rejection,
but numbing (e.g., DeWall & Baumeister, 2006). and ostracism create real or imagined distance between indi-
The aim of this research is to focus on the circumstances viduals. These are the very situations thought to trigger
under which pain is heightened or numbed following the social pain. And, indeed, individuals report various types of
experience of social exclusion. To preview our hypothesis, emotional distress following social exclusion, including
we believe that both outcomes are possible and depend on reduced mood (e.g., Williams et al., 2002), a reduced sense
the severity of the social-exclusionary experience—with a of meaningfulness (Stillman et al., 2009), lowered self-
“severe” social injury triggering numbing to pain and a esteem (e.g., Bernstein, Sacco, Brown, Young, & Claypool,
“minor” social injury triggering hypersensitivity to pain. 2010; Leary et al., 1995), and so forth (for a meta-analytic
Below, we detail the existent research on the exclusion–pain review, see Gerber & Wheeler, 2009; but see Baumeister,
relation and explain the rationale of our hypothesis. DeWall, & Vohs, 2009, for a rejoinder). If the social- and
physical-pain systems are linked and social exclusion causes
emotional pain, it too should trigger physical pain.
Social Exclusion: Its Parallel Supportive of this assertion, recent neuro-imaging studies
Impacts on Social and Physical Pain show the dorsal anterior cingulate cortex (dACC), a structure
In the social-exclusion literature, two types of painful known to activate during the experience of physical pain
responses have received empirical and theoretical attention. (Price, 2000; Rainville, Duncan, Price, Carrier, & Bushnell,
The first is social pain, which has been defined as “the dis- 1997), also activates during an experience of social exclusion
tressing experience arising from actual or potential psycho- (Eisenberger et al., 2003; Lieberman & Eisenberger, 2005).
logical distance from close others or from a social group” For example, in Eisenberger and colleagues’ work, exclusion
(Eisenberger & Lieberman, 2005, p. 112), and the second is was manipulated using Cyberball, an online ball-tossing
physical pain, or the “unpleasant sensory and emotional game reliably shown to successfully manipulate feelings of
experience associated with actual or potential tissue dam- inclusion and exclusion (e.g., Williams et al., 2002).
age” (International Association for the Study of Pain, 1979, Participants were placed in an fMRI and led to believe they
as cited in Eisenberger & Lieberman, 2005, p. 112). Multiple would be engaging in a game with two other participants, also
researchers have postulated a link between these pain types. in fMRIs. In reality, no other players were present, and the
Namely, both pain overlap theory (e.g., Eisenberger & game unfolded via preprogrammed responses. During the
Lieberman, 2005) and social pain theory (MacDonald, course of the game, participants were included, were told
Kingsbury, & Shaw, 2005; MacDonald & Leary, 2005) sug- they were unable to receive the ball (implicit exclusion), or
gest that a system capable of detecting and responding to received the ball at the start of the game and were then ostra-
social pain “piggybacked” onto the preexisting physical- cized for the remainder of the experience (explicit exclusion).
pain system during evolution (Nelson & Panksepp, 1998). Regardless of exclusion type, dACC activation was height-
Because both distance from others (Baumeister & Leary, ened as compared to the inclusion condition. Moreover,
1995) and tissue damage pose threats to humans’ well-being within the explicit exclusion condition, results indicated that
and survival, a system of registering and responding to these individuals’ experienced self-reported distress was positively
Bernstein and Claypool 3

correlated with dACC activation (self-reported distress was numbing postexclusion comes from a recent meta-analysis
not measured in the implicit exclusion condition). conducted by Blackhart, Nelson, Knowles, and Baumeister
These results were interpreted by Eisenberger and col- (2009). Based on an examination of the literature, they con-
leagues as suggesting that the experiences of social pain and cluded that emotional reactions to social exclusion tend to be
physical pain may share a neurological basis and that social minimal, suggesting it is not uncommon following experi-
exclusion can cause both. More recent evidence further cor- mentally induced social exclusion for there to be no changes
roborates this assertion; individuals taking acetaminophen in mood at all. These researchers have asserted this is pre-
(a common physical-pain suppressant) showed reduced cisely because exclusionary experiences elicit an emotional
dACC activity in response to social-exclusion experiences numbness, which, as other findings suggest, appears to
(DeWall et al., 2010). In other words, ingestion of a medication accompany a state of physical numbness.
to quash physical pain attenuated a neurological reaction to a Namely, in a series of studies conducted by DeWall and
social threat. Baumeister (2006), participants’ pain tolerance (how much
In addition to this neurological evidence, other findings pain they could stand) and threshold (the point at which they
elucidate a correspondence between physical and emo- first experienced a sensation as painful) were measured
tional responses to social events. For example, in one study using a pressure algometer. Following these baseline mea-
(Eisenberger, Jarcho, Lieberman, & Naliboff, 2006), partici- sures, participants responded to a bogus personality test.
pants’ baseline unpleasantness thresholds for cutaneous heat They were then given false feedback, allegedly based on
were assessed at the start of the study. Participants then their answers, about their future lives (future-life paradigm),
engaged in a similar online ball-tossing task as described being told they would have lives full of long-lasting relation-
previously (Williams et al., 2002), during which participants ships (inclusion condition), lives alone (exclusion condi-
were either included or excluded (exclusion was once again tion), lives full of physical mishaps (misfortune/control
either explicit or implicit, as in Eisenberger et al., 2003). condition), or no information at all (no feedback/control con-
Following the last portion of the Cyberball game, pain dition). Pain tolerance and threshold measures were then
threshold measures were taken again, and self-reported measured again. Across four studies, the same basic find-
social distress was assessed. Results revealed that individu- ing occurred: Social exclusion led to physical insensitivity
als whose baseline sensitivity to physical pain was high (numbing) to pain in comparison to the other conditions.
experienced greater social distress in response to social They also found a similar pattern for participants’ emotional
exclusion, compared to those low in physical-pain sensitiv- reactions. Specifically, excluded individuals were less
ity. Furthermore, as reported social distress in response to extreme in their affective forecasting in response to possible
the ball-tossing game increased, so too did postgame physi- positive and negative events (Study 3) and less able to empa-
cal pain. Thus, these studies suggest that social distress and thize with others (Studies 4 and 5) than were those in the
physical pain are intimately connected—greater distress in included and control conditions. The overall conclusion
one domain seems to predict greater distress in the other. drawn by these researchers was that social exclusion leads to
If, indeed, social exclusion triggers social pain, then, as a numbing of both the physical- and social-pain systems.
the just-described studies suggest, a parallel impact on phys- Thus, the social-exclusion literature to date is quite con-
ical pain should arise. But some have argued that social sistent in showing that exclusion produces an effect on phys-
exclusion may trigger the opposing reactions, both emo- ical pain with a concomitant reaction on emotional pain.
tional and physical numbness. MacDonald and colleagues This is compelling evidence that the social- and physical-
(2005) propose that “both social and physical pain lead to pain systems are connected. What is less clear, however, is
reactions that prepare an organism for quick reaction to . . . whether the impact of social exclusion itself is one of hyper-
danger” (p. 79). When responding to a physical threat, the sensitivity or numbness. Some evidence suggests that social
body typically undergoes changes to ready an appropriate exclusion makes victims hurt, both emotionally and physi-
reaction. One such change is the release of analgesics that cally (e.g., Eisenberger et al., 2003), whereas other evidence
numb the body, which might aid one in fleeing while injured suggests that social exclusion leads to simultaneous emo-
and still under attack (MacDonald et al., 2005). If, as both tional and physical numbness (e.g., DeWall & Baumeister,
pain overlap and social pain theories assert, the physical- and 2006). In the remainder of this article, we argue that both
social-pain systems are linked, then social threats might trig- responses are possible and dependent, in part, on a crucial
ger the same numbing reaction, both emotionally and physi- moderator—the severity of the social-exclusionary injury.
cally (MacDonald et al., 2005).
Consistent with this notion, Twenge, Catanese, and
Baumeister (2003) found that social exclusion puts individu- Injury Severity and Pain
als into what they termed a “deconstructed state.” This If the social- and physical-pain systems overlap, then fac-
involves a lack of emotion, lethargy, time distortion, and a tors known to moderate one type of painful reaction should
desire to escape self-awareness, all pointing to a state of similarly moderate the other type. In the domain of physical
“inner numbness” (p. 409). Further evidence for emotional pain, one’s reactions vary based on experienced injury
4 Personality and Social Psychology Bulletin XX(X)

severity, or the extent of tissue damage done. In fact, the tended to utilize the Cyberball paradigm.1 On its face, not
body’s reaction to physical injury is not linear. Stubbing being thrown a virtual ball during a trivial computer game,
one’s toe is a fairly minor injury that hurts less than break- though perhaps upsetting, does not seem nearly as devastat-
ing a finger, a comparably more severe injury. Generally ing as being told that one’s future life will be spent alone.
speaking, as physical injuries increase in severity, so too Indeed, given that the need to belong is fundamental
does the associated pain. That is, as the event causes more (Baumeister & Leary, 1995), it is difficult to imagine a worse
tissue damage, the victim experiences more distress. prognosis. Thus, the perceived severity of the “social injury”
However, at some point, an injury can become so severe may vary between these paradigms and ultimately may trig-
that the body does not experience a heightened sense of ger different pain reactions.
pain but instead experiences a numbing. When painful
stimulation is too great or occurs for too long, the body
enters a state of shock in which pain and emotional responses Overview
are dulled (see Kandel, Schwartz, & Jessell, 2000, for a To examine our severity hypothesis, we first assessed indi-
review). We can imagine the victim of a gunshot or a car viduals’ perceptions of the severity of two different exclu-
crash and how the experienced feeling of the pain is not sion experiences. We then randomly assigned participants to
always commensurate with the severity of the injury. This be excluded or included in one of them. The paradigm par-
serves to protect the body from wasting resources because of ticipants reported as being most severe should result in
the hyperactivity of the many systems involved in pain physical-pain numbing, whereas the one rated as mildly
detection that would be forced to continue if the pain were severe should result in hypersensitivity. In a second experi-
not dulled (Kandel et al., 2000). ment, we manipulated the severity of the exclusion experi-
Given that the social pain system “co-opted” the physical ence within one of the paradigms itself to further examine
pain system (see Eisenberger & Leiberman, 2005; whether high-severity social exclusions result in numbing,
MacDonald & Leary, 2005), perhaps it is possible that the whereas low-severity ones result in hypersensitivity.
body might react in a similar manner to an extremely severe
social injury as it would an extremely severe physical one.
That is, an experience that causes major amounts of “social Pilot Study 1
damage”—by instantiating psychological distance between In an initial pilot study, we asked participants to judge the
the self and others of great magnitude or duration—may trig- perceived severity of social exclusionary and inclusionary
ger numbing, rather than hypersensitivity. Physical injuries experiences in the Cyberball and future-life paradigms. We
lead to nociceptive pain when the nerves responsible for examined these two paradigms specifically because they are
detecting such pain (nociceptive nerves) are stimulated. the ones most commonly used in investigations of exclu-
These nerves can be overstimulated, however, and elicit sion’s impact on physical-pain sensitivity and, because, as
physical numbness (Kandel et al., 2000). Perhaps, similarly, noted, they intuitively appear to vary in their perceived
the “nerves” that detect social injuries (e.g., self-esteem, as severity. In this pilot study, 36 students (23 females) partici-
in the sociometer theory; Leary et al., 1995) might also pated for course credit. Students were randomly assigned to
become over stimulated if the social injury is “extreme” or one condition of a 2 (Paradigm: Cyberball vs. future-life) ×
“severe” enough, leading to a physical-pain numbing. 2 (Inclusionary Status: exclusion vs. inclusion) between-
We believe the differing outcomes in the literature on the subjects design. Participants were seated in front of comput-
emotional and physical reactions to social exclusion (hyper- ers and told they would be performing a task involving how
sensitivity vs. numbness) may be explained by our severity they perceive different situations. All students were told
hypothesis. This hypothesis asserts that “minor” social inju- they would read about a situation and would then rate it on
ries should trigger painful (hypersensitive) reactions, several dimensions. Depending on condition, participants
whereas “major” social injuries should result in numbing then read a brief description of a typical Cyberball study or
(insensitive) responses. In the current work, we focus exclu- a future-life study. Those in the Cyberball conditions were
sively on physical reactions, though our severity hypothesis told to imagine playing a virtual ball-tossing game with two
would make identical predictions for emotional reactions. other people on a computer. Those in the inclusion condition
Researchers who have shown numbing in response to social were further asked to imagine that they were thrown the ball
exclusion may have been subjecting participants to quite about one third of the time. Those in the exclusion condition
severe or major social injuries, whereas researchers report- were asked to imagine being thrown the ball twice near the
ing hypersensitivity may have used more mild forms. beginning of the game, but then never again. Those in the
Consistent with this speculation, there does appear to be a future-life conditions were asked to imagine taking a person-
confounding in the literature between social-exclusion para- ality test, having that test analyzed by a computer, and then
digm and type of pain response. Broadly, studies showing receiving feedback about the results. Those in the exclusion
physical pain numbness have tended to utilize the future-life condition read the future-alone feedback that forecasts a
manipulation, whereas those showing hypersensitivity have future devoid of meaningful social relationships (taken from
Bernstein and Claypool 5

Twenge, Baumeister, Tice, & Stucke, 2001) and were asked Study 1
to imagine that this is the feedback they received. Those in
the inclusion condition did the same but read the future- Having shown that these manipulations of exclusion do dif-
belonging feedback that forecasts a future filled with mean- fer in their perceived severity, we next examined if these
ingful relationships. After reading about and imagining one manipulations affected participants’ physical pain sensitivi-
of these situations, participants rated them on a variety of ties differently. In Study 1, participants’ initial pain threshold/
dimensions, with the key one concerning how severely tolerance levels were assessed shortly after arrival at the
positive or negative they found the situation to be (rated on lab. Following this, they engaged in either Cyberball or the
a scale of –4 = very negative to +4 = very positive). future-life paradigm and, within each, were either excluded
Though the exclusion experiences would likely seem or included. Following this activity, their pain threshold/
more negative than the inclusionary experiences, we pre- tolerance levels were measured again. Because Cyberball
dicted that this effect would be moderated by the manipula- exclusion may be akin to a “mild” social injury, we hypoth-
tion of paradigm. Specifically, we expected future-alone to esized that it (a less-severe social injury than is future-alone)
be perceived as more severely negative than Cyberball should decrease pain threshold and tolerance (make indi-
exclusion and future-belonging to be perceived as more posi- viduals more sensitive to pain), whereas future-life exclu-
tive than Cyberball inclusion. A 2 (Paradigm: Cyberball vs. sion (a more-severe social injury) should actually increase
future life) × 2 (Inclusionary Status: exclusion vs. inclusion) pain threshold and tolerance (make individuals less sensitive
between-subjects ANOVA revealed a significant main effect to pain). We predicted no differences between the inclusion-
of Inclusionary Status, F(1, 32) = 98.19, p < .001, η2 = .75. ary conditions or changes from baseline, as these conditions
Exclusion experiences, overall (M = –2.73, SD = 1.66), were should be relatively akin to a control group. Indeed, in
perceived as more negative than were inclusion experiences DeWall and Baumeister (2006), there was no reliable or
(M = 2.29, SD = 1.61). This main effect, however, was quali- consistent change in pain tolerance and threshold between
fied by the predicted interaction, F(1, 32) = 10.80, p < .01, baseline and postmanipulation for those who were included.
η2 = .25. Imagined receipt of the life-alone feedback (M = –3.36, Moreover, the theories in the literature to date have argued
SD = 1.27) was perceived as significantly more negative than specifically that exclusion should activate the pain system
was imagined exclusion in the Cyberball game (M = –1.88, but are agnostic about the impact of inclusion on that same
SD = 1.81, p = .036). In addition, imagined receipt of the system.
future-belonging feedback (M = 3.11, SD = 1.17) was per-
ceived as significantly more positive than was imagined inclu-
sion in the Cyberball game (M = 1.38, SD = 1.60, p = .020). Method
Thus, it seems clear that people do indeed perceive exclu- Participants and design. For course credit, 52 (29 female)
sion as more negative than inclusion, not surprisingly. But, undergraduates from the psychology participant pool partici-
more importantly, future-alone exclusion was perceived pated. Participants were instructed not to ingest any foods,
as more severely negative and future-belonging inclusion as alcohol, or pain medicine for at least 4 hours prior to partici-
more severely positive than was Cyberball exclusion and pating in the experiment (Kanarek & Carrington, 2004;
inclusion. Therefore, if our severity hypothesis is correct in Mercer & Holder, 1997). Moreover, selected participants
postulating that severe social injuries should result in numb- were nonsmokers and were right handed. These are similar
ing and mild social injuries should result in hypersensitivity, participant requirements and a priori exclusion criteria used
exclusion in the future-life paradigm should lead to numb- by DeWall and Baumeister (2006), except they told partici-
ing, whereas exclusion in the Cyberball paradigm should pants not to eat sugary foods 8 hours in advance, whereas we
lead to hypersensitivity. asked participants not to eat anything for only 4 hours in
Interestingly, this hypothesis and the initial pilot data are advance. All participants were randomly assigned to one
quite consistent with the work of DeWall et al. (in press). condition of a 2 Inclusionary Status (exclusion vs. inclu-
In their study, participants received either future-alone or sion) × 2 Paradigm (Cyberball vs. future life) between-subjects
future-belonging feedback (actual experience) or were asked design.
to imagine they were to receive such feedback (imagined Procedure. Participants were run one at a time in the labo-
experience). Participants then rated their mood (actual expe- ratory. After arriving at the lab and completing a thorough
rience) or how they thought they would feel (imagined expe- written and verbal informed consent process, participants’
rience) following the feedback. Among those who imagined baseline measures of pain threshold and tolerance were
the experience, expected mood was reported to be much recorded. Single measures of both threshold and tolerance
lower in the future-alone than in the future-belonging condi- were taken at 90-second intervals to prevent habituation
tion. However, for actual experience, there was no difference (DeWall & Baumeister, 2006; Orbach, Mikulincer, King,
between the two conditions with respect to mood. Thus, just Cohen, & Stein, 1997). Pain threshold and tolerance were
as we speculate, future-alone exclusion is perceived quite measured using a pressure algometer (Wagner FPIX 50).
negatively and severely but, when experienced, may lead to This device assesses the amount of pressure applied to a
numbing. bone or muscle and has been used as one method of
6 Personality and Social Psychology Bulletin XX(X)

assessing pain sensitivity in medicine and other research relationships, the odds are you’ll end up being alone
fields, including those in the rejection literature (e.g., DeWall more and more.
& Baumeister, 2006; Pauli, Wiedemann, & Nickola, 1999).
Following the method of the aforementioned studies, the These feedback descriptions were taken directly from Twenge
algometer was applied perpendicularly to the skin. All pain and colleagues’ (2001) work.
measurements were taken at the first dorsal interosseous The other half of participants engaged in the online ball-
muscle (i.e., behind the first knuckle of the index finger) of tossing game called Cyberball (Williams et al., 2002).
the participant’s right hand. Pressure was applied steadily at Participants in this condition were told they were playing
an average rate of 5 kPa per second. For pain threshold, par- with two other students from around campus who were also
ticipants were verbally instructed to say “now” when they involved in similar studies. In reality, no other participants
first experienced pain because of the pressure increase. For were involved, and the computer controlled the two agents
pain tolerance, they were instructed to say “stop” when the involved in the game. Nonetheless, to facilitate this cover
pain became too uncomfortable to continue. When the par- story, the experimenter placed two fake phone calls suppos-
ticipant acknowledged the sensation of pain (threshold) or edly to one of the other laboratories involved in this study.
requested the pressure to cease (tolerance), the algometer Both calls were placed in the room with the actual partici-
was immediately stopped, which automatically recorded the pant, and in both calls the experimenter pretended to ask
amount of pressure applied prior to its cessation.2 As in whether the other participants were ready, made a comment
DeWall and Baumeister (2006), the order of measurement about it being good that everyone arrived on time, and stated
for threshold and tolerance was counterbalanced. Participants that, should there be any problems, they should call back
had their threshold or tolerance measured first, took a 90-second at the experimenter’s number. Participants were informed
break, and then continued with the other measure. This that they would be represented by an animated hand at the
counterbalancing factor had no effect on the outcomes of the bottom of the screen whereas the two other players would
study. be represented by animated figures located above and to the
Next, participants began either the Cyberball game or the right and left of the participant’s figure. Participants were
future-life paradigm. For those in the future-life condition, instructed to click on one of the two figures to throw them
they were asked to complete a personality test used in previ- the ball throughout the task. For those in the inclusion condi-
ous studies (DeWall & Baumeister, 2006). After completing tion, participants were thrown the ball roughly one third
the personality test, the computer allegedly analyzed their of the time by the other “players.” For those in the exclusion
responses. Participants first received accurate feedback condition, they were thrown the ball twice at the beginning
based on their responses to the personality assessment con- of the game and then not again for an additional 45 throws.
cerning their levels of introversion or extroversion. This was Immediately following both manipulations of social
done to bolster the believability of the bogus, randomly inclusionary status, two additional measures of pain thresh-
assigned “future-lives” feedback that they received next. old and tolerance were taken, using the same procedure from
This manipulation has been used previously (Baumeister, the beginning of the study.
DeWall, Ciarocco, & Twenge, 2005; Baumeister, Twenge, Following this task, participants were given a thorough
& Nuss, 2002; DeWall & Baumeister, 2006; Twenge et al., debriefing. Participants were told the exact nature of the
2001) and constituted the manipulation of inclusionary sta- study and how each aspect was related to the others.
tus. Participants in the inclusion (future belonging) condition Importantly, participants in all conditions were told that the
were told, exclusion/inclusion feedback they received (future-life para-
digm) or the exclusion/inclusion episode they experienced
You’re the type who has rewarding relationships (Cyberball) was completely bogus and randomly assigned.
throughout life. You’re likely to have a long and stable After the debriefing, participants were thanked and encour-
marriage and have friendships that will last into your aged to asked questions before leaving.
later years. The odds are that you’ll always have
friends and people who care about you.
Results
Participants in the exclusion (future alone) condition were told, We hypothesized that exclusion in Cyberball would increase
pain sensitivity (i.e., reduce pain tolerance and threshold) but
You’re the type who will end up alone later in life. that exclusion in the future-life paradigm would decrease
You may have friends and relationships now, but pain sensitivity (i.e., increase pain tolerance and threshold).
by your mid 20’s most of these will have drifted away. To test these predictions, we first standardized each partici-
You may even marry or have several marriages, but pant’s baseline pain tolerance and pain threshold measures.
these are likely to be short-lived and not continue into Once standardized, these measures were averaged to form an
your 30’s. Relationships don’t last, and when you’re overall measure of baseline pain sensitivity (with lower num-
past the age where people are constantly forming new bers indicating more sensitivity). The same procedure was
Bernstein and Claypool 7

(e.g., on self-esteem; Gerber & Wheeler, 2009), these results


show, in a single study, that social exclusion can both
increase and decrease pain tolerance/threshold and that the
directional impact depends on the nature of the exclusionary
experience. As predicted, Cyberball exclusion causes hyper-
sensitivity to pain, whereas future-alone exclusion causes
numbness to pain. Thus, our hypothesis was unambiguously
supported.

Discussion
We hypothesized that an important determinant of exclu-
sion’s influence on pain responses is the severity of the
exclusionary experience itself. Our pilot data indicated that
Cyberball exclusion is perceived as a “mild” social injury,
Figure 1. The effects of exclusion and inclusion on pain whereas future-alone exclusion is perceived as a “severe”
sensitivity as a function of paradigm one. Accordingly, our severity hypothesis predicted that
Lower numbers indicate more sensitivity to pain (i.e., a lower combined exclusion in the Cyberball paradigm should decrease pain
pain threshold and tolerance).
threshold/tolerance (i.e., increase pain sensitivity) but that
exclusion in the future-life paradigm should increase pain
performed for participants’ postmanipulation pain threshold/ threshold/tolerance (i.e., decrease pain sensitivity). Indeed,
tolerance measures. We next conducted a 2 (Inclusionary this is exactly what this first study found. These results are
Status: exclusion, inclusion) × 2 (Paradigm: Cyberball, future important not only because they support the primary hypoth-
life) between-subjects ANCOVA on the postmanipulation esis set forth in this article but also because they represent
averaged scores with the premanipulation averaged scores as experimental evidence showing that these two common
a covariate (as per DeWall & Baumeister, 2006).3 The results manipulations of social exclusion lead to different effects.
revealed the predicted interaction, F(1, 47) = 16.44, p < .001, Though Study 1 was successful in showing that Cyberball
η2 = .26 (see Figure 1). Simple effects analyses showed that exclusion increases pain sensitivity and that future-life
though the future belonging (M = 0.098, SD = 0.71) and exclusion decreases it, there are, of course, limitations. Of
Cyberball inclusion (M = –0.024, SD = 0.96) conditions did primary concern is that there are numerous other factors,
not differ in terms of pain sensitivity, F(1, 23) < 1, p > .81, besides social-injury severity, that differ across these two
exclusion via Cyberball (M = –0.42, SD = 0.91) and exclu- paradigms. For example, they differ in temporality; Cyberball
sion via future alone (M = 0.29, SD = 1.02) were different occurs in the present whereas future-life is in the future.
from each other, F(1, 23) = 20.12, p < .001. Also, they differ in attributional ambiguity; the cause of the
Moreover, not only did future alone and Cyberball exclu- exclusion in Cyberball may be less clear, whereas in future-
sions differ from each other, but both resulted in changes life it is levied directly on the participants’ personality. Thus,
from baseline in the hypothesized directions. Using one- although our pilot data suggest that these two exclusion para-
sample t tests, we compared the change in pain sensitivity in digms differ in perceived severity, the presence of these
each of the four conditions to zero (i.e., a difference score of other confounding variables makes it difficult to definitively
zero would indicate no change from Time 1 to Time 2, a conclude that is it severity, and not one of the other factors,
negative change score would indicate hypersensitivity, and a that produced hypersensitivity versus numbing across exclu-
positive change score would indicate numbing; see DeWall sion conditions.
& Baumeister, 2006, for similar procedures). Although To produce more compelling evidence for our severity
acceptance via Cyberball did not lead to any change in pain hypothesis, therefore, we directly manipulated the severity
sensitivity from Time 1 to Time 2, t(12) = 0.59, p > .50, (i.e., the extent of the “social damage”) of an exclusionary
Cyberball exclusion did, in fact, lead to a hypersensitivity to experience within one of these paradigms in Study 2 while
pain relative to baseline, t(11) = –4.27, p = .001. On the other keeping all other variables constant. Using this approach, if
hand, receiving future-belonging feedback did not lead to we again find that a severe social injury triggers numbing
any change in pain sensitivity from baseline, t(12) = 0.094, and a mild social injury causes hypersensitivity, we will
p > .90, but receiving future-alone feedback led to a signifi- have greater confidence in our hypothesized interpretation.
cant decrease in pain sensitivity, t(13) = 2.68, p = .019.
To our knowledge, this study is one of the only studies to
directly compare these two very different manipulations of Study 2
social exclusion experimentally. Consistent with the meta- In this study, we manipulated the perceived severity of a
analytic evidence that exclusion manipulations are not inter- social-exclusion experience directly while keeping all other
changeable and can produce effects that differ in magnitude aspects of the manipulation constant. We did this by creating
8 Personality and Social Psychology Bulletin XX(X)

a “high-severity” version of the standard future-alone feed- 75%) of the relationships you intend to be “long-term,”
back and a similarly worded, but less severe companion. We including the ones you have now and the ones you
expected that individuals in the “high-severity” exclusion may make, are going to be short-lived and not con-
experience should show the same pattern of pain sensitivity tinue into your 30s. All people change as they get
as individuals excluded in the future-life paradigm of Study 1 older, but people who respond to our survey in the
(i.e., they should experience numbing), whereas those combination of ways that you did tend to have changes
exposed to a “low-severity” exclusion should experience a that don’t fit with those relationships they tend to cur-
pattern of sensitivity equivalent to those participants exposed rently have. Your relationships don’t last, and when
to Cyberball exclusion in Study 1 (i.e., a hypersensitivity to you’re past the age where people are constantly form-
pain). If these predictions are confirmed, this would lend ing new relationships, you’ll find you have fewer
much support to the hypothesis that the severity of the relationships than you would like to have and about
social-exclusion experience drives subsequent reactions on 75% fewer relationships than the average individual.
physical pain and is at the heart of the opposing findings in
the literature concerning the relation social exclusion shares After reading about and imagining one of these situations,
with pain sensitivity. We began with a pilot study to assess participants rated them on how severely positive or negative
whether our manipulation of severity was valid. they found the situation to be (rated on a scale of –4 = very
negative to +4 = very positive), just as in Study 1.
We predicted that the high-severity future-alone condi-
Pilot Study 2 tion would be perceived as more severely negative than the
Pilot tests of the severity manipulation were conducted using low-severity future-alone condition. An independent-samples
the same procedure as in the pilot for Study 1. In this study, t test confirmed this to be true, t(14) = –2.29, p = .038; indi-
16 participants (11 females) participated for course credit. viduals asked to rate the high-severity feedback (M = –2.25,
They were randomly assigned to one of two conditions (high SD = 2.31) found it to be more negative than did those asked
severity vs. low severity) in a between-subjects design. Just to imagine receiving the low-severity feedback (M = –0.13,
as in Study 1, participants were told they would be perform- SD = 1.25). It thus seems clear that our manipulation of
ing a task involving how they perceive different situations. severity did indeed differ in the way we predicted. With the
All students were told they would read about a situation and manipulation pretested, we next conducted Study 2.
would then rate it on several dimensions.
All participants read about an exclusion experience, but
the severity of that experience varied. Participants in the Method
“high-severity” condition were asked to imagine being told a Participants and design. For course credit, 24 (17 female)
very similar version of the original future-alone feedback: undergraduates from the psychology participant pool partici-
pated. As in Study 1, participants were instructed not to
Your score indicates that you are the type who will end ingest any foods, alcohol, or pain medicine for at least
up almost completely alone later in life. You may have 4 hours prior to participating in the experiment. They were
friends and relationships now, but by your mid-20s all nonsmokers and were right handed. All participants were
most if not all of these will have drifted away. All of randomly assigned to one of two conditions. In both, partici-
your relationships you intend to be “long-term,” both pants suffered an experience of social exclusion, but some
the ones you have now and the ones you may make, are experienced a highly severe social injury whereas others
going to be short-lived and not continue into your 30s. experienced a less-severe social injury.
All people change as they get older, but people who Procedure. Participants were run one at a time in the labo-
respond to our survey in the combination of ways that ratory. After completing a thorough written and verbal
you did tend to have changes that don’t fit with those informed consent procedure, participants’ baseline measures
relationships they tend to currently have. Your relation- of pain threshold and tolerance were recorded. This proce-
ships don’t last, and when you’re past the age where dure was identical to Study 1. Next, all participants were
people are constantly forming new relationships, the asked to complete the same bogus personality test used in
odds are you’ll end up being alone more and more. Study 1. After completing the personality test, the computer
analyzed their responses. Then, participants first received
Participants in the “less severe” condition were asked to accurate feedback concerning their introversion/extroversion
imagine being told, (see Study 1) followed by bogus feedback concerning their
“personality profile” and how their responses predicted their
Your score indicates that you are the type who will future lives. This is where the manipulation of severity occurred.
end up with fewer relationships later in life than you Participants in the “high-severity” condition were given
probably expected. You may have friends and rela- the feedback indicating they would lose virtually all of their
tionships now, but by your mid-20s at least 71% (on social connections (as described in the Study 2 Pilot). In this
average) of these will have drifted away. Most (about situation, the extent of the “social damage” is quite extensive.
Bernstein and Claypool 9

Recipients are led to believe that essentially all of their social future-alone feedback so that some participants were exposed
relationships will be “broken” and that they will exist in near to a very severe manipulation (which is quite similar to the
isolation. Participants in the “less severe” condition were one currently used in the literature), whereas others received
given the other feedback described in the pilot study, indicat- a less-severe version. We hypothesized and found that the
ing they would lose much of the social connections but main- less-severe version of the manipulation actually led to more
tain some. In this condition, “social damage” has certainly pain sensitivity (yielding results that looked very much like
occurred, but it is not as severe. Recipients still will feel con- those engendered by Cyberball rejection in Study 1), whereas
nected to others, but the extent and magnitude of their social the more-severe version replicated the numbing of pain from
fulfillment is not what they would have hoped. Study 1 and prior work.
Just as in Study 1, immediately following receipt of this
feedback, two additional measures of pain threshold and tol-
erance were taken, using the same procedure from the begin- General Discussion
ning of the study. Following this task, participants were given Within the exclusion literature, a contradiction has existed
a thorough debriefing just as in Study 1. After the debriefing, regarding the effect of social exclusion on pain sensitivity.
participants were thanked and encouraged to ask questions Though both pain overlap (Eisenberger & Lieberman, 2005)
before leaving. and social pain theories (MacDonald & Leary, 2005) sug-
gest that social exclusion might trigger a response from the
physical- and social-pain systems, the nature of this response
Results and Discussion is unclear. Both a numbing (e.g., DeWall & Baumeister,
We hypothesized that the severity of the social injury (i.e., the 2006) and a hypersensitivity reaction (e.g., Eisenberger et al.,
exclusion experience) would affect the effect that exclusion 2003) appear possible. We hypothesized that these different
has on pain sensitivity. Specifically, we predicted that when patterns of findings may be the result of the severity of the
an exclusion experience is extremely severe, like the standard social-exclusion experiences themselves. Physical injuries
future-alone feedback, participants should experience a and experienced pain share a nonlinear relationship, such
decrease in pain sensitivity. At the same time, a somewhat that as the damage from the injury increases, so too does the
less severe experience of social exclusion should actually experience of pain, but only to a certain point; eventually,
elicit more sensitivity to pain. To test these predictions, we injuries become too severe and pain actually diminishes as
once again standardized each participant’s baseline pain toler- the body experiences numbing. We asserted that perhaps
ance and pain threshold measures. Once standardized, these social injuries follow a similar pattern, such that as social
measures were averaged to form an overall measure of base- injuries (e.g., from social exclusion) increase in their per-
line pain sensitivity (with lower numbers indicating more ceived severity (i.e., as the victim perceives greater social
sensitivity). The same procedure was performed for partici- distance from others), pain increases as well until a critical
pants’ postmanipulation pain threshold/tolerance measures. threshold is reached, at which point a numbing begins.
We performed an ANCOVA comparing the high-severity The results of Study 1 unambiguously supported this
and lower-severity versions of the manipulation of social hypothesis: Cyberball exclusion (shown in pilot testing to be
exclusion on the postmanipulation averaged pain scores a relatively low-severity exclusion) caused hypersensitivity
while using the premanipulation as a covariate (as in Study 1).4 to pain, whereas future-alone exclusion (shown to be a rela-
The result was significant and supported our hypothesis, tively high-severity exclusion) caused numbness to pain. We
F(1, 21) = 8.65, p = .008, η2 = .29 (see Figure 2). Participants believe the finding that the type of social exclusion experi-
in the high-severity condition (M = 0.12, SD = 0.71) experi- ence itself can moderate the response to physical pain is a
enced a relative decrease in pain sensitivity compared to novel contribution itself. Furthermore, to our knowledge,
those in the lower-severity condition (M = –0.14, SD = 1.18). this study is the first to directly compare these two very dif-
When using a one-sample t test to compare the difference ferent manipulations of social exclusion within the same
between postmanipulation pain and premanipulation pain to study and show that they produce opposing outcomes. Based
0, we found that participants in the high-severity condition on these results, it no longer seems wise to assume that all
experienced a decreased pain sensitivity (higher pain thresh- exclusion experiences affect their victims equivalently.
old and tolerance) relative to baseline, t(12) = 2.69, p = .02. Though the results of Study 1 were consistent with our
Moreover, the opposite was found for the lower-severity severity hypothesis, they were not completely conclusive
condition; participants in this condition experienced a higher because many other alternative explanations could apply. In
pain sensitivity (lower pain threshold and tolerance) relative Study 2, however, we directly manipulated the severity of
to baseline, t(10) = –2.12, p = .058. the exclusion experience while holding all other features of
Overall, we hypothesized that the severity (or extent of the episode constant (thus ensuring none of the possible
“social damage”) of the exclusion experience might dictate confounds from the manipulations in Study 1 were respon-
the effect social exclusion has on pain sensitivity. In this sec- sible for our findings). Consistent with the hypothesis, our
ond study, we employed two different versions of the results revealed that the manipulation of exclusion severity
10 Personality and Social Psychology Bulletin XX(X)

led to opposing pain responses, such that a less severe to consider social exclusion as leading to either antisocial or
future-alone rejection led to an increase in sensitivity to prosocial responses but, instead, to consider that social exclu-
painful stimuli, whereas the highly severe version led to sion leads to behaviors aimed at either fixing the situation or
pain numbing. protecting the self and that the extent to which anti- versus
Though Study 1 offers novel evidence concerning the dif- prosocial reactions occur is likely moderated by the severity
ferences between these two different manipulations of exclu- of the social exclusion. If this perspective were supported, it
sion, the results of Study 2 in particular may yield potentially would offer a new understanding of social exclusion’s
important insights regarding possible moderators of social- effects and might spawn new and interesting predictions. For
exclusion outcomes more broadly. A lingering question instance, perhaps low-severity exclusions elicit the purchase
among researchers studying exclusion focuses on explaining of luxury items that indicate status (in an attempt to attract
why the outcomes of social exclusion vary as they do. If the social connections), whereas high-severity social exclusions
severity of the exclusion experience is the reason why perhaps elicit the purchase of survival items (in an attempt to
Cyberball exclusion increases pain sensitivity and future- protect the self). Future research would benefit the literature
alone exclusion numbs one to pain, this might explain, in by examining these ideas further.
part, the tendency to find prosocial, adaptive responses fol- Though there is much promise in this research, these stud-
lowing Cyberball exclusion and antisocial, maladaptive ies, like all others, have some limitations. One obvious limita-
responses following future-alone exclusion. tion is that Study 2 manipulated severity within the future-life
Cyberball exclusion, we argue, leads to a low-severity paradigm only. The outcome was as hoped, that a less-severe
experience of exclusion. It hurts, both emotionally (as shown future-alone manipulation triggered increased pain sensitiv-
previously) and physically. Just as physical pain directs us to ity. In subsequent work, however, it will be equally important
engage in behaviors to remedy the situation, the social dis- to manipulate severity within other exclusion paradigms and
tress associated with the low-severity pain of Cyberball to show that more and less severe versions can produce pain
exclusion should lead us to engage in corrective behaviors. numbing and hypersensitivity, respectively. For instance,
People should take steps toward fixing the injury and thus does writing about a time one experienced a mild exclusion
reducing the pain. Helping others (Williams & Sommer, (e.g., friends forgetting to call you on a Friday night) lead to
1997), engaging in behavioral mimicry (Lakin & Chartrand, heightened sensitivity to pain, and does writing about a more
2005), and attending to cues relevant for reaffiliation serious social infraction (e.g., the end of a multiyear relation-
(Bernstein, Sacco, Brown, Young, & Claypool, 2010; Bernstein, ship) lead to a numbing of pain?
Young, Brown, Sacco, & Claypool, 2008) are all behaviors We are also limited in our understanding of whether or
that lead to the desired end state of reaffiliation and thus a not our results could be mapped at the neurological level.
reduction in social distress and pain. There is now ample evidence that social pain is experienced
On the other hand, future-alone exclusion is not a low- by the same centers of the brain as is physical pain (see
severity injury. It is a major, shock-inducing injury that Eisenberger et al., 2003). It would be interesting to deter-
numbs rather than hurts. Because it leads to emotional and mine if the severity of a social injury also moderates the neu-
physical numbness, people experience no pain and thus are rological reactions to rejection. Presently, we do not know
not compelled in the same way to fix the situation. DeWall whether our effect is driven by neurological responses or
and Baumeister (2006) argued that people may use their whether it is the result of other processes. Future research
emotional faculties to understand the world around them and should investigate this issue.
to determine how to interact with other people. If people’s In closing, we believe this work has the potential to make
emotional systems are shocked into numbness, this might varied and valuable contributions to the social-exclusion lit-
explain why people engage in behaviors that seem to be erature. This work is the first to experimentally compare two
counter to the goal of affiliating with others—like aggressive distinct methods of social exclusion and show, in a single
behavior (e.g., Twenge et al., 2001). Perhaps the only caveat study, that not all methods of exclusion are the same.
to DeWall and Baumeister’s argument that we would add, Moreover, this work showed that Cyberball exclusion can
then, is that it is not true that all exclusionary experiences lead to pain hypersensitivity, that future-life exclusion can
lead to this numbing. The severity of the experience appears lead to pain numbing, and that these different patterns may
to be an important moderator. “Minor” social injuries should be the result of the two types of exclusions varying in their
trigger pain, which may lead to prosocial responses. “Severe” perceived severity. In addition, this work offers new evidence
social injuries, on the other hand, should trigger numbing in support of pain overlap theory (Eisenberger & Lieberman,
and thus lead to more antisocial behaviors. 2005) and social pain theory (MacDonald & Leary, 2005),
Future research should examine the extent to which low- both of which argue that social and physical pain share a
severity social exclusions trigger reaffiliative behaviors and neurological system. Finally, and most broadly, this work
otherwise adaptive responses and the extent to which high- shows, in a unique way, what social psychologists have long
severity exclusions trigger more maladaptive and antisocial argued—that one’s social experiences can have profound
behaviors. Furthermore, to extend the link between physical effects on one’s functioning, in this case even altering one’s
pain and social pain even further, perhaps it would be best not physical sensations.
Bernstein and Claypool 11

Declaration of Conflicting Interests (p = .001). The acceptance conditions did not differ in either
paradigm between Time 1 and Time 2 (both ps > .58).
The author(s) declared no potential conflicts of interest with respect 4. As in Study 1, when conducting the analyses using a 2 (Severity:
to the research, authorship, and/or publication of this article. high, low) × 2 Measurement Time (premanipulation, postma-
nipulation) mixed-model ANOVA with repeated measures on
Funding the last factor, the interaction was significant, and the pattern of
The author(s) received no financial support for the research, data remained unchanged, F(1, 22) = 11.34, p = .003. Individu-
authorship, and/or publication of this article. als in the “low-severity” condition experienced a decrease in
their combined threshold/tolerance measure (p = .021), whereas
Notes individuals receiving the “high-severity” feedback experienced
1. One exception to this pattern comes from MacDonald, Kings- a numbing of pain sensitivity, as indicated by an increased com-
bury, and Shaw (2005), who excluded or accepted participants bined threshold/tolerance (p = .033).
in Cyberball (Williams et al., 2002). Prior to the game, partici-
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