1. Social rejection
Domina Petric, MD

2. The pain of being excluded is not so different from the pain of physical injury. 
Social rejection can influence emotions, cognition and physical health. 

3. Pain in the brain Humans rely on social groups for survival.
We evolved to live in cooperative societies.
Our need for acceptance emerged as a mechanism for survival.

4. Cyberball (designed by Williams) and fMRI (Eisenberger, DeWall) study
Cyberball: the subject plays an online game of catch with two other players.
Eventually the two other players begin throwing the ball only to each other, excluding the subject. 
Compared with volunteers who continue to be included, those who are rejected show increased activity in the dorsal anterior cingulate and the anterior insula.
Dorsal anterior cingulate and anterior insula are two of the regions that show increased activity in response to physical pain. 

5. Anterior cingulate cortex
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6. Anterior insula
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7. Effects of social rejection
Social rejection increases anger, anxiety, depression, jealousy and sadness.
It reduces performance on difficult intellectual tasks.
It can also contribute to aggression and poor impulse control (DeWall, Current Directions in Psychological Science, 2011).
People who routinely feel excluded have poorer sleep quality, their immune system do not function as well as in people with strong social connections.
People often respond to rejection by seeking inclusion elsewhere.
Some people respond to rejection with anger and lashing out.

8. Overgeneralising
The major problem is that one rejection in our lifes can be crucial and after that rejection people tend to generalise and feel excluded in other situations.
˝Very often we have that one rejection, maybe we didn’t get hired for this job we really wanted, and it makes us feel just lousy about our capabilities and ourselves in general˝ (Leary).
˝If people could stop overgeneralizing, it would take a lot of the angst out of it˝ (Leary).

9. Discrimination and social rejection hurt!
Our responsibility as society is to built inclusive democratic environment to prevent social discrimination and rejection.
Understanding that social rejection is attack on someone´s basic psychological need, can help us stop doing things that we would not like to be done to us.

10. Literature
(Kirsten Weir)
Virupaksha Harve Shanmugam, Kalmady Sunil V, Shivakumar Venkataram, Arasappa Rashmi, Venkatasubramanian Ganesan, Gangadhar Bangalore N. Volume and asymmetry abnormalities of insula in antipsychotic-naive schizophrenia: A 3-Tesla magnetic resonance imaging study, Indian Journal of Psychological Medicine, 2012.