Emotional and Cognitive Consequences of Social Rejection: An Entry Door to Major Depression
Interpersonal factors are strong predictors of the onset and course of major depression. However, the biological and neural bases of interpersonal difficulties in major depression are unknown. In this chapter we describe a general homeostatic system that monitors the social acceptance of individuals. We show that this system is activated in response to actual or putative threats to social acceptance and signals of social rejection. Our model describes a cascade of cognitive, emotional, and behavioural consequences of social exclusion. The model emphasizes the role of specific regions—the subgenual anterior cingulate, the insula, and the default mode network—in the detection and regulation of social signals. Hence we propose that major depressive disorder is tightly linked to the processing of social exclusion and may represent a specific impairment in the homeostatic system that monitors social acceptance.