A Cross-Sectional Study of Social Exclusion in Schizophrenia: Emotional Blunting and Autonomic Arousal in Response to Cyberball

INTRODUCTION: Social exclusion affects patients with schizophrenia (SCZ) both because of a fundamental disposition to introversion and through social discrimination. Here, we explore the emotional and cardiac autonomic responses to ostracism using a ball-tossing experiment. METHODS: Through a cross-sectional design, 30 patients with SCZ and 30 healthy controls (HC) performed the Cyberball task. We measured respiratory sinus arrhythmia (RSA) at baseline, immediately after each gameplay (inclusion and ostracism) and after 10 minutes (reflective stage), as well as self-reported ratings of threats toward one's fundamental need to belong. RESULTS: Participants with SCZ showed reduced RSA at baseline, which remained low for the task's entire duration, regardless of the experimental condition. When excluded, they self-reported a lower sense of threat to fundamental needs, as compared with HC. CONCLUSIONS: Patients with SCZ showed a persistent defensive autonomic state and displayed a blunted emotional response to experimental ostracism, suggesting difficulties in activating social engagement strategies.