Attachment Modulates Neural Responses to Social Exclusion vs. Inclusion: An fMRI Cyberball Study in Children.

Individual differences in attachment classification reflect children's social expectations given early relational experiences with primary caregivers. When experiencing rejection - when affective needs are unmet - children can develop avoidant attachment strategies, including suppression of negative emotions and inhibition of observable reactions to adversity. A key aversive situation is social rejection, but how attachment differences affect neural responses to it is poorly understood. We combined functional MRI and the Cyberball paradigm to investigate responses to social rejection in 38 children (9-11 years) classified using the Child Attachment Interview. BOLD activation in the anterior cingulate cortex and right ventrolateral prefrontal cortex (vlPFC) was increased for events of social exclusion relative to inclusion. Dorsal to this effect, right vlPFC showed a negative correlation between exclusion-related BOLD activity and attachment dismissal, a continuous marker for avoidant attachment, reflecting greater vlPFC responses during inclusion (fair play) for avoidant attachment but unchanged responses to exclusion, suggesting increased regulatory monitoring during fair play in higher-dismissal children, rather than altered exclusion reactivity. This may be related to greater expressed worry about exclusion despite fair play in the inclusion condition. Our results suggest that avoidant attachment in children may be associated with impaired emotion regulation and greater expectation of rejection.