Interact VR: Examining Social-Affective Responses to Social Exclusion in Adolescents with Conduct Disorder

Introduction: Social exclusion is associated with adverse social and emotional consequences and is particularly relevant for adolescents with conduct disorder (CD), who experience disproportionately high rates of peer rejection and interpersonal difficulties. Although Cyberball has been widely used to study social exclusion, less is known about how adolescents respond to varying levels of exclusion, and few studies have examined these experiences using immersive virtual reality (VR). The present study provides initial validation evidence for Interact VR; an immersive VR paradigm adapted from Cyberball that examines multidimensional social-affective functioning across varying levels of social exclusion.Method: Adolescents with CD aged 13 – 17 years (Mage = 15.75, 66.5% male) completed three Interact VR conditions: inclusion, subtle exclusion, and severe exclusion. Following each condition, participants completed self-report measures of perceived social regard, belonging, competence, meaningful existence, affective valence, arousal, control, and discrete emotions. Linear mixed-effects models examined differences across conditions, and repeated binary outcomes were analyzed using logistic regression models. Results: Increasing social exclusion produced systematic and theoretically coherent changes across multiple domains of social-affective functioning. Participants reported lower perceived social regard, belonging, meaningful existence, increasingly negative affective valence, lower perceived control, and had a greater likelihood of reporting sadness, anger and disgust, and reduced happiness as exclusion increased. Most outcomes distinguished inclusion, subtle exclusion, and severe exclusion, demonstrating sensitivity to varying levels of social exclusion. Competence differentiated only severe exclusion from the other conditions, subjective arousal decreased as exclusion increased, and fear did not differ across conditions. Conclusions: These findings provide initial validation evidence for Interact VR as an ecologically valid paradigm for investigating multidimensional social-affective responses to social exclusion. More broadly, the findings demonstrate that adolescents with CD distinguish between subtle and severe social exclusion across multiple domains of social-affective functioning, providing a richer understanding of how they subjectively experience social exclusion and a promising platform for investigating the social-affective processes underlying CD.