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SOCIAL PSYCHOLOGY | REVIEW ARTICLE
COGENT PSYCHOLOGY
2024, VOL. 11, NO. 1, 2336362
On the other side of ostracism: a systematic literature review of the
cyberball overinclusion condition
Alessandra Telescaa,b , Alessia Telaric , Monica Consonnib , Chiara De Panlisd and Paolo Rivac
aPh.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy; bFondazione IRCCS
Istituto Neurologico “Carlo Besta”, Milan, Italy; cDepartment of Psychology, University of Milano-Bicocca, Milan, Italy; dDepartment of
Medicine and Surgery, Unit of Neuroscience, University of Parma, Parma, Italy
ABSTRACT
Cyberball, the paradigm developed by Kipling D. Williams and colleagues (2000) to study
ostracism, initially counted three experimental conditions: inclusion, exclusion, and
overinclusion. The least known of these conditions is overinclusion, a social interaction
characterized by excessive social attention (rather than fairness or no attention). This review
provides an overview of original empirical studies implementing the overinclusion condition
since its development. Following the PRISMA 2020 criteria, studies were drawn from four
electronic databases (PubMed, Springer, PsycINFO, Web of Science), and Google Scholar was
screened as a web-based academic search engine. In all, 33 studies met the inclusion criteria.
Included studies described overinclusion specificities compared with exclusion and inclusion
conditions, its effects in paradigms other than Cyberball, brain correlates associated with
overinclusion, and its impact on clinical populations. 26 studies compared the inclusion and
overinclusion conditions. 20 revealed significant differences between the two conditions, and
13 observed better mood and higher psychological needs satisfaction associated with the
overinclusion condition. Studies investigating neural correlates revealed dACC involvement, P3
reduction, and P2 increase during overinclusion, supporting the idea of an ameliorative effect
induced by the over-exposition to social stimulation. Findings on clinical populations suggest
that overinclusion may help detect the social functioning of patients with psychological
impairment. Despite the heterogeneity of the studies, our results showed that overinclusion
can be associated with ameliorative psychological functioning. However, implementing
standard guidelines for overinclusion will help provide a more thorough investigation of the
psychological consequences of receiving excess social attention.
Introduction
Cyberball is a virtual ball-tossing game used to
study, in a controlled setting, the effects of ostra-
cism, a social phenomenon that occurs when some-
one is excluded or ignored by others (Riva & Eck,
2016; Williams et al., 2000). Ostracism has been
defined as ‘being excluded and ignored’ (Williams &
Nida, 2011), and it represents an instance of social
exclusion, which has been defined as the experience
of being kept apart from others physically (e.g.
social isolation) or emotionally (e.g. being ignored
or told one is not wanted). This includes different
phenomena, such as social rejection (i.e. being
explicitly told one is not wanted) and - as previously
mentioned - ostracism (i.e. primarily characterized
by being ignored) (Riva & Eck, 2016).
Cyberball has been widely used for over two
decades, probably because of the simplicity of its
use and the reproducibility of its effects. In 2015,
Cyberball was administered to more than 11,000 par-
ticipants worldwide (Hartgerink et al., 2015).
The game ostensibly involves a group of people toss-
ing a virtual ball back and forth among them.
Participants are told to play with other players (usually
2 or 3), which are actually controlled by a computer
program. The course and speed of the game, the
© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
CONTACT Alessandra Telesca a.telesca@campus.unimib.it Department of Psychology, University of Milano-Bicocca, Piazza Ateneo Nuovo, 1,
20126, Milano, Italy
Supplemental data for this article can be accessed online at https://doi.org/10.1080/23311908.2024.2336362.
This article has been corrected with minor changes. These changes do not impact the academic content of the article.
https://doi.org/10.1080/23311908.2024.2336362
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unre-
stricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the
posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
ARTICLE HISTORY
Received 18 December
2023
Revised 20 March 2024
Accepted 25 March 2024
KEYWORDS
Cyberball; overinclusion;
ostracism; inclusion;
systematic review
REVIEWING EDITOR
Daryl O’Connor, University
of Leeds, United Kingdom
SUBJECTS
Applied Social
Psychology; Psychiatry &
Clinical Psychology
- Adult
2A. TELESCA ETAL.
frequency of inclusion, players’ information, and iconic
representation can be programmed by researchers. The
paradigm allows manipulating independent variables
such as the number of tosses received by the human
player, the total number of tosses in each game, and
the number of players (e.g. avatars). As regards observed
measures, the most used one has been the Need Threat
Scale (NTS) (Williams et al., 2000), which assesses the
level of satisfaction of four fundamental needs: belong-
ingness (i.e. the feeling of being connected to a group
or another individual), self-esteem (i.e. self-attributions
that constitute the value that each person has for them-
selves), control (i.e. the feeling of having control over
one’s social environment), and meaningful-existence (i.e.
the feeling of being recognized for existing and being
worthy for attention; see (Williams, 2009).
The original version of the paradigm (Williams
etal., 2000) included three different experimental con-
ditions: (1) inclusion, in which all three players receive
a fair amount of ball tosses (around 33%); (2) com-
plete ostracism, in which the human player (experi-
mental subject) is excluded receiving only two tosses
at the beginning of the game and then never again;
(3) partial ostracism, in which participants received the
20% of the total tosses, and (4) overinclusion in which
the human player gets more than 33% (in a three
players game) of the total tosses. For simplification
and since partial ostracism is not considered as a
peculiar condition in this systematic review, from here
on in the manuscript the word ‘ostracism’ will refer to
the condition of complete ostracism.
Overinclusion represents the other side of the
ostracism coin. In the ostracism condition, the human
participant receives no (or almost no) social attention
from the fictitious players. In the overinclusion con-
dition, the human participant receives most of the
social attention from the fictitious players (Van Beest
et al., 2011; Van Beest & Williams, 2006).
Initially, Williams et al. (2000) decided to include
the overinclusion condition to rule out the possibility
that the adverse outcomes observed in the ostracism
condition were due to feelings of conspicuousness
and self-awareness rather than ostracism per se. The
original (Williams et al., 2000) and the subsequent
research (Van Beest et al., 2011) indicated this was
not the case. Firstly, Williams et al. (2000) showed
that participants could detect overinclusion accu-
rately; they perceived more throws during overinclu-
sion than during inclusion and ostracism. Crucially,
although both overinclusion and ostracism produced
feelings of conspicuousness, overinclusion did not
elicit any adverse effect, while ostracism did. Thus,
the authors concluded that ostracism’s negative
effects were not mere results of feelings of conspic-
uousness. Moreover, receiving most of the available
social attention (e.g. being overincluded) resulted in
a similar emotional experience to being included
(Williams et al., 2000). This finding suggested that
the participants’ emotional responses to the three
conditions did not have a linear trend: overinclusion
did not result in a more favorable outcome than
inclusion and was, therefore, considered redundant.
Based on these premises, most subsequently pub-
lished studies using Cyberball relied only on two
experimental conditions: inclusion (typically viewed
as a baseline or a control condition) and exclusion
(Hartgerink et al., 2015; Reinhard et al., 2019).
However, as a result of this choice, we were left
with 25 years of data and research on the negative
effects of ostracism and lack of social attention, with
little information on the effects of increased social
attention. For this reason, we think it might be inter-
esting to investigate the other side of the ostracism
coin, which is what the psychological effects of an
excess of social attention are. For this reason, we
think it might be interesting to investigate the other
side of the ostracism coin, which is what the psycho-
logical effects of an excess of social attention are.
Hence, we argue that good theoretical and method-
ological reasons exist to regain interest in the origi-
nal overinclusion condition. Indeed, the overinclusion
condition could be informative regarding the psycho-
logical and physiological consequences of various
social interaction dynamics. In particular, from a
social point of view, an excess of social attention can
result in both a feeling of being overwhelmed and a
positive sense of being important and powerful
(Brewer, 1991); moreover, from a psychological and
clinical perspective, the information about instances
in which people receive excessive social attention
could help shed light on peculiar psychological pat-
terns, such as maladaptive interpersonal coping strat-
egies, dysfunctional interpersonal emotional reactions,
or hypervigilance to social stimuli (Reinhard et al.,
2019). By further exploring overinclusion reactions,
similar hypotheses may be developed and tested.
Over the years, sporadically, some studies have
nevertheless used overinclusion for various reasons,
both directly related to the phenomenon of overin-
clusion in Cyberball (i.e.Cheng et al., 2019; De
Waal-Andrews & Van Beest, 2021; Anderson, 2011)
and indirectly related to it (i.e. Bonow, 2013; Kwok
et al., 2018; van Bommel etal., 2016) using the par-
adigm for other main purposes (see Table 1 for the
aims of the included studies). Some of these studies
have considered using Cyberball to test the effect of
COGENT PSYCHOLOGY 3
Table 1. Description of articles implementing overinclusion condition in the Cyberball paradigm (34).
References
Study
design
Cyberball
conditions
% of
tossess in
over No Aim of the study Overinclusion condition eects Measurements
Biomarkers/
neurophysiological
measurements
STUDIES COMPARING OVERINCLUSION AND EXCLUSION CONDITIONS (6)
Bonow (2013) B Exc - over 45% 89 HS To investigate attachment-related biases
in interpersonal perceptions
Higher levels of positive emotionality
and mood; lower levels of distress
ECR, AAQ-II, DTS,
DERS, FFMQ,
SSQSS, APS
n/a
De Waal-Andrews and
Van Beest (2021)
B/W Exc - over 50% 100 HS To evaluate people’s experience of social
outcomes (claim process versus grant
process)
Over was more pleasurable at the
interpersonal level when granted
than when claimed.
NTS 20; PANAS; 6
items for
participants’
self-perceived
warmth; 9-items
for antisocial
cognitions.
n/a
Cheng et al. (2019) W Periods of exc
- periods of
over
63% 61 HS To investigate the specicity of neural
responses in processing rejection
related aective distress
vLPFC, PFC rostromedial and left
intraparietal sulcus responded
similarly to cumulative exc and inc
rounds. No behavioral eects of
ove r.
NTS 12 fMRI
Meneguzzo et al.
(2020)
B/W Exc - over 46% 32 AN; 34
HS
To investigate the eect of being
ostracized or included by peers in
patients with Anorexia using the
Cyberball
Over was associated with better mood
and needs in both AN and HS. No
dierences between patients and
controls were found as regards the
fundamental psychological needs
during over
NTS 20; BDI-II,
YSQ-S3, eating
disorder
examination
questionnaire
n/a
Meneguzzo et al.
(2022)
BExc - over 46% 34 OS; 44
HS
To assess preliminary evidence about
how OS patients evaluate social inc
and exc through Cyberball, looking at
the inuence of early maladaptive
schemas
Dierences between exc and over
were found for the fundamental
needs in both groups. OS patients
reported to receive less ball tosses
than HS during over. No other
overinclusion eects are
documented.
NTS-21 n/a
Okanga (2021) W progressive inc
- progressive
exc
n.r. 814 HS To examine the link between well-being
and in-group favoritism, following
threat manipulated through
progressive ostracism amongst
minimal groups.
Participants receiving 2, 3, 3, 4 balls
across rounds had signicantly
higher threat to their psychological
needs than those receiving 4, 6, 7,
8 balls across rounds.
NTS-20 n/a
STUDIES COMPARING OVERINCLUSION AND INCLUSION CONDITIONS (26)
References Study
design
Cyberball
conditions
% of
tosses
in
over
No. Aim of the study Overinclusion condition eects Measurements Biomarkers/
neurophysiological
measurements
Studies nding signicant dierences between overinclusion and inclusion conditions (19)
Williams et al., 2000 BExc – partial exc
– inc – over
67% 1486 HS Development of Cyberball paradigm Over was perceived as dierent from
inc but no eects on mood and
fundamental needs were found.
NTS 16 n/a
Carter-Sowell et al.
(2010)
BInc - exc- over 50% 111 HS To investigate the perception of an
observed target’s level of basic need
satisfaction and positive mood after
being identied as superior or inferior
to other group members
Independently of the inclusionary
status (superior/inferior),
participants perceived inc and over
as dierent.
NTS 12 n/a
(Continued)
4A. TELESCA ETAL.
References
Study
design
Cyberball
conditions
% of
tossess in
over No Aim of the study Overinclusion condition eects Measurements
Biomarkers/
neurophysiological
measurements
Shade (2010) B Extreme exc
- slight exc -inc
- over
35% 245 HS The role of RS in perceptions of inclusion
in a social interaction (Cyberball) and
reactions to various degrees of
inclusion
Increase in positive aect and
decrease in negative aect in
relation to the perception of
increased inclusion.
RSQ, PANAS,
behavioral checks,
Rosenberg
self-esteem scale
n/a
Anderson (2011) B/W Inc - exc - over 48% 37 HS To investigate the impact of varying
degrees of social inclusion on the
fundamental needs
Improved mood and psychological
needs in participants with high
rejection sensitivity levels.
NTS 12; RSQ; STAI-Y
ECR-S
n/a
Van Beest et al. (2011) B Inc - exc - over 50% 270 HS Ostracism in relation to feeling of being
singled out (Cyberbomb)
Being overincluded in Cyberbomb was
painful. Being overincluded in a
negative situation (Cyberbomb)
might cause people to retaliate.
NTS 20 n/a
Ho et al. (2014) W Rounds of gradual
increase
Exc - over
48% 126 HS To study the eects of subtle exclusion
on implicit mood and self-esteem,
and the eect of introspection on the
same implicit processes
Over was perceived as dierent from
inc. No other eects on mood and
fundamental needs.
NTS 12 n/a
Niedeggen et al.
(2014)
B/W Inc - over 46% 40 HS To investigate whether reducing the
involvement of the participant, it
activates a neural alarm system,
threatening fundamental social needs
Increase of social needs- except for
self-esteem; enhanced P2
amplitude during over
NTS 16 ERPs
De Panlis et al.
(2015)
BInc - exc - over 45% 61 BPD BPD emotional reactions in interpersonal
exchanges
Over was associated with less negative
emotions. BPD reported levels of
negative emotions comparable to
those of controls only when
overincluded.
NTS 12; SCID-II,
SCID-I/P; SCL-90-R
- RES, IOS
n/a
Burgdorf et al. (2016) W Inc - exc - over 40% 48 HS Cyberball consequences mediated by
dierent attachment styles and
µ-opioid antagonist naltrexone eects
Enhanced positive and reduced
negative emotionality, increased
physiological activation, and levels
of vasodilation and of cardiac vagal
tone as seen in rest (relaxation
response)
Emotion self-report ECG; Blood pressure
van Bommel et al.
(2016)
BInc - exc - over 80% 138 HS Bystander eect and helping behaviour Over fullled signicantly more the
need for control and self-esteem
compared to inc, but there is no
dierent between over and inc in
terms of helping behaviors.
NTS 12 n/a
Venturini et al. (2016) W Inc - exc- over 50% 62 HS To test the eect of a virtual
reality-based Cyberball paradigm with
highly anthropomorphic avatars
After over, participants felt greater
sense of belonging, meaning
existence, self-esteem and control
than inc and exc in Cyberball
paradigms with low highly
anthropomorphic avatars
NTS 20; RES n/a
Kwok et al. (2018) B Inc - exc - over 50% 331 HS Social exclusion consequences on
anthropomorphizing objects,
evaluating if they incentive the
sentimental and instrumental values
of objects
Over determined the highest feeling
and the highest scores of
satisfaction for all the four
fundamental needs and determined
greatest sentimental attachment to
the objects
12 NTS; SI-R; AMS n/a
Table 1. Continued.
(Continued)
COGENT PSYCHOLOGY 5
References
Study
design
Cyberball
conditions
% of
tossess in
over No Aim of the study Overinclusion condition eects Measurements
Biomarkers/
neurophysiological
measurements
Weinbrecht etal.
(2018)
WInc - exc- over 45% 29 BPD; 28
SAD
To verify whether patients with BPD
process social overinclusion in a
biased manner
BPD and SAD reported stronger need
threat, negative emotions, and
feeling of exclusion compared with
HS after inc but not over. P3 was
larger after inc than over and for
SAD and BPD than HS.
NTS 20 ERPs
Grossman (2019) B/W Inc – over
– strong over
38-42% 142 HS To test if level of inclusion moderates the
relationship between fear of positive
evaluation and negative aect
Over was perceived as dierent from
inc. No other eects on aect
levels and fear of positive
evaluation
FPES; SPS; SIAS;
BSAM; PANAS;
debrieng
questionnaire
about Cyberball;
BFNE
n/a
Erel et al. (2021) B Inc – exc – over 75% 36 HS To test if interactions between one
participant and two non-humanoid
robots can lead to negative feelings
related to ostracism and if it impacts
on fundamental needs
Over satises the need for self-esteem
signicantly more than inc. No
other dierence between over and
inc is signicant.
NTS-12; Godspeed
questionnaire;
Mood
questionnaire (8
items)
n/a
Weinbrecht etal.
(2021)
WInc – over n.r. 28 SAD; 29
BPD; 28 HC
To examine how individuals with SAD,
BPD and HS process an increase in
the frequency of social interaction in
a virtual ball tossing game (Cyberball)
based on EEG data.
Participants estimated to have
received the ball more often in
over than inc.
HSs and BPD, but not SAD, showed an
increase in P2 amplitude from inc
to over. Positive emotions did not
change from inc to over.
The Emotion Scale ERPs
Ikeda and Takeda
(2021)
Inc – over 47% 42 HS To test the eects of holding a soft
cushion under frequent positive
feedback
Overincluded participants felt less
social pain compared to included
participants, independently from
the type of cushion (hard or soft).
P3 was signicantly larger in
amplitude in inclusion than
overinclusion.
4 items: one for each
fundamental need
ERPs
Kawamoto et al.
(2012)
WInc - exc - over 80% 22 HS To investigate the role of the dACC in
detecting social exclusion Vs.
expectancy violation
Deactivation of dACC and sense of
conspicuousness during inc but no
dierences between inc and over
NTS 16 fMRI
Schrantz et al. (2021) B Inc – exc – over 50% 180 HS To examine the inuence of social
exclusion on false confessions
The 60% of overincluded participants
made false confessions, compared
to the 53% of included participants
and the 76,6% of excluded
participants
n/a n/a
Studies not nding signicant dierences between overinclusion and inclusion conditions (6)
Goodwin et al. (2010) W Inc- exc - over 50% 614 HS To investigate whether attributing
ostracism to racial prejudice mediates
recovery
No detection of over - authors
collapsed data of inc and over
Behavioral checks; 5
for aective
assessment
n/a
Hawkley et al. (2010) B Inc - exc - over >50% 780 HS To investigate the mechanisms involved
in age dierences in the aective
experience of ostracism
No detection of over - authors
collapsed data of inc and over
MGPQ, LEQ; R-SRRS;
chronic stress test;
LTS
n/a
Table 1. Continued.
(Continued)
6A. TELESCA ETAL.
References
Study
design
Cyberball
conditions
% of
tossess in
over No Aim of the study Overinclusion condition eects Measurements
Biomarkers/
neurophysiological
measurements
Leitner et al. (2014) B Inc - exc - over 50% 61 HS ADS scale validation to investigate the
tendency to disengage self-esteem
from negative outcomes
No dierences ADS n/a
Peake (2016) W 2 rounds:
1) mixed inc/over;
2) mixed inc-exc
50% 55 HS To identify individual dierences in
susceptibility to peer inuence and
the eect of positive and negative
social contexts on adolescent decision
making
No dierences NTS 12 - RPI - YRBS
- BIS15 - BSSS
- SPSRQ - PEQ-R
- ACES-C - CBCL
- SCARED
- CED-DC
n/a
Lansu et al. (2017) B/W 3 versions of exc
– inc – over
50% 564 HS To investigate whether victimization is
associated with negatively distorted
social cognition (bias) or with a
specic increased sensitivity to social
negative cues
n.r. NTS 20 - qualitative
assessment of
victimization
n/a
Ghosh, 2021) B Inc – partial exc
- exc – over
67% 171 To test the relation between Fear of
Positive Evaluation, negative aect,
and levels of inclusion.
No dierences PAI-BOR; TASIT; SAM n/a
STUDIES USING OVERINCLUSION AS DEBRIEFING POST-OSTRACISM (2)
White et al. (2016) W Inc - exc - over 42% 65 Children To investigate in which social contexts
children use the ability of
understanding others’ mental states.
Over used as debrieng. n/a n/a
White et al. (2021) W Inc - exc - over n.r. 165 Children To track event-related cardiac slowing, a
physiological correlate of rejection,
especially when unexpected.
Over used as debrieng. n/a ECG
Note: B = between subjects design, W = within subjects design, B/W = between subjects and within subjects (or mixed) design; inc = inclusion, exc = exclusion, over = overinclusion; HS = healthy subjects, AN = anorexia
nervosa, OS = obesity surgery, BPD = borderline personality disorder, SAD = social anxiety disorder, HC = healthy controls.
Table 1. Continued.
COGENT PSYCHOLOGY 7
excessive social attention on clinical populations. For
instance, in the case of individuals suffering with
borderline personality disorder (BPD), investigating
these patients’ emotional reactions to overinclusion,
as opposed to fair inclusion, aimed to explore the
hypothesis that BPD patients would rely on atypical
social norms when compared to healthy controls.
Since patients with BPD react as if they were excluded
regardless of objectively including or excluding social
exchanges, considering the framework of expectancy
violation might help understanding this response
pattern. Among healthy controls, neural reactions to
social exclusion also involve an expectancy violation
mechanism. When approaching social exchanges,
people expect others to follow the ‘unwritten rule’:
to include them in a social interaction. The violation
of this expectation activates brain areas signaling
alarm, conflict, and threats to acceptance (Bolling
et al., 2011; Somerville et al., 2006). Consequently,
while healthy individuals are affected by social exclu-
sion because this condition violates their implicit
expectation of being included by others, people with
BPD might react as if they were ostracized even in
inclusion scenarios because fair inclusion violates
their implicit expectations for extreme social inclu-
sion. Therefore, evaluating whether BPD patients
respond with lower negative emotions to the
Cyberball overinclusion as compared to the inclusion
and ostracism conditions can allow investigating
whether this patient population relies on a higher
threshold of social attention from others, which can
result in rejection feelings even in fairly including
scenarios (De Panfilis et al., 2015).
Therefore, this systematic review focused on the
empirical studies that adopted the overinclusion con-
dition in Cyberball. We believe that a systematic
review of studies using overinclusion can provide a
more comprehensive and objective understanding of
the methods and effects of its use, so that future
studies can leverage this awareness to improve its
application in experimental and clinical contexts. We
decided to compare especially overinclusion to inclu-
sion, reasoning that directly comparing overinclusion
and ostracism would be more trivial as they repre-
sent the extremes of a continuum. First, we provided
an overview of overinclusion implementation in liter-
ature, describing its methodological peculiarities
across studies. Then, we presented the results of
neuroscientific studies inquiring about brain activity
during the detection of overinclusion. Finally, we
reported the effects of overinclusion in clinical pop-
ulations (e.g. borderline personality disorder, social
anxiety, and eating disorders). We conclude by
discussing the limits of this condition and further
steps to improve its applicability, particularly in clini-
cal settings.
Methods
Literature search
A literature search was conducted to select
peer-reviewed original papers published online in
English before the end of October 2021, following
the PRISMA 2020 criteria (Supplementary material 1)
(Page et al., 2021). We searched all studies that
included the overinclusion condition in the Cyberball
paradigm using ‘Cyberball overinclusion’ and
‘Cyberball over-inclusion’ as keywords to search in
the title and abstract. We screened scientific data-
bases (PubMed, Springer, PsycINFO, Web of Science)
and the academic search engine Google Scholar.
2020. The algorithms used are shown in
Supplementary Table S1. All experimental conditions
with a percentage of ball-tosses higher than 33%
were considered as overinclusion. This percentage is
not arbitrary: indeed, being a game with 3 players,
33% is considered the fair number of ball passes
among the three players. Hence, every higher per-
centage is an approximation of overinclusion.
We adopted the following exclusion criteria:
papers written in languages other than English;
papers published in other than journal articles or
Ph.D./M.D. thesis; articles using paradigms different
from Cyberball (or its main variations Cyberbomb,
Claimball, and €yberball); articles without the overin-
clusion condition.
Records screening and quality assessment
For the duplicates removal and the title-abstract
blinded screening process, two researchers (A.T. and
F.P.) used Rayyan (rayyan.qcri.org/), a web and mobile
systematic reviews manager (Ouzzani etal., 2016), to
independently categorize results as ‘included’,
‘excluded’ or ‘maybe’. Then, the same two researchers
analyzed the full texts of the remaining records and
independently selected eligible studies. In both the
title–abstract and full-text screening phases, ‘maybe’
and conflicting decisions were solved by consensus
or discussed by consulting a third researcher (P.R.).
One researcher (A.T.) extracted data using a struc-
tured form, collecting: (1) article characteristics (e.g.
year of publication, author), (2) sample characteristics
(e.g. patients vs. healthy control group, age, and sex),
(3) operationalization of experimentally induced
8A. TELESCA ETAL.
ostracism (paradigm characteristics), and (4) outcome
measures. The other authors checked the data for
consistency and accuracy (P.R. and M.C.). Discrepancies
were resolved by consensus.
The quality of the included studies was assessed
considering the following criteria, in order of impor-
tance: (1) blinding of participants; (2) randomization
of participants; (3) sample size calculation; (4)
blinding of the experimenter. We considered four
levels of risk of bias: low level, when the criteria (1)
and (2) were fully respected; moderate level, when
(1) was fully respected but (2) was uncertain; seri-
ous level, when (1) was not respected; critical level,
when more than three criteria including (1) were
not respected. Two researchers independently
checked the presence of each criterion in all papers
included, scoring ‘yes’ when the criterion was
respected, ‘no’ when it was not respected, and
‘unclear’ when the information was missing or not
clearly reported.
Results
We identified a total of 202 publications. At the
title-abstract review, we removed 20 duplicates and
126 records that did not meet our inclusion criteria.
Then, we examined the full text of the remaining
56 records. We excluded 22 records at this stage:
three were duplicates, one was excluded because it
was not in English, three were excluded because
they were not on journal articles or published the-
sis, three were excluded because they were not
based on Cyberball, and 12 were excluded because
they did not use overinclusion condition in their
experiments. Thus, thirty-four studies met the crite-
ria to be included in our review (Figure 1 and
Table 1).
The results of the quality assessment are reported
in Figure 2. We evaluated reporting bias based on
the available details in each article. We calculated the
number of studies that met the four criteria men-
tioned above: all but one study respected the
blinding of participants (1); 23 of 33 studies (69%)
respected the randomization of participants, and 6 of
33 (18%) did not mention the randomization method
(2); 9 of 33 studies (27%) respected the sample size
calculation (3); finally, only 3 of 33 studies (9%)
declared that experimenters were also blinded (4).
Overall, only one study did not respect any criteria
(Burgdorf et al., 2016), and only one study respected
them all (Grossman, 2019). The blinding of partici-
pants was the most respected compared to the oth-
ers. Based on these considerations, 69% of the cited
studies meet the indicative criteria for good study
quality, while the results of the studies out of the
68% reporting a moderate, serious, and critical risk of
bias may include major biases that could affect the
validity of the results, which should be consequently
interpreted with caution.
Characteristics of included studies
The studies that were included in the systematic
review are published articles in peer-review scientific
journals (Table 1) and six published Ph.D. or master’s
degree theses (Bonow, 2013; Ghosh, 2021; Grossman,
2019; Okanga, 2021; Peake, 2016; Shade, 2010). The
overall number of participants is 7.344, with an aver-
age age of 34.5 ± 0.5. The mean percentage of tosses
used to obtain overinclusion is 49%, but the total
number of tosses changed over a wide range from
15 to 200. Six studies implemented only exclusion
and overinclusion (Bonow, 2013; Cheng et al., 2019;
De Waal-Andrews & Van Beest, 2021; Meneguzzo
et al., 2020; 2022; Okanga, 2021), and five imple-
mented only inclusion and overinclusion (Grossman,
2019; Ikeda & Takeda, 2021; Niedeggen et al., 2014;
Weinbrecht et al., 2018; 2021). Eight studies used a
between-group design, fourteen were within-group
studies, and twelve had a mixed study design
(between-within-subject study). Six studies tested
Cyberball effects on clinical populations (De Panfilis
et al., 2015; Ghosh, 2021; Meneguzzo et al., 2020;
2022; Weinbrecht et al., 2018, 2021), and six studies
investigated the neural correlates elicited by the
Cyberball paradigm (Cheng et al., 2019; Ikeda &
Takeda, 2021; Kawamoto et al., 2012; Niedeggen
et al., 2014; Weinbrecht et al., 2018, 2021). Four stud-
ies structured the Cyberball manipulation as a seam-
less succession of all the experimental conditions
resulting in rounds of inclusion mixed with overinclu-
sion, rounds of inclusion mixed with exclusion, or a
gradual increase or decrease of tosses to obtain
social inclusion or exclusion (Cheng et al., 2019; Ho
et al., 2014; Okanga, 2021; Peake, 2016). Regarding
the outcomes’ evaluation of Cyberball, all the selected
studies assessed the number of tosses perceived by
participants (this measure is usually considered a
manipulation check). Nineteen studies used the Need
Threat Scale (NTS) to measure the psychological
effects of the paradigm, and two used overinclusion
as a debriefing phase with children (White et al.,
2016; 2021). See Table 1 for further details. Guided
by the contents of the articles included in the sys-
tematic review, we decided to describe the included
articles by dividing them into three groups to
COGENT PSYCHOLOGY 9
facilitate reading. Specifically, in addition to the gen-
eral category of articles comparing the effects of
inclusion and overinclusion, we categorized articles
concerning clinical populations and those adopting
specific neuroscience techniques to investigate the
effects of overinclusion on the human brain.
Among our thirty-three selected studies, six
(Bonow, 2013; Cheng et al., 2019; De Waal-Andrews
& Van Beest, 2021; Meneguzzo et al., 2020; 2022;
Okanga, 2021) directly compared the effects of
social exclusion to those of overinclusion, omitting
the inclusion condition, acknowledged as the base-
line to evaluate the paradigm effects on the emo-
tional and psychological well-being of the
participants (Riva et al., 2014).
In these six studies, participants assigned to the
overinclusion condition reported receiving more ball
tosses than those in the exclusion condition.
Figure 1. PRISMA 2020 owchart showing the selection process of papers.
Figure 2. Risk of bias evaluation of the papers extracted from the systematic review procedure. The bar represents the per-
centage of studies with dierent degrees of risks of bias: low (green) = randomization and blinding of participants criteria
were respected; moderate (yellow) = blinding of participants criterion was respected but randomization data were incomplete;
serious (orange) = not respecting the randomization criterion; critical (red) = not respecting any criteria.
10 A. TELESCA ETAL.
Furthermore, all but one (Cheng et al., 2019) study
reported that overinclusion is associated with
improved mood and higher satisfaction with basic
psychological needs (Bonow, 2013; De Waal-Andrews
& Van Beest, 2021; Meneguzzo et al., 2020; 2022;
Okanga, 2021). Further details on these studies are
available in Supplemental materials, Table S3.
However, the direct comparison of exclusion and
overinclusion could mask the specificity of the condi-
tion of overinclusion as it compares two extremes of
social attention (ostracism, not receiving attention;
overinclusion, receiving more attention than other
players receive). Indeed, both exclusion and overinclu-
sion represent conditions that ‘alter’ the baseline state,
but when the baseline state isn’t measured, it becomes
challenging to deduce the actual impact that either
condition has on the outcome variable. Therefore, the
emerging results could be less reliable. In conclusion,
we believe that the direct comparison between exclu-
sion and overinclusion, while confirming the outcome
of improvement in mood and fundamental needs,
does not add more valuable information to the results;
instead, it represents a methodological limitation.
More interesting is to know if overinclusion is different
from fair inclusion in Cyberball, namely, if excessive
social attention represents a psychologically different
condition from a fair share of social attention. To date,
this issue is unsolved.
To address this, we decided to focus mainly on
selecting twenty-six studies that have dealt with the
difference between the effects induced by a condition
of equal social attention between players (inclusion)
and those generated by a condition of greater atten-
tion towards the human participant (overinclusion).
Comparing overinclusion and inclusion
conditions
Twenty-five studies compared the inclusion and
overinclusion conditions. One mentioned overinclu-
sion in methods, but its related outcomes have not
been described (Lansu et al., 2017). Among the
remaining twenty-four studies, nineteen (79%)
reported statistically significant differences between
the effects of the two inclusion conditions. Compared
to inclusion, all the nineteen studies reported that
overinclusion is associated with the perception of
getting more ball tosses. Twelve of them (50%)
reported also improved psychological needs and
mood of the participants (Anderson, 2011; Burgdorf
et al., 2016; De Panfilis et al., 2015; Erel et al., 2021;
Ikeda & Takeda, 2021; Kwok et al., 2018; Niedeggen
et al., 2014; Schrantz et al., 2021; Van Beest et al.,
2011; van Bommel et al., 2016; Venturini et al., 2016;
Weinbrecht etal., 2018). One study associated these
positive emotional effects with social pain reduction
(Ikeda & Takeda, 2021), and another with a physio-
logical state typical of relaxation (Burgdorf et al.,
2016). The positive effects of overinclusion on the
participants’ psychological well-being were also
tested by modifying the meaning assumed by the
condition of overinclusion. Finally, only one study
reported a possible effect of overinclusion on behav-
ior. Specifically, investigating the impact of various
levels of social inclusion on participants’ willingness
to make false confessions in court, the authors
found a lower frequency of false confessions in
included and overincluded participants compared to
excluded participants (Schrantz et al., 2021).
Six studies compared inclusion and overinclusion
without finding statistically significant differences
(Ghosh, 2021; Goodwin et al., 2010; Hawkley et al.,
2010; Lansu et al., 2017; Leitner et al., 2014; Peake,
2016). Of these, two used a few game tosses (i.e. fif-
teen; Goodwin et al., 2010; Hawkley et al., 2010),
with a percentage of tosses received by the partici-
pant equal to 50% in overinclusion and 33% in inclu-
sion. Not finding any differences between the two
conditions, the authors collapsed the overinclusion
data with those of the inclusion. Six studies found no
difference between inclusion and overinclusion. The
lack of significance could not be accounted for by
the type of study (between or within), the total num-
ber of tosses, the order of conditions, the outcome
measures, and the number of game rounds. None of
these variables were differently addressed in studies
finding statistical differences between inclusion and
overinclusion.
Brain activity involved in overinclusion detection
Among our selected studies, six investigated the
neural correlates associated with the experience of
Cyberball overinclusion. Two studies used functional
Magnetic Resonance Imaging (fMRI) (Cheng et al.,
2019; Kawamoto et al., 2012), and four used
event-related potentials (ERPs) (Ikeda & Takeda, 2021;
Niedeggen etal., 2014; Weinbrecht etal., 2018, 2021).
Both fMRI studies inquired about the involve-
ment of the dorsal anterior cingulate cortex (dACC),
which has been previously associated with detect-
ing social exclusion and non-social expectancy vio-
lation. Kawamoto et al. (2012) found a selective
increase of dACC activation during the ostracism
condition, which did not occur in any other
Cyberball conditions, even overinclusion.
COGENT PSYCHOLOGY 11
Furthermore, no significant cortical activations were
associated with overinclusion, and no differences in
the neural correlates between inclusion and overin-
clusion were detected (Kawamoto et al., 2012).
Cheng et al. (2019) documented an increase in the
activation of the dACC passing from an overinclu-
sion to an exclusion condition and a decrease in
the activation of the dACC passing from the exclu-
sion to the overinclusion condition. Thus, according
to the authors, dACC was not sensitive to the spe-
cific condition of ostracism but to the transition
from one condition to another (Cheng et al., 2019).
However, this issue remains open to further
investigation.
Four studies recorded ERPs, a neurophysiological
technique able to detect electrical activity generated
in the brain structures in response to specific events
or stimuli, in this case, Cyberball games. They found
peculiar neural activity during the overinclusion ses-
sion: a reduction in the amplitude of P3 and an
increase in the amplitude of P2, especially when
experiencing overinclusion after inclusion (Niedeggen
et al., 2014; Ikeda & Takeda, 2021; Weinbrecht et al.,
2018; Weinbrecht et al., 2021). In the literature, P3 is
associated with decision-making processes and sub-
jects’ reactions to unexpected or infrequent stimuli,
while P2 is related to social reward processes. Overall,
the neurophysiological results suggest that overinclu-
sion might be experienced as less unexpected but
more socially rewarding than fair inclusion. These
results also align with participants’ behavioral
responses in the psychological needs satisfaction
questionnaires (Niedeggen et al., 2014; Ikeda &
Takeda, 2021). In this regard, it can be noted that the
unexpectedness may be accounted for by the greater
uncertainty for the human participant in the inclu-
sion condition than in the overinclusion one. As
opposed to the inclusion condition, indeed, in the
overinclusion condition, the behavior of the other
two players becomes easily predictable since the
early stage of the game.
Two studies cited in this section analyzed physio-
logical responses in clinical populations (Weinbrecht
etal., 2018; Weinbrecht etal., 2021). Considering the
neurophysiological data of these two studies,
patients with borderline personality disorder (BPD)
and social anxiety disorder (SAD) showed a greater
amplitude of P3 than healthy controls both during
the inclusion and the overinclusion conditions, sig-
naling that both conditions violated patients’ expec-
tations. However, when overincluded, BPD and SAD
patients showed a reduction of P3 like healthy con-
trols did, indicating that overinclusion violates their
expectations to a lesser extent than inclusion
(Weinbrecht et al., 2018). Differently, the population
of SAD patients differed from the non-clinical and
BPD populations due to the absence of the P2
increase in correspondence with the overinclusion
condition, suggesting that overinclusion is not pro-
cessed at the neural level as a socially rewarding
stimulus by SAD patients. The authors concluded
that SAD and BPD patients differ in processing social
participation. Compared to healthy controls and
BPDs, SAD patients show greater difficulty in appre-
ciating, at the neural level, the increased social
involvement induced by overinclusion in Cyberball
(Weinbrecht et al., 2021).
Overinclusion eects on clinical populations
Despite the small effects of overinclusion on healthy
subjects, Cyberball overinclusion has been increas-
ingly adopted and revealed to be particularly effec-
tive as an emotional trigger in the clinical population
(Reinhard et al., 2019). However, to date, only five
studies investigated the specific role of the overinclu-
sion condition involving BPD, SAD (De Panfilis et al.,
2015; Weinbrecht et al., 2018, 2021), Anorexia
Nervosa, and patients who underwent Obesity
Surgery (Meneguzzo et al., 2020, 2022).
Considering the BDP and SAD groups, three stud-
ies reported that patients experienced fewer positive
emotions than healthy controls (De Panfilis et al.,
2015; Weinbrecht etal., 2018; Weinbrecht etal., 2021).
Regarding BPD, two studies reported that patients
experienced greater rejection-related emotions and
negative mood than healthy controls during the
inclusion condition but comparable levels during the
overinclusion condition. These findings suggest that
BPD patients may need a greater share of social
attention than healthy controls to feel included.
However, BPD patients reported fewer feelings of
social connection and less need satisfaction than
healthy controls during both the inclusion and over-
inclusion conditions (De Panfilis et al., 2015;
Weinbrecht etal., 2018).
Concerning SAD populations, two of the studies
mentioned above compared their subjective and EEG
responses to inclusion and overinclusion with those
of healthy controls and BPD patients (Weinbrecht
et al., 2018, 2021). Similarly to BPD patients, individ-
uals with SAD reported higher levels of ostracism
intensity and negative mood than healthy controls in
the inclusion but not in the overinclusion condition.
However, differently from BPD patients, overinclusion
in the SAD group also led to decreased perceived
12 A. TELESCA ETAL.
need threats to levels comparable to those of healthy
controls, suggesting a BPD-specific bias to feel threat-
ened in one’s need to belong even in a condition of
extreme inclusion.
Considering eating disorders, the studies on the
Anorexia Nervosa population (Meneguzzo et al.,
2020) did not find differences between patients and
controls in perceived mood and needs satisfaction
during the overinclusion condition. The authors only
found that during the overinclusion condition, both
patients and controls correctly recognized receiving
more ball tosses than during the exclusion condition
(Meneguzzo et al., 2020). The other study involving
the Obesity Surgery clinical population (Meneguzzo
et al., 2022), instead showed that, compared to
healthy controls, patients underestimated the per-
centage of ball tosses received during both ostracism
and overinclusion. No other differences between
groups related to the overinclusion condition were
found. Interestingly, Obesity Surgery patients, but
not healthy controls, did not perceive differences
between the exclusion and the overinclusion condi-
tions in feelings of Self-Esteem and Meaningful exis-
tence (Meneguzzo et al., 2022). This result revealed
that patients were less aware of their exclusionary
status; thus, they seemed less vulnerable to ostra-
cism than controls. Both latter studies used exclusion
and overinclusion conditions, omitting the inclusion
baseline (Meneguzzo et al., 2020; Meneguzzo et al.,
2022). This choice was motivated by the first study
on patients with anorexia nervosa, stating that exclu-
sion and overinclusion required skills to manage
socially exclusive experiences, which were the most
salient for the clinical population under examination.
Consequently, we cannot fully understand the role of
overinclusion with such patients.
General discussion
Among the Cyberball experimental conditions, the
one that has been ‘ostracized’ by researchers since its
introduction is the overinclusion condition. The main
reason for this neglect might be how overinclusion
was initially presented. Kipling D. Williams et al.
(2000) were mainly interested in studying the effects
of ostracism and implemented overinclusion only to
control possible effects on the participants’ sense of
conspicuousness. Finding no significant differences
between the overinclusion and the inclusion condi-
tions, the authors concluded that participants did
not perceive overinclusion as different from the
inclusion condition. Thus, in subsequent studies,
leaving out the overinclusion condition was probably
a good way to economize experimental resources
(e.g. number of participants in between-subject
designs and experiment duration in within-subjects
designs).
Despite this, it was later noticed that overinclusion
could have peculiar psychological and physiological
effects, and that it can impact differently on people,
according to their individual differences. In support
of this hypothesis, a study in 2018 pointed out the
importance of exploring social inclusion effects,
showing that when participants are the target of
specific social attention, their mood and fundamental
needs are fortified (Simard & Dandeneau, 2018).
Moreover, a meta-analytic study, published after our
systematic review was conducted and aimed at
understanding the impact of overinclusion in
Cyberball and the role of social anxiety in this pro-
cess (Hay et al., 2023), revealed that the impact of
overinclusion on participants’ psychological
well-being, namely positive affect, feelings of belong-
ingness, self-esteem, meaningful existence and con-
trol, may change according to their individual
differences.
Psychological and cognitive eects of
overinclusion on clinical populations
In line with the hypothesis of psychological effects
related to the overinclusion condition, our systematic
review highlighted that overinclusion was perceived
as different from fair social inclusion in twenty out of
twenty-six studies (equal to 77%) that compared
these two critical conditions. More specifically, in
thirteen (50%) of these studies, overincluded partici-
pants showed improved psychological needs or
mood compared to fairly included ones. This is fur-
ther supported by reduced social pain (Ikeda &
Takeda, 2021) and a physiological state typical of
relaxation (Burgdorf et al., 2016). Our finding aligns
with Hay et al. (2023) detecting a small effect of
overinclusion on positive affect and a moderate
effect on fundamental needs, mainly belonging and
control.
Concerning the feeling of conspicuousness deter-
mined by overinclusion, the results of our review
suggest that being overincluded may be a form of
standing out (Van Beest 2011; De Waal-Andrews &
Van Beest, 2021). Indeed, if ostracism represents a
deprivation of attention, in the case of overinclusion,
it involves an excess of attention. In some non-clinical
social groups, such as famous and popular people,
both standing out and being at the center of some-
one’s attention are quite common. Moreover, ‘fame’
COGENT PSYCHOLOGY 13
seems to be related to higher feelings of belonging-
ness (Greenwood et al., 2013) and self-esteem (Utz
etal., 2012), both included in the fundamental needs
(Williams et al., 2000). Hence, we could consider that
popularity and standing out phenomena are concep-
tually similar to the overinclusion effects. However,
Cyberball overinclusion represents a specific condi-
tion within an experimental paradigm, where the
phenomenon is directly elicited during the investiga-
tion itself. On the contrary, popularity is a more com-
plex and identity-related construct. Indeed, it is
typically investigated through peer hierarchical eval-
uations or status assessments: those ranked highest
in these evaluations are typically identified as ‘popu-
lar’ (Cillessen & Marks, 2011). In this sense, one (over-
inclusion) represents a state variable while the other
(popularity) a trait variable, but beyond this key dif-
ference future research should consider exploring the
links between these two constructs.
However, the standing out phenomenon may be
particularly relevant when overinclusion is applied to
clinical populations. We identified a few clinical pop-
ulations on which overinclusion was tested. The
results supported the idea that the overinclusion
condition can modulate the participants’ emotional-
ity and that their baseline psychic status can affect
their reaction to Cyberball conditions differently.
In line with Hay et al.’ meta-analysis (2023), we
found that overinclusion has a particular subjective
effect on social anxiety disorder (SAD) patients due
to their baseline low levels of mood and feelings of
belongingness in the inclusion condition. Specifically,
both of them increase to levels comparable to those
of healthy controls during overinclusion (Weinbrecht
et al., 2018), and this result is in line with those of
Hay et al. (2023). However, neuroscientific studies
have also revealed that these individuals are not as
socially rewarded as healthy people by being overin-
cluded (Weinbrecht et al., 2021). This aligns with the
impaired positivity hypothesis in SAD, according to
which this patient population would process and
experience positive social information more nega-
tively (Gilboa-Schechtman et al., 2014). Therefore,
people with SAD may need stronger signals to feel
included while still disliking being in the spotlight.
Also individuals with borderline personality disor-
der (BPD) show a biased processing of social inclu-
sion. Indeed, fair inclusion is considered unexpected
and associated with greater negative emotions and
lower feelings of belongingness compared to healthy
controls. Conversely, overinclusion is perceived as
socially rewarding and reduces negative emotions to
levels similar to healthy controls. However, even
when overincluded, BPD patients still report lower
feelings of belongingness and process overinclusion
as more unexpected than controls (although less
unexpected than fair inclusion; De Panfilis et al.,
2015; Weinbrecht et al., 2018, 2021). These findings
suggest that individuals with BPD could rely on atyp-
ical social norms: their profound, inner need to be
‘extremely’ included by others would make them
experience fair inclusion as distressing and unex-
pected. This response pattern is only partially miti-
gated by the overinclusion condition, effectively
improving their negative emotions but not feelings
of belongingness. Nonetheless, violating patients’
expectations less and being evaluated as more
socially rewarding than fair inclusion, overinclusion
seems closer to meeting their unrealistic need of
being extremely included by others.
However, the number of investigated psychopa-
thologies is still limited. Yet, implementing overinclu-
sion could be an opportunity to examine the social
and relational abilities of patients suffering from
clinical conditions. More broadly, many psychologi-
cal disorders are characterized by relational and
social cognition difficulties (Andreou et al., 2015;
Ridenour et al., 2019). Given the dual nature of an
emotional enhancer and social attention centralizer,
future studies should take advantage of overinclu-
sion to test the social abilities and social cognition
patterns of patients with difficulties in these domains.
Regarding cognitive skills in general, we could iden-
tify only one study that used the overinclusion of
Cyberball testing decision-making skills. The results
of this study suggested a promising use of Cyberball’s
overinclusion in cognitive assessment contexts
(Schrantz et al., 2021).
The role of overinclusion as a maximizer of
social attention
A question that may arise about overinclusion is whether
the need to feel included follows a maximizing principle
(i.e. the more the social attention the better) or an opti-
mizing principle (i.e. there is an optimal level of belong-
ingness and higher levels of social attention can be
experienced as overwhelming). This concept is also
intertwined with Brewer’s ‘Optimal Distinctiveness
Theory’ (1991), suggesting that humans are driven by
two main needs: the need of inclusion, corresponding
to the need for cooperation to survival and adaptation,
and the need for differentiation, that concerns the need
to differentiate from others when the need for inclusion
is adequately met. Baumeister and Leary (1995) in their
foundational work about the need to belong propose
14 A. TELESCA ETAL.
that it is subjected to the satiation principle, implying
that after an optimal satisfaction level, human beings no
longer seek for social connections. Our systematic
review revealed that overinclusion can be beneficial
especially in those cases where people feel less con-
nected at baseline, like patients with SAD and BPD, thus
suggesting that there may be an optimal level of inclu-
sion. Nevertheless, future studies are needed to examine
in greater depth this aspect.
Methodological heterogeneity in implementing
the overinclusion condition
Despite the promising obtained results, some character-
istics of the paradigm implementation must be consid-
ered to determine the strength of overinclusion effects
effectively. The heterogeneity in Cyberball implementa-
tion, particularly in overinclusion conditions, is the first
critical point revealed by our systematic analysis. We
argue that methodological differences (e.g. different
numbers of tosses, different percentages of overinclu-
sion, different game time, and implementation settings)
in applying the overinclusion condition have strongly
limited the results’ reliability and generalizability. For
example, too short games with few ball passages may
not give enough information to participants to detect
differences between inclusion and overinclusion. We
also noted that four studies used the paradigm by
implementing conditions in rounds, creating a contin-
uum between one condition and another in a single
play session, thus mixing the conditions (Ho etal., 2014;
Peake, 2016; Cheng et al., 2019; Okanga, 2021). This
implementing mode could have reduced the effective-
ness of each paradigm condition in eliciting specific psy-
chological reactions. Furthermore, Cyberball was initially
developed as a paradigm with a between-subjects
design (Williams et al., 2000), and adopting a
within-subjects design could interfere with its psycho-
logical effects. In some cases, authors have good rea-
sons to modify the original Cyberball parameters (e.g.
Okanga, 2021; White et al., 2016; Hawkley et al., 2010);
however, in our opinion, when possible, it is critical to
keep the implementation parameters stable and in line
with those of the paradigm developers.
Based on this review, there is a need to develop
guidelines on the overinclusion condition. In this
regard, the percentage of tosses used to induce
overinclusion is of primary importance. According to
the data emerged from our review, the human
player should receive at least 40% of total tosses to
be considered overinclusion. Indeed, 40% is the
minimum percentage of tosses set to induce the
overinclusion condition in the studies included in
this review (Table 1), and their results significantly
indicated that the overinclusion condition produced
some different effects compared to the inclusion
condition. Only Shade (2010) adopted a lower per-
centage because the game did not have the typical
3-player setting but rather a 4-player setting, and in
that case the related percentage for a fair game was
25.5%. Therefore, for overinclusion, it was a lower
value than 40%, namely 35%. Consequently, we con-
clude that 40% is the least amount of ball tosses
needed to induce the overinclusion condition.
Moreover, it is crucial always to have the inclusion
condition as a control, as the studies that did not
implement it (Bonow, 2013; Cheng et al., 2019; De
Waal-Andrews & Van Beest, 2021; Meneguzzo et al.,
2020; Meneguzzo etal., 2022) do not allow inferences
to be drawn on the specificity of overinclusion effects.
Finally, further studies are needed to point out the
best settings to elicit overinclusion effects, and gold
standards on programming parameters (e.g. number
of total passes) should be proposed and adopted to
apply the overinclusion condition profitably.
Conclusions
We reviewed the studies that used the overinclusion
condition in Cyberball paradigms following a stan-
dard and replicable process, as outlined in the
PRISMA guidelines for systematic reviews. In this
review, we focused on the overinclusion condition
starting from its original development within the
Cyberball paradigm, which has been the primary
context for exploring this condition. However, a few
other paradigms have been introduced over the
decades to study the phenomenon of social exclu-
sion. Some of these paradigms could also elicit an
overinclusion condition, such as the Ostracism Online
paradigm (Wolf etal., 2015) and the O-Cam (Goodacre
& Zadro, 2010; see Riva & Eck, 2016). Therefore, fur-
ther reviews may consider broadening the perspec-
tive to include these paradigms. Despite the
heterogeneity of its usage and results, we docu-
mented specific positive effects of overinclusion in
eighteen of twenty-six included studies that com-
pared inclusion and overinclusion conditions.
Future research should consider that overinclusion
can be perceived as a qualitatively independent con-
dition from inclusion in Cyberball. We, therefore, sug-
gest using the overinclusion condition in studies
aimed at investigating emotional and behavioral
reactions to excessive social attention, with particular
interest in clinical populations. To our account, both
the lack of social attention (i.e. the ostracism
COGENT PSYCHOLOGY 15
condition) and an excess of it (as induced in the
overinclusion condition) can provide valuable knowl-
edge on psychological functioning during social
interactions.
Acknowledgments
The authors wish to thank Francesca Pellegrini for her help
with papers selection and quality assessment of the
included studies in this systematic review.
Disclosure statement
The authors have no conicts of interest to declare.
Funding
This research was funded by PRIN 2022X44WX4 – Italian
Ministry of Education. Project: “Human connections in the
Digital Era (CONNECT)” (PI: Prof. Paolo Riva).
About the authors
Alessandra Telesca is clinical researcher at the Department
of Clinical Neurosciences at the IRCCS “Carlo Besta”
Neurological Institute of Milan, Italy. She obtained her
Ph.D. in Clinical Neuroscience at the University of
Milano-Bicocca. Her main research interest is approaching
the pain domain from dierent perspectives, with particu-
lar attention to the social aspects of pain. She explores the
cognitive and psychological functioning of patients suer-
ing from chronic pain, integrating the neuropsychological
evaluation with the application of non-invasive brain stim-
ulation techniques. Moreover, she is interested in investi-
gating the neurophysiological aspects of some pain related
phenomena such as nociception and the cognitive pro-
cessing of pain stimuli, both patients and healthy subjects.
In Social Connections & Technology Lab, she contributes to
evaluating social pain in chronic pain populations, proving
the ecacy of experimental social cognition paradigms.
Alessia Telari is a Ph.D. student in Social, Cognitive and
Clinical Psychology at the University of Milano-Bicocca,
where she is part of the Social Connections & Technology
Lab. Her main research interest concerns social exclusion
and social connectedness. Currently, she is investigating
the impact of digital technologies (i.e. social media, arti-
cial intelligence systems, smartphones) on social connec-
tions, both as social interference and facilitator, and
people’s response to dierent degrees of social exclusion
(and inclusion) in healthy and clinical populations.
Monica Consonni is a researcher of the Department of
Clinical Neurosciences at the IRCCS “Carlo Besta” Neurological
Institute of Milan, Italy. She obtained degree in Experimental
Psychology in 2005 and PhD in Neuroscience in 2010 at the
V-S San Raaele University of Milan. Since 2011 she works
as neuropsychologist at the IRCCS “Carlo Besta” Neurological
Institute of Milan. Her research interests and clinical activi-
ties focus on the identication of cognitive and behavioural
impairment of patients with neurodegenerative diseases
and chronic pain. Since 2020 she serves as Review Editor of
Frontiers Neuroscience.
Chiara De Panlis is an Associate Professor of Psychiatry at
the Department of Medicine and Surgery of Parma
University. Her research focuses on personality disorders
and, specically, on the social-cognitive styles that underlie
the diculties in interpersonal functioning exhibited by
this patient population. She investigates how individuals
aected by personality disorders perceive and react to var-
ious social cues, such as social exclusion and inclusion,
facial expressions, emotional body language, cooperative
behavior, with the goal to elucidate potential social-cognitive
biases that could be addressed in treatment.
Paolo Riva is an Associate Professor at the University of
Milano-Bicocca Psychology Department. He is the Director
of the Social Connections & Technology Lab (https://
connectlab.psicologia.unimib.it/). His research interests lie
broadly in social inuence processes with a specic focus
on the need to belong and its threats, including social
exclusion, ostracism, and rejection, examining the conse-
quences of exclusion and the possible strategies to buer
against and reduce its eects. He currently explores the
impact of digital technologies on social connections and
isolation processes, social exclusion in real groups, and
brain mechanisms involved in emotion regulation follow-
ing exclusion.
ORCID
Alessandra Telesca http://orcid.org/0000-0002-3640-4408
Alessia Telari http://orcid.org/0009-0005-0910-7693
Monica Consonni http://orcid.org/0000-0002-0479-2290
Chiara De Panlis http://orcid.org/0000-0003-1907-6702
Paolo Riva http://orcid.org/0000-0002-9855-994X
Data availability statement
The data that support the ndings of this study are avail-
able at https://osf.io/fd8jx/?view_only=db244ee956bb4eb0
85dd8e346924206b.
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