Oxytocin and Reduction of Social Threat Hypersensitivity in Women With Borderline Personality Disorder
TL;DR: Borderline patients exhibit a hypersensitivity to social threat in early, reflexive stages of information processing, and oxytocin may decrease social threat hypersensitivity and thus reduce anger and aggressive behavior in borderline personality disorder or other psychiatric disorders with enhanced threat-driven reactive aggression.
Abstract: Objective: Patients with borderline personality disorder are characterized by emotional hyperarousal with increased stress levels, anger proneness, and hostile, impulsive behaviors. They tend to ascribe anger to ambiguous facial expressions and exhibit enhanced and prolonged reactions in response to threatening social cues, associated with enhanced and prolonged amygdala responses. Because the intranasal administration of the neuropeptide oxytocin has been shown to improve facial recognition and to shift attention away from negative social information, the authors investigated whether borderline patients would benefit from oxytocin administration. Method: In a randomized placebocontrolled double-blind group design, 40 nonmedicated, adult female patients with a current DSM-IV diagnosis of borderline personality disorder (two patients were excluded based on hormonal analyses) and 41 healthy women, matched on age, education, and IQ, took part in an emotion classification task 45 minutes after intranasal administration of 26 IU of oxytocin or placebo. Dependent variables were latencies and number or initial reflexive eye movements measured by eye tracking, manual response latencies, and blood-oxygen-level-dependent responses of theamygdalato angryandfearfulcompared with happy facial expressions. Results: Borderline patients exhibited more and faster initial fixation changes to the eyes of angry faces combined with increased amygdala activation in response to angry faces compared with the control group. These abnormal behavioral and neural patterns were normalized after oxytocin administration. Conclusions: Borderline patients exhibit a hypersensitivity to social threat in early, reflexive stages of information processing. Oxytocin may decrease social threat hypersensitivity and thus reduce anger and aggressive behavior in borderline personality disorder or other psychiatric disorders with enhanced threat-driven reactive aggression. (Am J Psychiatry 2013; 170:1169–1177)
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TL;DR: The Borderline-Personlichkeitsstorung (BPS) as discussed by the authors is a psychische storung, which with weitreichenden Beeintrachtigungen im Selbst and in interpersonellen Funktionen einhergeht.
Abstract: Die Borderline-Personlichkeitsstorung (BPS) ist eine schwere psychische Storung, die mit weitreichenden Beeintrachtigungen im Selbst und in interpersonellen Funktionen einhergeht. Nicht zuletzt vor dem Hintergrund der breiten Datenbasis bleibt die BPS als einzige kategoriale Personlichkeitsdiagnose in der International Statistical Classification of Diseases and Related Health Problems (ICD) 11 bestehen, wenn auch gekoppelt an die Feststellung von Schweregraden von Beeintrachtigungen. Wir mussen uns also spatestens mit deren Inkrafttreten 2022 mit einer dimensionalen Konzeptualisierung von Personlichkeitsstorungen auseinandersetzen, welche auch durch neurowissenschaftliche Daten unterstutzt wird. Dieses narrative Review gibt einen Uberblick uber neurowissenschaftliche Erkenntnisse zu Beeintrachtigungen im Selbst und in interpersonellen Funktionen bei Patienten mit BPS. Veranderungen im medialen prafrontalen Kortex, temporoparietalen Ubergang und Pracuneus mediieren Defizite im selbstreferenziellen Denken und Mentalisieren der Gefuhle und Intentionen anderer. Erhohte Konnektivitat zwischen Amygdala und Mittellinienstrukturen sind mit Hypermentalisierung assoziiert, die gleichzeitig erhohte Insulaaktivierung scheint dem verstarkten unreflektierten Teilen von Gefuhlen anderer Menschen zu unterliegen. Frontolimbische Veranderungen sind transdiagnostisch mit defizitarer Emotionsregulation und negativer Affektivitat assoziiert, Veranderungen in Belohnungs- und kognitiven Kontrollregionen mit Impulsivitat. Neurowissenschaftliche Befunde tragen zum besseren Verstandnis zugrunde liegender Mechanismen zentraler Funktionsbeeintrachtigungen der BPS bei und konnen den Ubergang zu ICD-11 und die Implementierung neuer Interventionen unterstutzen.
5 citations
01 Jan 2019
TL;DR: In this article, the authors make a contribution to the understanding of socioemotional functioning in borderline personality disorder (BPD) by critically examining social cognition and emotion regulation research from a developmental perspective.
Abstract: This thesis makes an original contribution to our understanding of socioemotional functioning in borderline personality disorder (BPD) by critically examining social cognition and emotion regulation BPD research from a developmental perspective. It also extends on previous research, making a novel and important contribution to our understanding of sociocognitive functioning and emotion regulation ability in youth with first presentation BPD. This was achieved via two critical narrative reviews of the existing literature and two empirical studies, which examined aspects of social cognition and emotion regulation considered key to interpersonal functioning in BPD. The empirical studies assessed, 1) unconscious simulation processes, a key aspect of affective empathy, and 2) the application of two emotion regulation strategies, expressive suppression and cognitive reappraisal, in the regulation of negative and positive affect, in a standard laboratory context, as well as in the context of social rejection. The reviews demonstrated that despite their shared diagnosis, important differences between young people and adults with BPD, in terms of their sociocognitive functioning and emotion regulation abilities, are evident. Future research and reviews should avoid conflating developmental age and stage of disorder. Instead, these processes, which are central to interpersonal functioning, need to be better understood over the course of BPD, especially early in its course. The empirical studies demonstrated that socioemotional functioning in youth with first presentation BPD is not uniformly affected. Specifically, rapid facial mimicry was unimpaired, contradicting predictions that heightened unconscious motor mimicry leads to heightened emotional contagion, and associated emotion regulation difficulties. Future research is needed to determine whether this finding also holds true for adults and young people later in the course of the disorder. Future research should also explore other factors that might lead to heightened emotional contagion and associated emotion regulation difficulties in BPD. Emotion regulation ability was largely preserved in youth with first presentation BPD, and functioning was mostly similar to that of typically developing young people. Specifically, for the most part, they could apply expressive suppression and cognitive reappraisal, to regulate both positive and negative affect (felt subjectively and expressed behaviourally), in a standard laboratory context and in the context of social rejection, with similar effectiveness to that of healthy youth. However, youth with first presentation BPD were not only unable to apply cognitive reappraisal to regulate the behavioural expression of negative emotions in the context of social rejection, but its application in this context intensified their facial expression of negative affect. They also demonstrated a pattern of pervasively blunted positive affect, relative to healthy youth, across indices and contexts. Further research is needed to better understand whether the effectiveness of cognitive reappraisal can be improved in this context, or whether it is contraindicated. Given that social rejection is commonly experienced by this group, and given the common application of cognitive strategies in therapy, future research is clearly needed to better understand the effectiveness and consequences of this, and alternative strategies, for use in the context of social rejection by youth with first presentation BPD. Finally, while positive affect has often been neglected in BPD research, the evident pervasive blunting clearly needs greater research and clinical attention in this group.
5 citations
Cites background from "Oxytocin and Reduction of Social Th..."
...For example, oxytocin has been found to diminish attentional bias towards socially threatening cues for adults with BPD, as assessed using eye tracking, fMRI, and behavioural dot-probe outcomes (Bertsch et al., 2013; Brüne et al., 2013)....
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TL;DR: In this article, the full text of works made available under a Creative Commons license can be used according to the terms and conditions of said license, without the right holder (author or publisher) if not exempted from copyright protection by the applicable law.
Abstract: (Article begins on next page) Anyone can freely access the full text of works made available as \"Open Access\". Works made available under a Creative Commons license can be used according to the terms and conditions of said license. Use of all other works requires consent of the right holder (author or publisher) if not exempted from copyright protection by the applicable law. Availability: This is the author's manuscript
5 citations
Additional excerpts
...[104], 40 non medicated female BPD patients and 41 healthy women took part in an emotion classification task after intranasal administration of 26 UI of oxytocin or placebo....
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TL;DR: This study examines the effects of intranasal oxytocin (IN-OT) on emotion regulation in adolescents during parent-adolescent stressful interactions, and on each adolescent’s visual and neurophysiological strategies when visualizing attachment-related pictures.
Abstract: Background: Emotional dysregulation and impaired attachment are potential contributors to the development of psychopathology in adolescence. This raises the question of whether oxytocin (OT), the paradigmatic “attachment hormone,” may be beneficial in such contexts. Recent evidence suggests that intranasal administration of OT increases affiliative behavior, including trust and empathy. OT may also facilitate social reciprocity by attenuating the stress response to interpersonal conflict. To date, few studies have investigated the effects of intranasal oxytocin (IN-OT) on neurophysiological emotion regulation strategies in healthy adolescents, particularly during parent-adolescent interaction. To understand these mechanisms, our study will examine the effects of IN-OT on emotion regulation in adolescents during parent-adolescent stressful interactions, and on each adolescent’s visual and neurophysiological strategies when visualizing attachment-related pictures. We hypothesize that IN-OT will influence psychophysiological outcomes under conditions of stress. We predict that IN-OT will momentarily increase feelings of safety and attenuate stress and hostile behavior during conflict situations. OT may also enhance attachment security by increasing comfort and proximity-seeking, and reducing neurophysiological hyperactivation. Objective: The objective of this study is to evaluate the effects of IN-OT on insecure adolescents by studying their behavior and discourse during a disagreement with one of their parents. Their neurophysiological responses to pictures eliciting attachment-related emotions and their visual exploration strategies will also be investigated. Methods: In this randomized, double-blind, placebo-controlled parallel-group design, 60 healthy male adolescents classified as insecurely attached will receive 24 international units (IU) of IN-OT versus placebo (PB), 45 minutes before the experimental tasks. Each adolescent will then be invited to engage in an experimental conflict discussion with one of his parents. The conflict session will be videotaped and coded for verbal and non-verbal interaction behavior, using the Goal-Corrected Partnership in Adolescence Coding System (GPACS). Each adolescent will then be asked to visualize attachment-related pictures on a screen. Eye-tracking (ET) and neurophysiological responses, including electrodermal activity (EDA) and heart rate (HR), will be recorded simultaneously and continuously during attachment-related picture viewing (Besancon Affective Picture Set-Adolescents, BAPS-Ado). Results: Enrollment for the study was completed in May 2016. Data analysis commenced in July 2016. Study results will be submitted for publication in the winter of 2017. Conclusions: OT is a complex molecule with many facets that are not yet fully understood. This experimental protocol will increase scientific and clinical knowledge of emotion regulation skills in insecure adolescents by assessing the impact of IN-OT on parent-adolescent interaction and on the visual processing of attachment-related emotions. Positive results could lead to therapeutic uses of IN-OT to treat emotion dysregulation in adolescence. [JMIR Res Protoc 2016;5(4):e206]
5 citations
Cites background from "Oxytocin and Reduction of Social Th..."
...These discoveries have led researchers to investigate the effects of intranasal oxytocin (IN-OT) within the healthy [39-45] and clinical [46-49] population....
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TL;DR: In this paper, a review summarizes empirical evidence on alterations in four distinct interoceptive facets, namely, objective physiological states, interoception accuracy, interceptive sensitivity, and interceptive awareness in borderline personality disorder (BPD) and related conditions.
Abstract: This review summarizes empirical evidence on alterations in four distinct interoceptive facets, namely, objective physiological states, interoceptive accuracy, interoceptive sensitivity, and interoceptive awareness in borderline personality disorder (BPD) and related conditions. We focus on psychological and neurophysiological mechanisms and discuss their possible relevance for the pathogenesis of BPD. Recent findings on objective physiological states suggest that patients with BPD likely exhibit reduced central representation of interoceptive signals as baseline, which might be related to diminished autonomic balance in these patients. Findings on interoceptive accuracy in BPD either suggest reduced or intact interoceptive processing during conscious attention towards inner sensations, eventually presenting a potential target of therapeutic intervention for particular subgroups. Although evidence is sparse, interoceptive sensitivity may be reduced in BPD. Distinguishing levels of interoception according to Forkmann et al. (2016) revealed a severe pattern of disturbed neurophysiological processing, including difficulties in representing inner sensations and regulating emotions, such as a generally reduced trait to focus on bodily sensations. We propose a heightened attentional bias towards external cues to guide behavior together with a reduced integration of inner sensations, potentially resulting from a learning history of invalidation of own sensations and feelings in childhood.
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References
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TL;DR: An anatomical parcellation of the spatially normalized single-subject high-resolution T1 volume provided by the Montreal Neurological Institute was performed and it is believed that this tool is an improvement for the macroscopical labeling of activated area compared to labeling assessed using the Talairach atlas brain.
13,678 citations
"Oxytocin and Reduction of Social Th..." refers methods in this paper
...Since we hypothesized modulatory effects of oxytocin in the amygdala, we applied a small-volume correction for multiple comparisons in predefined bilateral anatomical amygdala regions of interest (35)....
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TL;DR: Oxytocin seems to enhance the buffering effect of social support on stress responsiveness, concur with data from animal research suggesting an important role of oxytocin as an underlying biological mechanism for stress-protective effects of positive social interactions.
1,760 citations
"Oxytocin and Reduction of Social Th..." refers background in this paper
...In healthy individuals, the intranasal administration of oxytocin reduces anxiety and stress in social situations (15), enhances the recognition of facial expressions (16–19), and shifts attention from negative to positive information (20–22), although individual differences and situational factors seem to play an important role (23)....
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Book•
01 Jan 1997
TL;DR: This greatly enlarged new edition of Atlas of the Human Brain provides the most detailed and accurate delineations of brain structure available and includes features which assist in the new fields of neuroscience - functional imaging, resting state imaging and tractography.
Abstract: Material and methods topographic and topometric atlas myeloarchitectonic atlas hierarchical tree.
1,515 citations
"Oxytocin and Reduction of Social Th..." refers methods in this paper
...Anatomical labels for subregions within the amygdala were specified by comparing the location of activation clusters with high-resolution diagrams of the human amygdala as depicted in an anatomical atlas (36)....
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TL;DR: It is shown that human amygdala function is strongly modulated by oxytocin, and this results indicate a neural mechanism for the effects of Oxytocin in social cognition in the human brain and provide a methodology and rationale for exploring therapeutic strategies in disorders in which abnormal amygdala function has been implicated, such as social phobia or autism.
Abstract: In non-human mammals, the neuropeptide oxytocin is a key mediator of complex emotional and social behaviors, including attachment, social recognition, and aggression. Oxytocin reduces anxiety and impacts on fear conditioning and extinction. Recently, oxytocin administration in humans was shown to increase trust, suggesting involvement of the amygdala, a central component of the neurocircuitry of fear and social cognition that has been linked to trust and highly expresses oxytocin receptors in many mammals. However, no human data on the effects of this peptide on brain function were available. Here, we show that human amygdala function is strongly modulated by oxytocin. We used functional magnetic resonance imaging to image amygdala activation by fear-inducing visual stimuli in 15 healthy males after double-blind crossover intranasal application of placebo or oxytocin. Compared with placebo, oxytocin potently reduced activation of the amygdala and reduced coupling of the amygdala to brainstem regions implicated in autonomic and behavioral manifestations of fear. Our results indicate a neural mechanism for the effects of oxytocin in social cognition in the human brain and provide a methodology and rationale for exploring therapeutic strategies in disorders in which abnormal amygdala function has been implicated, such as social phobia or autism.
1,477 citations
"Oxytocin and Reduction of Social Th..." refers background in this paper
...anterior) amygdala to negative emotional stimuli (13, 25, 26), whichmay reflect a neural mechanism of its anxiolytic properties (24, 26)....
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TL;DR: OXT and AVP are emerging as targets for novel treatment approaches — particularly in synergistic combination with psychotherapy — for mental disorders characterized by social dysfunction, such as autism, social anxiety disorder, borderline personality disorder and schizophrenia.
Abstract: The neuropeptides oxytocin (OXT) and arginine vasopressin (AVP) are evolutionarily highly conserved mediators in the regulation of complex social cognition and behaviour. Recent studies have investigated the effects of OXT and AVP on human social interaction, the genetic mechanisms of inter-individual variation in social neuropeptide signalling and the actions of OXT and AVP in the human brain as revealed by neuroimaging. These data have advanced our understanding of the mechanisms by which these neuropeptides contribute to human social behaviour. OXT and AVP are emerging as targets for novel treatment approaches — particularly in synergistic combination with psychotherapy — for mental disorders characterized by social dysfunction, such as autism, social anxiety disorder, borderline personality disorder and schizophrenia.
1,436 citations
"Oxytocin and Reduction of Social Th..." refers background in this paper
...It has therefore been suggested that borderline patients who are hypersensitive to negative, threatening social information may benefit from intranasal oxytocin administration (29)....
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