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: This paper provides an alternate model for the role of neurobiological temperamental factors, including brain circuitry and neuropeptide modulation, in mediating social cognition and the internalization and maintenance of attachment patterns.
Abstract: While attachment has been a fruitful and critical concept in understanding enduring individual templates for interpersonal relationships, it does not have a well-understood relationship to personality disorders, where impairment of interpersonal functioning is paramount. Despite the recognition that attachment disturbances do not simply reflect nonoptimal caretaking environments, the relationship of underlying temperamental factors to these environmental insults has not been fully explored. In this paper we provide an alternate model for the role of neurobiological temperamental factors, including brain circuitry and neuropeptide modulation, in mediating social cognition and the internalization and maintenance of attachment patterns. The implications of these altered attachment patterns on personality disorders and their neurobiological and environmental roots for psychoanalytically based treatment models designed to ameliorate difficulties in interpersonal functioning through the medium of increased access to mature forms of mentalization is discussed.
5 citations
01 Jan 2015
TL;DR: The synergistic or antagonistic interaction of psychotherapies and drugs for treating personality disorder should be studied in conjunction with their mechanisms of change throughout the development of each.
Abstract: The evidence base for the eff ective treatment of personality disorders is insuffi cient. Most of the existing evidence on personality disorder is for the treatment of borderline personality disorder, but even this is limited by the small sample sizes and short follow-up in clinical trials, the wide range of core outcome measures used by studies, and poor control of coexisting psychopathology. Psychological or psychosocial intervention is recommended as the primary treatment for borderline personality disorder and pharmacotherapy is only advised as an adjunctive treatment. The amount of research about the underlying, abnormal, psychological or biological processes leading to the manifestation of a disordered personality is increasing, which could lead to more eff ective interventions. The synergistic or antagonistic interaction of psychotherapies and drugs for treating personality disorder should be studied in conjunction with their mechanisms of change throughout the development of each.
4 citations
TL;DR: In this paper , the authors discuss limitations of these previous studies and propose strategies which may help overcome these limitations in order to achieve both: transdiagnostic classification and prediction of individual treatment outcomes.
Abstract: Aggression affects nearly all mental disorders and constitutes a burden for society in general and the mental health sector in particular. An incomplete understanding of its underlying neurobiological mechanisms limits treatment efficacy and hinders the development of precision medicine approaches. Here we review recent efforts employing neuroimaging, hormonal and (epi)genetic data to develop biomarkers for aggression. Our goal is to discuss limitations of these previous studies and propose strategies which may help overcome these limitations in order to achieve both: transdiagnostic classification and prediction of individual treatment outcomes. In order to develop clinically relevant biomarkers for aggression, candidate biomarkers have to be combined and their reliability and validity has to be tested rigorously in large patient cohorts. Besides generating a better mechanistic understanding, we should strive to create multimodal biomarkers that medical professionals can utilize in clinical practice to guide and improve the management and clinical outcome of pathological aggression.
4 citations
Dissertation•
05 Apr 2019
TL;DR: In this paper, the authors present a methodologie d'etude multimodale de la reponse individuelle au stress, prenant en compte des elements de motricite, de mimique faciale, de physiologie neurovegetative et d'hormonologie.
Abstract: Dans ce travail de these nous nous interessons a la facon dont se co-construisent chez l'Humain les systemes physiologiques de reponse au stress, et le systeme d'attachement affectif entre le sujet et son entourage. Pour cela, avons structure notre travail synthetique et experimental selon deux âges cruciaux du neurodeveloppement : la petite enfance, et l'adolescence. Dans une premiere partie, nous presentons des situations experimentales mettant en jeu des nourrissons (3-6 mois) en interaction avec un parent. Nous utilisons des methodes d'analyse quantitative du signal audio qui permettent d'analyser l'interaction selon deux niveaux : le tour de parole, et l'utilisation du mamanais. Dans des interactions mere-bebe, nous montrons que le bebe joue un role actif dans la reprise de l'interaction apres une interruption brutale (article 1). Nous montrons que la prise d'ocytocine par les peres n'a pas d'influence sur l'interaction vocale au cours d'un Still Face pere-bebe (article 2). Dans la deuxieme partie de la these on s'interesse aux adolescents presentant un trouble de personnalite limite. Nous presentons d'abord une synthese bibliographique sur les liens entre stress et ce trouble de la personnalite (article 3). Ensuite, nous presentons une methodologie d'etude multimodale de la reponse individuelle au stress, prenant en compte des elements de motricite, de mimique faciale, de physiologie neurovegetative et d'hormonologie. Ce protocole a ete valide chez des sujets sains (article 4). Nous montrons comment il est developpe pour l'etude de populations d' adolescents presentant un trouble de personnalite limite (en cours).
4 citations
TL;DR: In this article , the authors studied underlying hormonal mechanisms of disrupted mother-child interaction in BPD and found that alterations in oxytocin, cortisol, and testosterone contribute to disruptions in motherchild interaction.
4 citations
References
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"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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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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