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: In this paper, a comprehensive analysis of the association of oxytocin with the pathogenesis of BPD and its possible role as a therapeutic agent is provided, which indicates that a combination of genetic and environmental factors causes BPD patients to have lower baseline levels of oxyocin, leading to increased activation of the amygdala.
Abstract: Borderline personality disorder (BPD) is a serious psychiatric condition characterized by dysfunctional relations, abnormal social behavior, and high morbidity Many studies have implicated abnormal oxytocinergic system as a causative factor of behavioral dysregulation in BPD patients The objective of this review is to provide a comprehensive analysis of the association of oxytocin with the pathogenesis of BPD and its possible role as a therapeutic agent Our review indicates that a combination of genetic and environmental factors causes BPD patients to have lower baseline levels of oxytocin, leading to increased activation of the amygdala This results in defective cognition of social stimuli, leading to abnormal behaviors like affective instability, unresolved attachment, and emotional dysregulation Clinical trials conducted on BPD patients using intranasal oxytocin have shown both prosocial and trust-lowering effects The effects of oxytocin depend upon various patient characteristics like the history of childhood trauma and the nature of attachment Even though evidence of oxytocin's role in modulating behavior in BPD patients already exists, further studies are required to more clearly elaborate on this role to fully explore oxytocin's potential as a therapeutic agent
4 citations
TL;DR: The current level of evidence is moderate showing no effect of intranasal oxytocin on AB or ER in AN, however, brain exposure may not have been sufficient which future studies with IN-OT need to ensure by considering dose and dose-to-task interval.
Abstract: The psychopathology of anorexia nervosa (AN) includes altered social cognition and information processing of fear and anxiety. Oxytocin, a neuromodulating hormone, may influence these functions and could be valuable for the treatment of AN. The current study aimed at reviewing the effect of intranasal oxytocin (IN-OT) on attentional bias (AB) and emotion recognition (ER) in AN. A systematic literature review was done for free-text and the MeSH-terms: anorexia nervosa, feeding and eating disorders, and oxytocin. Six publications, reporting from 4 unique clinical trials, were included in this review. A meta-analysis was conducted to examine the effects of IN-OT on AB towards food images and ER on healthy controls (HC) and patients with AN. Overall, IN-OT did not influence AB towards food images (effect size = 0.20 [− 0.16, 0.57], p = 0.28) and had no effect on ER (effect size = − 0.01 [− 0.27, 0.26], p = 0.97) in patients with AN and healthy control (HC) subjects collectively. Assessing HC and AN separately in subgroup analyses did not show any significant effect on AB and ER in neither of the subgroups. All tests were done between 15 and 55 min post-administration of IN-OT, while peak concentration in the cerebrospinal fluid has been determined to be at 75 min. The current level of evidence is moderate showing no effect of IN-OT on AB or ER in AN. However, brain exposure may not have been sufficient which future studies with IN-OT need to ensure by considering dose and dose-to-task interval.
4 citations
Cites background from "Oxytocin and Reduction of Social Th..."
...This altered sensitivity towards social threats was shown to be normalized by IN-OT (Bertsch et al. 2013)....
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TL;DR: In this article, neurobiologische literatures in kognitive Empathies einerseits and emotionale Empathie and anotherseits are differenziert. Anders als die unscharfe Verwendung des Begriffs Empathia im allgemeinen Sprachgebrauch differenziate the neurobiologicische Literatur in kognitiv empathie einer-seits und emotionale empathies and otherseits.
Abstract: Anders als die unscharfe Verwendung des Begriffs Empathie im allgemeinen Sprachgebrauch differenziert die neurobiologische Literatur in kognitive Empathie einerseits und emotionale Empathie andererseits. Erstere umfasst das kognitive Erkennen der seelischen Verfassung des Anderen anhand reflektierter Perspektivenubernahme und „Theory-of-mind“-Funktionen, Letztere das reflexiv-intuitive Mitfuhlen und Teilen von Emotionen des Anderen. Beiden, voneinander unabhangigen und interindividuell unterschiedlich ausgepragten Facetten lassen sich unterschiedliche Hirnnetzwerke zuordnen, die diese Vorgange prozessieren. Evolutionar fruh liegende Prozesse der emotionalen Empathie entwickeln sich bereits beim Saugling auf dem Weg der spiegelbildlichen Nachahmung von Mimik und Gestik primarer Beziehungspersonen und beziehen u. a. pramotorische Regionen, Areale des sensomotorischen Kortex, des inferioren parietalen Lobulus und die vordere Inselregion ein. Phylogenetisch jungere Prozesse der kognitiven Empathie sind v. a. in Mittellinienstrukturen wie medialem prafrontalem Kortex, superiorem temporalem Sulcus, posteriorem Cingulum bzw. Praecuneus sowie im temporoparietalen Ubergang reprasentiert und finden in geteilten Aufmerksamkeitsprozessen in fruhen dyadischen Beziehungen ihren Anfang. Beide empathischen Facetten sind an moralischen Entscheidungsprozessen beteiligt. Dabei zeigen neurobiologische Studien, dass „psychopaths“ uber ungestorte kognitiv-empathische Fahigkeiten verfugen und grundsatzlich in der Lage sind, moralische Werte zu erkennen und anzuwenden, aber diesen wenig attentionale Bedeutung verleihen, wenn sie mit eigenen Zielen konkurrieren. Individuen mit Borderline-Personlichkeitsstorung im Unterschied zu „psychopaths“ zeigen Beeintrachtigungen in kognitiver Empathie: Die Defizite betreffen Mentalisierungsfunktionen, die das Verstehen mentaler Zustande anderer und eigener betreffen sowie Ausgangspunkt von vielen Missverstandnissen im interpersonellen Kontext sind. Zudem neigen Individuen mit Borderline-Personlichkeitsstorung dazu, Emotionen mit anderen Menschen zu teilen. Damit gelingen ihnen Mitgefuhl und Mitleid, allerdings verbunden mit der Gefahr der Diffusion von Selbst‑/Fremdgrenzen.
4 citations
Cites background from "Oxytocin and Reduction of Social Th..."
...Solche sensorischen Verzerrungsprozesse gingen zudem mit einer erhöhten Amygdala-Aktivität einher (Bertsch et al. 2013)....
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01 Jan 2019
TL;DR: The resulting neurobiological portrait of IED is of a person with a lifelong history of angry outbursts, with evidence of disturbed, stress-related 5-HT signaling, which worsens the very system that can regulate stress reactivity.
Abstract: According to the SEIP/predictive coding framework, neurotransmitters and neuromodulators have a role as signaling molecules in circuits that enable social interaction. Depending on the balance of stress demands on the system and its biological vulnerabilities, variability can be seen in the balance of facilitation versus restraining of aggression. Neurobiological research has pointed to disturbed serotonin signaling in impulsive aggression. Impulsive aggression is indeed caused by serotonin dysregulation but in distinct, receptor-specific pathways. Recent research has not provided evidence to the contrary, but has rather expanded the network of connections to serotonin to distributed brain circuits and even out into the body in immune and intracellular signaling cascades. In total, the resulting neurobiological portrait of IED is of a person with a lifelong history of angry outbursts, with evidence of disturbed, stress-related 5-HT signaling. This 5-HT dysfunction worsens the very system that can regulate stress reactivity, centered on hubs in the prefrontal cortex. Contributing to this positive feedback loop may be an overtaxed immune system, tasked with cleaning up the metabolically costly synaptic downsides of stress. Despite progress in understanding the basic biological mechanism of IED, many unanswered questions remain regarding the role of neurotransmitters and neuromodulators. The task is daunting, because the brain is an enormously complicated system; its functions are not captured simply. System-based approaches have increasingly been called on in the treatment of other complex medical disorders and will likely be required to understand and treat IED. Neurotransmitter and neuromodulator signaling systems have a key role in how brain circuits learn about social interaction over time. This work can be considered as part of the larger effort to understand IED as a brain-based disorder of interpersonal reactivity.
4 citations
TL;DR: In this paper, the authors present a case study of a rejection sensitive individual who was asked to rate her interpersonal events over the course of a week and found that covariations among her interpersonal perceptions suggest a negativity bias that may be basis of a self-fulfilling prophecy, in which her rejection expectancies come to be realized through her treating agency as unfriendly behavior.
Abstract: The present research case sought to illustrate how self-regulatory patterns of interpersonal behavior manifest within a rejection sensitive individual at the daily level. Cross-sectional research has demonstrated negative relational outcomes associated with rejection sensitivity, but less attention has been paid to how this manifests in daily relational events. Expanding upon prior research evaluating the daily interpersonal functioning of those with high rejection sensitivity in a large sample, the research case study of Mary demonstrates how findings from research may manifest within a rejection sensitive individual who was asked to rate her interpersonal events over the course of a week. For Mary, covariations among her interpersonal perceptions suggest a negativity bias that may be basis of a self-fulfilling prophecy, in which her rejection expectancies come to be realized through her treating agency as unfriendly behavior. The implications for psychotherapy of interpersonal patterns typically observed in rejection sensitive clients are discussed.
4 citations
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"Oxytocin and Reduction of Social Th..." refers methods in this paper
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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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