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 , the authors investigated behavioral and neurophysiological foundations of emotional face processing in individuals with borderline personality disorder and in healthy controls, taking participants' sex into account, and found that BPDrelated alterations in behavioral and P3/LPP correlates exist in both men and women, supposedly without sex-related interactions.
Abstract: Emotional dysregulation is a core feature of borderline personality disorder (BPD); it is, for example, known to influence one's ability to read other people's facial expressions. We investigated behavioral and neurophysiological foundations of emotional face processing in individuals with BPD and in healthy controls, taking participants' sex into account. 62 individuals with BPD (25 men, 37 women) and 49 healthy controls (20 men, 29 women) completed an emotion classification task with faces depicting blends of angry and happy expressions while the electroencephalogram was recorded. The cortical activity (late positive potential, P3/LPP) was evaluated using source modeling. Compared to healthy controls, individuals with BPD responded slower to happy but not to angry faces; further, they showed more anger ratings in happy but not in angry faces, especially in those with high ambiguity. Men had lower anger ratings than women and responded slower to angry but not happy faces. The P3/LPP was larger in healthy controls than in individuals with BPD, and larger in women than in men; moreover, women but not men produced enlarged P3/LPP responses to angry vs. happy faces. Sex did not interact with behavioral or P3/LPP-related differences between healthy controls and individuals with BPD. Together, BPD-related alterations in behavioral and P3/LPP correlates of emotional face processing exist in both men and women, supposedly without sex-related interactions. Results point to a general 'negativity bias' in women. Source modeling is well suited to investigate effects of participant and stimulus characteristics on the P3/LPP generators.
1 citations
01 Jan 2018
TL;DR: Greifzu et al. as mentioned in this paper showed that the Effektstarken von pharmakologischen and psychotherapeutischen Interventionen vergleichbar sind and dass the Kombination beider Verfahren oftmals den grostmoglichen Nutzen fur Patienten herbeifuhrt.
Abstract: Die letzten beiden Dekaden neurowissenschaftlicher und hier vor allem bildgebender Forschung haben eindrucklich belegen konnen, dass psychotherapeutische Interventionen zu funktionellen und strukturellen Veranderungen des Gehirns und damit zu Korrekturen im Erleben und Verhalten fuhren konnen (Schiepek 2011). Auch wenn im Erwachsenenalter die Dynamik eines Neugeborenen oder eines Jugendlichen in der Pubertat nicht mehr erreicht wird, so bleibt das Gehirn bis ins hohe Alter plastisch und damit veranderbar (neuronale Plastizitat). Man geht davon aus, dass sich neuronale Netzwerke in erfahrungsabhangiger Weise verandern konnen und dass stimulierende Bedingungen in Form von z. B. korperlichen, sozialen oder kognitiven Anreizen die Voraussetzung dafur bilden (Greifzu et al. 2014). Auf das therapeutische Setting ubertragen: Sobald also zwei Personen miteinander kommunizieren und dies uber einen gewissen Zeitraum und unter Anwendung verschiedener therapeutischer Techniken und Interventionen tun, werden sie gewissermasen zu Neurobiologen, die mit ihrem Handeln bis auf molekulare Ebene wirksam sind. Jeder Psychotherapeut sollte sich daruber im Klaren sein, dass er es neben dem Klienten oder dem Paar auch mit nahezu 100.000.000.000 Nervenzellen zu tun hat, von denen jede einzelne Nervenzelle uber etwa 10.000 Synapsen in intensivem Austausch mit anderen Neuronen steht. Welche Herausforderung und Komplexitat und zugleich Trost fur die vielen Phanomene, die fur Therapeuten wie Klienten nicht immer verstehbar sind. Die „sprechende Medizin“ und ihre intensive Weiterentwicklung hinsichtlich storungsubergreifender und storungsspezifischer Techniken haben sich von einem belacheltem Nischendasein zu einer in Wissenschaft und Gesellschaft anerkannten und bei Patienten intensiv nachgefragten Therapieform entwickelt. Klinische und experimentelle Studien haben zeigen konnen, dass die Effektstarken von pharmakologischen und psychotherapeutischen Interventionen vergleichbar sind und dass die Kombination beider Verfahren oftmals den grostmoglichen Nutzen fur Patienten herbeifuhrt (Aigner und Lenz 2011; De Maat et al. 2007). Gleichzeitig wird klar, dass mit biologischen und psychologischen Therapieformen nicht immer die gleichen Zielstrukturen angesteuert werden, sondern dass hier durchaus Unterschiede existieren. So scheint vereinfachend gesagt, die Wirksamkeit von z. B. Antidepressiva bei Depressionen mehrheitlich uber eine Modulation subkortikaler Strukturen wie der Amygdala, Hirnstamm und limbischem System erklarbar zu sein (bottom-up), wahrend eine kognitive Verhaltenstherapie zunachst vor allem kortikale und hier vor allem prafrontale Prozesse anspricht und erst daruber Einfluss auf emotionale Prozesse bzw. die Aktivitat der Amygdala und assoziierten Strukturen ausubt (top-down) (DeRubeis et al. 2008; Hartley und Phelps 2010). Bei emotions- und erlebnisfokussierten Ansatzen konnte dies wiederum anders sein, sodass hier angesichts der Vielzahl unterschiedlicher Therapiemethoden vorschnelle Verallgemeinerungen problematisch sind.
1 citations
TL;DR: The findings of this study revealed that the rejection sensitivity in BPD patients is not associated with oxytocin levels and childhood traumas, indicating the need to assess the B PD patients in terms of other biopsychosocial factors related to the etiopathogenesis of BPD.
Abstract: Objective In this study, it is aimed to investigate the relationship between the oxytocin level and the rejection sensitivity, childhood mental traumas, and attachment styles in patients diagnosed with borderline personality disorder (BPD). Methods Participants between the ages of 18–30 were included in the study. The patient group consists of 31 participants and the healthy control group consists of 31 participants. Sociodemographic/Clinical Variables Questionnaire, Relationship Scales Questionnaire, Rejection Sensitivity Questionnaire and Childhood Trauma Questionnaire were administered to the participants included in the study. Serum oxytocin levels of the participants were measured using the Elisa method. Results The oxytocin levels were found to be significantly lower in patients with BPD than in healthy control subjects, whereas the rejection sensitivity and childhood traumas were found to be significantly higher. No difference was found between the patient and control groups in terms of attachment styles, yet it was determined that there may be differences between the oxytocin levels of the BPD patients according to the attachment styles the patients have. Conclusion In conclusion, the findings of this study revealed that the rejection sensitivity in BPD patients is not associated with oxytocin levels and childhood traumas, indicating the need to assess the BPD patients in terms of other biopsychosocial factors related to the etiopathogenesis of BPD.
1 citations
Dissertation•
28 Nov 2018
TL;DR: In this paper, the authors investigated some key mechanisms underlying hypersensitivity to social threats in individuals with BPD traits from developmental, cognitive, and interpersonal perspectives using a multimethod approach and found that attachment anxiety and self-criticism mediated and moderated the association between rejection sensitivity and BPD features.
Abstract: Borderline personality disorder (BPD) is a serious psychiatric condition, which is characterised by interpersonal difficulties, intense fears of abandonment, affective instabilities, and impulsivity. The current research investigated some key mechanisms underlying hypersensitivity to social threats in individuals with BPD traits from developmental, cognitive, and interpersonal perspectives using a multimethod approach. Study 1, using self-report measurements, found that developmental factors including attachment anxiety and self-criticism mediated and moderated the association between rejection sensitivity and BPD features (n = 256). Study 2, using the similar methodological approach, found that intolerance of ambiguity and effortful control mediated and moderated the association between rejection sensitivity and BPD features (n = 256). Study 3 examined the impact of the activation of the attachment system on learning among people with BPD features (n = 96) using the Go/No-go paradigm. Study 4 investigated the impact of ambiguous social interactions on effortful control and mentalizing using a behavioural paradigm (n = 42). Study 5 examined the effect of expectation violation and social rejection, manipulated by the Cyberball paradigm, on effortful control and mentalizing in non-clinical participants (n = 123). Study 6 examined the effect of inclusive and exclusive social interactions, manipulated by the Cyberball paradigm, on mentalizing in BPD patients (n = 22) compared to healthy individuals (n = 28). Overall, results indicate that possible maladaptive coping strategies (anxious attachment, self-criticism) may be developed in response to heightened rejection sensitivity among individuals with BPD features. Furthermore, social cues perceived as threats (ambiguity, social interactions) may 4 activate the attachment system and impair various cognitive functions including contingency learning, effortful control and mentalizing among individuals with BPD symptoms. Future studies are needed to replicate the current findings and examine the impact of negative emotional arousal in response to interpersonal threats on cognitive capacities in larger non-clinical and clinical BPD populations.
18 Dec 2020
TL;DR: In this paper, the authors investigated the attentional bias on emotional faces in people with BPD in the dot-probe task using eye tracking and found that there is an AB for emotional faces of anger in people having BPD at automatic processing stage.
Abstract: The main characteristic of a borderline personality disorder (BPD) is an interpersonal relationship difficulty. The attentional bias (AB) would be the differential location to stimuli considered threatening to the detriment of neutral stimuli. Knowing whether people with BPD has a biased attentional processing in the face of facial expressions is relevant to help better understand the pathology and give more focus to clinical interventions. Objective: Investigate AB on emotional faces in people with BPD in the dot-probe task using eye tracking. Method: participants were N=12 people with borderline personality traits (clinical group) and N=13 with depression (control-clinical group) who responded to a dot-probe task with emotional faces in the exposure times of 250ms and 1000ms. Results: There were group differences in reaction time for the emotional face of anger in 250ms with the clinical group being faster to respond to the trials than the control group. Regarding eye tracking, there were differences in groups, which control group looked more at the eyes of the neutral faces than the clinical group in incongruent trials. Conclusions: Study suggests that there is AB for emotional faces of anger in people with BPD at automatic processing stage. Therapeutic interventions focused on BPD is suggested.
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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"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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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.
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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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