Oxytocin and Reduction of Social Threat Hypersensitivity in Women With Borderline Personality Disorder
Oxytocin and Reduction of Social Threat Hypersensitivity in Women With Borderline Personality Disorder
复制标题
DOI：
10.1176/appi.ajp.2013.13020263
复制
发表时间：
2013-10-01
影响因子：
17.7
通讯作者：
Herpertz, Sabine C.
中科院分区：
文献类型：
--
作者：
Bertsch, Katja;Gamer, Matthias;Herpertz, Sabine C.
目的：边缘型人格障碍患者的特征是情绪过度觉醒，压力水平增加，愤怒倾向，敌对，冲动行为。他们倾向于将愤怒归因于模糊的面部表情，并在对威胁性社会线索的反应中表现出增强和延长的反应，这与增强和延长的杏仁核反应有关。由于鼻内注射神经肽催产素已被证明可以改善面部识别并将注意力从负面社会信息中转移出来，作者调查了边缘患者是否会从催产素给药中受益。在随机安慰剂对照双盲组设计中，目前DSM-IV诊断为边缘型人格障碍的成年女性患者（根据激素分析排除了两名患者）和41名健康女性，年龄，教育和智商匹配，在鼻内施用26 IU催产素或安慰剂后45分钟，参与情绪分类任务。因变量是lavelion和数量或初始反射性眼动眼动眼跟踪，手动响应lavelion，和血氧水平依赖的杏仁核的反应，愤怒和恐惧相比，快乐的面部表情expressions.Results：边缘患者表现出更多和更快的初始固定变化的眼睛愤怒的面孔相结合，增加杏仁核的激活，在响应愤怒的面孔与对照组相比。这些异常的行为和神经模式正常化后催产素administration.Conclusions：边缘患者表现出对社会威胁的早期，反射性阶段的信息处理的超敏反应。催产素可以降低社会威胁超敏反应，从而减少边缘型人格障碍或其他具有增强的威胁驱动的反应性攻击的精神疾病的愤怒和攻击行为。
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 placebo-controlled 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 the amygdala to angry and fearful compared 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.