The Effects of Intranasal Oxytocin on Social Cognitive Functioning in Adolescents

描述（由申请人提供）：青春期是一个巨大变化的时期，在身体特征和社会行为方面都有显著的发展（Spear，2000）。这也是精神障碍的高峰发作的时间段（国家科摩罗调查复制研究; Kessler等人，2005年）的报告。大约50%的美国人在其一生中将满足精神障碍的标准，其中第一次发作发生在儿童期或青春期（Kessler等人，2005年）。鉴于精神疾病的普遍性和早期发病，重点应放在青少年精神疾病的识别和治疗上，以针对早期问题行为，以免它们在成年后根深蒂固。边缘型人格障碍（BPD）是一种精神疾病，涉及维持健康社会关系的重大问题，以及其他情绪和行为问题。许多理论模型已经被提出来解释BPD中的社会缺陷。Fonagy及其同事（2009）认为BPD患者在社会关系中遇到的问题是基于依恋的社会认知能力受损的结果，特别是在心理理论或心理化方面。心理化是指个体在心理状态方面理解和解释自我和他人行为的能力（Fonagy等人，1991），并在婴儿期和儿童期从早期依恋经验（Fonagy & Sharp. 2008年）。最近，Stanley和Siever（2010）提出了BPD的神经肽模型，该模型表明催产素功能障碍损害心智化，这可能在BPD的人际症状的发作中起重要作用。在青少年中，来自我们实验室的证据支持青少年心智化障碍与新兴BPD特征之间的联系（Sharp，Mr.，Ha等人，2011; Sharp，Ha，Carbone等人，在印刷中），如通过体内心智化任务所评估的。具体而言，患有新兴BPD的青少年患者表现出一种以过度心理化（或过度解释社会线索）为特征的社会认知推理风格; Sharp等人，2011年）。在此背景下，本研究的总体目标是提供 了解青少年BPD出现的社会认知机制的基础，旨在改善青少年（12-17岁）的早期干预。为此，将采用双盲、随机和安慰剂对照实验设计，与一组健康非临床青少年相比，检查鼻内催产素对青少年BPD患者样本体内心理化的影响。具体目标有两个方面：1）研究鼻内催产素对BPD青少年体内心智化能力（特别是超心智化）的影响，与非临床青少年组相比，2）评估基于特质的心智化能力在调节催产素和体内心智化能力之间关系中的潜在作用。这项拟议的研究将有可能解决整体的实证问题，并为研究调查BPD的早期干预措施提供基础。

DESCRIPTION (provided by applicant): Adolescence is a time period of great change with significant development in both physical characteristics and social behaviors (Spear, 2000). It is also a time period of peak onset for psychiatric disorders (National Comorbidity Survey Replication study; Kessler, et al., 2005). About 50% of Americans will meet criteria for a psychiatric disorder in their lifetime with the first onset occurring in childhood or adolescence (Kessler et al., 2005). Given the prevalence of psychiatric disorders and early onset, an emphasis should be placed on the identification and treatment of mental illnesses in adolescence to target early problem behaviors before they become ingrained in adulthood. Borderline Personality Disorder (BPD) is a mental illness which involves significant problems in maintaining healthy social relationships, as well as other emotional and behavioral problems. Many theoretical models have been proposed to explain the social impairments in BPD. Fonagy and colleagues (2009) have suggested that problems BPD patients experience in social relationships are a result of impairment in attachment-based social-cognitive abilities, specifically, in theory of mind or mentalization. Mentalization refers to an individual's capacity o understand and interpret the behavior of self and others in terms of mental states (Fonagy, et al., 1991), and develops during infancy and childhood from early attachment experiences (Fonagy & Sharp. 2008). Recently, Stanley and Siever (2010) have proposed a neuropeptide model of BPD which suggests that dysfunction of oxytocin impairs mentalization, which may play an important role in the onset of interpersonal symptoms of BPD. In adolescents, evidence from our lab support the link between mentalization impairment in youth and emerging BPD traits (Sharp, Pane, Ha, et al., 2011; Sharp, Ha, Carbone, et al., in press) as assessed by an in-vivo mentalization task. Specifically, adolescent patients with emerging BPD showed a style of social- cognitive reasoning characterized by hypermentalizing (or over-interpretation of social cues; Sharp et al., 2011). Against this background, the overall goal of this research is to provide the foundation for understanding the social-cognitive mechanisms involved in the emergence of BPD in adolescents with the aim of improving early interventions for youths (12-17 years). To this end a double-blind, randomized, and placebo-controlled experimental design will be used to examine the effects of intranasal oxytocin on in-vivo mentalization in a sample of adolescent BPD patients in comparison to a group of healthy non-clinical adolescents. The specific aims are two-fold: 1) to investigate the effects of intranasal oxytocin on in-vivo mentalization capacit (specifically hypermentalizing) in adolescents with BPD compared to a non-clinical group of adolescents, and 2) to evaluate the potential role of trait-based mentalization capacity in moderating the relation between oxytocin and in-vivo mentalization capacity. This proposed research will have the potential to address integral empirical questions and provide a foundation for research investigating early interventions for BPD.