The Effects of Intranasal Oxytocin on Social Cognitive Functioning in Adolescents

描述（由申请人提供）：青春期是身体特征和社会行为发生重大变化的时期（Spear, 2000）。这也是精神疾病的发病高峰时期（国家共病调查复制研究；Kessler等，2005）。大约50%的美国人在其一生中会符合精神障碍的标准，首次发病发生在童年或青春期（Kessler et al., 2005）。鉴于精神疾病的普遍性和早发性，我们应该把重点放在青少年时期精神疾病的识别和治疗上，以便在这些问题行为在成年期变得根深蒂固之前针对它们。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，以及其他情感和行为问题。人们提出了许多理论模型来解释BPD的社会障碍。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。心理化是指个体从心理状态来理解和解释自我和他人行为的能力（Fonagy, et al., 1991），在婴儿期和儿童期从早期的依恋经历中发展而来（Fonagy & Sharp. 2008）。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了精神化，这可能在BPD人际症状的发病中起重要作用。在青少年中，我们实验室的证据支持青少年心智障碍与新出现的BPD特征之间的联系（Sharp, Pane, Ha, et al., 2011; Sharp, Ha, Carbone, et al., In press），通过体内心智化任务进行评估。具体来说，新发BPD的青少年患者表现出一种以过度精神化（或过度解释社会线索；Sharp et al., 2011）为特征的社会认知推理风格。在此背景下，本研究的总体目标是提供

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.