The Effects of Intranasal Oxytocin on Social Cognitive Functioning in Adolescents

描述(申请人提供)：青春期是一个巨大变化的时期，身体特征和社会行为都有显著的发展(Spear，2000)。这也是精神疾病的发病高峰期(国家共病调查复制研究；Kessler等人，2005年)。大约50%的美国人将在他们的一生中达到精神障碍的标准，首次发病发生在儿童或青春期(Kessler等人，2005年)。鉴于精神障碍和早发性疾病的流行，应重视青春期精神疾病的识别和治疗，以便在成年前将早期问题行为作为目标。交界性人格障碍(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。人们提出了许多理论模型来解释BPD中的社会缺陷。Fonagy和他的同事(2009)提出，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精神化方面。心理化是指个体通过心理状态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历中发展起来(Fonagy和Sharp)。2008年)。最近，Stanley和Siever(2010)提出了BPD的神经肽模型，认为催产素功能障碍损害了精神化，这可能在BPD人际关系症状的发生中起重要作用。在青少年中，我们实验室的证据支持通过体内精神化任务评估的青年心智障碍和新出现的BPD特征之间的联系(Sharp，Pane，Ha等人，2011；Sharp，Ha，Carbone等人，正在出版中)。具体地说，出现BPD的青少年患者表现出一种以过度情绪化(或过度解读社交线索；Sharp等人，2011年)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 为了解青少年出现BPD的社会认知机制奠定了基础，目的是改进对青少年(12-17岁)的早期干预。为此，将采用双盲、随机和安慰剂对照的实验设计，以健康的非临床青少年为对照，研究鼻腔内注射催产素对青春期BPD患者体内精神化的影响。研究的具体目的有两个：1)与非临床青少年组相比，鼻内注射催产素对BPD青少年体内的心智形成能力(特别是过度心智作用)的影响；2)评估基于特质的心智能力在调节催产素和体内心智形成能力之间的关系中的潜在作用。这项拟议的研究将有可能解决完整的经验性问题，并为研究BPD的早期干预提供基础。

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.