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Ivančík V, Čavojská N, Straková A, Januška J, Kraus J, Pečeňák J, Heretik A, Hajdúk M. Trustworthiness judgments and pupil-size in individuals with schizophrenia. Behav Brain Res 2024; 471:115141. [PMID: 38992846 DOI: 10.1016/j.bbr.2024.115141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/26/2024] [Accepted: 07/04/2024] [Indexed: 07/13/2024]
Abstract
Individuals with schizophrenia show aberrant processing of social cues. In the current study, we (1) compared trustworthiness ratings of faces between patients with schizophrenia and healthy controls, (2) compared pupillary reactivity between patients and controls (3) examined whether trustworthiness judgments in schizophrenia are related to pupil reactivity, (4) and examined associations between trustworthiness judgements and symptom severity, specifically paranoia. Patients with schizophrenia spectrum disorders (N = 48) and healthy controls (N = 33) completed a Trustworthiness Task, during which their pupil size was measured via an eye-tracking device. The mean baseline-corrected pupil size was calculated from 24 pictures of real neutral faces, each presented for 2500 ms. Self-reported psychotic experiences were measured by Community Assessment of Psychic Functioning (CAPE-42), and symptom severity was rated by Brief Psychiatric Rating Scale (BPRS). No group differences were found in trustworthiness ratings or pupil reactivity parameters during trustworthiness judgments. Separately, among patients, absolute difference in pupil-size change and dilation after reaching minimum size were related to more severe positive symptoms and self-reported paranoia. Our results did not show social cognitive biases in the stable outpatients with schizophrenia, or the role of pupil reactivity in trustworthiness judgments. Future studies should use longer stimuli for pupillary reactivity and control the type and dosage of utilized antipsychotic medication. Further studies are required to explore relationships in larger and more symptomatic groups of patients.
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Affiliation(s)
- Vladimír Ivančík
- Department of Psychology, Faculty of Arts, Comenius University in Bratislava, Slovakia; Centre for Psychiatric Disorders Research, Science Park, Comenius University in Bratislava, Slovakia.
| | - Natália Čavojská
- Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Slovakia; Centre for Psychiatric Disorders Research, Science Park, Comenius University in Bratislava, Slovakia
| | - Alexandra Straková
- Department of Psychology, Faculty of Arts, Comenius University in Bratislava, Slovakia; Centre for Psychiatric Disorders Research, Science Park, Comenius University in Bratislava, Slovakia
| | - Jakub Januška
- Department of Psychology, Faculty of Arts, Comenius University in Bratislava, Slovakia; Centre for Psychiatric Disorders Research, Science Park, Comenius University in Bratislava, Slovakia
| | - Jakub Kraus
- Department of Psychology, Faculty of Arts, Comenius University in Bratislava, Slovakia; Centre for Psychiatric Disorders Research, Science Park, Comenius University in Bratislava, Slovakia
| | - Ján Pečeňák
- Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Slovakia; Centre for Psychiatric Disorders Research, Science Park, Comenius University in Bratislava, Slovakia
| | - Anton Heretik
- Department of Psychology, Faculty of Arts, Comenius University in Bratislava, Slovakia; Centre for Psychiatric Disorders Research, Science Park, Comenius University in Bratislava, Slovakia
| | - Michal Hajdúk
- Department of Psychology, Faculty of Arts, Comenius University in Bratislava, Slovakia; Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Slovakia; Centre for Psychiatric Disorders Research, Science Park, Comenius University in Bratislava, Slovakia
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Bradley ER, Portanova J, Woolley JD, Buck B, Painter IS, Hankin M, Xu W, Cohen T. Quantifying abnormal emotion processing: A novel computational assessment method and application in schizophrenia. Psychiatry Res 2024; 336:115893. [PMID: 38657475 DOI: 10.1016/j.psychres.2024.115893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/31/2023] [Accepted: 04/03/2024] [Indexed: 04/26/2024]
Abstract
Abnormal emotion processing is a core feature of schizophrenia spectrum disorders (SSDs) that encompasses multiple operations. While deficits in some areas have been well-characterized, we understand less about abnormalities in the emotion processing that happens through language, which is highly relevant for social life. Here, we introduce a novel method using deep learning to estimate emotion processing rapidly from spoken language, testing this approach in male-identified patients with SSDs (n = 37) and healthy controls (n = 51). Using free responses to evocative stimuli, we derived a measure of appropriateness, or "emotional alignment" (EA). We examined psychometric characteristics of EA and its sensitivity to a single-dose challenge of oxytocin, a neuropeptide shown to enhance the salience of socioemotional information in SSDs. Patients showed impaired EA relative to controls, and impairment correlated with poorer social cognitive skill and more severe motivation and pleasure deficits. Adding EA to a logistic regression model with language-based measures of formal thought disorder (FTD) improved classification of patients versus controls. Lastly, oxytocin administration improved EA but not FTD among patients. While additional validation work is needed, these initial results suggest that an automated assay using spoken language may be a promising approach to assess emotion processing in SSDs.
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Affiliation(s)
- Ellen R Bradley
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; San Francisco Veterans Affairs Medical Center, CA, USA.
| | - Jake Portanova
- Department of Biomedical Informatics and Medical Education, University of Washington, WA, USA
| | - Josh D Woolley
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; San Francisco Veterans Affairs Medical Center, CA, USA
| | - Benjamin Buck
- Behavioral Research in Technology and Engineering (BRiTE) Center, Department of Psychiatry and Behavioral Sciences, University of Washington, USA
| | - Ian S Painter
- Department of Statistics, University of Washington, USA
| | | | - Weizhe Xu
- Department of Biomedical Informatics and Medical Education, University of Washington, WA, USA
| | - Trevor Cohen
- Department of Biomedical Informatics and Medical Education, University of Washington, WA, USA; Behavioral Research in Technology and Engineering (BRiTE) Center, Department of Psychiatry and Behavioral Sciences, University of Washington, USA
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West T, Mendes WB. Affect contagion: Physiologic covariation and linkage offer insight into socially shared thoughts, emotions, and experiences. ADVANCES IN EXPERIMENTAL SOCIAL PSYCHOLOGY 2023. [DOI: 10.1016/bs.aesp.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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4
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Marazziti D, Diep PT, Carter S, Carbone MG. Oxytocin: An Old Hormone, A Novel Psychotropic Drug And Possible Use In Treating Psychiatric Disorders. Curr Med Chem 2022; 29:5615-5687. [PMID: 35894453 DOI: 10.2174/0929867329666220727120646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/17/2022] [Accepted: 04/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Oxytocin is a nonapeptide synthesized in the paraventricular and supraoptic nuclei of the hypothalamus. Historically, this molecule has been involved as a key factor in the formation of infant attachment, maternal behavior and pair bonding and, more generally, in linking social signals with cognition, behaviors and reward. In the last decades, the whole oxytocin system has gained a growing interest as it was proposed to be implicated in etiopathogenesis of several neurodevelopmental and neuropsychiatric disorders. METHODS With the main goal of an in-depth understanding of the oxytocin role in the regulation of different functions and complex behaviors as well as its intriguing implications in different neuropsychiatric disorders, we performed a critical review of the current state of art. We carried out this work through PubMed database up to June 2021 with the search terms: 1) "oxytocin and neuropsychiatric disorders"; 2) "oxytocin and neurodevelopmental disorders"; 3) "oxytocin and anorexia"; 4) "oxytocin and eating disorders"; 5) "oxytocin and obsessive-compulsive disorder"; 6) "oxytocin and schizophrenia"; 7) "oxytocin and depression"; 8) "oxytocin and bipolar disorder"; 9) "oxytocin and psychosis"; 10) "oxytocin and anxiety"; 11) "oxytocin and personality disorder"; 12) "oxytocin and PTSD". RESULTS Biological, genetic, and epigenetic studies highlighted quality and quantity modifications in the expression of oxytocin peptide or in oxytocin receptor isoforms. These alterations would seem to be correlated with a higher risk of presenting several neuropsychiatric disorders belonging to different psychopathological spectra. Collaterally, the exogenous oxytocin administration has shown to ameliorate many neuropsychiatric clinical conditions. CONCLUSION Finally, we briefly analyzed the potential pharmacological use of oxytocin in patient with severe symptomatic SARS-CoV-2 infection due to its anti-inflammatory, anti-oxidative and immunoregulatory properties.
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Affiliation(s)
- Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy.,Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Phuoc-Tan Diep
- Department of Histopathology, Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom
| | - Sue Carter
- Director Kinsey Institute, Indiana University, Bloomington, IN, USA
| | - Manuel G Carbone
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, 21100 Varese, Italy
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The Role of OXT, OXTR, AVP, and AVPR1a Gene Expression in the Course of Schizophrenia. Curr Issues Mol Biol 2022; 44:336-349. [PMID: 35723404 PMCID: PMC8929099 DOI: 10.3390/cimb44010025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/03/2022] [Accepted: 01/08/2022] [Indexed: 01/04/2023] Open
Abstract
Schizophrenia is a serious and chronic mental illness, the symptoms of which usually appear for the first time in late adolescence or early adulthood. To date, much research has been conducted on the etiology of schizophrenia; however, it is still not fully understood. Oxytocin and vasopressin as neuromodulators that regulate social and emotional behavior are promising candidates for determining the vulnerability to schizophrenia. The aim of this study was to evaluate the expression of OXT, OXTR, AVP, and AVPR1a genes at the mRNA and protein levels in patients with schizophrenia. Due to the neurodegenerative nature of schizophrenia, the study group was divided into two subgroups, namely, G1 with a diagnosis that was made between 10 and 15 years after the onset of the illness, and G2 with a diagnosis made up to two years after the onset of the illness. Moreover, the relationship between the examined genes and the severity of schizophrenia symptoms, assessed using PANSS (Positive and Negative Syndrome Scale) and CDSS scales (Clinical Depression Scale for Schizophrenia) was evaluated. The analysis of the expression of the studied genes at the mRNA and protein levels showed statistically significant differences in the expression of all the investigated genes. OXT and AVPR1a gene expression at both the mRNA and protein levels were significantly lower in the schizophrenia group, and OXTR and AVP gene expression at both the mRNA and protein levels was higher in the schizophrenia subjects than in the controls. Furthermore, a significant correlation of OXT gene expression at the mRNA and protein levels with the severity of depressive symptoms in schizophrenia as assessed by CDSS was found.
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Thorson KR, McKernan SM, West TV, Woolley JD, Mendes WB, Stauffer CS. Oxytocin increases physiological linkage during group therapy for methamphetamine use disorder: a randomized clinical trial. Sci Rep 2021; 11:21004. [PMID: 34697392 PMCID: PMC8546069 DOI: 10.1038/s41598-021-99957-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 09/22/2021] [Indexed: 11/24/2022] Open
Abstract
Patients and psychotherapists often exhibit behavioral, psychological, and physiological similarity. Here, we test whether oxytocin—a neuropeptide that can enhance expressivity and social perception—influences time-lagged “linkage” of autonomic nervous system responses among participants and facilitators during group therapy. Physiological linkage estimates (n = 949) were created from ten cohorts, each with two facilitators (n = 5) and four to six participants (n = 48), over six weekly sessions of group therapy for methamphetamine use disorder. All participants of a cohort received oxytocin or placebo intranasally in a randomized double-blind procedure before each session. Cardiac interbeat intervals (IBI) were measured continuously during sessions to estimate physiological linkage, operationalized as one cohort-mate’s IBI reactivity during one minute predicting another cohort-mate’s IBI reactivity during the following minute. In oxytocin cohorts, participants and facilitators experienced significant physiological linkage to their cohort-mates (i.e., their physiological responses were predicted by the prior responses of their cohort-mates) and significantly more linkage than people in placebo cohorts. Both effects occurred during the first and second sessions but not later sessions. Results suggest that oxytocin may enhance psychosocial processes often associated with linkage—such as social engagement—in groups and highlight oxytocin’s potential to improve group cohesion during group therapy. Clinical Trials Registration: NCT02881177, First published on 26/08/2016.
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Affiliation(s)
- Katherine R Thorson
- Department of Psychology, Barnard College of Columbia University, 3009 Broadway, New York, NY, 10027, USA.
| | - Scott M McKernan
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Tessa V West
- Department of Psychology, New York University, New York, NY, USA
| | - Joshua D Woolley
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA.,San Francisco Veterans Affairs Health Care System, 4150 Clement St, San Francisco, CA, 94121, USA
| | - Wendy Berry Mendes
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Christopher S Stauffer
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA. .,Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA. .,Portland VA Medical Center, 1601 E 4th Plain Blvd (V3SATP), Vancouver, WA, 98661, USA.
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7
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Oxytocin in Schizophrenia: Pathophysiology and Implications for Future Treatment. Int J Mol Sci 2021; 22:ijms22042146. [PMID: 33670047 PMCID: PMC7926349 DOI: 10.3390/ijms22042146] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 11/17/2022] Open
Abstract
Schizophrenia is a form of mental disorder that is behaviorally characterized by abnormal behavior, such as social function deficits or other behaviors that are disconnected from reality. Dysregulation of oxytocin may play a role in regulating the expression of schizophrenia. Given oxytocin’s role in social cognition and behavior, a variety of studies have examined the potential clinical benefits of oxytocin in improving the psychopathology of patients with schizophrenia. In this review, we highlight the evidence for the role of endogenous oxytocin in schizophrenia, from animal models to human studies. We further discuss the potential of oxytocin as a therapeutic agent for schizophrenia and its implication in future treatment.
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8
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Abstract
BACKGROUND Schizophrenia (SCZ) is a neurodevelopmental disorder that leads to poor social function. Oxytocin (OXT), a neuropeptide involved in social cognition, is a potential therapeutic agent for alleviating social dysfunction. Therefore, we investigated the effects of intranasal oxytocin (IN-OXT) on emotional processes in experimental interactive social contexts in individuals with SCZ. METHODS In a male-only parallel randomized placebo-controlled double-blind trial, we investigated the effects of IN-OXT (24 IU) on visual fixation on pictures of faces and emotion recognition in an interactive ball-tossing game that probed processing of social and nonsocial stimuli. RESULTS Intranasal oxytocin enhanced the recognition of emotions during an emotion-based ball-tossing game. This improvement was specific to the game that included social cue processing. Intranasal oxytocin did not affect eye gaze duration or gaze dwell time on faces in these patients. CONCLUSIONS An acute low dose of IN-OXT had a modest effect on social cue processing and was limited to emotion recognition. Higher doses and long-term trials targeting emotional processing in SCZ may lead to improved social function.
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9
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Bègue I, Kaiser S, Kirschner M. Pathophysiology of negative symptom dimensions of schizophrenia – Current developments and implications for treatment. Neurosci Biobehav Rev 2020; 116:74-88. [DOI: 10.1016/j.neubiorev.2020.06.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/13/2020] [Accepted: 06/02/2020] [Indexed: 02/06/2023]
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10
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Exogenous effects of oxytocin in five psychiatric disorders: a systematic review, meta-analyses and a personalized approach through the lens of the social salience hypothesis. Neurosci Biobehav Rev 2020; 114:70-95. [DOI: 10.1016/j.neubiorev.2020.04.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 04/19/2020] [Accepted: 04/21/2020] [Indexed: 02/08/2023]
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11
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Abram SV, De Coster L, Roach BJ, Mueller BA, van Erp TGM, Calhoun VD, Preda A, Lim KO, Turner JA, Ford JM, Mathalon DH, Woolley JD. Oxytocin Enhances an Amygdala Circuit Associated With Negative Symptoms in Schizophrenia: A Single-Dose, Placebo-Controlled, Crossover, Randomized Control Trial. Schizophr Bull 2020; 46:661-669. [PMID: 31595302 PMCID: PMC7147578 DOI: 10.1093/schbul/sbz091] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Negative symptoms are core contributors to vocational and social deficits in schizophrenia (SZ). Available antipsychotic medications typically fail to reduce these symptoms. The neurohormone oxytocin (OT) is a promising treatment for negative symptoms, given its role in complex social behaviors mediated by the amygdala. In sample 1, we used a double-blind, placebo-controlled, crossover design to test the effects of a single dose of intranasal OT on amygdala resting-state functional connectivity (rsFC) in SZ (n = 22) and healthy controls (HC, n = 24) using a whole-brain corrected approach: we identified regions for which OT modulated SZ amygdala rsFC, assessed whether OT-modulated circuits were abnormal in SZ relative to HC on placebo, and evaluated whether connectivity on placebo and OT-induced connectivity changes correlated with baseline negative symptoms in SZ. Given our modest sample size, we used a second SZ (n = 183) and HC (n = 178) sample to replicate any symptom correlations. In sample 1, OT increased rsFC between the amygdala and left middle temporal gyrus, superior temporal sulcus, and angular gyrus (MTG/STS/AngG) in SZ compared to HC. Further, SZ had hypo-connectivity in this circuit compared to HC on placebo. More severe negative symptoms correlated with less amygdala-to-left-MTG/STS/AngG connectivity on placebo and with greater OT-induced connectivity increases. In sample 2, we replicated the correlation between amygdala-left-MTG/STS/AngG hypo-connectivity and negative symptoms, finding a specific association with expressive negative symptoms. These data suggest intranasal OT can normalize functional connectivity in an amygdala-to-left-MTG/STS/AngG circuit that contributes to negative symptoms in SZ.
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Affiliation(s)
- Samantha V Abram
- Sierra Pacific Mental Illness Research Education and Clinical Centers, San Francisco VA Medical Center, and the University of California, San Francisco, CA,Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA,Department of Psychiatry, University of California San Francisco, San Francisco, CA
| | - Lize De Coster
- Department of Computer Science, Universidad Carlos III de Madrid, Madrid, Spain
| | - Brian J Roach
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA,Department of Psychiatry, University of California San Francisco, San Francisco, CA
| | - Bryon A Mueller
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | - Theo G M van Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - Vince D Calhoun
- The Mind Research Network, Albuquerque, NM,Department of Psychiatry, University of New Mexico, Albuquerque, NM,Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM
| | - Adrian Preda
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - Kelvin O Lim
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | | | - Judith M Ford
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA,Department of Psychiatry, University of California San Francisco, San Francisco, CA
| | - Daniel H Mathalon
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA,Department of Psychiatry, University of California San Francisco, San Francisco, CA
| | - Joshua D Woolley
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA,Department of Psychiatry, University of California San Francisco, San Francisco, CA,To whom correspondence should be addressed; 4150 Clement Street, Box (116C-1 [Joshua Woolley]), San Francisco, CA 94121, US; tel: 415-221-4810-x24117; fax: 415-379-5667, e-mail:
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12
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Bradley ER, Seitz A, Niles AN, Rankin KP, Mathalon DH, O'Donovan A, Woolley JD. Oxytocin increases eye gaze in schizophrenia. Schizophr Res 2019; 212:177-185. [PMID: 31416746 PMCID: PMC6791758 DOI: 10.1016/j.schres.2019.07.039] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 05/23/2019] [Accepted: 07/25/2019] [Indexed: 12/18/2022]
Abstract
Abnormal eye gaze is common in schizophrenia and linked to functional impairment. The hypothalamic neuropeptide oxytocin modulates visual attention to social stimuli, but its effects on eye gaze in schizophrenia are unknown. We examined visual scanning of faces in men with schizophrenia and neurotypical controls to quantify oxytocin effects on eye gaze. In a randomized, double-blind, crossover study, 33 men with schizophrenia and 39 matched controls received one dose of intranasal oxytocin (40 IU) and placebo on separate testing days. Participants viewed 20 color photographs of faces while their gaze patterns were recorded. We tested for differences in fixation time on the eyes between patients and controls as well as oxytocin effects using linear mixed-effects models. We also tested whether attachment style, symptom severity, and anti-dopaminergic medication dosage moderated oxytocin effects. In the placebo condition, patients showed reduced fixation time on the eyes compared to controls. Oxytocin was associated with an increase in fixation time among patients, but a decrease among controls. Higher attachment anxiety and greater symptom severity predicted increased fixation time on the eyes on oxytocin versus placebo. Anti-dopaminergic medication dosage and attachment avoidance did not impact response to oxytocin. Consistent with findings that oxytocin optimizes processing of social stimuli, intranasal oxytocin enhanced eye gaze in men with schizophrenia. Further work is needed to determine whether changes in eye gaze impact social cognition and functional outcomes. Both attachment anxiety and symptom severity predicted oxytocin response, highlighting the importance of examining potential moderators of oxytocin effects in future studies.
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Affiliation(s)
- Ellen R Bradley
- University of California, San Francisco, CA, United States of America; San Francisco Veteran's Affairs Medical Center, San Francisco, CA, United States of America.
| | - Alison Seitz
- University of California, San Francisco, CA, United States of America
| | - Andrea N Niles
- University of California, San Francisco, CA, United States of America; San Francisco Veteran's Affairs Medical Center, San Francisco, CA, United States of America
| | | | - Daniel H Mathalon
- University of California, San Francisco, CA, United States of America; San Francisco Veteran's Affairs Medical Center, San Francisco, CA, United States of America
| | - Aoife O'Donovan
- University of California, San Francisco, CA, United States of America; San Francisco Veteran's Affairs Medical Center, San Francisco, CA, United States of America
| | - Joshua D Woolley
- University of California, San Francisco, CA, United States of America; San Francisco Veteran's Affairs Medical Center, San Francisco, CA, United States of America
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13
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Teed AR, Han K, Rakic J, Mark DB, Krawczyk DC. The influence of oxytocin and vasopressin on men's judgments of social dominance and trustworthiness: An fMRI study of neutral faces. Psychoneuroendocrinology 2019; 106:252-258. [PMID: 31015068 DOI: 10.1016/j.psyneuen.2019.04.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 03/17/2019] [Accepted: 04/10/2019] [Indexed: 02/06/2023]
Abstract
Cues signaling trust and dominance are crucial for social life. Previous studies on the effects of oxytocin (OT) nasal sprays on trustworthiness evaluations have been inconsistent and its influence on dominance is unknown. Vasopressin (AVP) may also influence social cue perception, but even fewer investigations have evaluated this possibility. We evaluated the effects of intranasal OT and AVP compared to placebo control during three double-blinded functional magnetic resonance imaging sessions. Twenty males received a pseudo-randomized order of nasal spray conditions and rated the trustworthiness and dominance of neutral faces. OT increased facial dominance ratings compared to placebo. Neuroimaging results revealed an inverse relationship between brain activation and face ratings for OT compared to placebo in regions involved in processing emotional expressions. Specifically, the right superior temporal gyrus was attenuated as ratings increased and the left precuneus selectively diminished with increasing dominance ratings. Additionally, OT increased functional connectivity between frontoparietal regions and the right amygdala for faces rated as highly dominant, but OT increased connectivity between the fusiform gyrus, hippocampus, and bilateral ventral tegmental area (VTA) for faces perceived as highly trustworthy. Overall, OT increased the perception of dominance but did not influence trustworthiness judgments. However, we observed regional neural effects for OT that differed between judgments of trustworthiness and dominance. AVP attenuated left temporoparietal junction activity as face ratings increased, a result consistent with AVP influencing mentalization. AVP also led to increased left amygdala and right VTA connectivity with the putamen, which is consistent with cue-driven, habitual responses.
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Affiliation(s)
- Adam R Teed
- Center for BrainHealth®, The University of Texas at Dallas, USA.
| | - Kihwan Han
- Center for BrainHealth®, The University of Texas at Dallas, USA
| | - Jelena Rakic
- Center for BrainHealth®, The University of Texas at Dallas, USA
| | - Daniel B Mark
- Department of Psychology, University of North Texas, Denton, USA
| | - Daniel C Krawczyk
- Center for BrainHealth®, The University of Texas at Dallas, USA; School of Behavioral and Brain Sciences, The University of Texas at Dallas, USA; Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, USA
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14
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Strauss GP, Granholm E, Holden JL, Ruiz I, Gold JM, Kelly DL, Buchanan RW. The effects of combined oxytocin and cognitive behavioral social skills training on social cognition in schizophrenia. Psychol Med 2019; 49:1731-1739. [PMID: 30180918 DOI: 10.1017/s0033291718002465] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Individuals with schizophrenia have deficits in social cognition that are associated with poor functional outcome. Unfortunately, current treatments result in only modest improvement in social cognition. Oxytocin, a neuropeptide with pro-social effects, has significant benefits for social cognition in the general population. However, studies examining the efficacy of oxytocin in schizophrenia have yielded inconsistent results. One reason for inconsistency may be that oxytocin has typically not been combined with psychosocial interventions. It may be necessary for individuals with schizophrenia to receive concurrent psychosocial treatment while taking oxytocin to have the context needed to make gains in social cognitive skills. METHODS The current study tested this hypothesis in a 24-week (48 session) double-blind, placebo-controlled trial that combined oxytocin and Cognitive-Behavioral Social Skills Training (CBSST), which included elements from Social Cognition and Interaction Training (SCIT). Participants included 62 outpatients diagnosed with schizophrenia (placebo n = 31; oxytocin n = 31) who received 36 IU BID, with supervised administration 45 min prior to sessions on CBSST group therapy days. Participants completed a battery of measures administered at 0, 12, and 24 weeks that assessed social cognition. RESULTS CBSST generally failed to enhance social cognition from baseline to end of study, and there was no additive benefit of oxytocin beyond the effects of CBSST alone. CONCLUSIONS Findings suggest that combined CBSST and oxytocin had minimal benefit for social cognition, adding to the growing literature indicating null effects of oxytocin in multi-dose trials. Methodological and biological factors may contribute to inconsistent results across studies.
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Affiliation(s)
| | - Eric Granholm
- VA San Diego Healthcare System, Department of Psychiatry,University of California San Diego School of Medicine,San Diego, CA,USA
| | - Jason L Holden
- VA San Diego Healthcare System, Department of Psychiatry,University of California San Diego School of Medicine,San Diego, CA,USA
| | - Ivan Ruiz
- Department of Psychology,University of Georgia,Athens, GA,USA
| | - James M Gold
- Department of Psychiatry,Maryland Psychiatric Research Center, University of Maryland School of Medicine,Baltimore, MD,USA
| | - Deanna L Kelly
- Department of Psychiatry,Maryland Psychiatric Research Center, University of Maryland School of Medicine,Baltimore, MD,USA
| | - Robert W Buchanan
- Department of Psychiatry,Maryland Psychiatric Research Center, University of Maryland School of Medicine,Baltimore, MD,USA
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15
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Strauss GP, Chapman HC, Keller WR, Koenig JI, Gold JM, Carpenter WT, Buchanan RW. Endogenous oxytocin levels are associated with impaired social cognition and neurocognition in schizophrenia. J Psychiatr Res 2019; 112:38-43. [PMID: 30849617 DOI: 10.1016/j.jpsychires.2019.02.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 02/15/2019] [Accepted: 02/21/2019] [Indexed: 01/20/2023]
Abstract
Intranasal administration of the neuropeptide oxytocin (OT) has yielded inconsistent effects on social cognition and general cognition in individuals with schizophrenia (SZ). Few studies have examined whether endogenous peripheral OT levels are also associated with social and general cognition in SZ. The current study examined whether plasma OT levels are associated with performance on a higher-order social cognition measure (i.e., a task that requires inferential processes and knowledge not directly presented in social stimuli), as well as domains of general cognition. Participants included 30 individuals with SZ and 21 demographically matched healthy controls (CN). The MATRICS Consensus Cognitive Battery was administered to assess neuropsychological impairment in relation to 7 domains (processing speed, attention/vigilance, working memory, verbal learning, visual learning, reasoning/problem solving, and social cognition). Plasma OT levels were measured via radioimmunoassay. SZ had significantly lower endogenous OT levels and poorer MCCB performance on all 7 domains than CN. In CN and SZ, lower endogenous OT was associated with poorer social cognition. In SZ, lower endogenous OT was also associated with poorer processing speed and working memory. The significant association between OT and social cognition in both CN and SZ highlights the importance of endogenous OT levels as a biological predictor of social cognition, irrespective of clinical status. Significant associations between plasma OT and general neurocognition may reflect either an anxiolytic effect of plasma OT that results in better neurocognitive performance, or OT's action on dopamine and enhancement of dopamine tone that results in improved cognition.
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Affiliation(s)
| | | | - William R Keller
- Dartmouth College Geisel School of Medicine, Department of Psychiatry, USA
| | - James I Koenig
- University of Maryland School of Medicine, Department of Psychiatry and Maryland Psychiatric Research Center, USA
| | - James M Gold
- University of Maryland School of Medicine, Department of Psychiatry and Maryland Psychiatric Research Center, USA
| | - William T Carpenter
- University of Maryland School of Medicine, Department of Psychiatry and Maryland Psychiatric Research Center, USA
| | - Robert W Buchanan
- University of Maryland School of Medicine, Department of Psychiatry and Maryland Psychiatric Research Center, USA
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16
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Adjunctive intranasal oxytocin for schizophrenia: A meta-analysis of randomized, double-blind, placebo-controlled trials. Schizophr Res 2019; 206:13-20. [PMID: 30573406 DOI: 10.1016/j.schres.2018.12.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 12/07/2018] [Accepted: 12/07/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Findings on the efficacy of intranasal oxytocin (IN-OT) in schizophrenia have been inconsistent. This meta-analysis of double-blind randomized controlled trials (RCTs) examined the efficacy and tolerability of adjunctive IN-OT in the treatment of schizophrenia. METHODS Standardized mean differences or risk ratios (SMDs or RRs) with their 95% confidence intervals (CIs) were used to synthesize the results of studies included in the meta-analysis. RESULTS Ten RCTs (n = 344) with 172 schizophrenia subjects on adjunctive IN-OT [range = 40-80 International Units (IU)/day] and 172 schizophrenia subjects on adjunctive placebo over 2-16 weeks were included. No significant differences regarding total psychopathology measured with the total Positive and Negative Syndrome Scale (PANSS) or the Brief Psychiatric Rating Scale (BPRS) [8 RCTs, n = 203; SMD: -0.08 (95%CI: -0.53, 0.37), P = 0.74, I2 = 59%] and the positive, negative and general symptom scores [SMD: -0.20 to -0.04 (95%CI: -0.75, 0.36), P = 0.28 to 0.78; I2 = 0% to 72%] were found between the IN-OT and placebo groups. Similarly, subgroup analyses for total psychopathology found no group differences. Dose-response effect analyses showed that only 80 IU/day IN-OT had superiority over placebo in improving total psychopathology (P = 0.02) and positive symptom score (P = 0.01). No group differences between adjunctive IN-OT and placebo regarding discontinuation due to any reason [RR: 1.12 (95%CI: 0.67, 1.88), P = 0.67, I2 = 0%] and adverse drug reactions were found. CONCLUSIONS Although the meta-analysis did not show a positive effect in general, the higher dose of adjunctive IN-OT (80 IU/day) appears to be efficacious and safe in improving total psychopathology and positive symptoms in schizophrenia. REVIEW REGISTRATION CRD42017080856.
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17
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Xu L, Becker B, Kendrick KM. Oxytocin Facilitates Social Learning by Promoting Conformity to Trusted Individuals. Front Neurosci 2019; 13:56. [PMID: 30787864 PMCID: PMC6372972 DOI: 10.3389/fnins.2019.00056] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 01/21/2019] [Indexed: 11/20/2022] Open
Abstract
There is considerable interest in the role of the neuropeptide oxytocin in promoting social cohesion both in terms of promoting specific social bonds and also more generally for increasing our willingness to trust others and/or to conform to their opinions. These latter findings may also be important in the context of a modulatory role for oxytocin in improving the efficacy of behavioral therapy in psychiatric disorders. However, the original landmark studies claiming an important role for oxytocin in enhancing trust in others, primarily using economic game strategies, have been questioned by subsequent meta-analytic approaches or failure to reproduce findings in different contexts. On the other hand, a growing number of studies have consistently reported that oxytocin promotes conformity to the views of groups of in-group individuals. Most recently we have found that oxytocin can increase acceptance of social advice given by individual experts without influencing their perceived trustworthiness per se, but that increased conformity in this context is associated with how much an expert is initially trusted and liked. Oxytocin can also enhance the impact of information given by experts by facilitating expectancy and placebo effects. Here we therefore propose that a key role for oxytocin is not in facilitating social trust per se but in conforming to, and learning from, trusted individuals who are either in-group members and/or perceived experts. The implications of this for social learning and use of oxytocin as an adjunct to behavioral therapy in psychiatric disorders are discussed. Interpersonal trust within social groups is of key importance for social interactions, bonds, cooperation and learning and trust between different groups can also help ensure a stable and peaceful co-existence as well as mutually beneficial co-operation and trade. Trust is generally considered to be critical for co-operation and reciprocity in social and economic interactions but importantly trust also involves risk of potential injury if misplaced or broken and we have a natural aversion to taking such risks (Hardin, 2002; Ostrom and Walker, 2003). Indeed, an important factor influencing our trust behavior is that we are strongly motivated to avoid others betraying our trust (Bohnet and Zeckhauser, 2004; Bohnet et al., 2008). Trust can potentially be influenced by our assessment of the level of risk that trusting others might have and also by increased sensitivity to physical and/or other cues for detecting trustworthiness. It is therefore of great importance to identify both behavioral and physiological factors which can act to enhance trust, particularly in situations where individuals have impaired trust and therefore find it hard to interact socially with others and learn from them and/or to benefit optimally from cognitive and behavioral therapeutic strategies.
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Affiliation(s)
| | | | - Keith M. Kendrick
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China
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18
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Grainger SA, Henry JD, Steinvik HR, Vanman EJ. Intranasal oxytocin does not alter initial perceptions of facial trustworthiness in younger or older adults. J Psychopharmacol 2019; 33:250-254. [PMID: 30326770 DOI: 10.1177/0269881118806303] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Oxytocin is a neuropeptide involved in a range of social processes, and prior research has shown that intranasal oxytocin (iOT) may enhance trusting behaviors. However, it is unclear whether iOT influences perceptions of whether a face is trustworthy. In addition, no studies in this literature have investigated whether the participant's age may play a moderating role in the effects of iOT on trust. AIMS We aimed to examine for the first time whether iOT influences perceptions of facial trustworthiness and eye-gaze patterns and, if so, whether age moderates these iOT effects. METHODS One hundred and eighteen participants took part in a randomized, double-blind, placebo-controlled, within-groups study. Participants made judgments about the perceived trustworthiness of a series of faces while their eye movements were monitored. RESULTS Younger and older adults differed in their judgments of facial trustworthiness. However, most critically, iOT had no effect on these judgments for either age group. For the eye-tracking data, prior age effects in attending to the stimuli were replicated, with older adults gazing less at the eye region and more at the mouth region relative to younger adults. However, iOT had no effect on eye gaze. CONCLUSIONS These findings are discussed in relation to the growing body of literature that suggests that the effect of iOT on social processing is complex and may not be as robust as first thought.
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Fulford D, Treadway M, Woolley J. Social motivation in schizophrenia: The impact of oxytocin on vigor in the context of social and nonsocial reinforcement. JOURNAL OF ABNORMAL PSYCHOLOGY 2019; 127:116-128. [PMID: 29369669 DOI: 10.1037/abn0000320] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Experiential negative symptoms-including diminished motivation-have a profound impact on functional outcomes in schizophrenia. Animal research suggests that abnormalities in dopaminergic regulation can negatively impact effort exertion, a translational model that has been applied to individuals with schizophrenia. Paradigms that assess effort-based decision making, for example, suggest less likelihood of choosing high effort tasks that are high in probability of success, and this preference varies with negative symptoms and impaired functioning. Although asociality is another well-documented component of experiential negative symptoms, it is unclear whether diminished motivation for monetary reward extends to the social domain. To test this question, the authors designed the Social Vigor Task (SVT)-a measure of effort exertion in the context of live social encouragement. They further examined the effect of oxytocin, a neuropeptide implicated in social behavior, on vigor. Forty-two individuals with schizophrenia and 43 healthy controls completed the SVT twice: once after intranasal administration of saline placebo and again after oxytocin. Both groups showed similar increases in vigor in response to social encouragement, suggesting effort in the social context is spared in schizophrenia. Group differences in the effect of social encouragement on vigor varied by point-based reward rate and trial length. Oxytocin did not increase vigor during social encouragement in either group. Within the schizophrenia group, clinician-rated passive social withdrawal, but not active social avoidance, was negatively associated with vigor. Results suggest that people with schizophrenia show normative levels of effort in the context of social encouragement; low approach motivation, however, relates to lower effort. (PsycINFO Database Record
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Affiliation(s)
- Daniel Fulford
- Departments of Occupational Therapy and Psychological & Brain Sciences, Boston University
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20
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Oxytocin effects in schizophrenia: Reconciling mixed findings and moving forward. Neurosci Biobehav Rev 2017; 80:36-56. [PMID: 28506922 DOI: 10.1016/j.neubiorev.2017.05.007] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 05/06/2017] [Accepted: 05/09/2017] [Indexed: 12/22/2022]
Abstract
Schizophrenia is a severe mental illness that causes major functional impairment. Current pharmacologic treatments are inadequate, particularly for addressing negative and cognitive symptoms of the disorder. Oxytocin, a neuropeptide known to moderate social behaviors, has been investigated as a potential therapeutic for schizophrenia in recent years. Results have been decidedly mixed, leading to controversy regarding oxytocin's utility. In this review, we outline several considerations for interpreting the extant literature and propose a focused agenda for future work that builds on the most compelling findings regarding oxytocin effects in schizophrenia to date. Specifically, we examine underlying causes of heterogeneity in randomized clinical trials (RCTs) conducted thus far and highlight the complexity of the human oxytocin system. We then review evidence of oxytocin's effects on specific deficits in schizophrenia, arguing for further study using objective, precise outcome measures in order to determine whether oxytocin has the potential to improve functional impairment in schizophrenia.
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21
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Schlosser DA, Campellone TR, Biagianti B, Delucchi KL, Gard DE, Fulford D, Stuart BK, Fisher M, Loewy RL, Vinogradov S. Modeling the role of negative symptoms in determining social functioning in individuals at clinical high risk of psychosis. Schizophr Res 2015; 169:204-208. [PMID: 26530628 PMCID: PMC4681660 DOI: 10.1016/j.schres.2015.10.036] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 10/23/2015] [Accepted: 10/24/2015] [Indexed: 12/12/2022]
Abstract
A priority for improving outcome in individuals at clinical high risk (CHR) is enhancing our understanding of predictors of psychosis as well as psychosocial functioning. Social functioning, in particular, is a unique indicator of risk as well as an important outcome in itself. Negative symptoms are a significant determinant of social functioning in CHR individuals; yet, it is unclear which specific negative symptoms drive functional outcome and how these symptoms function relative to other predictors, such as neurocognition and mood/anxiety symptoms. In a sample of 85 CHR individuals, we examined whether a two-factor negative symptom structure that is found in schizophrenia (experiential vs expressive symptoms) would be replicated in a CHR sample; and tested the degree to which specific negative symptoms predict social functioning, relative to neurocognition and mood/anxiety symptoms, which are known to predict functioning. The two-factor negative symptom solution was replicated in this CHR sample. Negative symptom severity was found to be uniquely predictive of social functioning, above and beyond depression/anxiety and neurocognition. Experiential symptoms were more strongly associated with social functioning, relative to expression symptoms. In addition, experiential symptoms mediated the relationship between expressive negative symptoms and social functioning. These results suggest that experiences of motivational impairment are more important in determining social functioning, relative to affective flattening and alogia, in CHR individuals, thereby informing the development of more precise therapeutic targets. Developing novel interventions that stimulate goal-directed behavior and reinforce rewarding experiences in social contexts are recommended.
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Affiliation(s)
| | | | | | | | | | | | | | - Melissa Fisher
- University of California at San Francisco,San Francisco Veterans Affairs Medical Center
| | | | - Sophia Vinogradov
- University of California at San Francisco,San Francisco Veterans Affairs Medical Center
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