The influence of oxytocin on volitional and emotional ambivalence

Oxytocin, but not vasopressin, decreases willingness to harm others by promoting moral emotions of guilt and shame

Prosocial and moral behaviors have overlapping neural systems and can both be affected in a number of psychiatric disorders, although whether they involve similar neurochemical systems is unclear. In the current registered randomized placebo-controlled trial on 180 adult male and female subjects, we investigated the effects of intranasal administration of oxytocin and vasopressin, which play key roles in influencing social behavior, on moral emotion ratings for situations involving harming others and on judgments of moral dilemmas where others are harmed for a greater good. Oxytocin, but not vasopressin, enhanced feelings of guilt and shame for intentional but not accidental harm and reduced endorsement of intentionally harming others to achieve a greater good. Neither peptide influenced arousal ratings for the scenarios. Effects of oxytocin on guilt and shame were strongest in individuals scoring lower on the personal distress subscale of trait empathy. Overall, findings demonstrate for the first time that oxytocin, but not vasopressin, promotes enhanced feelings of guilt and shame and unwillingness to harm others irrespective of the consequences. This may reflect associations between oxytocin and empathy and vasopressin with aggression and suggests that oxytocin may have greater therapeutic potential for disorders with atypical social and moral behavior.

Would you? Effects of oxytocin on moral choices in forensic psychopathic patients

Psychopaths are suggested to be more likely to favor utilitarian outcomes over non-utilitarian (i.e., deontological) choices. Here we re-test this hypothesis and investigate whether oxytocin, a hormone associated with empathy, can counter this utilitarian effect. Forensic psychopathic patients and non-psychopathic controls participated in a sacrificial moral decision-making paradigm. Psychopathic patients performed the task in a double-blind cross-over placebo-controlled oxytocin administration paradigm. We found no evidence for psychopathic patients to act more utilitarian (or sacrificial) or any effect of oxytocin administration. Psychopathic traits within the control group, particularly traits associated with lack of empathy and failure to consider consequences, were however associated with more utilitarian choices, but only when these actions were low in emotion. In contrast, psychopathy severity in psychopathic patients, particularly impulsivity-related traits, predicts deontological choices, but only in highly emotional actions. Thus, although psychopathic traits do predict utilitarianism when emotional investment is low, this is not the case in full-blown psychopathy. Instead, there is a link between impulsivity and deontological choices in psychopathic patients, but only when emotional investment is high, and self-interest is not at stake. These preliminary results are discussed to whether utilitarian outcomes align with the personal goals of psychopathic individuals.

Intranasal oxytocin as a treatment for anxiety and autism: From subclinical to clinical applications

Animal and human studies have demonstrated that intranasal oxytocin (OT) can penetrate the brain and induce cognitive, emotional, and behavioral changes, particularly in social functioning. Consequently, numerous investigations have explored the potential of OT as a treatment for anxiety and autism, conditions characterized by social deficits. Although both subclinical and clinical studies provide converging evidence of the therapeutic effects of OT in reducing anxiety levels and improving social symptoms in autism, results are not always consistent. Additionally, the pharmacological mechanism of OT requires further elucidation for its effective clinical application. Therefore, this review aims to examine the contentious findings concerning the effects of OT on anxiety and autism, offer interpretations of the inconsistent results from the perspectives of individual differences and varying approaches to OT administration, and shed light on the underlying mechanisms of OT. Ultimately, standardization of dosage, frequency of administration, formulation characteristics, and nasal spray devices is proposed as essential for future human studies and clinical applications of OT treatment.

Neural mechanisms of different types of envy: a meta-analysis of activation likelihood estimation methods for brain imaging

Previous studies have a lack of meta-analytic studies comparing the trait (personality) envy, social comparison envy, and love-envy, and the understanding of the similarities and differences in the neural mechanisms behind them is relatively unclear. A meta-analysis of activation likelihood estimates was conducted using 13 functional magnetic resonance imaging studies. Studies first used single meta-analyses to identify brain activation areas for the three envy types. Further, joint and comparative analyses were followed to assess the common and unique neural activities among the three envy types. A single meta-analysis showed that the critical brain regions activated by trait (personality) envy included the inferior frontal gyrus, cingulate gyrus, middle frontal gyrus, lentiform nucleus and so on. The critical brain regions activated by social comparison envy included the middle frontal gyrus, inferior frontal gyrus, medial frontal gyrus, precuneus and so on. The critical brain regions activated by love-envy included the inferior frontal gyrus, superior frontal gyrus, cingulate gyrus, insula and so on. In terms of the mechanisms that generate the three types of envy, each of them is unique when it comes to the perception of stimuli in a context; in terms of the emotion regulation mechanisms of envy, the three types of envy share very similar neural mechanisms. Both their generation and regulation mechanisms are largely consistent with the cognitive control model of emotion regulation. The results of the joint analysis showed that the brain areas co-activated by trait (personality) envy and social comparison envy were frontal sub-Gyral, inferior parietal lobule, inferior frontal gyrus, precuneus and so on; the brain areas co-activated by trait (personality) envy and love-envy were extra-nuclear lobule, lentiform nucleus, paracentral lobule, cingulate gyrus and so on; the brain regions that are co-activated by social comparison envy and love-envy are anterior cingulate gyrus, insula, supramarginal gyrus, inferior frontal gyrus and so on. The results of the comparative analysis showed no activation clusters in the comparisons of the three types of envy.

Enhanced endogenous oxytocin signaling in the brain modulates neural responses to social misalignment and promotes conformity in humans: A multi-locus genetic profile approach

The neuropeptide oxytocin (OT) is known to promote social conformity. However, the specific neurocognitive mechanisms underlying OT-induced conformity remain unclear. We aimed to address this gap by examining how genetic variation in the oxytocin receptor gene (OXTR) is linked with behavioral conformity and its underlying neural systems. Specifically, we utilized the genotype-tissue expression database (GTEx) to create a novel multi-locus genetic profile score (MPS) that reflects the level of OXTR expression in the human brain. A total of 194 participants (Neuroimaging N = 50, Behavioral N = 144) performed a novel conformity task in which they viewed a series of word pairs depicting various moral values and virtues widely recognized in the United States. In each trial, participants indicated the relative importance of these words and subsequently learned about the majority opinion. Participants later rated the same word pairs a second time. Changes in participants' ratings between the first and second sessions were measured and analyzed with respect to social feedback, blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) signals, and OXTR MPS. We found that participants adjusted their ratings in accordance with the majority opinions. Social misalignment between self and others activated brain areas such as the striatum and the posterior medial frontal cortex (pMFC). However, unlike most findings from previous studies, activation in the pMFC during the inconsistent social feedback negatively, rather than positively, predicted behavioral conformity. Notably, those with higher OXTR MPS had reduced pMFC activation in the face of social misalignment, which led to greater conformity. Our findings suggest that OT may promote conformity by dampening the conflict-related signals in the pMFC. They also show that OXTR MPS may be useful for studying the effect of genes on highly complex human social traits, such as conformity.

Moral judgment and hormones: A systematic literature review

This systematic review of the literature aims to evaluate possible associations between moral judgment and hormones. The electronic databases PsycINFO, PubMed, Scielo, Web of Science, Scopus, and LILACS were used. Twenty studies with different methodological designs were reviewed, covering the hormones cortisol, oxytocin, and testosterone, assessing aspects related to polymorphisms in receptor genes, endogenous levels, and exogenous administration. Taken together, the reviewed studies showed a trend towards an association between hormones and moral judgment, with important specificities involving biological, environmental, and individual aspects. Endogenous levels of cortisol, released under stress, showed negative associations with altruistic and utilitarian decisions only in highly emotionally charged dilemmas. Oxytocin receptor gene polymorphisms (rs2268498, rs237889, and rs2254298) and acute administration of this hormone were associated with variability in moral judgment, with sex as an important moderating variable. Testosterone studies have tended to show a positive association with utilitarian moral judgments, particularly in female and in individuals with low prenatal exposure to this hormone. Knowing how hormones influence moral judgment may help expand our understanding of the plurality of human behavior. However, this area of research is new and still little explored, which does not allow for conclusions with a high level of evidence. Subsequent research will benefit from methodological improvements to extend current findings.

Medication-Enhanced Psychotherapy for Posttraumatic Stress Disorder: Recent Findings on Oxytocin's Involvement in the Neurobiology and Treatment of Posttraumatic Stress Disorder

Background

Traumatic experiences may result in Posttraumatic Stress Disorder (PTSD), which is characterized as an exaggerated fear response that cannot be extinguished over time or in safe environments. What are beneficial psychotherapeutic treatment options for PTSD patients? Can oxytocin (OXT), which is involved in the stress response, and safety learning, ameliorate PTSD symptomatology and enhance psychotherapeutic effects? Here, we will review recent studies regarding OXT's potential to enhance psychotherapeutic therapies for PTSD treatment.

Method

We conducted a literature review on the neurobiological underpinnings of PTSD especially focusing on OXT's involvement in the biology and memory formation of PTSD. Furthermore, we researched successful psychotherapeutic treatments for PTSD patients and discuss how OXT may facilitate observed psychotherapeutic effects.

Results

For a relevant proportion of PTSD patients, existing psychotherapies are not beneficial. OXT may be a promising candidate to enhance psychotherapeutic effects, because it dampens responses to stressful events and allows for a faster recovery after stress. On a neural basis, OXT modulates processes that are involved in stress, arousal and memory. OXT effectively counteracts memory impairments caused by stress and facilitates social support seeking which is a key resilience factor for PTSD and which is beneficial in psychotherapeutic settings.

Conclusion

OXT has many characteristics that are promising to positively influence psychotherapy for PTSD patients. It potentially reduces intrusions, but preserves memory of the event itself. Introducing OXT into psychotherapeutic settings may result in better treatment outcomes for PTSD patients. Future research should directly investigate OXT's effects on PTSD, especially in psychotherapeutic settings.

Oxytocin Receptor Gene DNA Methylation: A Biomarker of Treatment Response in Obsessive-Compulsive Disorder?

INTRODUCTION

Obsessive-compulsive disorder (OCD) is associated with high chronicity and treatment resistance, indicating the need for early therapy response markers enabling fast and personalized treatment adaptations. Although epigenetic mechanisms such as DNA methylation of the oxytocin receptor (OXTR) gene have previously been linked to OCD pathogenesis, epigenetic markers as predictors of treatment success have not yet been investigated in OCD.

OBJECTIVE

For the first time, this therapyepigenetic study aimed to investigate the role of OXTR methylation as a treatment response marker in OCD.

METHODS

In total, 113 inpatients with OCD (57 females) were compared to 113 age- and sex-matched healthy controls. Patients were investigated over a 10-week course of standardized, OCD-specific cognitive-behavioral psychotherapy. Clinical response was measured using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) at baseline, before in vivo exposure, and after therapy. OXTR exon III methylation was analyzed via direct sequencing of sodium bisulfite-treated DNA extracted from blood cells.

RESULTS

Relative OXTR hypermethylation was observed in OCD patients compared to healthy controls. In OCD, higher baseline OXTR methylation was found to predict impaired treatment response at both categorical (responders vs. nonresponders) and dimensional (relative Y-BOCS reduction) levels, whereas lower baseline methylation was related to treatment response and greater symptom improvements. Analysis of Y-BOCS subdimensions revealed that the association between OXTR hypermethylation with impaired treatment response applied especially to symptoms related to obsessions, but not compulsions.

CONCLUSIONS

OXTR hypermethylation may constitute a predictive marker of impaired treatment response in OCD and thus carries great potential for future personalized treatment efforts in OCD.

I only have eyes for you: Oxytocin administration supports romantic attachment formation through diminished interest in close others and strangers

Animal studies confirm oxytocin's (OT) role in regulating monogamous sexual behavior in pair-bonding rodents; and human studies are beginning to translate how this highly conserved neuropeptide is implicated in romantic attachment formation. A number of studies have shown how OT promotes relationship exclusivity by diminishing interest in strangers and increasing reward response to partners. Less clear is whether these effects are modulated by romantic duration or life history factors, or if OT's social distancing effects generalize beyond strangers to close relationships. We report the results of a double-blind, placebo-controlled crossover study on the effects of a single dose of intranasal OT (24 IU) on forty-four young adults (91% female) in different stages of romantic attachment formation (M duration=21 months). Participants completed a screening survey and two lab visits separated by 4-weeks, including a diagrammatic measure of attachment to parents and peers, attitudes related to sexual conservatism and partner infidelity, ratings scales of closeness to romantic partners, and visual attractiveness ratings of strangers. Individual differences were examined by life history factors, including maternal love withdrawal and parental separation. Results indicated that OT administration decreased attachment to mothers, decreased attachment to subsidiary attachment figures, and decreased attraction to strangers. In all cases, emotional distancing was stronger among participants in newer romantic relationships. OT increased arousal to partner infidelity and increased sexual conservatism among participants with negative life history experiences (parental separation and high love withdrawal), whereas the reverse was true for participants reporting a more positive life history. Findings suggest that OT supports exclusivity through social distancing from strangers and close others within a sensitive period of attachment formation. In addition, findings indicate OT plays a different role in mate retention strategies by life history.

Hunters and Gatherers of Pictures: Why Photography Has Become a Human Universal

Photography is ubiquitous worldwide. We analyzed why people take, share, and use personal photographs, independent of their specific cultural background. These behaviors are still poorly understood. Experimental research on them is scarce. Smartphone technology and social media have pushed the success of photography, but cannot explain it, as not all smartphone features are widely used just because they are available. We analyzed properties of human nature that have made taking and using photographs functional behaviors. We did this based on the four levels, which Nikolaas Tinbergen suggested for analyzing why animals behave in a particular way. Including findings from multiple disciplines, we developed a novel conceptual framework-the "Mental Utilization Hypothesis of Photography." It suggests that people adopt photography because it matches with core human mental mechanisms mainly from the social domain, and people use photography as a cognitive, primarily social coping strategy. Our framework comprises a range of testable predictions, provides a new theoretical basis for future empirical investigations into photography, and has practical implications. We conclude that photography has become a human universal, which is based on context-sensitive mental predispositions and differentiates itself in the social and societal environment.

Intranasal oxytocin may help maintain romantic bonds by decreasing jealousy evoked by either imagined or real partner infidelity

BACKGROUND

While romantic jealousy may help to maintain relationships, following partner infidelity and an irretrievable loss of trust it can also promote break-ups. The neuropeptide oxytocin can enhance the maintenance of social bonds and reduce couple conflict, although its influence on jealousy evoked by imagined or real infidelity is unclear.

AIMS

This study aimed to investigate the effects of intranasal oxytocin (24 IU) on romantic jealousy in both males and females in imagined and real contexts.

METHODS

Seventy heterosexual couples participated in this double-blind, placebo-controlled, between-subject design study. Jealousy was firstly quantified in the context of subjects imagining partner infidelity and secondly in a Cyberball game where their partner interacted preferentially with an opposite-sexed rival stranger to simulate partner exclusion, or rejected a neutral stranger but not the partner.

RESULTS

Oxytocin primarily decreased jealousy and arousal ratings towards imagined emotional and sexual infidelity by a partner in both sexes. During the Cyberball game, while male and female subjects in both groups subsequently threw the ball least often to the rival stranger, under oxytocin they showed reduced romantic jealousy and arousal ratings for stranger players, particularly the rival one, and reported reduced negative and increased positive feelings while playing the game.

CONCLUSIONS

Together, our results suggest that oxytocin can reduce the negative emotional impact of jealousy in established romantic partners evoked by imagined or real infidelity or exclusive social interactions with others. This provides further support for oxytocin promoting maintenance of relationships.

Neural and Molecular Contributions to Pathological Jealousy and a Potential Therapeutic Role for Intranasal Oxytocin

Romantic jealousy, especially in its pathological form, is a significant contributor to both domestic abuse, including partner sexual coercion and even murder, although relatively little research has been conducted on it. Both obsessive and delusional forms have been identified although only the latter is currently recognized as a pathological disorder. Studies in both clinical and healthy populations have identified altered fronto-striatal responsivity as being associated primarily with romantic jealousy and to date drug based treatments have targeted both dopaminergic and serotonergic systems. However, there is increasing interest in a potential role for the neuropeptide oxytocin, which can also modulate dopaminergic and serotonin systems in the brain and has been shown to altered in other psychotic conditions, such as schizophrenia and obsessive compulsive disorder. Recent studies in healthy populations have reported that when oxytocin is administered intranasally it can influence the brain to promote strengthening of romantic bonds and reduce romantic jealousy in both men and women evoked in either imagined or real contexts. These findings indicate a possible therapeutic use of intranasal oxytocin administration in pathological jealousy.

The role of oxytocin in delay of gratification and flexibility in non-social decision making

Oxytocin is well-known for its impact on social cognition. This specificity for the social domain, however, has been challenged by findings suggesting a domain-general allostatic function for oxytocin by promoting future-oriented and flexible behavior. In this pre-registered study, we tested the hypothesized domain-general function of oxytocin by assessing the impact of intranasal oxytocin (24 IU) on core aspects of human social (inequity aversion) and non-social decision making (delay of gratification and cognitive flexibility) in 49 healthy volunteers (within-subject design). In intertemporal choice, patience was higher under oxytocin than under placebo, although this difference was evident only when restricting the analysis to the first experimental session (between-group comparison) due to carry-over effects. Further, oxytocin increased cognitive flexibility in reversal learning as well as generosity under conditions of advantageous but not disadvantageous inequity. Our findings show that oxytocin affects both social and non-social decision making, supporting theoretical accounts of domain-general functions of oxytocin.

Oxytocin-induced facilitation of learning in a probabilistic task is associated with reduced feedback- and error-related negativity potentials

BACKGROUND

Feedback evaluation of actions and error response detection are critical for optimizing behavioral adaptation. Oxytocin can facilitate learning following social feedback but whether its effects vary as a function of feedback valence remains unclear.

AIMS

The present study aimed to investigate whether oxytocin would influence responses to positive and negative feedback differentially or equivalently.

METHODS

The present study employed a randomized, double-blind, placebo controlled within-subject design to investigate whether intranasal oxytocin (24 IU) influenced behavioral and evoked electrophysiological potential responses to positive or negative feedback in a probabilistic learning task.

RESULTS

Results showed that oxytocin facilitated learning and this effect was maintained in the absence of feedback. Using novel stimulus pairings, we found that oxytocin abolished bias towards learning more from negative feedback under placebo by increasing accuracy for positively reinforced stimuli. Oxytocin also decreased the feedback-related negativity difference (negative minus positive feedback) during learning, further suggesting that it rendered the evaluation of positive and negative feedback more equivalent. Additionally, post-learning oxytocin attenuated error-related negativity amplitudes but increased the late error positivity, suggesting that it may lower conflict detection between actual errors and expected correct responses at an early stage of processing but at a later stage increase error awareness and motivation for avoiding them.

CONCLUSIONS

Oxytocin facilitates learning and subsequent performance by rendering the impact of positive relative to negative feedback more equivalent and also by reducing conflict detection and increasing error awareness, which may be beneficial for behavioral adaption.

Bittersweet: The Neuroscience of Ambivalent Affect

Ambivalent affective states, such as bittersweetness, nostalgia, and longing, which are felt as having both positive and negative aspects, are an important component of human experience but have received little attention. The most influential theoretical frameworks in affective neuroscience focus largely on univalenced states. As a result, it is not known whether ambivalent affect corresponds to a simultaneously positive and negative valenced state or whether it results from a rapid vacillation between positive and negative states. Here we hypothesize that ambivalent affect involves both mechanisms, that is, rapid vacillation and simultaneity of positive and negative affect, albeit at different neurobiological levels. Rapidly vacillating univalent emotions could give rise to an ambivalent feeling, a mechanism that depends on brainstem nuclei that facilitate rapid action programs of emotional behavior while inhibiting opposing behaviors. This reciprocal inhibition prevents organisms from simultaneously implementing responses to conflicting emotions but also allows for rapid switching between emotions triggered by counterfactual thinking and rapid reappraisal of situations. We propose that as these transitions occur and respective interoceptive information reaches the insular cortex, further processing of this "emotional moment" would allow separate emotional events to be experienced as one "mixed" and integrated feeling.

Oxytocin amplifies the influence of good intentions on social judgments

Studies have shown that the evolutionarily conserved neuropeptide oxytocin (OT) promotes various prosocial behaviors, yet there are few studies of the effect of OT on social judgments, especially on judgments when the actor's intention and the final outcome are incongruent. In a double-blind, placebo-controlled experiment, participants were asked to play the role of the recipient in a dictator game and to make social judgments about the dictator after intranasal OT administration. To isolate the outcome and the intention of the dictator's allocation, we developed a novel social judgment task in which recipients were told that 50% of the dictators' proposals would be reversed. The results showed that the effect of OT on social judgment was modulated by intention: OT increased goodness ratings only towards dictators with hyperfair intention. Our findings support the affiliative-motivation theory which states that OT enhances the affiliative motivation and recognition of positive-valence social stimuli.

Oxytocin improves probabilistic reversal learning but not effortful motivation in Brown Norway rats

Deficits in cognition and motivation are common and debilitating aspects of psychiatric disorders, yet still go largely untreated. The neuropeptide oxytocin (OT) is a potential novel therapeutic for deficits in social cognition and motivation in psychiatric patients. However, the effects of OT on clinically relevant domains of non-social cognition and motivation remain under studied. The present study investigated the effects of acute and chronic (21-day) administration of subcutaneous OT (0.04, 0.2, and 1 mg/kg) in cross-species translatable operant paradigms of reward learning and effortful motivation in male and female Brown Norway (BN) rats (n = 8-10/group). Reward learning was assessed using the probabilistic reversal learning task (PRLT) and effortful motivation was measured using the progressive ratio breakpoint task (PRBT). As predicted, BN rats exhibited baseline deficits in the detection of reversals of reward contingency in the PRLT relative to Long Evans (LE) rats. The two strains performed equally in the PRBT. Thirty minutes after a single OT injection (1 mg/kg), measures of both initial probabilistic learning (trials to first criterion) and subsequent reversal learning (contingency switches) were significantly improved to levels comparable with LE rats. The OT effect on switches persisted in male, but not female, BN rats 30 min, 24 h, and 6 days after long-term OT administration, suggesting the induction of neuroplastic changes. OT did not affect effortful motivation at any time-point. The beneficial effects of OT on reward learning in the absence of increased effortful motivation support the development of OT as a novel therapeutic to improve cognitive functioning.

Oxytocin reduces a chemosensory-induced stress bias in social perception

Social transmission of fear is not restricted to visual or auditory cues, but extends to the phylogenetically more ancient olfactory domain. Anxious individuals exhibit heightened sensitivity towards chemosensory stress signals in sweat; however, it is still unknown whether endogenous neuromodulators such as the peptide hormone oxytocin (OXT) influence the chemosensory communication of stress. Here, we investigated whether OXT selectively diminishes behavioral and neural responses to social chemosensory stress cues utilizing a randomized, double-blind, placebo (PLC)-controlled, within-subject functional MRI study design. Axillary sweat was obtained from 30 healthy male donors undergoing the Trier Social Stress Test (stress) and bicycle ergometer training (sport). Subsequently, 58 healthy participants (30 females) completed a forced-choice emotional face recognition task with stimuli of varying intensities (neutral to fearful) while they were exposed to both sweat stimuli and a non-social control odor following intranasal OXT or PLC administration, respectively. OXT diminished stress-induced recognition accuracy and response time biases towards fear. On the neural level, OXT reduced stress-evoked responses in the amygdala in both sexes, the anterior cingulate cortex (ACC) in females, and the hippocampus in males. Furthermore, OXT reinstated the functional connectivity between the ACC and the fusiform face area that was disrupted by stress odors under PLC. Our findings reveal a new role for OXT signaling in the modulation of chemosensory communication of stress in humans. Mechanistically, this effect appears to be rooted in a downregulation of stress-induced limbic activations and concomitant strengthening of top-down control descending from the ACC to the fusiform face area.

Longitudinal changes in the mismatch field evoked by an empathic voice reflect changes in the empathy quotient in autism spectrum disorder

Autism spectrum disorders (ASDs) are neurodevelopmental conditions with impairments in social communication and interaction. Empathy is the ability to understand and share another person's inner life, and it is an essential process in social cognition, which is deficient in ASD. The mismatch field (MMF) has been used as a neurophysiological marker for the automatic detection of changes in auditory stimuli. In the present study, we focused on long-term changes in MMF evoked by an empathic voice and changes in the empathy quotient (EQ) in ASD during an 8-week clinical trial using oxytocin (OT). Ten males with ASD without intellectual disability participated in this pilot study. The results demonstrated a significant positive correlation between the change in the MMF amplitude in the auditory cortex (i.e., right banks of the superior sulcus) and the change in the EQ score during the 8-week clinical trial, whereas no significant change was observed in the MMF amplitude or EQ score after the administration period of OT. Although we cannot conclude that the observed relationships were caused by OT's effect or by natural changes, our results suggest that MMF evoked by social voice can be a state-dependent marker of empathic abilities in male adults with ASD.

Oxytocin increases eye-gaze towards novel social and non-social stimuli

Research on oxytocin (OT) has revealed a substantial involvement of this neuropeptide in social cognition processes and attachment behavior. The rationale of the present project was to decipher the differential role of OT in basic social cognition processes towards non-erotic attachment stimuli vs. reproduction-related stimuli in human subjects. In a randomized double-blind repeated-measures cross-over design, N = 82 participants were investigated twice and received either intranasal OT or placebo at the first assessment followed by placebo or OT at second assessment. Participants were presented with standardized pictures of parent-child dyads, romantic couples engaging in non-erotic or explicit sexual activities, and non-social pictures while we assessed pupil dilation and eye focus on specific pre-defined areas of interest. Multilevel analyses suggest that during the initial presentation, OT increased pupil dilation towards all categories of stimuli and led the eye focus towards the eyes and body regions, followed by a strong decrease in pupil dilation and fixations at the second session. These carry-over effects indicate that hormonal treatment at an initial contact to social stimuli can determine how these stimuli are processed later. These results might have implications for OT as a treatment in interventions with repeated exposure to social material.

Oxytocin and brain activity in humans: A systematic review and coordinate-based meta-analysis of functional MRI studies

Oxytocin (OXT) is a neuropeptide which has a critical role in human social behaviour and cognition. Research investigating the role of OXT on functional brain changes in humans has often used task paradigms that probe socioemotional processes. Preliminary evidence suggests a central role of the amygdala in the social cognitive effects of intranasal OXT (IN-OXT), however, inconsistencies in task-design and analysis methods have led to inconclusive findings regarding a cohesive model of the neural mechanisms underlying OXT's actions. The aim of this meta-analysis was to systematically investigate these findings. A systematic search of PubMed, PsycINFO, and Scopus databases was conducted for fMRI studies which compared IN-OXT to placebo in humans. First, we systematically reviewed functional magnetic resonance imaging (fMRI) studies of IN-OXT, including studies of healthy humans, those with clinical disorders, and studies examining resting-state fMRI (rsfMRI). Second, we employed a coordinate-based meta-analysis for task-based neuroimaging literature using activation likelihood estimation (ALE), whereby, coordinates were extracted from clusters with significant differences in IN-OXT versus placebo in healthy adults. Data were included for 39 fMRI studies that reported a total of 374 distinct foci. The meta-analysis identified task-related IN-OXT increases in activity within a cluster of the left superior temporal gyrus during tasks of emotion processing. These findings are important as they implicate regions beyond the amygdala in the neural effects of IN-OXT. The outcomes from this meta-analysis can guide a priori predictions for future OXT research, and provide an avenue for targeted treatment interventions.

Oxytocin shapes the priorities and neural representations of attitudes and values

The phylogenetically ancient neuropeptide oxytocin has been linked to a plethora of social behaviors. Here, we argue that the action of oxytocin is not restricted to the downstream level of emotional responses, but substantially alters higher representations of attitudes and values by exerting a distant modulatory influence on cortical areas and their reciprocal interplay with subcortical regions and hormonal systems.

Exogenous testosterone decreases men's personal distance in a social threat context

BACKGROUND

Testosterone can motivate human approach and avoidance behavior. Specifically, the conscious recognition of and implicit reaction to angry facial expressions is influenced by testosterone. The study tested whether exogenous testosterone modulates the personal distance (PD) humans prefer in a social threat context.

METHODS

82 healthy male participants underwent either transdermal testosterone (testosterone group) or placebo application (placebo group). Each participant performed a computerized stop-distance task before (T1) and 3.5h after (T2) treatment, during which they indicated how closely they would approach a human, animal or virtual character with varying emotional expression.

RESULTS

Men's PD towards humans and animals varied as a function of their emotional expression. In the testosterone group, a pre-post comparison indicated that the administration of 50mg testosterone was associated with a small but significant reduction of men's PD towards aggressive individuals. Men in the placebo group did not change the initially chosen PD after placebo application independent of the condition. However comparing the testosterone and placebo group after testosterone administration did not reveal significant differences. While the behavioral effect was small and only observed as within-group effect it was repeatedly and selectively shown for men's PD choices towards an angry woman, angry man and angry dog in the testosterone group. In line with the literature, our findings in young men support the influential role of exogenous testosterone on male's approach behavior during social confrontations.

Oxytocin differentially alters resting state functional connectivity between amygdala subregions and emotional control networks: Inverse correlation with depressive traits

The hypothalamic neuropeptide oxytocin (OT) has received increasing attention for its role in modulating social-emotional processes across species. Previous studies on using intranasal-OT in humans point to a crucial engagement of the amygdala in the observed neuromodulatory effects of OT under task and rest conditions. However, the amygdala is not a single homogenous structure, but rather a set of structurally and functionally heterogeneous nuclei that show distinct patterns of connectivity with limbic and frontal emotion-processing regions. To determine potential differential effects of OT on functional connectivity of the amygdala subregions, 79 male participants underwent resting-state fMRI following randomized intranasal-OT or placebo administration. In line with previous studies OT increased the connectivity of the total amygdala with dorso-medial prefrontal regions engaged in emotion regulation. In addition, OT enhanced coupling of the total amygdala with cerebellar regions. Importantly, OT differentially altered the connectivity of amygdala subregions with distinct up-stream cortical nodes, particularly prefrontal/parietal, and cerebellar down-stream regions. OT-induced increased connectivity with cerebellar regions were largely driven by effects on the centromedial and basolateral subregions, whereas increased connectivity with prefrontal regions were largely mediated by right superficial and basolateral subregions. OT decreased connectivity of the centromedial subregions with core hubs of the emotional face processing network in temporal, occipital and parietal regions. Preliminary findings suggest that effects on the superficial amygdala-prefrontal pathway were inversely associated with levels of subclinical depression, possibly indicating that OT modulation may be blunted in the context of increased pathological load. Together, the present findings suggest a subregional-specific modulatory role of OT on amygdala-centered emotion processing networks in humans.

Oxytocin and Interpersonal Relationships

The neuropeptide oxytocin (OT) has emerged as a potent modulator of diverse aspects of interpersonal relationships. OT appears to work in close interaction with several other neurotransmitter networks, including the dopaminergic reward circuit, and to be dependent on sex-specific hormonal influences. In this chapter, we focus on four main domains of OT and interpersonal relationships, including (1) the protective effect of OT on an individual's ability to withstand stress (i.e., stress buffering), (2) the effect of OT on emotion recognition and empathy, (3) OT's ability to enhance social synchrony and cooperation among individuals, and (4) the effect of OT on an individual's perception of social touch. We then illustrate the connection between OT and loneliness while grieving the loss of a loved one. We finish by discussing the clinical potential of OT, focusing on its potential role as an adjunct to psychotherapy, its enhancement through sex-specific hormonal influences, and the difficulties that present themselves when considering OT as a therapy. Overall, we argue that OT continues to hold strong therapeutic promise, but that it is strongly dependent on internal and external influences, for instance the patient's personal past experiences and interaction with the therapist, in order to provide the best possible therapy.

Ambivalence: Prerequisite for success in motivational interviewing with adolescents?

BACKGROUND AND AIMS

The exploration and resolution of ambivalence play an essential role in motivational interviewing (MI) theory. However, most adolescent MI studies have not examined ambivalence as a contributor to behaviour change. This paper reviewed research findings on the role of ambivalence in the adolescent change process.

METHODS AND RESULTS

We undertook a narrative review of the published empirical and theoretical literature on ambivalence and mechanisms of change in MI for adolescents and found that current MI evaluations appear not to have access to reliable and valid measures of ambivalence in adolescence or neuroimaging methods to evaluate the mechanisms of treatment response.

CONCLUSIONS

Improved instrumentation is needed to assess adolescents' ambivalence in clinical and research settings. Innovative methodology, including neuroimaging, may help identify factors mediating relationships between adolescents' ambivalence and treatment response.

An Integrative Bio-Psycho-Social Theory of Anorexia Nervosa

The need for novel approaches to understanding and treating anorexia nervosa (AN) is well recognized. The aim of this paper is to describe an integrative bio-psycho-social theory of maintaining factors in AN. We took a triangulation approach to develop a clinically relevant theory with face validity and internal consistency. We developed theoretical ideas from our clinical practice and reviewed theoretical ideas within the eating disorders and wider bio-psycho-social literature. The synthesis of these ideas and concepts into a clinically meaningful framework is described here. We suggest eight key factors central to understanding the maintenance and treatment resistance of anorexia nervosa: genetic or experiential predisposing factors; dysfunctional feelings processing and regulation systems; excessive vulnerable feelings; 'feared self' beliefs; starvation as a maladaptive physiological feelings regulation mechanism; maladaptive psychological coping modes; maladaptive social behaviour; and unmet physical and psychological core needs. Each of these factors serves to maintain the disorder. The concept of universal physical and psychological core needs can provide an underpinning integrative framework for working with this distinctly physical and psychological disorder. This framework could be used within any treatment model. We suggest that treatments which help address the profound lack of trust, emotional security and self-acceptance in this patient group will in turn address unmet needs and improve well-being. Copyright © 2016 John Wiley & Sons, Ltd.

KEY PRACTITIONER MESSAGE

The concept of unmet physical and psychological needs can be used as an underlying integrative framework for understanding and working with this patient group, alongside any treatment model. A functional understanding of the neuro-biological, physiological and psychological mechanisms involved in anorexia nervosa can help patients reduce self-criticism and shame. Fears about being or becoming fat, greedy, needy, selfish and unacceptable ('Feared Self') drive over-compensatory self-depriving behaviour ('Anorexic Self'). Psychological treatment for anorexia nervosa should emphasize a focus on feelings and fostering experiences of acceptance and trust. Treatment for patients with anorexia nervosa needs to be longer than current clinical practice.

Clinical trial of modulatory effects of oxytocin treatment on higher-order social cognition in autism spectrum disorder: a randomized, placebo-controlled, double-blind and crossover trial

BACKGROUND

Autism spectrum disorders are neurodevelopmental conditions with severe impairments in social communication and interaction. Pioneering research suggests that oxytocin can improve motivation, cognition and attention to social cues in patients with autism spectrum disorder. The aim of this clinical trial is to characterize basic mechanisms of action of acute oxytocin treatment on neural levels and to relate these to changes in different levels of socio-affective and -cognitive functioning.

METHODS

This clinical study is a randomized, double-blind, cross-over, placebo-controlled, multicenter functional magnetic resonance imaging study with two arms. A sample of 102 male autism spectrum disorder patients, diagnosed with Infantile Autistic Disorder (F84.0 according to ICD-10), Asperger Syndrome (F84.5 according to ICD-10), or Atypical Autism (F84.1 according to ICD-10) will be recruited and will receive oxytocin and placebo nasal spray on two different days. Autism spectrum disorder patients will be randomized to determine who receives oxytocin on the first and who on the second visit. Healthy control participants will be recruited and case-control matched to the autism spectrum disorder patients. The primary outcome will be neural network activity, measured with functional magnetic resonance imaging while participants perform socio-affective and -cognitive tasks. Behavioral markers such as theory of mind accuracy ratings and response times will be assessed as secondary outcomes in addition to physiological measures such as skin conductance. Trait measures for alexithymia, interpersonal reactivity, and social anxiety will also be evaluated. Additionally, we will analyze the effect of oxytocin receptor gene variants and how these potentially influence the primary and secondary outcome measures. Functional magnetic resonance imaging assessments will take place at two time points which will be scheduled at least two weeks apart to ensure a sufficient wash-out time after oxytocin treatment. The study has been approved by an ethical review board and the competent authority.

DISCUSSION

Revealing the mechanisms of acute oxytocin administration, especially on the socio-affective and -cognitive domains at hand, will be a further step towards novel therapeutic interventions regarding autism.

TRIAL REGISTRATION

German Clinical Trial Register DRKS00010053 . The trial was registered on the 8^th of April 2016.

Dissecting the Role of Oxytocin in the Formation and Loss of Social Relationships

Current concepts of human sociality highlight a fundamental role of the hypothalamic peptide oxytocin (OXT) in the formation and maintenance of social relationships. However, emerging evidence indicates that OXT does not invariably facilitate social bonding but also produces nonprosocial effects that may have evolved to promote offspring survival. From a mechanistic perspective, we hypothesize that OXT modulates interoceptive signals and self-referential processing, which may result in various social outcomes depending on context- and person-dependent variables such as early-life adversity. Based on this theoretical framework, we discuss translational implications for clinical trials and identify open questions for future research. Specifically, we propose that disrupted OXT signaling due to the loss of affectionate bonds may contribute to emotional disequilibrium and confer elevated risk for the onset of stress-related disorders.

Hormonal contraceptives suppress oxytocin-induced brain reward responses to the partner's face

The hypothalamic peptide oxytocin (OXT) has been identified as a key modulator of pair-bonding in men, but its effects in women are still elusive. Moreover, there is substantial evidence that hormonal contraception (HC) influences partner preferences and sexual satisfaction, which constitute core domains of OXT function. We thus hypothesized that OXT effects on partner-related behavioral and neural responses could be significantly altered in women using HC. In this functional magnetic resonance imaging study involving 40 pair-bonded women, 21 of whom were using HC, we investigated whether a 24-IU nasal dose of OXT would modulate brain reward responses evoked by the romantic partner's face relative to the faces of familiar and unfamiliar people. Treatment with OXT increased the perceived attractiveness of the partner relative to other men, which was paralleled by elevated responses in reward-associated regions, including the nucleus accumbens. These effects of OXT were absent in women using HC. Our results confirm and extend previous findings in men that OXT interacts with the brain reward system to reinforce partner value representations, indicating a common OXT-dependent mechanism underlying partner attraction in both sexes. This mechanism may be disturbed in women using HC, suggesting that gonadal steroids could alter partner-specific OXT effects.