Modulation of interpersonal trust in borderline personality disorder by intranasal oxytocin and childhood trauma

Abstract

Borderline personality disorder (BPD) is characterized by interpersonal difficulties, whereby patients are negatively biased concerning the evaluation of others' trustworthiness. Here, we examined the effect of oxytocin on interpersonal behavior of BPD patients in a trust game, emphasizing the assessment of facial attractiveness of the patients' counterparts in the game, and patients' history of childhood trauma. Thirteen BPD patients and thirteen healthy controls played a trust game after receiving oxytocin or placebo in a randomized, double-blind crossover design. Childhood trauma was evaluated using the Childhood Trauma Questionnaire (CTQ). Patients transferred less money in the oxytocin condition compared to placebo. While healthy controls transferred more money units (MUs) to attractive counterparts than to unattractive ones only after the administration of oxytocin, BPD patients showed this pattern in both conditions. Emotional neglect during childhood negatively correlated with the amount of MUs transferred by patients under oxytocin, but not placebo. Oxytocin had a trust-lowering effect in BPD, which was correlated with patients' history of childhood trauma. Patients' evaluation of interpersonal trust seems to depend more on attractiveness features of their counterparts than in controls, a finding that may have important implications for further research on the usefulness of "prosocial" peptides as an adjunct to psychotherapeutic interventions.

Oxytocin conditions trait-based rule adherence

“…For example, Bartz et al (2011b) and Ebert et al (2013) found that the administration of intranasal oxytocin to participants with borderline personality disorder—characterized by emotional instability and impulsiveness—led to less trusting and cooperative behaviour (also see Simeon et al , 2011). Together with the present results, these findings may point to an inverted U-shape relationship between oxytocin and rigid rule following on the one hand, and extreme emotional stability and impulsiveness on the other.…”

Attachment, Neurobiology, and Mentalizing along the Psychosis Continuum

“…It is important to note however that more studies are needed to inform our understanding of the relationship between oxytocin levels and psychotic symptomatology, as well as on the effects of oxytocin on the development of trust in clinical samples. For example, current evidence on the therapeutic effects of oxytocin administration in the treatment of psychotic symptoms are mixed (Feifel et al, 2016; Lee et al, 2016) and although oxytocin administration is shown to facilitate trust and corporation in healthy samples, the opposite effect has been observed in some studies involving patients suffering from BPD (Bartz et al, 2011; Ebert et al, 2013). …”

Oxytocin and callous-unemotional traits: towards a social-cognitive approach to forensic analysis

“…These inter-individual differences may be a product of the social stimuli salience effect of oxytocin: as individuals with borderline personality disorder have increased incidences of insecure attachments and negative expectations from social interaction, increased salience to such stimuli may promote defensive behaviors and distress. Supporting evidence for this hypothesis includes findings that oxytocin may be most deleterious in individuals with borderline personality disorder who are anxiously attached (72) or reporting a history of emotional neglect in childhood (73).…”