Oxytocin and Reduction of Social Threat Hypersensitivity in Women With Borderline Personality Disorder

Bertsch, Katja; Gamer, Matthias; Schmidt, Brigitte; Schmidinger, Ilinca; Walther, Stephan; Kästel, Thorsten; Schnell, Knut; Büchel, Christian; Domes, Gregor; Herpertz, Sabine C.

doi:10.1176/appi.ajp.2013.13020263

Cited by 191 publications

(148 citation statements)

References 41 publications

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“…Bartz et al [68]] showing heterogeneous effects on trust as a function of attachment style challenge further research before considering oxytocin for treatment in BPD. Together with data indicating lower plasma oxytocin concentrations in BPD patients compared to healthy participants [67], these findings support the theory that the consequences of early maltreatment may at least be partially mediated by the oxytocin system.…”

Section: Neurochemistry Underlying Affective Dysregulation Impulsivisupporting

confidence: 81%

“…Consistent with this, early social-environment-induced changes in the oxytocin system were shown to be associated with the social phenotype implying that social functioning might be under epigenetic control probably via deoxyribonucleic acid DNA methylation of the oxytocin receptor [66]. Bertsch et al [67] recently provided first evidence that the intranasal application of oxytocin may decrease threat hypersensitivity in BPD patients. Using an eye-tracking methodology, BPD patients were shown to exhibit more and faster initial fixation changes to the eyes of angry faces, and this behavioral pattern was associated with increased posterior amygdala activation compared with the control group.…”

Section: Neurochemistry Underlying Affective Dysregulation Impulsivimentioning

confidence: 88%

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Social Dysfunctioning and Brain in Borderline Personality Disorder

Herpertz

Jeung²,

Mancke³

et al. 2014

Psychopathology

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Interpersonal dysfunction is the most prominent and best discriminating characteristic in individuals with borderline personality disorder (BPD). Data from experimental psychopathology point to emotional lability, (auto-)aggression, threat hypersensitivity, poor chance of interpersonal repair, frequent misunderstandings and self/other diffusion as the most significant factors which contribute to the interpersonal derailments typical of BPD. Neuroscientific methods are suitable to elucidate the mechanisms which mediate deficient social functioning in BPD, i.e. affective dysregulation, impulsivity/disinhibition and poor social cognition as well as their neurobiological correlates. Low prefrontoamygdalar coupling together with low activity in inhibiting prefrontal areas, high activity in the mirror neuron system, low activity in the mentalizing circuit, and low anterior insular activity in case of social norm violations are the most significant functional neuroimaging findings that have been reported from individuals with BPD, up to now. In addition, peculiarities of facial emotion processing have been detected by means of psychophysiological methodology in BPD patients. Data have led to preliminary models of social dysfunctioning in BPD that have to be experimentally tested in the future, evolving neuroscience into an important tool to better understand what distresses patients with BPD when communicating with others.

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Section: Neurochemistry Underlying Affective Dysregulation Impulsivisupporting

confidence: 81%

Section: Neurochemistry Underlying Affective Dysregulation Impulsivimentioning

confidence: 88%

Social Dysfunctioning and Brain in Borderline Personality Disorder

Herpertz

Jeung²,

Mancke³

et al. 2014

Psychopathology

Self Cite

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“…Oxytocin-induced increases in social cognitive ability correlate with increased pupil dilation, which is in turn coupled with increased locus caeruleus firing [87,88]. Moreover, oxytocin administration increases attention toward the eye region as measured by eye gaze or reaction time [89,90,91,92]. There is also evidence that oxytocin affects social cognition through modulation of amygdala activity and subcortical attention/orienting networks [93,94].…”

Section: Proposed Models For the Effects Of Exogenous Oxytocin On Menmentioning

confidence: 99%

“…Beyond the hypothesized optimal point, social cognition becomes distorted through excessive salience/attention towards social stimuli and attentional biases [78,89] resulting in overactive, poorly controlled and distorted mentalization termed hypermentalizing [100,101], and hence, oxytocin administration will have a negative effect. This second, interactionist model is similar to the inverted U-shaped model proposed by Fonagy et al [102] with regard to arousal/stress and mentalization but allows for a more precise delineation and testing of dose response curves after oxytocin administration within the context of different attachment styles.…”

Section: Proposed Models For the Effects Of Exogenous Oxytocin On Menmentioning

confidence: 99%

“…Although these models remain untested, the literature on intranasal oxytocin administration in BPD seems to support an interactionist model, with effects of oxytocin on social cognition ranging from positive to negative across studies [82,89,90,103,104]. The type of model subscribed to will also have implications for how a psychodynamic-based treatment is organized.…”

Section: Proposed Models For the Effects Of Exogenous Oxytocin On Menmentioning

confidence: 99%

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Personality Disorders, Attachment and Psychodynamic Psychotherapy

2014

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While attachment has been a fruitful and critical concept in understanding enduring individual templates for interpersonal relationships, it does not have a well-understood relationship to personality disorders, where impairment of interpersonal functioning is paramount. Despite the recognition that attachment disturbances do not simply reflect nonoptimal caretaking environments, the relationship of underlying temperamental factors to these environmental insults has not been fully explored. In this paper we provide an alternate model for the role of neurobiological temperamental factors, including brain circuitry and neuropeptide modulation, in mediating social cognition and the internalization and maintenance of attachment patterns. The implications of these altered attachment patterns on personality disorders and their neurobiological and environmental roots for psychoanalytically based treatment models designed to ameliorate difficulties in interpersonal functioning through the medium of increased access to mature forms of mentalization is discussed.

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Psychological therapies for people with borderline personality disorder

Storebø

Stoffers‐Winterling

Völlm

et al. 2020

Cochrane Database of Systematic Reviews

243

244

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This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the beneficial and harmful effects of psychological therapies for people with borderline personality disorder (BPD). B A C K G R O U N D Description of the condition Borderline personality disorder (BPD) is a condition first recognised in the 20th century (Gunderson 2009). Historically, the term BPD was coined by Adolph Stern to describe a condition in the 'borderland' between psychosis and neurosis (Stern 1938). Subsequent psychoanalytic contributions (especially that of Kernberg 1975) have reaffirmed this distinction, emphasising that the capacity to test reality remains grossly intact but is subject to subtle distortions, especially under stress. According to current diagnostic criteria, BPD is characterised by a pervasive pattern of instability in affect regulation, impulse control , interpersonal relationships, and self-image (APA 2013; WHO 1993). Clinical hallmarks include emotional dysregulation, impulsive aggression, repeated self-injury, and chronic suicidal tendencies (Fonagy 2009; Lieb 2004). Whereas some authors have suggested that it is a variant of affective disorders (Akiskal 2004), others claim that it is only the causes of these diseases that partially overlap in BPD (Paris 2007). Despite the difficulties in defining and delimiting the condition, BPD is still being widely researched. Its importance stems from the considerable psychological suffering of the persons concerned (

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Oxytocin and Reduction of Social Threat Hypersensitivity in Women With Borderline Personality Disorder

Cited by 191 publications

References 41 publications

Social Dysfunctioning and Brain in Borderline Personality Disorder

Social Dysfunctioning and Brain in Borderline Personality Disorder

Personality Disorders, Attachment and Psychodynamic Psychotherapy

Psychological therapies for people with borderline personality disorder

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