The Influence of an Attachment-Related Stimulus on Oxytocin Reactivity in Poly-Drug Users Undergoing Maintenance Therapy Compared to Healthy Controls

Abstract

Background: Substance use disorders (SUDs) have been described as a dysfunctional way to compensate for deficiencies in that person's underlying attachment system. Furthermore, the neuropeptide oxytocin (OT), which is a critical component of the neurobiology of the attachment system, has been shown to effectively reduce addictive behavior and therefore has been discussed as a potential medication in SUD treatment. This study investigates variation in peripheral OT plasma levels as a function of exposure to an attachment-related stimulus in SUD patients compared to healthy controls (HCs). Methods: A total sample of 48 men, 24 inpatients in maintenance treatment who were diagnosed with poly-drug use disorder (PUD) and 24 HC, was investigated. A 15-min exposure to the Adult Attachment Projective Picture System (AAP) was used as an attachment-related stimulus and coded for attachment status. Blood samples before and after the AAP-assessment were taken and assayed for OT levels. Variation in baselines level of OT was examined in relation to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), the Adult Attachment-Scale (AAS), and the Brief Symptom Inventory (BSI). Results: Following the AAP stimulus controls showed no significant difference in OT levels elevation from baseline compared to the PUD group's OT levels. Furthermore, in the PUD group only OT-baseline-levels may be negatively associated with the AAS subscale "Comfort with Closeness" and "Anxiety" and lifetime substance use.

Reactivity of the Oxytocinergic and Neuroendocrine System Following the Adult Attachment Projective Picture System in Men of Recent Fatherhood: Results from an Exploratory Pilot Study with a Cross-Sectional Design

“…Although, in this study, no significant differences were observed between the different AR subgroups, mothers with an insecure AR tended to have stronger increases in oxytocin. Compared to healthy controls, males suffering from poly-drug-use disorder did not differ in oxytocin reactivity following AAP administration [ 32 ]. However, multi-drug users did not differ in AR from controls, making it rather difficult to directly compare these results with our study findings in AR subgroups.…”

“…Another study investigating oxytocin levels in the context of attachment in young and older men and women found that lower plasma oxytocin levels were associated with higher attachment anxiety in young men [ 38 ]. In contrast, higher baseline blood oxytocin levels were observed in poly-drug users compared to healthy controls [ 32 ]. From a methodological point of view, the comparability between oxytocin levels in saliva and blood and their reactivity in response to an external stimulus needs further research.…”

“…However, little is known about the effect of attachment-related stimuli on oxytocin and neuroendocrine reactivities. To the best of our knowledge, only three studies investigated oxytocin and/or cortisol reactivity in response to an attachment-related stimulus [ 3 , 11 , 32 ]. For example, elevations in cortisol in response to the Adult Attachment Interview (AAI) correlated with dismissive AR in patients with a diagnosis of idiopathic spasmodic torticollis (IST) [ 3 ].…”

“…Krause et al [ 11 ] demonstrated elevated oxytocin and decreased cortisol concentrations in serum after AAP exposure compared to baseline in women three months after parturition. Finally, higher baseline oxytocin levels but no differences in oxytocin reactivity were observed in patients with polydrug user disorder compared to healthy controls following the administration of the AAP [ 32 ].…”