Nonverbal communication of patients with borderline personality disorder during clinical interviews: a double-blind placebo-controlled study using intranasal oxytocin.

Interpersonal dysfunction is central to borderline personality disorder (BPD). Recent research has focused on the role of oxytocin (OT) in BPD, with mixed results regarding the processing of social information. Fifteen BPD patients and 15 controls participated in two clinical interviews, one under OT and one under placebo, which were randomly conducted 1 week apart in a double-blind fashion. Nonverbal behavior was evaluated using the Ethological Coding System for Interviews. Childhood trauma was examined using the Childhood Trauma Questionnaire. The patients with BPD showed less affiliative behavior than the controls. Notably, the controls, but not the patients, displayed more affiliation when OT was given at T1 compared with OT given at T2. OT was also associated with less flight behavior in both groups when given at T1 compared with placebo. OT responses were unrelated to the patients' history of childhood trauma. The present findings are informative with respect to patients' nonverbal prosocial behavior in clinical settings.

Oxytocin influences avoidant reactions to social threat in adults with borderline personality disorder.

BACKGROUND: Borderline personality disorder (BPD) is characterized by interpersonal dysfunction, emotional instability, impulsivity, and risk-taking behavior. Recent research has focused on the role of oxytocin in BPD, with mixed results as regards the processing of social stimuli. METHODS: In a double-blind randomized placebo-controlled study, 13 BPD patients and 13 controls performed a dot probe task to examine attentional biases to happy and angry faces after intranasal application of oxytocin or placebo. Childhood trauma was examined using the childhood trauma questionnaire. RESULTS: In the placebo condition, patients with BPD (but not controls) showed an avoidant reaction to angry faces (but not happy faces). The strength of the avoidant reaction correlated with the severity of childhood trauma. This behavioral response (as well as the correlation) was abolished in the oxytocin condition. CONCLUSIONS: Adult patients with BPD show an avoidant response to social threat, a reaction that is linked with traumatic experiences during childhood. This response pattern is altered by oxytocin, possibly by reducing stress and inhibiting social withdrawal from distressing social stimuli.

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

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.