Am J Psychiatry. 2013 Oct;170(10):1169-77. doi: 10.1176/appi.ajp.2013.13020263.
Patients with borderline personality disorder are characterized by emotional hyperarousal with increased stress levels, anger proneness, and hostile, impulsive behaviors. They tend to ascribe anger to ambiguous facial expressions and exhibit enhanced and prolonged reactions in response to threatening social cues, associated with enhanced and prolonged amygdala responses. Because the intranasal administration of the neuropeptide oxytocin has been shown to improve facial recognition and to shift attention away from negative social information, the authors investigated whether borderline patients would benefit from oxytocin administration.
In a randomized placebo-controlled double-blind group design, 40 nonmedicated, adult female patients with a current DSM-IV diagnosis of borderline personality disorder (two patients were excluded based on hormonal analyses) and 41 healthy women, matched on age, education, and IQ, took part in an emotion classification task 45 minutes after intranasal administration of 26 IU of oxytocin or placebo. Dependent variables were latencies and number or initial reflexive eye movements measured by eye tracking, manual response latencies, and blood-oxygen-level-dependent responses of the amygdala to angry and fearful compared with happy facial expressions.
Borderline patients exhibited more and faster initial fixation changes to the eyes of angry faces combined with increased amygdala activation in response to angry faces compared with the control group. These abnormal behavioral and neural patterns were normalized after oxytocin administration.
Borderline patients exhibit a hypersensitivity to social threat in early, reflexive stages of information processing. Oxytocin may decrease social threat hypersensitivity and thus reduce anger and aggressive behavior in borderline personality disorder or other psychiatric disorders with enhanced threat-driven reactive aggression.
边缘型人格障碍患者的特点是情绪高度兴奋，压力水平升高，易发怒，以及具有敌意和冲动行为。他们往往将愤怒归因于模糊的面部表情，并对威胁性社会线索表现出增强和延长的反应，与杏仁核反应增强和延长有关。由于鼻内给予神经肽催产素已被证明可以改善面部识别，并将注意力从负面社会信息上转移开，因此作者研究了边缘型人格障碍患者是否会从催产素给药中受益。
在一项随机安慰剂对照双盲组设计中，40 名未接受药物治疗的成年女性边缘型人格障碍患者（两名患者因激素分析被排除在外）和 41 名健康女性，按年龄、教育程度和智商相匹配，在鼻内给予 26IU 催产素或安慰剂后 45 分钟，参加了情绪分类任务。依赖变量是潜伏期和通过眼动追踪测量的初始反射性眼球运动的数量或潜伏期、手动反应潜伏期以及杏仁核对愤怒和恐惧面部表情与快乐面部表情的血氧水平依赖性反应。
边缘型人格障碍患者在对愤怒面孔的眼睛进行初始注视时表现出更多和更快的变化，并且与对照组相比，杏仁核对愤怒面孔的激活增加。这些异常的行为和神经模式在催产素给药后得到了正常化。
边缘型人格障碍患者在信息处理的早期、反射阶段表现出对社会威胁的高度敏感。催产素可能会降低社会威胁的敏感性，从而减少边缘型人格障碍或其他具有增强威胁驱动的反应性攻击性的精神障碍中的愤怒和攻击行为。
