The Interplay of Oxytocin and Attachment in Schizophrenic Patients: An fMRI Study

Abstract

Background: Attachment theory offers an important framework for understanding interpersonal interaction experiences. In the present study, we examined the neural correlates of attachment patterns and oxytocin in schizophrenic patients (SZP) compared to healthy controls (HC) using fMRI. We assumed that male SZP shows a higher proportion of insecure attachment and an altered level of oxytocin compared to HC. On a neural level, we hypothesized that SZP shows increased neural activation in memory and self-related brain regions during the activation of the attachment system compared to HC. Methods: We used an event-related design for the fMRI study based on stimuli that were derived from the Adult Attachment Projective Picture System to examine attachment representations and their neural and hormonal correlates in 20 male schizophrenic patients compared to 20 male healthy controls. Results: A higher proportion of insecure attachment in schizophrenic patients compared to HC could be confirmed. In line with our hypothesis, Oxytocin (OXT) levels in SZP were significantly lower than in HC. We found increasing brain activations in SZP when confronted with personal relevant sentences before attachment relevant pictures in the precuneus, TPJ, insula, and frontal areas compared to HC. Moreover, we found positive correlations between OXT and bilateral dlPFC, precuneus, and left ACC in SZP only. Conclusion: Despite the small sample sizes, the patients’ response might be considered as a mode of dysregulation when confronted with this kind of personalized attachment-related material. In the patient group, we found positive correlations between OXT and three brain areas (bilateral dlPFC, precuneus, left ACC) and may conclude that OXT might modulate within this neural network in SZP.

Two Sides of Theory of Mind: Mental State Attribution to Moving Shapes in Paranoid Schizophrenia Is Independent of the Severity of Positive Symptoms

“…Psychopathological abnormalities of ToM have thus far primarily been described in autism spectrum disorders [17], yet schizophrenia is also discussed to be characterized by ToM impairment, e.g., [18][19][20][21][22], which might be a key contributor to the poor social functioning in this disorder. In this regard, ToM deficits were confirmed in patients diagnosed with schizophrenia with predominantly negative symptoms, but these also already existed at the time of onset of the disease [11,12,23].…”

“…Moreover, it was shown that individuals with pronounced disorganized symptoms [4,20] and thought disorders [24] have problems making mental attributions [22].…”