Psychophysiological effects of oxytocin on parent-child interactions: A literature review on oxytocin and parent-child interactions.

Oxytocin (OT), often called the 'hormone of love' or 'hormone of attachment,' plays a fundamental role in the establishment and quality of parent-infant bonding. However, emerging evidence indicates that OT can also produce antisocial behavior. To clarify these effects, we review studies examining the role of endogenous and exogenous OT on several determinants of attachment: parental sensitivity, and bonding or synchrony in parent-child dyads. Contextual and individual factors moderating the effect of intranasal OT and its peripheral levels are also reviewed. Finally, potential therapeutic applications for OT and current limitations in human OT research are examined. This systematic literature review was based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, with two electronic databases and other bibliographic sources. We identified a total of 47 relevant studies for inclusion in our review. Most of the findings are in accordance with recent ideas that OT administration may increase parent-child prosocial interaction, showing that OT exerts beneficial effects on processes thought to promote bonding, sensitivity, and synchrony. However, we found that OT can induce antisocial behavior (e.g., anxiety) or adverse effects (modulation of maternal care recollections) that are moderated by different contextual (e.g., maltreatment level, presence of unfamiliar people) and individual (attachment style) factors. This review reinforces the importance of context- and individual-dependent factors, which must be taken into account when analyzing the psychophysiological effects of OT.

Parsing the construct of maternal insensitivity: distinct longitudinal pathways associated with early maternal withdrawal.

The current paper expands on Ainsworth's seminal construct of maternal sensitivity by exploring the developmental pathways associated with one particular form of insensitivity: maternal withdrawal. Drawing on longitudinal data from infancy to age 20 in a high-risk cohort, we highlight how maternal withdrawal over the first eight years of life is associated with child caregiving behavior and with maternal role confusion, as well as with features of borderline and antisocial personality disorders. We also present evidence for the specificity of this pathway in relation to other aspects of maternal insensitivity and other aspects of child adaptation. To illuminate these pathways we both review recent published work and report new findings on the middle childhood and adolescent components of these trajectories. Finally, we consider the implications for assessment of maternal behavior in high-risk samples and indicate directions for productive future work.

MATERNAL ROLE CONFUSION: RELATIONS TO MATERNAL ATTACHMENT AND MOTHER-CHILD INTERACTION FROM INFANCY TO ADOLESCENCE.

Self-reports of role confusion with the parent in childhood are associated with a variety of adverse outcomes. However, role-confusion has been studied primarily from the point of view of the child. The current study evaluated an instrument for assessing role confusion from maternal interviews rather than from child observations or self-reports in adulthood. Fifty-one mothers participating in a longitudinal study since their own child's infancy were administered the Experiences of Caregiving Interview (C. George & J. Solomon, 1996) when the child was age 20. Interviews were coded using the newly developed Parental Assessment of Role Confusion (PARC; L. Vulliez-Coady & K. Lyons-Ruth, 2009). Maternal PARC scores were related to observational measures of role-confusion in interaction with the child both in infancy and late adolescence. PARC scores also were related to mothers' hostile-helpless states of mind on the Adult Attachment Interview (C. George, N. Kaplan, & M. Main, 1984, 1985, 1986) and to the extent of Unresolved loss, but not Unresolved Trauma. PARC scores also were related to mothers' self-reports of helplessness experienced in the parenting role. Discriminant validity of the PARC was demonstrated in that role confusion on the PARC was not related to hostile or disoriented forms of parent-child interaction. Implications for clinical assessment of role confusion are discussed.

Anxiety and hospitalization in adolescence: relations to attachment style and parental support.

This exploratory study examined attachment style and state/trait anxiety in adolescents - 30 recently hospitalized psychiatric patients, and 49 school controls. All were aged 13-18, with the majority (67%) female. The attachment style interview (ASI, Bifulco et al. 2002) was administered, together with the Recent Life Events questionnaire (Brugha & Cragg 1990) and the STAI anxiety questionnaire (Spielberger et al. 1983). Results showed the hospitalised group to have significantly more negative interactions with parents and poorer support than the comparison group. They had significantly more insecure attachment style (96% s 37%). Among the hospitalized adolescents, both the Anxious and the Avoidant attachment style group had higher anxiety scores on the STAI-trait scores than on the STAI-state scores assessed during the first days of hospitalisation. This suggests adolescents, even those with Avoidant attachment feel less anxious after admission. Implications for assessing attachment style in adolescent patients to aid with care planning is discussed.

Attachment-based parent-adolescent interaction linked to visual attention and autonomic arousal to distress and comfort stimuli.

In infancy and in the early years of life, emotion regulation and attachment relationships with parents are tightly intertwined. However, whether this link persists into adolescence has not yet been established and requires exploration. This pilot study utilizes an experimental design to assess the patterns of parent-adolescent interactions that are hypothesised to be related to two specific aspects of adolescents' emotion regulation, namely: visual attention and autonomic arousal to distress and comfort stimuli. Two innovative and ecologically valid methodologies were utilized to assess (a) patterns of attachment-based parent-adolescent interactions among 39 adolescent-parent dyads from the general population, using the Goal-corrected Partnership in Adolescence Coding System (Lyons-Ruth et al. Goal corrected partnership in adolescence coding system (GPACS), 2005) applied to a conflict discussion task; (b) the two aspects of adolescent emotion regulation were assessed with the Visual/Autonomic Regulation of Emotions Assessment (VAREA) (Vulliez-Coady et al. Visual/Autonomic Regulation of Emotions Assessment, VAREA) paradigm, an attachment-related, emotionally arousing experimental procedure, using a distress-then-comfort paradigm, in conjunction to an eye-tracker synchronized with a physiological device that measured gaze and skin conductance response, (SCR), or emotional reactivity. In line with research in infancy, as predicted, markers of secure parent-adolescent interaction were linked to higher amplitude of SCR for distress and comfort pictures, and with longer attention to comfort pictures. On the other hand, parental role-confusion was associated with less time spent on comfort pictures by the adolescent. Overall, this pilot study suggests that interventions supporting collaborative communication between adolescents and their parents, as well as working to reduce parental role-confusion, may improve adaptive adolescent emotion regulation as assessed via physiological measures.

The influence of attachment styles on autonomic correlates of perspective-taking.

This study examined the effects of attachment styles on physiological responses during a perspective-taking task. Sixty-eight participants were selected according to attachment styles. Physiological responses were assessed using skin conductance responses (SCRs) in the three attachment groups (secure, insecure-anxious and insecure-avoidant) during the presentation of attachment-based pictures (distress, comfort or neutral) in two different perspective-taking conditions: self perspective-taking (i.e. imagine how you would feel in the given situation) or other perspective-taking (i.e. imagine how that person could feel in this situation). In the self perspective-taking condition, insecure-anxious individuals displayed higher SCRs than secure individuals for distress pictures. In the other perspective-taking condition, insecure-anxious individuals showed higher SCRs than secure individuals for comfort pictures. The results also showed a strong negative association between self-reported perspective-taking tendencies and SCRs in secure individuals. The findings suggest that perspective-taking plays an important role in the modulation of physiological responses in reaction to attachment-related pictures, which varies according to attachment styles.

The relationship between dispositional attention to feelings and visual attention to emotion.

Attention to feelings is a core dimension of individual differences in the perception of one's emotions. It concerns the frequency with which own emotions are attended to. The aim of the present eye-tracking investigation was to examine the relationship of dispositional attention to feelings with early and late attentional processes in the visual perception of emotional information. Attentional orientation was assessed in a sample of healthy women (N = 91) using eye-tracking during a free viewing task in which images with positive, negative and neutral content were shown simultaneously. Pictures were taken from the Besançon Affective Picture Set. State and trait affect, depression, and intelligence of participants were controlled. In our sample, attention to feelings was not related to positive affect, negative affect, depression or intelligence. Attention to feelings was negatively correlated with entry times for all emotional picture types. Moreover, attention to feelings was positively correlated with dwell time on positive images and negatively correlated with dwell time on neutral images. Our data indicate that devoting habitually attention to one's feelings is linked to an enhanced initial orientation of attention towards emotional scenes, irrespective of affective valence. Dispositional attention to feelings might also be associated with an attentional preference for emotional over neutral visual stimuli. The present findings on general individual differences in attention to feelings could have important implications for future clinical research on attentional biases.

The Besançon affective picture set-adult (BAPS-Adult): Development and validation.

We developed and validated a new picture database of attachment-related photographs, the BAPS-Adult. Participants (N = 315) rated 256 pictures, according to dimension (valence, arousal, and dominance) using Self-Assessment Manikins (SAM), emotional category (positive, negative, mixed, and neutral) using labels, and discrete emotion (comfort, joy, complicity, distress, horror, and hate) using linear scales. Pictures were then classified into four types, depending on content (distress, comfort, complicity-joy, and neutral). Dimensional ratings of valence, arousal, and dominance, as well as discrete emotion ratings, differed significantly from each other between picture types. The BAPS-Adult is a new, highly discriminated database, allowing researchers to select from a variety of pre-rated, attachment-related pictures.

How do adolescents regulate distress according to attachment style? A combined eye-tracking and neurophysiological approach.

According to attachment theory, attachment representations influence emotion regulation (ER) across the lifespan. However, research into attachment-related ER in adolescence is still scarce. The aim of this study was to assess attachment-related ER using a multimodal approach, relying on behavioral and neurophysiological parameters. Attachment styles in eighty-one adolescents were assessed with the Attachment Style Interview (ASI). A distress-then-comfort paradigm based on visual stimuli (the Besancon Affective Picture Set-Adolescents) was employed to "activate" then "deactivate" the attachment system. Gaze and neurophysiological parameters of ER strategies were assessed using eye-tracking synchronized with a physiological device. During the first phase "distress exposure", attachment style was associated with the early stage of distress processing indexed by first fixation duration. Withdrawn adolescents fixated distress pictures less than other groups. Fearful adolescents showed a longer first fixation duration than withdrawn adolescents. During the following phase, "comfort-seeking", all groups initially fixed joy-complicity and comfort pictures earlier than neutral pictures, except for withdrawn adolescents, who fixated comfort pictures later than neutral pictures. Additionally, withdrawn adolescents explored comfort pictures less than enmeshed adolescents. Enmeshed adolescents explored neutral pictures less than comfort and joy-complicity pictures. Concerning neurophysiological parameters, first fixation duration correlated positively with Skin Conductance Response (SCR) rise time in fearful adolescents, while glance count correlated negatively with SCR latency in withdrawn adolescents. This study provides an innovative and objective evaluation of behavioral and neurophysiological parameters for attachment-related ER in adolescents, with a temporal resolution. These parameters constitute potential biomarkers that could contribute to our understanding of ER differences in insecure adolescents. This study was registered with the clinical trials database ClinicalTrials.gov on August 01, 2016, under the number NCT02851810.

Effects of Intranasal Oxytocin on Emotion Regulation in Insecure Adolescents: Study Protocol for a Double-Blind, Randomized Controlled Trial.

BACKGROUND: Emotional dysregulation and impaired attachment are potential contributors to the development of psychopathology in adolescence. This raises the question of whether oxytocin (OT), the paradigmatic "attachment hormone," may be beneficial in such contexts. Recent evidence suggests that intranasal administration of OT increases affiliative behavior, including trust and empathy. OT may also facilitate social reciprocity by attenuating the stress response to interpersonal conflict. To date, few studies have investigated the effects of intranasal oxytocin (IN-OT) on neurophysiological emotion regulation strategies in healthy adolescents, particularly during parent-adolescent interaction. To understand these mechanisms, our study will examine the effects of IN-OT on emotion regulation in adolescents during parent-adolescent stressful interactions, and on each adolescent's visual and neurophysiological strategies when visualizing attachment-related pictures. We hypothesize that IN-OT will influence psychophysiological outcomes under conditions of stress. We predict that IN-OT will momentarily increase feelings of safety and attenuate stress and hostile behavior during conflict situations. OT may also enhance attachment security by increasing comfort and proximity-seeking, and reducing neurophysiological hyperactivation. OBJECTIVE: The objective of this study is to evaluate the effects of IN-OT on insecure adolescents by studying their behavior and discourse during a disagreement with one of their parents. Their neurophysiological responses to pictures eliciting attachment-related emotions and their visual exploration strategies will also be investigated. METHODS: In this randomized, double-blind, placebo-controlled parallel-group design, 60 healthy male adolescents classified as insecurely attached will receive 24 international units (IU) of IN-OT versus placebo (PB), 45 minutes before the experimental tasks. Each adolescent will then be invited to engage in an experimental conflict discussion with one of his parents. The conflict session will be videotaped and coded for verbal and non-verbal interaction behavior, using the Goal-Corrected Partnership in Adolescence Coding System (GPACS). Each adolescent will then be asked to visualize attachment-related pictures on a screen. Eye-tracking (ET) and neurophysiological responses, including electrodermal activity (EDA) and heart rate (HR), will be recorded simultaneously and continuously during attachment-related picture viewing (Besançon Affective Picture Set-Adolescents, BAPS-Ado). RESULTS: Enrollment for the study was completed in May 2016. Data analysis commenced in July 2016. Study results will be submitted for publication in the winter of 2017. CONCLUSIONS: OT is a complex molecule with many facets that are not yet fully understood. This experimental protocol will increase scientific and clinical knowledge of emotion regulation skills in insecure adolescents by assessing the impact of IN-OT on parent-adolescent interaction and on the visual processing of attachment-related emotions. Positive results could lead to therapeutic uses of IN-OT to treat emotion dysregulation in adolescence.

The Besançon Affective Picture Set-Adolescents (the BAPS-Ado): Development and validation.

Emotional pictures are commonly used as visual stimuli in a number of research fields. Choosing relevant visual stimuli to induce emotion is fundamental in attachment and affective research. Attachment theory provides a theoretical basis for the understanding of emotional and relational problems, and is especially related to two specific emotions: distress and comfort. The lack of normalized visual stimuli soliciting these attachment-related emotions has led us to create and validate a new photographic database: the Besançon Affective Picture Set-Adolescents. This novel stimulus set is composed of 93 photographs, divided into four categories: distress, comfort, joy-complicity and neutral. A group of 140 adolescents rated the pictures with the Self-Assessment Manikin system, yielding three dimensions: valence, emotional arousal, and dominance. The pictures were also assessed, using a continuous scale, for different emotions (distress, hate, horror, comfort, complicity and joy). The ANOVAs for arousal and the Kruskal-Wallis tests for valence and dominance showed strong effects for category. However, for comfort and complicity, the dimensions of valence and dominance were not significantly different, while results for arousal showed no significant difference between complicity and distress. Our study provides a tool that allows researchers to select visual stimuli to investigate attachment-related emotion processing in adolescence.