Social Safety Learning in the Brain Oxytocin System

University of Washington121 enrolled

Overview

The investigators are conducting this research study to examine whether oxytocin enhances social safety learning (learning safety through the experience of another individual) in people with social anxiety disorder (SAD) compared to healthy volunteers. Oxytocin is a hormone that can also act as a chemical messenger in the brain. Oxytocin plays a role in a number of functions, including responding to fear and social interactions. In this study, the investigators would like to compare the effects of oxytocin and placebo nasal sprays in adults with SAD and healthy adults. This research study will compare an oxytocin nasal spray to a placebo nasal spray. About 120 people will take part in this research study, all at the University of Washington (UW).

The goal of the current study is to examine the potential role of oxytocin in enhancing social learning in SAD. The investigators' primary hypothesis is that vicarious extinction learning will contribute to safety learning and that oxytocin will potentiate vicarious extinction learning in patients with SAD, compared to healthy controls (HC). The investigators will directly test the effect of intranasal oxytocin and matching placebo on the brain mechanisms underlying vicarious extinction learning using a novel task. 60 adults with SAD and 60 healthy control participants will perform a task that involves three phases: (i) a standard social fear acquisition procedure while in a mock scanner, followed by (ii) a vicarious extinction and (iii) fear reinstatement test procedure, while being scanned during functional magnetic resonance imaging (fMRI). Participants will receive oxytocin or placebo prior to the extinction phase. The investigators will also measure skin conductance responses as an index of learning in each phase.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Eligibility

Sex: ALLMin age: 18 YearsMax age: 45 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: For Clinical Sample * Men and women age 18-45 * Women must be having regular menstrual cycles and not be taking oral contraception * Primary diagnosis of social anxiety disorder For Healthy Sample * Men and women age 18-45 * Women must be having regular menstrual cycles and not be taking oral contraception * No current or lifetime history of psychiatric, neurological, or medical disorders Exclusion Criteria: For All Groups * Pregnancy or breastfeeding * Positive urine drug screening test result * History of nasal pathology * Current use of any psychotropic medication or steroids * Active substance use disorder within the past 6 months * History of serious medical illnesses or untreated endocrine diseases * History of head injury, neurological disorder, or neurosurgical procedure * Positive magnetic resonance (MR) screen For Clinical Sample * Lifetime diagnoses of mania or psychotic disorder based on the Diagnostic and Statistical Manual (DSM- 5th ed) * Acute suicidal ideation For Healthy Sample * Lifetime DSM-5 diagnosis of any medical, neurological, or psychiatric illness

Outcomes

Primary Outcomes

Neural Responses in the CS+R vs CS+S Contrast in the Insula During the Extinction Phase

Change in task-related blood oxygen level dependent (BOLD) responses in the insula during vicarious extinction (specifically for CS+R (reinforced) versus CS+S (non-reinforced) conditions). Changes in BOLD responses refer to differences in neural responses between these two task conditions, which were extracted from the insula region of interest and estimated using a general linear model. Higher mean responses reflect greater discrimination (better able to distinguish between threat and safety cues) between the task conditions.