The Link Between Low Levels of Oxytocin and Social Skills
For years oxytocin has been extensively studied for the role it plays in producing contraction of the uterus during childbirth. It is also important for breast feeding. These two functions have earned oxytocin the name of the “great facilitator of life” because of the role it plays in propagating the species (childbirth) and enhancing the survival of newborns (breastfeeding).
Oxytocin is a protein neuropeptide hormone which is present in the blood. Recently it has been discovered that it is also a neurotransmitter produced by the pituitary gland in the brain. It has been demonstrated that oxytocin acts on a part of the brain called the amygdala which plays a major role on social, cognitive and emotional behaviors.
It is the effects of oxytocin on the brain that is attracting renewed interest in the medical scientific and psychiatry circles. Scientists have been trying to establish whether there is a link between oxytocin and autism. The prevalence of autism has been increasing worldwide and the search is on in earnest to examine all possible etiology as well as interventions that could allow children to reach their highest possible neuro-psychiatric development potential.
Research done on animals has strongly established oxytocin as the hormone (the cuddle hormone) which promotes bonding between mother and her off-springs. There is a body of research which shows a strong association between oxytocin and increased protective, caring, bonding behavior among non-human mammals. The research done on human subject is not as clear as the establishment of pro-social behavior is multi-factorial. The development of social ability is influenced by biology, socialization, the environment and even hereditary factors.
The effects of this neurotransmitter on the brain being researched are the effects on:
- Social behavior (attachment, affiliation)
Hypotheses documented show that oxytocin appears to affect an individual’s willingness to accept social risks arising through interpersonal interactions. Results from animal research suggest that oxytocin is a biological basis of prosocial approach behavior. The challenge has been to demonstrate this in human subjects.
What is Autism?
Children with autism are less able to interact with the world as their normal peers. They exhibit deficits in three major functions:
- Social awareness and interactions
- Verbal and non-verbal communication
- Imaginative play demonstrating variable behaviors and interests
The term autism spectrum disorder acknowledges that there is a range of functionality seen in children with autism. At one end of the spectrum some children function at a high level while those at the lower end exhibit the classic deficits.
Research seeking to correlate Oxytocin effects on Pro social Behavior may have over simplified this correlation as the association is rather complex and could have given a false premise on which to base possible treatment.
There is now new research that has caught the attention of not only the medical science community but also the community of persons affected by autism.
The Stanford Study
The largest study done to date is the Stanford Study. The research papers coming out of Stanford University of Medicine and Lucile Packard Children’s Hospital Stanford take a closer look at whether there might be any possible correlation between low levels of oxytocin in the blood and an increased risk of a child developing autism. The research does not support previously published claims that a low levels of oxytocin cause autism. It however appears that due to the effect of the hormone on the brain, some autistic children may benefit from this treatment as it helps to increase social skills. This effect was demonstrated in both healthy and a sub-set of autistic children.
Of note, the researchers studied the effect of the hormone using in the study group children with autism, normal children with no autistic sibling and the siblings of autistic children. All three groups had higher social functions with greater concentrations of oxytocin.
What is interesting about the findings of this study is that the blood oxytocin levels were in the same range for all three groups with comparable number of children having low, medium and high oxytocin level. Of no real surprise, the children with high blood oxytocin had better social ability than those in the study whose blood levels were low.
So then, it really did not matter whether the normally developing child or his autistic sibling or his none autistic sibling had low oxytocin levels as all would exhibit poor social ability. This is entirely different from what was previously understood. Poor social ability is linked to low oxytocin level but low oxytocin levels did not result in children being autistic.
One leading professor of psychiatry and behavioral sciences has opined that “Oxytocin appears to be a universal regulator of social functioning in humans”. What has been understood by this research is that autistic children with low blood levels of oxytocin will exhibit a more severe form of autism spectrum disorder than those children with higher blood levels of oxytocin. The children with higher blood levels of oxytocin function at a higher level with respect to social ability. Oxytocin he opined is a vulnerability factor that ought to be accounted for but clearly it is not the only causative factor which leads to the development of the autism spectrum disorders. With respect to the treatment of autism some children could benefit from oxytocin-type medications.
One area of further study needed is to measure the levels of oxytocin in the cerebrospinal fluid which bathes the spinal cord and the brain. This may help us to better understand more about the biology of oxytocin.
A genomic researcher from Duke University, who is part of another research team, has suggested that a child who has low oxytocin could benefit from oxytocin treatment. He too has said it ought not to be surprising that autistic kids have widely varying levels of blood oxytocin as we have for some time now recognized that autism is not a disease but a spectrum of disorders.
The Stanford team is doing further work to clarify more about the association of the biology of oxytocin and autism. Low levels of blood oxytocin cannot explain all of the cases of autism.
Other Research on Autism
Other researchers are studying the possible association between autism and a genetic link with a small variation in the gene coding for the oxytocin receptors. The researchers found that scores on standard tests of social ability were linked to certain receptor variants. There appears to be a highly heritable risk for the variant gene. Blood levels of the hormone oxytocin may be inherited in families.
It has been suggested that both children with low blood oxytocin levels and those with oxytocin receptor gene variants linked to poor social functioning could benefit from oxytocin drugs. This would then present an opportunity for earlier diagnosis of autism spectrum disorders using a biomarker. This by extension would also help in the selection of autistic children who are likely to benefit from the therapy.
In a review done by Inga Neumann it was deduced that oxytocin positively impacted social behavior that contribute to the fostering of:
- Psychological stability
Other researchers Insel, T. R. and Fernald, R.D. in 2004 demonstrated that not only oxytocin alone has an effect on social behavior but also vasopressin. This was published in the Annu. Rev. Neurosci., 27:697-722. The findings of these and other research have strengthen the interest to do more clinical research to explore the therapeutic effect oxytocin has on a malfunctioning amygdala and by extension social dysfunctional behavior.
The potential use and efficacy of oxytocin to enhance well-being and interpersonal interactions is indeed exciting as there may be other neuropsychiatric disorders that could be improved applying oxytocin. These neuropsychiatric illnesses include behaviors of:
- Repetitive habits
- General lack of trust
- Avoidance of social interactions
- Persistent fear/Irrational phobias
Two such groups of illnesses which exhibit the above behaviors are autism spectrum disorder and anxiety disorder.
Potential Use of Oxytocin to treat Autism
Oxytocin was used as an intranasal application in a 2013 study of 17 children diagnosed with autism spectrum disorders. The researchers using functional magnetic resonance imaging diagnostics found that the oxytocin temporarily normalized brain regions responsible for the social deficit seen in autistic children.
Researchers Kosfeld, M., et al concluded that oxytocin has the potential to increase trust in humans and therefore augment the benefits that can arise from social interactions. The oxytocin acts on the amygdala to reduce the autonomic and behavioral manifestations fear. This finding that oxytocin can modulate neural circuitry for social cognition and fear in humans has spawned intense interest in further research on persons diagnosed with autism.
Brain oxytocin has been shown to reduce the stress response which causes anxiety. It has been demonstrated in research that oxytocin reduces amygdala activity. The amygdala is the part of the brain which responds to potential danger by triggering the fear response. Kirsch P et al showed that oxytocin can modulate the activity of the amygdala and reduce the coupling of the amygdala to brainstem regions implicated in autonomic and behavioral manifestations of fear.
In a Psychopharmacology 2011 publication a research paper presented results from a study which involved applying intranasal oxytocin to a study group. The researchers noted that the effect of the oxytocin made subjects more extroverted, improved self-perception in social settings and amplified personality traits of trust warmth, openness and altruism.
The use of oxytocin to help persons with neuropsychiatric conditions is also very promising. This biomedical therapy is certainly good news for both patients living with anxiety disorders as well as the health professionals who treat these conditions. The use of oxytocin as part of the therapy for autistic children is exciting but we must also temper the expectation that all autistic children may not significantly benefit from the use of oxytocin.
The intranasal application makes use very convenient. Information on dosage and frequency of use especially for the pediatric group will encourage more interest among main stream health professionals and parents/guardians of autistic children. We must also be prepared to discuss not only the benefits but also the safety profile, possible side effects and contraindications.
In summary, while we await the publication of more studies on human subjects to clarify the biology of oxytocin and social ability it is now better understood that low levels of oxytocin does not cause autism spectrum disorders. The hormone has so far demonstrated that in some subjects it can increase social skills and a subset of autistic children stand to benefit from the use of oxytocin-like drugs.
Combination therapies give the best outcomes for the treatment of neuropsychiatric disorders.
A Word on Combination Therapy
By combination therapy we refer to biomedical treatment and early Applied Behavior Analysis ABA therapy interventions, Relationship Development Intervention RDI, Sensory Integration and other therapies.
The medical community and families of autistic children may very well have another therapeutic preparation to add to the treatment and management of autism. It takes a team of therapists (speech, behavior, occupational) working together with the child’s doctor to consistently but progressively work at helping the autistic child to adapt to his environment and improve social ability.
Written by Hello_docja for Khemcorp
- Oxytocin increases trust in humans, Kosfeld M, Heinrichs M, Zak PJ, Fischbacher U, Fehr E.
- Impact of prosocial neuropeptides on human brain function, Meyer-Lindenberg
- Oxytocin modulates neural circuitry for social cognition and fear in humans, Kirsch P, Esslinger C, Chen Q, Mier D, Lis S, Siddhanti S, Gruppe H, Mattay VS, Galhofer B, Meyer-Lindenberg A
- Oxytocin reduces amygdala activity, increases social interactions, and reduces anxiety-like behavior irrespective of NMDAR antagonism, Sobota R, MiharaT, Forrest A, Featherstone RE, Siegel SJ
- Effect of intranasal oxytocin administration on psychiatric symptoms: A meta-Analysis of placebo-controlled studies, Hoffmann SG, Fang A, Brager DN
- What is oxytocin, and what does it do?, Oxytocin as potential psychiatric therapy, Markus MacGill
- Stanford Study clarifies biology of oxytocin in autism. Published in the Proceeding of the National Academy of Sciences
- Low levels of Oxytocin linked to Poor Social Skills, published in the proceedings of the National Academy of Sciences