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

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          Abstract

          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.

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          Most cited references70

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          Explicit and implicit emotion regulation: a dual-process framework.

          It is widely acknowledged that emotions can be regulated in an astonishing variety of ways. Most research to date has focused on explicit (effortful) forms of emotion regulation. However, there is growing research interest in implicit (automatic) forms of emotion regulation. To organise emerging findings, we present a dual-process framework that integrates explicit and implicit forms of emotion regulation, and argue that both forms of regulation are necessary for well-being. In the first section of this review, we provide a broad overview of the construct of emotion regulation, with an emphasis on explicit and implicit processes. In the second section, we focus on explicit emotion regulation, considering both neural mechanisms that are associated with these processes and their experiential and physiological consequences. In the third section, we turn to several forms of implicit emotion regulation, and integrate the burgeoning literature in this area. We conclude by outlining open questions and areas for future research. © 2011 Psychology Press, an imprint of the Taylor & Francis Group, an Informa business
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            Emotion dysregulation and adolescent psychopathology: a prospective study.

            Emotion regulation deficits have been consistently linked to psychopathology in cross-sectional studies. However, the direction of the relationship between emotion regulation and psychopathology is unclear. This study examined the longitudinal and reciprocal relationships between emotion regulation deficits and psychopathology in adolescents. Emotion dysregulation and symptomatology (depression, anxiety, aggressive behavior, and eating pathology) were assessed in a large, diverse sample of adolescents (N=1065) at two time points separated by seven months. Structural equation modeling was used to examine the longitudinal and reciprocal relationships between emotion dysregulation and symptoms of psychopathology. The three distinct emotion processes examined here (emotional understanding, dysregulated expression of sadness and anger, and ruminative responses to distress) formed a unitary latent emotion dysregulation factor. Emotion dysregulation predicted increases in anxiety symptoms, aggressive behavior, and eating pathology after controlling for baseline symptoms but did not predict depressive symptoms. In contrast, none of the four types of psychopathology predicted increases in emotion dysregulation after controlling for baseline emotion dysregulation. Emotion dysregulation appears to be an important transdiagnostic factor that increases risk for a wide range of psychopathology outcomes in adolescence. These results suggest targets for preventive interventions during this developmental period of risk. Copyright © 2011 Elsevier Ltd. All rights reserved.
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              Sniffing neuropeptides: a transnasal approach to the human brain.

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                Author and article information

                Contributors
                Journal
                JMIR Res Protoc
                JMIR Res Protoc
                ResProt
                JMIR Research Protocols
                JMIR Publications (Toronto, Canada )
                1929-0748
                Oct-Dec 2016
                02 November 2016
                : 5
                : 4
                : e206
                Affiliations
                [1] 1Laboratory of Clinical and Integrative Neuroscience EA481 University of Franche-Comte BesançonFrance
                [2] 2UFR SVTE COMUE Bourgogne Franche-Comté University of Burgundy DijonFrance
                [3] 3Clinical Investigation Center, CIC-IT 808, INSERM University Regional Hospital University of Franche-Comte BesançonFrance
                [4] 4Department of Child and Adolescent Psychiatry University Regional Hospital BesançonFrance
                [5] 5Clinical Investigation Center, CIC-IT 1431, INSERM University Regional Hospital BesançonFrance
                Author notes
                Corresponding Author: Monika Szymanska monika.szymanska@ 123456edu.univ-fcomte.fr
                Author information
                http://orcid.org/0000-0002-0144-774X
                http://orcid.org/0000-0001-6995-1670
                http://orcid.org/0000-0002-0183-4029
                http://orcid.org/0000-0001-5842-6897
                http://orcid.org/0000-0001-6146-5571
                http://orcid.org/0000-0001-9554-0568
                http://orcid.org/0000-0002-1450-0183
                http://orcid.org/0000-0002-9104-0862
                http://orcid.org/0000-0001-9758-9648
                http://orcid.org/0000-0003-2670-6186
                Article
                v5i4e206
                10.2196/resprot.5643
                5112367
                27806925
                00bed673-240d-4487-8244-e543d4e06dbb
                ©Monika Szymanska, Carmela Chateau Smith, Julie Monnin, Patrice Andrieu, Frédérique Girard, Lucie Galdon, Marie Schneider, Lionel Pazart, Sylvie Nezelof, Lauriane Vulliez-Coady. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 02.11.2016.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.

                History
                : 12 February 2016
                : 23 April 2016
                : 26 May 2016
                : 21 June 2016
                Categories
                Protocol
                Protocol

                intranasal oxytocin,attachment,adolescents,parent-adolescent interaction,randomized controlled trial

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