•Treating Trust: Oxytocin’s Effects of Trust in People and Implications as a Possible Treatment...

Treating Trust: Oxytocin’s Effects of Trust in People and Implications as a Possible Treatment for Schizophrenia

Jamie Brown

April 8, 2014

ENGL 202A: Final Report (Option #3)

Scientific American: MIND - The world’s leading source and authority for science and

technology information for science-interested citizens, delivering understandable, credible and

provocative content to an audience of more than 5 million people worldwide. Consisting of

articles by the world’s most creative minds.

New Articles for April



The human brain is a fascinating and mysterious organ. I say mysterious because even

though we have studied the brain for years and yet we still have so very much to learn due in part

by the ever-changing nature of the brain known as plasticity. This characteristic of the brain also

shows that the brain can be differently affected due to the certain chemicals it is exposed to,

which can be induced by concentration of a chemical produced and released in the body or by

insertion into the body through ingestion, injection, or inhalation. Some of these possible

chemicals can be induced through both methods, one in particular is a hormone released from the

pituitary gland called oxytocin. Oxytocin is known for its role in the neuroanatomy of intimacy,

especially in the case of sexual reproduction. Recently though there has been much investigation

into oxytocin’s role in more pro-social behaviors, which brings me to the topic at hand, whether

or not oxytocin impacts the amount of trust an individual has or how trusting an individual is.

The studies, which have been done on this topic show positive results in the relationship between

the level of oxytocin in a individual and how trusting an individual is so a person with higher

levels of oxytocin should be more trusting then an individual with lower levels of the hormone.

When I found this topic I was skeptical to the credibility of this finding for the fact that knowing

what makes a person trust another seemed to me almost like a super power and this finding is

truly one I believe can have rather negative consequences in the wrong hands. Now that this

finding has surfaced though it is time to assure it’s not used for negative and that this finding can

be rationalized to the general population. Prior to discovering this finding my only knowledge of

oxytocin was the role that it played in the posterior pituitary in intimacy and also knew about its

use in schizophrenic drugs, which made this finding rather intriguing for the fact that

schizophrenic individuals do not trust most people due to the disease. Due to oxytocin’s use in


these drugs my only assumption is that oxytocin is used in these drugs to make the schizophrenic

individual a more trusting adjusted person instead being a person with hyper paranoia.

As a jumping off point for my research I was able to find a study, by Dr. Michael Kosfeld

and colleagues of a double blind experiment in which participants had a trusting option and a risk

option. Participants were then informed that they would be involved in a decision-making task

with monetary rewards. In this experiment the variable was whether individuals were treated

with an oxytocin dose or a dose of a placebo. This was tested through 2 different game scenarios

designed by the researchers in which the individual would either make monetary transfers to a

trustee for an additional pay out or to make a monetary transfer into a project, in both cases

hoping for additional profit from these transfers. The amount that they transferred out of their

given monetary units was the factor of interest because it was found that in those individuals that

were given the oxytocin dose were more likely to given a higher monetary transfer, which says

that the individual trusted the method of transfer enough to risk more monetary units. The

researchers also found that individuals were more likely to transfer more monetary units in the

scenario with trustees where the participant actually interacted with the individual receiving the

transfer. This implies that trust was also assimilated with comfort of at least hearing that the

trustee was actually existed.

According to past and present research trust has been pinpointed as a characteristic,

which shapes all aspects of human life. In particular, some 2001 research done by Dr. P. J. Zak

and Dr. Steven Knack has assured three categories of society that show the necessity of trust for

success are economics, politics and social interactions. Everyone can recall instances in, which

they used trust in an individual, a group or event to help make a decision or to contribute to their

decision process. Trust as a social construct can be witnessed to start to shape from the time of


infancy through attachment to one’s mother, which then starts to shape the world around as one

of either trust or mistrust as diagrammed by Erik’s first stage in his model of psychosocial

development. Trust from this point on seems to peak its way into all major social aspects of life.

For instance, trust is used in relying on the cooperation of a fellow group member. Without trust

of a certain degree group members will not rely on other members to uphold their designated

duties, thus the individual will not consider working with group members in the first place. Trust

is thereby needed for a successful society due to how heavily interwoven this construct is in

human nature.

Dr. Ernst Fehr and Dr. Urs Fischbacher have found that oxytocin release in stressful

situations or through intranasal administration can affect the degree of trust a person has towards

a specific situation. One factor in particular that came into play with the degree of trust in

someone or something is whether or not there is risk involved at all. Another factor that is

agreed upon is if there is a reward for the risk and if there is a reward then the value of the

reward is also a factor. Also in 2011 Dr. Kate Bakermans-Kranenburg and colleagues found

that group dynamics are a factor in terms of in-group versus out-group relations as clear reason

between placing trust in an individual or group. Still there are more concepts of trust that show a

relationship with oxytocin release, such as betrayal aversion.

This evidence observes that possible social interaction stimulates the effect brought on by

oxytocin release. Dr. S. Ahmadi and colleagues agree with the findings from Fehr and

Fischbacher group’s experiment since they were able to acquire a similar finding in their 2013

survey of trust in politics in which their participants were given a treatment of either placebo or

oxytocin then asked to complete a survey on interpersonal trust, trust in government officials and

government institutions. The surveys from the Ahmadi group’s work were able to show that the


level of trust in people was significantly higher than political actors as they call government

officials depending on party affiliation. Even in the case of a participant’s own party affiliated

officials trust was reported higher than the opposing party’s official, but lower then trust of

normal people. The piece that integrates the Ahmadi group and the Fehr group is that in the

same fashion that the Fehr group observed participants hold more trust in a person then an

organization so did the Ahmadi group, whose participants saw government officials as just part

of their particular branch of government instead of individually. This recurring finding thus

illustrates that a social bond in place increases the likelihood that oxytocin administration will

have an effect on trust since placebo reports were significantly lower in trusting a person from

government or the government as an institution.

The finding from Dr. S. Ahmadi and colleagues that people trusted the regular people

significantly more than the government officials can be tied to in-group and out-group research

as well. Dr. Bakermans-Kranenburg would agree with the political findings because they found

that oxytocin increased in-group and out-group trust. Evidence implies that for the in-group

results the oxytocin treated participants trusted more in their in-group then the placebo group. In

terms of the out-group results, there was no significant difference between the trust level of the

placebo group and the oxytocin treated group, which further confirms that a social bond or some

type of interpersonal relation are a primary factor in oxytocin’s effect on the trust level of an

individual. The implications of research provide the groundwork for exploring the use of

oxytocin in interpersonal problems outside as well as inside the family. The 2011 findings of Dr.

C.K. De Dreu have taken that groundwork and applied it to the theory of attachment between a

mother and child. Dr. De Dreu’s research set out to determine if oxytocin had an effect on

individuals who were either high or low on attachment anxiety and attachment avoidance. The


findings implicated that attachment anxiety was not significantly affected but that attachment

avoidance was. Since attachment avoidance deals with the fear of dependency and closeness in

interpersonal relationships this finding directly correlates to the matter at hand. In the test on

attachment after individuals were given the oxytocin and placebo treatments they were randomly

paired to perform nonrelated tasks. The results that followed showed that in terms of attachment

avoidance oxytocin had decreased its levels. Participants were given questionnaires to see if

their cooperation had increased or it they were more comfortable in the interpersonal situation

that confirmed this finding. Individuals asserted that they were more motivated to cooperate

during the experiment, which illustrates that effects of attachment avoidance were decreased in

combination with betrayal aversion. This finding means that the individuals who were high in

attachment avoidance were able to trust their experiment partner more than they would have

usually because for those participants with high attachment avoidance who took part in the

placebo treatment there were more reports of low trust and lower comfort ability, which revealed

a heightened sense of betrayal aversion.

These findings lead to the inquiry of whether oxytocin will help in mental diseases and

illnesses, which have social implications such as schizophrenia. One of the feature symptoms of

people who suffer from schizophrenia is their high paranoia. This paranoia hinders the

individual in giving them delusional thinking and a severe lack of trust in people. The level of

trust these people suffer from is such a low level that it can be termed as illogical. Prior research

has now found that oxytocin increases trust behaviors in individuals the question now stands

whether or not oxytocin can be used as an effective treatment for the lack of trust that

schizophrenia patient’s exhibit towards others. Dr. M. Ashrafi and Dr. S.M. Hosseini have

already gone on to research this area of exploration in 2012 by running a placebo-controlled


oxytocin study on individuals with schizophrenia who took the oxytocin or placebo treatment

along with their usual dosage of Risperidone. The research implicated that the symptoms

affected by the oxytocin were positive ones, which correlate to a raised level of trusting those

around them. This finding is unlike those of the placebo treatment, which showed slight

improvement that was caused by the regular dosage of Risperidone, but none as significant as the

participants of the oxytocin treatment. One fallback to the findings of the Ashrafi group was that

the patients reported some adverse effects as a result of the treatment such as drowsiness,

headache, nausea, and increased or decreased appetite, which could not be disproven as a result

of the oxytocin due to the fact that they were not occurring regularly or reported prior.

The 2013 research of Dr. A. Tadjibaev also clarifies reason for the testing of oxytocin as

treatment for schizophrenia for his research found that schizophrenic patients actually have an

oxytocinergic dysfunction. The evidence Dr. Tadjibaev used was how schizophrenia begins with

social phobia, anxiety, and an inability to keep friends. These factors all coincide with the

amount of trust a person holds in a person, event, or even in themselves, which is what brings

about the curiosity of whether oxytocin will serve as a good treatment for schizophrenia. Dr.

Tadjibaev also has credited oxytocin dysfunction with impairing the ability to discriminate facial

emotions, which is another deciding factor of trusting in social interactions.

The normal way to go about testing with oxytocin is through intranasal administration but

due to lack of proper credentials I will not be engaging in any direct schizophrenic patient

testing. Since I lack the credentials and funding to administer any type of in-patient study with an

oxytocin treatment my own research was directed toward professionals who have done research

in this area and have experience in treating schizophrenia. In first contemplating which

professionals could be used as experts of this subject matter I thought of professions that deal


with schizophrenic patients on a daily basis. After my own research I also decided that those

with extensive knowledge of the brain would also be able to inform me with the knowledge I

sought out. In my search for experts I attempted to contact numerous neurologists for their

extensive knowledge of the brain but my efforts came up empty due to the dense schedule of

these doctors and the strict limitations of the semester. After failure to obtain “permission to

interview” and informed consent from a neurologist I carried on to two other professional classes

that I decided would be good sources of new information were psychiatrists and psychologists.

Psychiatrists would be a good source for their knowledge of the disease and the advised medical

regimen and psychologists for their knowledge pertaining to psychotherapy and research on

patients with schizophrenia. I then attempted to contact psychiatrist through university sources

and was able to arrange for an interview with Dr. Tina Welz M.D, a psychiatrist who works in

the psychological clinic at the Moore building at Penn State University. As I awaited

confirmation of when Dr. Welz would be available for our interview, I searched for a

psychologist by checking through the psychological clinic as well as the staff directory of the

psychology department to get a list of psychologist and contact information. I then contacted

these psychologists and awaited their replies. I must add though that I did not think to interview

any psychologists until after I got denied from so many neurologists. I decided that a

psychologist would be a nice substituted due to perhaps having a research background that

enable them to encounter and gain knowledge of the schizophrenic brain similar to that of a

neurologist. I then though failed to receive an interview with any of the psychologists I contacted

either because I did not receive a reply or they were unable to accommodate an interview in the

short span of time I had available to them. I then received confirmation from Dr. Welz that she

would be able to interview with me via phone on Monday March 31 at 7:30am.


After my interview with Dr. Welz I was able to gain a great deal of knowledge in respect

to medications taken by schizophrenic individuals as well as comparisons to oxytocin and her

opinion of oxytocin as a treatment for schizophrenia. Dr. Welz first informed me of a drug used

by schizophrenic patients that affects oxytocin release, which is clozapine, a medicine known for

being an antipsychotic. Dr. Welz then began to speak on typical medications, which were also

given to treat schizophrenia such as older antipsychotics like thorazine , haloperidol, and

trifluoperazine and newer atypical (like clozapine) antipsychotics like risperidone and

quetiapine. She then gave me some of the criteria that went into specifying, which medication to

prescribe. This criterion was dependent on the side effects of the specific medication. For

instance Dr. Welz spoke that if she had a schizophrenic patient who had trouble sleeping or who

was very energized she would prescribe an antipsychotic that is sedating. If Dr. Welz had a

patient that was obese she would prescribe an antipsychotic with less potential for weight gain.

Dr. Welz then spoke of how patients discontinue the use antipsychotics because of their many

undesirable effects. When I asked Dr. Welz about using oxytocin as a treatment she replied that

she would need to know about the safety of using oxytocin because even though it is produced in

the body that does not mean it is safe in heavy doses. She then gave me an example by saying

that you can treat someone with insulin, which is produced in the body, but too high of a dose

would make them ill or even kill them so due to there not being enough studies on the safety and

efficacy of oxytocin Dr. Welz would not prescribe it as a method of treatment.

We then began to speak about oxytocin research on symptoms of schizophrenia both

positive and negative. One aspect of interest was in whether or not oxytocin could be used to

help bring about normal social interaction with schizophrenic patients. Dr. Welz commented by

saying that she would be surprised if one drug could do this because schizophrenia is so


multifaceted. She reassured her point by saying that no treatment has been found to improve the

negative symptoms of schizophrenia. After talking about the fact that schizophrenic patients

have been found to have a dysfunction in oxytocin release and receptors I then asked if this could

perhaps be a root cause to schizophrenia and Dr. Welz replied that it could be possible but that

researchers are still a long way from finding that out. It was no surprise then when Dr. Welz said

researchers are still very far from finding a cure due to the complexity of the human brain and

the ethics of experimenting with people. To conclude, for future exploration Dr. Welz said that

the psychosocial factors are a dimension that calls for research attention.

My interview with Dr. Welz provided me with many areas to explore in terms of

oxytocin and other medications because through all my research I was unable to find any

medications that impacted oxytocin until Dr. Welz told me about colzapine. I was previously

able to find studies on medications such as risperidone but as far as anything correlating to the

same effects as oxytocin I came up empty. What I found most significant about the interview

with Dr. Welz was the amount that we still do not know or are unable to effect about

schizophrenia. I was especially surprised by the distance between a cure to schizophrenia and us

because of how fast society is advancing in present day. To conclude, my next steps in research

would be in the interview of a psychologist dealing with schizophrenic research for their close

nature to the subject my provide further incite. As a whole though, research on the various

effects oxytocin on the trust of normal and ailing individuals still has area for exploration for the

implications of its use could result in extreme changes to the world in terms of social relations

because trust is universal.


References

Bakermans-Kranenburg, M., & IJzendoorn, M. V. (2012). A sniff of trust: Meta-analysis

of the effects of intranasal oxytocin administration on face recognition, trust to in-group,

and trust to out-group. Psychoneuroendocrinology, 37(3), 438-443.

Burnett, G., & Ahmadi, S. (2013). Oxytocin and the Biological Basis for Interpersonal

and Political Trust. Political Behavior, 35(4), 753-776.

Dreu, C. K. (2012). Oxytocin modulates the link between adult attachment and

cooperation through reduced betrayal aversion. Psychoneuroendocrinology, 37(7), 871-

880.

Fischbacher, U., & Fehr, E. (2005). Oxytocin Increases Trust In Humans. Nature,

435(7042), 673-676.

Hosseini, S. M., & Ashrafi, M. (2013). Intranasal Oxytocin as an Adjunct to Risperidone

in Patients with Schizophrenia. CNS Drugs, 27(1), 57-65.

Tadjibaev, A. (2013). Oxytocin in Prevention of Shizophrenia. International Journal of

Prevention and Treatment, 1(11), 1-11.

Zak, P. J., & Knack, S. (2001). Trust And Growth. The Economic Journal, 111(470),

295-321.

•Treating Trust: Oxytocin’s Effects of Trust in People and Implications as a Possible Treatment...

Documents

Transcript of •Treating Trust: Oxytocin’s Effects of Trust in People and Implications as a Possible Treatment...