Social Safety Learning in the Brain Oxytocin System

Phase 2

Completed

Brief Summary: 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).

Detailed Description: 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.

Recruitment & Eligibility

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

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

Arm && Interventions

Group	Intervention	Description
Clinical	Oxytocin nasal spray	This group consists of individuals with at least moderate symptoms of social anxiety disorder. This group will receive either an oxytocin or placebo administration (blind randomization).
Controls	Oxytocin nasal spray	This group consists of a healthy sample of individuals (no lifetime diagnoses of mania or psychotic disorders). This group will receive either an oxytocin or placebo administration (blind randomization).

Primary Outcome Measures

Name	Time	Method
neural responses (e.g., regional brain activation in the ventromedial prefrontal cortex (vmPFC) to vicariously extinguished cue versus vicariously reinforced cue during reinstatement	immediately after the intervention	vmPFC blood oxygen level dependent (BOLD) responses for non-reinforced conditioned stimulus (CS-) versus reinforced conditioned stimulus (CS+)

Secondary Outcome Measures

Name	Time	Method
skin conductance responses (SCR) to vicariously extinguished cue versus vicariously reinforced cue during reinstatement	immediately after the intervention	mean SCR for CS- versus CS+

Locations (1): University of Washington
🇺🇸
Seattle, Washington, United States

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