2 - (SYM 85) Learning Safety from Others with Intranasal Oxytocin in Social Anxiety Disorder

  

Background: Despite the role of socially-acquired fear in etiological models of anxiety, no studies have examined whether social safety learning (learning safety through the safety experience of others) can augment treatment for social anxiety disorder (SAD). Given the role of the neuropeptide, oxytocin, in regulating social fear, avoidance, and approach behavior, we hypothesized that oxytocin, compared to placebo, may enhance social safety learning through a vicarious extinction learning task in patients with SAD.  

  

Methods: In this randomized, double-blind, placebo-controlled experiment, 44 participants (18 patients with SAD, 26 healthy controls (HC)) completed a task that assessed acquisition, vicarious extinction, and reinstatement using skin conductance responses (SCRs) as an index of learning. During acquisition, participants received mild electric shocks (US) that were either paired (CS+) or not paired (CS-) with angry face stimuli. A nasal spray containing either 24 IU oxytocin or placebo was administered prior to extinction, during which participants viewed a video of a learning model undergoing extinction (non-reinforced trials) for some CS+ (CSsafe) and continued reinforcement for other CS+ (CSreinf) stimuli. During reinstatement, participants received 3 unsignaled reminder shocks and viewed the same stimuli as during acquisition but without any additional shocks. A final sample of n=100 is anticipated by August 2024. 

  

Results: As expected, both groups showed differential SCRs to CS+ vs. CS- during acquisition, which was indicative of acquiring fear to CS+. During vicarious extinction, both groups appeared not to distinguish between CSreinf and CSsafe; however, during reinstatement, participants with SAD showed greater differential SCRs to CSreinf vs. CSsafe, compared to HC, suggestive of successful vicarious extinction learning (although this was not statistically significant). Effects of oxytocin will be revealed once the blind is broken at the end of the study. 
  

Conclusions: Our initial pattern of findings based on SCR data suggest that patients with SAD may gain more than HC from learning safety vicariously. The social transfer of safety information has important implications for the role of support figures during exposure therapy for SAD.