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Addiction and Attachment View all 23 Articles. Furthermore, the neuropeptide oxytocin OTwhich is a critical component of the neurobiology of the attachment system, has been shown to effectively reduce addictive behavior and therefore has been discussed as a potential medication in SUD treatment.

This study investigates variation in peripheral OT plasma levels as a function of exposure to an attachment-related stimulus in SUD patients compared to healthy controls HCs. Methods: A total sample of 48 men, 24 inpatients in maintenance treatment who were diagnosed with poly-drug use disorder PUD and 24 HC, was investigated. Discussion: Our suggest that peripheral OT levels in poly-drug users undergoing maintenance treatment are not ificantly different in responsiveness to an attachment related stimulus compared to HC.

With regard to non-ificant tendencies observed in this study which hint toward decreased OT-reactivity in the PUD group, further research is needed to explore this hypothesis with increased statistical power. Substance use disorders SUDs have been characterized as a compulsive substance use without consideration of the negative consequences 1 and are increasingly framed as a neurobiological disorder 23. Currently, the most common form of SUD in patients undergoing treatment in Austria is poly-drug use disorder PUDwith opioids as the primary drug of choice 4a pattern which is also found in the majority of SUD patients across Europe 5.

In recent years, increasing of patients are treated within maintenance treatment programmes, which have been shown to be effective treatments by reducing heroin use and risk behaviors as well as improving health, social and criminal justice outcomes 6. From a psychodynamic perspective, SUD has been understood in relation to attachment disorder 7 and as a dysfunctional way of self-medicating 8.

Specifically, insecure attachment has been linked to increased psychopathology for decades 9. Formed by early parent-infant interactions, which are gradually imprinted in neuronal pathways 1011attachment can be understood as a neurobiological system deed to promote social affiliation and primary bonding experiences 12 Recent studies indicate a substantial role of insecure attachment in the etiology of SUDs 14 — 16 —among other psychiatric disorders This relationship has been linked to the influence of attachment styles on the interpersonal regulation of human emotions particularly fear, anxiety and hedonic experiences within close relationships 18 Attachment research across mammalian species has suggested that Adult personal ads Graz neuropeptide oxytocin OT plays a central role in the neurobiological processes involved in the formation and maintenance of social bonds Adult personal ads Grazinterpersonal affect regulation 1421 and parent-child relationships 22 — 24but also protective aggression Through axonal transport OT is centrally released to hippocampus, amygdala, striatum, hypothalamus, nucleus accumbens, and the central brain in response to social interactions and stressors 27 — In line with the Calm and Connect Model 31which assumes that bonding, experienced through touch and social affection, le to OT production and thus positively reinforces social connection, several studies have linked insecure attachment patterns to impairments of the OT-system 232729 In the context of addiction, beneficial effects of administered OT on drug tolerance, withdrawal and seeking have been proposed across various substance classes 33 Individual differences in the endogenous OT-system may therefore affect the vulnerability to addiction.

SUDs have been repeatedly linked to decreased levels of OT 35 — Furthermore, OT is assumed to modulate the mesolimbic dopamine system 38a structure which is substantially involved with the process of addiction development and bond formation 2 Similarly, there is considerable evidence suggesting interactions between the OT and endogenous opioid system In line with these observations, a recent review by Zanos et al. Such findings inform the first aim of this study to investigate cross sectional relationships between substance use and OT levels.

research indicated a relationship between the administration of stimuli deed to activate the attachment system of participants and the OT-system.

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This study was conducted with a sample of healthy lactating mothers who might be thought to be especially responsive to attachment cues. Moreover, these authors hypothesized that women with more secure attachment patterns should show higher OT-reactivity. However, in this study, the authors were not able to confirm the proposed association between a larger increase in OT and more securely attached mothers.

This experimental paradigm using the AAP as an attachment stimulus is adopted in the current study, while our study is focused on substance users compared to healthy controls HCs. What is more, in recent years, several reviews have been published which critically asses methodical flaws frequently observed within the research of the human OT system [e.

These contributions Adult personal ads Graz emphasize the importance targeted hypotheses, consideration of differences between central processing of OT and its peripheral levels, as well studies focussed on peripheral levels making use of plasma samples, and plasma to be assayed for OT levels after extraction. With this in mind, this study aimed to enhance the understanding the relationship between attachment and the OT-system in patients with SUD. We sought to address two primary aims. In relation to the first aim, we expected to find OT levels negatively associated with insecure attachment patterns and psychopathological symptom burden in the PUD group.

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Our second aim follows the experimental study by Krause et al. Following Krause, we expected to see a rise in the OT levels of health controls when exposed to an attachment stimulus. However, as this is the first time, this experimental paradigm is investigated in patients undergoing maintenance treatment, this hypothesis remains exploratory. Participants in the clinical group met diagnostic criteria for PUD F Due to the haphazard drug use, one of the main characteristics for PUD, the drugs consumed cannot be reported in detail.

At the time of the study, all PUDs were currently participating in maintenance therapy as described below.

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PUDs with fluid psychotic symptoms were excluded. Comorbidities with other diagnoses were distributed as follows: 9. Furthermore, 21 PUD patients received additional psychopharmacological medication: 16 Participants of the non-clinical group, exclusively non-smoking men, reported either none or just a few experiences with illegal substances.

With the exception of occasional consumption of alcohol, no use of psychoactive substances was reported by HC in the last 30 days prior to the investigation and no use of psychopharmacological medication. HCs were included if they reported no past or present psychiatric disorder or chronic disease. Exclusion criteria for both groups were insufficient knowledge of the German language. Non-clinical subjects were recruited through advertising on social networks and via distribution of the University of Graz.

The study was approved by the ethics committee of the University of Graz, Austria and conducted in accordance with the Declaration of Helsinki. In order to eliminate any effects due to circadian rhythms the timing of the experiment was standardized.

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Participants were asked to fast for at least 3 hours before arriving in the laboratory between After written informed consent was obtained and the subjects were notified about the course of the experiment, the first venipuncture and blood collection was performed. The abstract line drawings indicate scenarios such as illness, separation, and abuse without detailed facial expression, allow a large scope of interpretation The AAP measure is deed around a common assumption in observational and discourse attachment measures that attachment behavior is best observed directly after an attachment related stimulus is delivered or represented such as a separation, loss, illness and so on The AAP interviews were administered by a trained psychologist in a standardized manner according to the published administration requirements.

Following the AAP, and 25 min after the first blood sample a second blood sample was collected, again via venipuncture. For this study, the interview was adapted as a self-report questionnaire. By adding the drug specific symptom scores an overall score for every symptom class mentioned aboveas well as a total score was calculated. The short version of the Brief Symptom Inventory [ BSI ; 51German Version: 52 ] assesses the amount of psychiatric burden of the last 7 days by means of 6 items on each of the Adult personal ads Graz subscales: 1 Somatization, 2 Depression, and 3 Anxiety.

The German Version of the Adult Attachment Scale [ AAS ; 5354 ] is a self-report method measuring attachment dimensions based on attachment theory This questionnaire consists of three subscales: 1 Anxiety about being rejected or unloved, 2 Comfort with Closeness and Intimacy, and 3 Comfort in Depending on others. This questionnaire consists of 18 items rated Adult personal ads Graz a 5-point Likert scale ranging from 1 strongly disagree to 5 strongly agree.

The mean intra-assay and inter-assay coefficients of variability were To evaluate the reactivity of OT, the amount of the difference value of pre- and post-OT-level was considered. However, with regard to recent critical reviews of OT-literature [e. In order to ensure a better evaluation of theeffect sizes were included. Socio-demographic variables, scores for addictive behavior as well as requirements prior to the interview of both groups are presented in Table 1.

Table 1 Group differences in demographic data and conditions prior to investigation. In order to enhance the understanding of the relationship of OT to SUD, we investigated the differences in psychopathology, attachment, and the OT-system between PUD patients undergoing maintenance treatment compared to HC, as well as differences in peripheral OT response to an attachment-related stimulus. Furthermore, baseline OT-levels showed a ificant relationship with decreased Comfort with closeness in PUD patients. However, these should be interpreted with caution.

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In the first instance, the sample size of the study was small and there were numerous ificance tests run. Following Nave et al. While the Bonferroni correction has been criticized as being overly conservative 5758the findings of this study are tentative and require replication in a larger study. The interpretation of this result needs Adult personal ads Graz remain speculative at this point. However, it is conceivable that this finding might be traced back to the characteristics of living in the therapeutic community which is characterized by high social cohesion and an attachment focused treatment approach Furthermore, in contrast to the HC group, PUD participants traveled to the OT measuring in groups, which might have further contributed to inflated OT baseline levels Another possibility would be an influence of the various medications used for maintenance therapy which interact with the opioid system, or indeed the use of antidepressant or antipsychotic medications in PUD participants.

However, while not extensively researched, recent literature indicates no influence of antidepressant pharmacological treatments on OT 61 but there have been some animal studies suggesting a relationship between antidepressants and OT metabolism Based on research it might be speculated 2942that an increase in OT in response to an attachment related stimulus is associated with seeking and finding of an internalized positive attachment representation.

Furthermore, animal research has shown that the administration of morphine potently inhibits the secretion of OT and depresses the OT-sensitivity of the mammary gland, due to inhibition of the firing of supraoptic OT-neurons 63 — Considering potential ceiling effects of methadone on the endogenous OT-system, its chronic administration could cause a maximum release of OT, so that further increases in OT are diminished, regardless of whether the person is triggered with an attachment related stimulus or not.

Regarding the statistical tendencies observed in our sample which hints in the direction described above, more data is needed to further evaluate this line of interpretation. Contradicting recent literature 1567no ificant differences between PUD patients and HC were found regarding adult attachment attitude using the AAS measure.

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Nevertheless, the non-ificant associations showed there may be important relationships here which the current study was underpowered to detect and are consistent with the pattern observed in research 1467 — In general, the main in this study may be influenced by several effects brought about by a combination of psychopharmacology, maintenance, and long-term psychotherapeutic treatment.

Corresponding to recent findings by Torres et al. Therefore, the mechanism of maintenance therapy might operate on the surface but helps PUD patients only to a limited extent in the formation of healthy interpersonal relationships and positive attachment representations that can be relied on in times of distress 15 Moreover, we observed tentative hints toward a link between OT-reactivity and increased Comfort with closeness which, however, did not achieve statistical ificance.

Similarly, Krause et al.

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Hence, while a relationship between attachment and OT-reactivity may be a reasonable premise, more research should be done to further analyse this subject matter. Findings of the present study are mainly limited by the sample size, the exclusion of the female gender and the use of self-report measures.

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Furthermore, the measurement of OT is controversially discussed in literature 43 Furthermore, nicotine abstinence was not given in PUD patients prior to the investigation in this study, which might be seen as a characteristic of PUD patients in maintenance treatment. However, in line with research, nicotine abuse was not related to OT 72 ,

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