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Oxytocin Level May Determine Strength of Maternal Bond
via - Psychiatryonline.org Research identifies oxytocin as the molecule responsible for the sense of joy and reward mothers feel when they play with their babies and watch them laugh or cry.
Oxytocin, a neuropeptide closely linked to childbirth and breast-feeding, may have an important role in the biological mechanism of bonding between mother and infant, according to a new study. It provides a clue to understanding the observation that women with insecure attachment themselves are more likely to have difficulty forming secure attachments to their children.
According to attachment theory, infants who bond with a sensitive, attentive caregiver are able to form secure attachment, and separation from or insensitive interaction with the primary caregiver can result in insecure attachment. In addition, the type of attachment formed in early childhood influences a person's interpersonal relationships in adulthood.
Animal studies have pointed to oxytocin as a key mediator of mother-infant attachment behaviors. The study, led by Lane Strathearn, M.B.B.S., an assistant professor of pediatrics at Baylor College of Medicine, and colleagues and published in the December 2009 Neuropsychopharmacology, is the first in humans to describe part of the neurobiological mechanisms and the role of oxytocin in maternal behaviors and attachment patterns.
In the study, the researchers enrolled 61 first-time mothers during their third trimester and determined their attachment type using a modified version of the Adult Attachment Interview, a semistructured interview that assesses a person's childhood interactions and bonding experience with their primary caregivers (generally parents).
About seven months after giving birth, the study participants had their blood drawn to measure their oxytocin levels before and after they played with their children. Then, at 11 months after delivery, each participant underwent functional magnetic resonance imaging (fMRI) scans as she was shown photos of her infant's face and an unknown infant's face. These photos displayed the infants' various emotions ranging from sad to happy.
Forty-four women participated in the fMRI scan. After excluding a small number of those with the insecure/preoccupied, combined, or atypical attachment types, 30 women were included in the analyses. Half of them were of the secure attachment type based on the prenatal interview, and the other half were of the insecure/dismissing type.
After comparing data from the two groups of women, the researchers found that women who were securely attached themselves produced significantly higher oxytocin levels after they played with their children than did women who had insecure attachment.
In addition, securely and insecurely attached mothers showed different patterns of brain response to their infants' photos. The securely attached women had greater activation in the reward-processing brain regions when they saw their children's smiling face as well as sad face. Insecurely attached women had activation in the reward regions only when they saw their children's happy face. Instead, their infant's sad face activated the brain regions associated with feelings of unfairness, pain, and disgust.
In other words, the securely attached women felt more rewarded and motivated to interact with their infants regardless of whether the infant appeared happy or sad. The insecurely attached women felt less motivated, especially toward a sad child.
These findings confirmed the direct link between oxytocin release and dopamine-controlled reward and reinforcement system in the brain. “Numerous animal studies have provided evidence for the effect of oxytocin on the dopaminergic reward system,” Strathearn told Psychiatric News. “It is difficult to study receptors [in the brain] in humans, but in our imaging study, we correlated the activation of dopamine regions with oxytocin release.” The oxytocin levels measured at seven months, he noted, were significantly correlated with the degree of activation of the reward regions at 11 months.
Previous studies indicated that a person's attachment type usually persists from childhood to adulthood, and an adult's attachment type is a reflection of his or her childhood bonding with parents. A certain attachment type, especially secure attachment, often is perpetuated in a family from one generation to next, said Strathearn. Attachment type, he said, “is not necessarily a fixed thing … [and] is pliable to life experiences. But infant attachment pattern sets up a trajectory for the person.”
Many animal studies have shown that the pattern of care an infant animal receives predicts the care it provides to its offspring, Strathearn noted. “This study links what we saw in animal studies and humans,” he said. The differences in oxytocin release and brain activities between securely and insecurely attached mothers suggest a physiological “imprint” of a person's attachment type, which has been formed in early life, persists through adulthood, and influences her behaviors toward her children.
In a commentary published in the same issue of Neuropsychopharmacology, James Rilling, Ph.D., an associate professor of anthropology and of psychiatry and behavioral sciences at Emory University, suggested that these findings have provided part of the biological explanation for the intergenerational transmission of attachment types. By tinkering with the oxytocin system and the reward-related brain circuitry, scientists may be able to “break the cycle” and alter maternal behaviors in adults with insecure attachment.
The intergenerational transmission of attachment types was also observed in this study, based on assessments of the infants at age 14 months, according to Strathearn. Babies born to securely attached mothers were more likely to have secure attachment. These data are in press pending publication.
“This early [mother-infant] relationship is what programs a lot of brain responses later in life,” said Strathearn. He emphasized that the long-term consequences of early life experience are a critical but poorly understood area.
New sex change regulations in Thailand require transgender people consult a psychiatrist
via - Asian one news. Areeya Milintanapa, a 26-year-old transvestite, had hoped to undergo sexual reassignment surgery at a private clinic in Bangkok next year, but her plans have hit a setback - new regulations by the Medical Council of Thailand. The council moved recently to strictly control sex change operations and require that transgender people consult a psychiatrist, live as a woman for a year and receive hormone therapy before being such an operation is allowed.
>> ASIAONE / NEWS / LATEST NEWS / ASIA / STORY New sex change regulations in Thailand Thu, Oct 29, 2009 The Nation/Asia News Network Areeya Milintanapa, a 26-year-old transvestite, had hoped to undergo sexual reassignment surgery at a private clinic in Bangkok next year, but her plans have hit a setback - new regulations by the Medical Council of Thailand. The council moved recently to strictly control sex change operations and require that transgender people consult a psychiatrist, live as a woman for a year and receive hormone therapy before being such an operation is allowed. For Areeya the new rules are an inconvenience. "I have already spent my whole life as a woman - since I was a little boy - and why (do) I have to live as a woman for another year to undergo sex change surgery?" she said. Areeya said she had wanted to be a woman since she was a young boy. She said she had played with dolls like girls did and wore her mother's skirts. "I know myself that I have always been woman not a man."
Areeya, who married an American man three years ago, said she started doing research and finding out information on sex change surgery over many years, by consulting transgender people who had undergone sex reassignment operations, before making a decision to undergo the operation herself next year. "This (operation) was going to be a special gift for me to celebrate the New Year," she said.
But her plan has been set back a year as the new regulations mean she cannot undergo a sex change without seeing a psychiatrist first. "The council want to make sure that they (transgender people) really want to be a woman and spend the rest of their lives as a woman, forever, not for a second," council president Dr Somsak Lohlekha said. "Sex reassignment surgery would affect the physical body (of the person undergoing the operation), as well as people's mental health and society around them."
The council's new rules will be enforced from November - next week. They will require transgender people to consult psychiatrist to assess people's mental state before they are allowed to get hormone therapy from endocrinologists. After that they have to live as a woman for a year before they can undergo a sex change. Somsak said at least two psychiatrists must give guarantees for transgender people who want to undergo a sex change.
Foreigners seeking to have such operations here must get approval from a psychiatrist in their country of origin as well as a psychiatrist in Thailand before undergoing surgery. After the operation, surgeons and physicians must follow up on their patient's condition and provide appropriate medical treatment.
The new regulations require that surgeons or physicians undertaking the sex change be registered with the Medical Council. They must also treat any complications that occur following surgery. Surgeons who violate the new regulations face warnings or the threat of having their medical licence revoked.
Dr Panom Ketman, of the Royal College of Psychiatrists of Thailand, said one year of living as woman should be enough to evaluate if a transgender person is ready for sex change surgery. "During this period, they have more time to ask themselves whether they really want to be a woman or not. If they are absolutely sure, psychiatrists will allow them to undergo such surgery," he said.
Dr Paiboon Jittrapai, of Thailand's Royal College of Surgeons, said the new rules would lift standards for sex change operations. They would also help screen transgender people who really need sex change surgery. He said some patients had committed suicide after a sexchange operation as they had later rejected changing sex.
"Some transgender people underwent reassignment surgery because they wanted to do it for their job, such as performing in a cabaret show, not because they want it for their lives." Transgender Women of Thailand chairperson Yollada Suanyot expressed satisfaction with the new regulations but said relevant agencies, such as the Interior, Foreign and Justice ministries, should revise laws to allow transgender people to change their gender title from Mr to Miss./p>
"Basic women's rights are also fundamental needs for transgender people," she said. "We also want the respect in human dignity, the same as anyone else." Areeya said things would be easier if she could change from being a 'Mr' to a 'Miss', as she could then register a married certificate like other women. "I just want my life to be complete as a woman. Why do I have to go to another country to be allowed to register a marriage certificate with a man who I love? Why can't this country where I was born give it to me?" said a business transgender woman.