The Effect of Intranasal Oxytocin on Neural Functioning in Widow(er)s

Abstract

The interplay between approach and avoidance in the bereavement process is central to conceptual models of complicated grief (CG), a persistent and unremitting form of acute grief. Oscillation between these motivation systems is thought to maintain maladaptive cognitive and behavioral patterns, prolonging the acute grief experience. Neuroimaging studies implicate known reward-related brain regions and associated neurochemical processes associated with CG. This study investigates these processes through: 1) the behavioral Approach Avoid Task (AAT), 2) fMRI, and 3) neuropharmacological manipulation via intranasal oxytocin (INT OT) administration. Method: A mixed sample of 37 spousally-bereaved older adults (CG =17; ncomplicated grief (NCG) = 20), completed the AAT, with 3 stimulus categories (spouse, stranger, and generic grief) during fMRI acquisition under two conditions (placebo and INT OT). Results: In a 2(group) x 2(condition) x 3(stimulus type) analysis, behavioral results indicate both groups showed a relative approach bias to spouse images. When viewing a spouse (vs. a stranger), those with CG showed increased activation in right inferior frontal gyrus, the precuneus, and right superior temporal sulcus (STS). During INT OT, the CG group uniquely demonstrated slowed reaction time across all stimulus types. The NCG group during INT OT showed increased activation in the superior temporal sulcus (STS) and right inferior frontal gyrus, relative to the CG group/placebo condition. Discussion: Areas associated with self-referential processing (precuneus) face processing (STS) and response inhibition/facial recognition (inferior frontal gyrus), but not reward, were associated with AAT performance. The social salience model may explain the differential effect of OT on CG. In all, the relative approach bias for idiographic grief stimuli holds implication for characterization and treatment of the dual motivation processes in grief.