Patients in Pain: The Effects of Oxytocin on Trust and Decision Making

Oxytocin (OT) is a naturally occurring hormone produce by the hypothalamus. While a growing body of work has focused on the role of OT in modulating human social cognition, a somewhat neglected but promising area of study is how OT effects pain perception and pain behavior. Animal studies consistently support OT as an analgesic but human studies are few and somewhat mixed. The current study explores whether the analgesic effect of OT diminish maladaptive decision making associated with pain, both directly and indirectly. At the same time, pain-related positive social behaviors such as trust and cooperation, may be heightened under the influence of oxytocin. Intranasal OT (24 IU) versus placebo trials were separated by a one-week washout period. The primary outcome measures include three indicators of change in social capital, including trust, cooperation, and safety perceptions. Furthermore, the analgesic effect of OT on pain sensitivity is evaluated in the context of interactive effects with pro social decision making. Behavioral rating scales examined delayed discounting, impulsivity, and loss aversion. In addition to behavioral measures, urine samples were collected to assess subject OT saturation and saliva samples were collected to test for genetic markers associated with pain and trust. We first examined if OT has a main effect (i.e., generalized) on pain perception and secondly, if pain-related social behavior is moderated by OT. Results support OT as a potential analgesic. Additionally, OT may not only act to relieve pain but may also reinforce other adaptive social behaviors exhibited by people in pain.