Motivation and emotion/Book/2020/Oxytocin and social support

Overview
Oxytocin has gained popularity in the media as the chemical of love, but that view only highlights a small portion of this particular neuropeptide’s actions within the human body. The peptide hormone plays a significant role in our instinct to love, feel empathy, effects our stress response and drives us to form close social relationships.

Human beings are social creatures who thrive in the presence of other people. Through comforting relationships and interactions, people are able to express their feelings and share their experiences. These relationships are essential for purposeful and meaningful life. Social support plays a fundamental role in maintaining and initiating every individual’s relationships. Social support is often linked to many benefits for both mental and physical health. The two models which link social support and health are the buffering hypothesis and the direct effect hypothesis (Cobb, 1976). The buffering hypothesis suggests that social support is only beneficial whilst experiencing stress, whilst the direct effect hypothesis forecasts that it is beneficial to have social support at all times, evidence has suggested to support both hypotheses (Taylor, 2011).

Oxytocin has been found to enhance the buffering effect of social support on stress responsiveness. A heightened stress level creates a hormone called cortisol in the body. Cortisol can lower the function of the digestive, reproductive, and immune systems. Together, social support and oxytocin interact to suppress levels of cortisol helping to explain the adaptive influence of social behaviour for emotional and physical health (Frisch et al., 2015).

This chapter starts with an overview of the definitions of oxytocin and social support along with their functions and applicable models. The purpose is to discuss the link between oxytocin and social support in regards to the human stress response. It is hoped that by understanding these two concepts and their interaction will lead to positive long term-health outcomes.

Focus questions:
 * What is oxytocin?
 * What is social support?
 * What is the relationship between oxytocin and social support?

Oxytocin
Oxytocin acts as both a peptide hormone and a neurotransmitter and is produced in the hypothalamus and secreted by the posterior pituitary gland. Once oxytocin is released into the body it plays a number of different roles. In women, oxytocin is released in large amounts causing contractions during labour. Furthermore, oxytocin is released in response to skin stimulation of low intensity, e.g. in response to touch or strokes etc. As a result, oxytocin is released not only during labour or mother to baby exchanges, but also during positive social interactions between people and the hormone has also been implicated in bonding between men and women (Heinrichs et al., 2003). More recently, an artificial form of oxytocin has been created, which can be administered nasally. The nasal cavity provides access to the brain as it is the only accessible surface of the body with a direct pathway (Quintana et al., 2018).

Physiological

 * Role in breastfeeding and labour: During childbirth, the body pumps out mass amounts of oxytocin to signal contraction of the unterus{{sp}. While breastfeeding, oxytocin is also released to trigger the flow of breast milk (Suzuki et al., 2020).
 * Oxytocin and vasopressin: Vasopressin appears to be antagonist of oxytocin, although both neuropeptide's share a very similar molecular structure. Vasopressin is a crucial component of the endocrine stress response through its actions in the posterior pituitary gland, where it stimulates the release of cortisol stress hormone, which oxytocin acts to suppress (Nephew, 2012).
 * Modulating the hypothalamic-pituitary-adrenal axis: Activity of the HPA axis is regulated by oxytocin. Notably, Oxytocin modulates the HPA axis by inhibiting the release of cortisol stress hormones from nearby neurons which overall diminishes HPA axis activity. Conversely, blocking the activity of oxytocin also results in increased HPA axis activity (Neumann et al., 2001).

Psychological

 * Human ingroup bonding: Oxytocin can facilitate a preference towards individuals who share similar characteristics to form a bonding relationship known as an ingroup. This effect promotes individuals to associate with members of their own group, whereas dissimilar individuals are classed as an out-group (Van Leengoed et al., 1987).
 * Effect it has on prosocial behaviours: Oxytocin promotes sociability in a number of different ways. It plays a role in the visual attention of social cues, judging the mental state of others from increasing gaze to the eye region and is seen to increase the effect of trust, empathy and generosity (Suzuki et al., 2020).

 {Where is oxytocin produced in the human brain? - Amygdala + Hypothalamus - Cerebral Cortex - Frontal Lobes - Cerebellum
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Social Support


Social support can be defined in numerous ways, depending on the perspective of the individual. The general premise of the term social support is the experience that one feels loved, cared for and valued by the people around them. Such support can come from a variety of individuals, including a significant other, children, other family members, and friends (Li, Dean and Ensel, 2014). Social contacts and social support are psychologically beneficial. Social support reduces mental distress such as depression or anxiety during times of stress (Lin et al., 1999).

Types of social support
While there are many different ways in which people can support one another, much research has been compiled on the effects of four distinct types of social support:


 * 1) Emotional support: This type of support is about providing love, reassurance, empathy and often involves physical comfort such as hugs and affection.
 * 2) Instrumental support: Includes offering assistance or taking on responsibilities for someone else in a physical way.
 * 3) Informational support: Is about providing support in form of advice, suggestions or information gathering and sharing to assist an individual to work through a particular situation or identify potential steps to move forward.
 * 4) Appraisal support: Providing information, such as feedback that is valuable for self-evaluation and reflection (Himle et al., 1991).

The buffering hypothesis
The buffering hypothesis is a theory which claims that the presence of a social support system helps buffer, or protect an individual from the negative impact of stressful life events. Stress occurs when a person feels like they are unable to cope with specific demands and events. Any situation that poses a perceived challenge to a person's wellbeing can cause stress and we can experience these demands in situations, such as work, family life, relationships and financial difficulties. Once a situation has been evaluated as stressful, our body begins to pump out hormones that prepare it to engage in the fight or flight response. The stress hormones are secreted in immense quantities throughout the body to trigger physical reactions such as, alertness, increased blood pressure, sweating and enhanced muscle preparedness. The theory is the buffering hypothesis asserts that social support has a direct effect on stress reactions (Cohen & Wills, 1985).

The direct effects hypothesis
The direct effects hypothesis is similar, however, it expresses that social support is beneficial at all times and people with higher levels of social support are healthier than those with lower levels, irrelevant of stress. Advocates of the direct effect theory maintain that individuals benefit overall from social networks because they provide regular positive experiences and provide individuals with information and experience that enables them to avoid and deal more effectively with daily stressors (Cohen & Wills, 1985).

 Leading up to an exam period can be exhausting and stressful time for university students. Due to the help from her friends and family, the stress of upcoming exams was lessened for Holly. Amelia, on the other hand, experienced the full impact of the stress, exhaustion, and fear that comes with exams. Holly was able to vent her frustrations, receive validation for concerns and complaints, and ask questions of her family and friends, thereby decreasing her stress about the upcoming exams. Amelia, however, didn't have anyone to validate her struggles, which caused her significant stress. When Holly was staying inside too much and isolating herself, her mother suggested she sign up for a study group to gain support from her fellow students. Staying inside and isolating oneself are common maladaptive responses to stress. However, Holly's social supports were able to guide her toward healthier behaviours. In contrast, Amelia's maladaptive behaviours turned into anxiety and depression. The social supports to correct these responses were not in place for Amelia, as they were for Holly.

The relationship
Evidence proposes that the influence of social support on health is mediated by oxytocin. The peptide hormone is released in connection with positive, warm interactions between humans (Light et al., 2005) which suggests a potential bidirectional relationship between oxytocin and social support. However, a majority of the research investigating the effects of oxytocin on social support has been conducted on animals, and research on humans has been somewhat limited. There has been great debate as to whether the effects of oxytocin and social support in animal models translate to humans. One of the main limitations of human studies surrounds the ability to obtain valid measures of oxytocin and how much of the neuropeptide actually crosses the blood-brain barrier (BBB) in sufficient quantities to have significant effect, and to evaluate whether the effects are centrally transmitted in the brain versus in the peripheral nervous system.

Social support and oxytocin interact to suppress Cortisol
Grewen and colleagues (2005) conducted one of the first human studies measuring the relationship between oxytocin and social support. 38 cohabiting couples were recruited and underwent spending time alone and then spending time together engaging in warm contact with their partner. Oxytocin levels were measured via blood sampling and perceived social support was obtained based on self-report measures. Unsurprisingly, perceptions of partner support was associated with higher oxytocin levels in both men and women. It was also hypothesised that oxytocin may be a primary pathway regulating the stress-buffering effects of social support on other physiological mechanisms (Grewen et al., 2005).

This theory was tested by Heinrichs and collegues (2003), investigating the stress-buffering effects of social support. The researchers used what is called The Trier social stress test (TSST), which is essentially referred to as a mock job interview in a laboratory setting. The interview involves a series of tasks performed in front of a panel, who have been instructed not to provide any facial or verbal feedback to the participants. The purpose of this type of reaction is to increase the participants anxiety and cortisol levels. The TTST has reliably activated the hypothalamic-pituitary-adrenal (HPA) stress axis and triggered the release of stress hormones (Kudielka et al., 2007). In the study participants received social support from romantic partners, a trained supporter or no social support. In addition, they also administered intranasal oxytocin to half of the participants whereas the other half received a placebo prior to the TSST. It was found that participants who received both social support and oxytocin had the lowest cortisol response, suggesting social support in combination with oxytocin suppressed cortisol responses. These findings support the theory that oxytocin is involved in dampening the the effects of the HPA-axis and that it promotes the beneficial effect of social support (Frisch et al., 2015).

Tend and befriend vs. fight or flight response
Human beings respond to stress or perceived threats in a number of different ways. The fight or flight or flight instinct is driven by the release of adrenaline and urges people to run or become aggressive when activated. According to evolutionary psychologists, another theory has evolved in response to stress known as tend and befriend. The tend and befriend response is evoked by the release of oxytocin in response to the distribution of cortisol and inspires people to seek out the help of others and to build and maintain strong social connections (Taylor et al., 2000).

From a biological perspective, the fight or flight systems were imperative for the survival of our species. Once these systems are activated, we produce a stream of the stress hormones including cortisol, norepinephrine and epinephrine to provide a surge of energy to fight off any attacks or run away from an immediate threat. This release would result in the subjective experiences of activating feelings of alertness, fear, anger or anxiety to energise the body to meet the demands of the threat. The short term effects were beneficial for their protective benefits ie. escaping the situation, however, with recurrent or repeated stress, these systems have long-term implications negatively impacting our health (McEwen, 1998). These include such chronic disorders as coronary heart disease, hypertension, Type II diabetes, and some cancers.

The tend and befriend response suggests that social contact during times of stress is more likely to act as a protective factor against the long term implications of stress. This evolutionary response, is encouraging us to seek out social support with the assiatance of the release of oxytocin. This effect protects our cardiovascular system, strengthens the heart and assists heart cells regenerate from any stress related damage. The physical benefits of oxytocin on our body are enhanced by social support ie. more of the hormone is released when you seek support and also when you help someone else. The tend and befriend response is an evolutionary mechanism for building stress resilience and the foundation of this process is social connectedness with one another (Taylor et al., 2000).

As a vast majority of research on the effects of oxytocin on and downregulating the stress response has been conducted on animals or females, it is evident that a gender difference exists. This suggests that women are more likely to use social support and seek out close relationships in times of stress than men (Tamres et al., 2002). Nevertheless, there is proof that men can benefit from social support during times of stress as well (Heinrichs et al, 2003).

Our modern-day life rarely requires such an extreme physiological reaction. While fight or flight was useful for our ancestors as a means of survival, we are not often faced with life threatening situations in our day to day life. Therefore, repeated and subsequent activation of the fight or flight response is maladaptive and can lead to poor health outcomes. These findings suggest that the tend and befriend response is a more favourable long term way of dealing with stress in our contemporary world leading to postive health outcomes due to its protective factors.

 {Which of the following are stress hormones? - Cortisol - Norepinephrine - Epinephrine + All of the above
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Conclusion
Oxytocin and social support relate to one another using the evolutionary model of stress via the social buffering hypothesis. Controversially, this so called 'love' hormone has been implicated as a stress hormone as it is secreted as part of the human stress response. Together, social support and oxytocin interact to suppress levels of cortisol. The interaction between oxytocin and seeking social support in response to stress has been theorised as the tend and befriend theory which helps to explain the adaptive consequences of social behaviour for emotional and physical health. While it is clear that oxytocin, in combination with social support, leads to positive health outcomes in response to stress, there are still some concerns regarding the validity of the current research. The research on humans has been quite limited and studies using men more specifically have fallen short. Furthermore, regarding the studies using intranasal administration of oxytocin has had its own set of limitations. There has been some evidence that oxytocin reaches the brain via nasal delivery. However, it is possible that these changes are secondary to peripheral oxytocin receptor activity. Further studies on humans measuring concentrations of oxytocin in the cerebrospinal fluid (CSF) during stress exposure with perceived social support are required to better understand the function of oxytocin in the central nervous system. Clearly, this subject is still in development, and more research is needed to establish its reliability and validity.


 * Oxytocin is a promising therapeutic target for social and affective disorders as its effect promotes social behaviours.
 * Using this knowledge to encourage people to seek out social contacts in stressful situations - Awareness is key.