ArticlePsychotherapy and psychosomatics2025
Trait-Like and State-Like Oxytocin: A Biomarker of Alliance in Patients with Depression and Borderline Personality Disorder.
Article in Psychotherapy and psychosomatics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionPatients with major depressive disorder (MDD) and borderline personality disorder (BPD) show a poorer prognosis compared to patients without BPD. A potential contributor is the complexity of establishing a therapeutic alliance with patients with BPD. A potential underlying biological mechanism is oxytocin (OT), a hormone associated with social bonding and trust. The aim of this study was to assess whether the interaction between OT pre-session (session-level trait-like) and change in OT throughout the session (state-like) in both patients and therapists predicts the therapeutic alliance in patients with MDD and varying severity levels of BPD. We hypothesized that patients with higher BPD severity would show a compensatory pattern, where an increase in state-like OT would compensate for low session-level trait-like OT, resulting in a stronger alliance. We also explored this interplay in the therapists' OT.
methodEighty-four patients from a randomized controlled trial were assessed for BPD severity prior to beginning 16 sessions of short-term psychotherapy. Both patients and therapists provided saliva samples pre- and post- sessions 4, 8, 12, and 16 for OT analysis. Alliance was measured post-session. A series of linear mixed-effects models was used to test the hypothesis.
resultsOur hypothesis was partially confirmed. In patients with higher BPD severity, when therapists had low session-level trait-like OT, the more they increased in state-like OT, patients rated their alliance as stronger. However, this compensatory pattern did not emerge in patients' OT.
conclusionThese findings demonstrate the potential importance of OT as a biomarker of therapeutic processes in patients with MDD and BPD.
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