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Letter to the Editor: Oxytocin and empathy to pain in schizophrenia: a reply

Published online by Cambridge University Press:  13 January 2015

A. Abu-Akel*
Affiliation:
School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
M. Fischer-Shofty
Affiliation:
Department of Psychology, University of Haifa, Haifa 31905, Israel
Y. Levkovitz
Affiliation:
The Emotion-Cognition Research Center, Shalvata Mental Health Care Center, Hod-Hasharon, Israel
J. Decety
Affiliation:
Department of Psychology, University of Chicago, Chicago, USA
S. Shamay-Tsoory
Affiliation:
Department of Psychology, University of Haifa, Haifa 31905, Israel
*Corresponding
* Address correspondence to: A. Abu-Akel, School of Psychology, University of Birmingham, Birmingham B15 2TT, UK. (Email: ama289@bham.ac.uk or abuakel@hotmail.com)
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Abstract

Type
Correspondence
Copyright
Copyright © Cambridge University Press 2015 

In their recent Letter in the Journal, Abed & Abbas (Reference Abed and Abbas2014) view our findings pertaining to the differential effect of oxytocin (OT) on the perception of empathy to pain experienced by outgroup members in patients with schizophrenia v. healthy controls (Abu-Akel et al. Reference Abu-Akel, Fischer-Shofty, Levkovitz, Decety and Shamay-Tsoory2014) as supportive evidence for their ‘Outgroup Intolerance Hypothesis’ (Abed & Abbas, Reference Abed and Abbas2011), which argues that an imbalanced ingroup-outgroup dynamics enhances the risk for schizophrenia. The relevance of our results to the ‘Outgroup Intolerance Hypothesis’ underscores the importance and promise of the Group-Dynamics Paradigm (GDP) to OT research in schizophrenia. This is particularly important in light of increasing support for the use of OT as a therapeutic agent for schizophrenia, which is motivated by evidence showing that OT can improve symptomatology and socio-cognitive abilities (Feifel, Reference Feifel2012). However, these findings were obtained in paradigms that are insensitive to cultural/group differences, which raise concerns about the possibility of reporting results that are spurious, or at least of limited generalizability. These concerns are warranted given ample evidence for the impact of cultural differences on schizophrenic symptomatology, prognosis and recovery (Koelkebeck & Wilhelm, Reference Koelkebeck, Wilhelm, Lysaker and Brüne2014) and the development of socio-cognitive abilities (Shahaeian et al. Reference Shahaeian, Peterson, Slaughter and Wellman2011).

The importance of the GDP to schizophrenia research is demonstrated in a rare study showing that the other-race effect (where remembering and recognizing emotions of faces from a different race or ethnicity incurs a processing cost) is preserved in patients with schizophrenia (Pinkham et al. Reference Pinkham, Sasson, Calkins, Richard, Hughett, Gur and Gur2008). This led the authors to raise concern over the validity of hitherto findings pertaining to face-processing abilities in schizophrenia. By extension, we argue that a fuller evaluation of the benefits of OT to patients with schizophrenia would ultimately need to be assessed within the framework of the GDP, particularly given the strong effects of OT on group dynamics. This is in agreement with the view of Abed and Abbas whereby the association of oxytocinergic abnormalities with the pathology of schizophrenia might be mediated by its actions on moderating group dynamics.

Investigating the inter-play of OT, group dynamics and the emergence of schizophrenia, can be informative both in detecting factors conferring risk for schizophrenia as well as in identifying protective measures, just as would be predicted by the ‘Outgroup Intolerance Hypothesis’.

Acknowledgements

This research was supported by the Binational Science Foundation (BSF). J.D. was supported by a grant from the John Templeton Foundation.

Declaration of Interest

None.

References

Abed, RT, Abbas, MJ (2014). Oxytocin and empathy to pain in schizophrenia. Psychological Medicine. Published online: 19 November 2014. doi:10.1017/S0033291714002700.Google Scholar
Abed, RT, Abbas, MJ (2011). A reformulation of the social brain theory for schizophrenia: the case for out-group intolerance. Perspectives in Biology and Medicine 54, 132151.CrossRefGoogle ScholarPubMed
Abu-Akel, A, Fischer-Shofty, M, Levkovitz, Y, Decety, J, Shamay-Tsoory, S (2014). The role of oxytocin in empathy to the pain of conflictual out-group members among patients with schizophrenia. Psychological Medicine 44, 35233532.CrossRefGoogle ScholarPubMed
Feifel, D (2012). Oxytocin as a potential therapeutic target for schizophrenia and other neuropsychiatric conditions. Neuropsychopharmacology 37, 304305.CrossRefGoogle ScholarPubMed
Koelkebeck, K, Wilhelm, C (2014). Cross-cultural aspects of social cognitive abilities in schizophrenia. In Social Cognition and Metacognition in Schizophrenia: Psychopathology and Treatment Approaches (ed. Lysaker, P. H., Brüne, M. and , G. , Dimaggio), pp. 2947. Academic Press: Amsterdam.CrossRefGoogle Scholar
Pinkham, AE, Sasson, NJ, Calkins, ME, Richard, J, Hughett, P, Gur, RE, Gur, RC (2008). The other-race effect in face processing among African American and Caucasian individuals with schizophrenia. American Journal of Psychiatry 165, 639645.CrossRefGoogle ScholarPubMed
Shahaeian, A, Peterson, CC, Slaughter, V, Wellman, HM (2011). Culture and the sequence of steps in theory of mind development. Developmental Psychology 47, 12391247.CrossRefGoogle ScholarPubMed
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