MEASUREMENT OF SUSPECTED OXYTOCIN DYSREGULATION: INDEX DEVELOPMENT AND TESTING

Purpose: Functional disorders of the gastrointestinal and genitourinary systems, such as irritable bowel syndrome and chronic pelvic pain affect millions of women and represent a significant proportion of annual health care costs, both in the US and abroad. They are also difficult to treat and lead to diminished quality of life in their sufferers. Therefore, innovative approaches to their conceptualization and treatment should be a research priority. Previous research has found a correlation between these conditions, grouped here under the umbrella of pelvic visceral disorders (PVDs), and post-traumatic stress disorder, especially the dissociative subtype of PTSD. This project builds off previous theoretical and pilot work positing oxytocin dysregulation as a mechanism for both the dissociative and PVD symptoms in female trauma survivors. Testing this theoretical mechanism is difficult, because there are a number of barriers to measuring oxytocin directly, and the interpretation of those values is similarly difficult.  Therefore, development of a reliable proxy for plasma oxytocin level is a priority for further research. The primary aim of this project was to develop such a proxy.

Background: This project builds off of Seng’s Post Traumatic Oxytocin Dysregulation Disorders (PODD) theory. Oxytocin plays a role in attachment, social engagement, feelings of safety, security and belonging, as well as, PODD theory suggests, pelvic and visceral smooth muscle function. In survivors of early relational trauma, PODD theory posits that early disruption of this oxytocin system leads to peripheral and central alterations in oxytocin function, which leads to both physical PVD symptoms and psychiatric symptoms such as PTSD and dissociation.

Methods: Using the above theoretical framework, we developed an index of physical symptoms in tissues thought to be regulated by oxytocin, the Oxytocin Dysregulation Suspicion Index (ODysSI).  We first performed a literature review to look for any documented link between pain or functional symptoms in these tissues and oxytocin. We then tested some of the index items through secondary analysis of an NIH-funded pilot study that evaluated possible links between hyperemesis gravidarum, trauma and oxytocin dysregulation using regression-based statistical analysis.

Results: In a series of regression models exploring the associations of childhood maltreatment, dissociation, and ODysSI score in relation to oxytocin level, all of the relationships were significant and in the expected direction.  The association between ODysSI score and oxytocin level was moderately strong (beta = .539, p = .025).

Conclusions: Because the secondary analysis was limited by small sample size and limited number of variables, this index must first be validated with further investigation. However, these limited results both validate the major tenants of PODD theory and the ODysSI as a promising proxy for oxytocin in further research.