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Objectives: Interpersonal dysfunction is a central feature of borderline personality disorder (BPD), and the neuropeptide oxytocin (OT) has been shown to impact patients' behaviour in numerous ways. Nonverbal signals such as the coordination of body movement (nonverbal synchrony) are associated with the success of interpersonal exchanges and could thus be influenced by features of BPD and by the administration of OT. Design: We explored the effect of intranasal OT (inOT) on nonverbal synchrony in sixteen patients with BPD and fifteen healthy controls (CTL) randomly assigned to two double‐blind clinical interviews under inOT and placebo (PL). Methods: Nonverbal synchrony was assessed by automated video‐analyses of subject's and interviewer's body movement. Lagged cross‐correlations were used to objectively quantify coordination in dyads. Results: Synchrony was higher than pseudosynchrony (= synchrony expected by chance), and there was a differential effect of inOT between groups: While healthy controls displayed increased synchrony under inOT, patients with BPD showed low levels of synchrony under inOT. Additionally, patient's synchrony was negatively associated with self‐reported childhood trauma. Conclusions: Nonverbal synchrony in clinical interviews is influenced by inOT, and this effect depends on subject's diagnosis. In line with previous research implying positive associations between nonverbal synchrony and relationship quality, inOT led to an increase of synchrony in healthy controls, but not in patients with BPD. Low levels of synchrony under inOT in patients and its association with childhood trauma suggest that additional mechanisms such as rejection sensitivity might mediate BPD patients' nonverbal behaviour. Practitioner points: Intranasal oxytocin (inOT) attenuated nonverbal synchrony – a proxy for relationship quality – in patients with borderline personality disorder (BPD), while it increased nonverbal synchrony in healthy controls (CTL).Available models (rejection sensitivity; social salience) suggest that inOT may alter the way patients with BPD assess social situations, and this alteration is expressed by changes in nonverbal coordination. Patients with BPD display low levels of synchrony which are even below expected pseudosynchrony based on chance.The association between self‐reported childhood trauma and lower synchrony in BPD was most evident for patient's imitative behaviour: Under inOT, patients with high scores of childhood trauma refrained from imitating their interview partners.Study limitations include small sample sizes and limited data on the psychological impact of the clinical interviews. [ABSTRACT FROM AUTHOR]

Objectives Interpersonal dysfunction is central to borderline personality disorder ( BPD). Recent research has focused on the role of oxytocin ( OT) in BPD, particularly regarding associations of OT activity with symptoms, genetic polymorphisms of the oxytocin receptor coding gene ( OXTR) in BPD, and experimental modification of interpersonal core problems of patients with BPD such as hypervigilance towards threat detection, mistrust, and non-verbal behaviour during social interaction by intranasal application of OT. Methods A literature ('medline') review was performed using the keywords 'oxytocin' and 'borderline personality disorder'. Secondary literature on trauma and attachment in relation to OT was also considered relevant. Results Together, findings suggest that in BPD OT is associated with enhanced defensive mechanisms and avoidance behaviour. Moreover, gene-environment interaction concerning polymorphic variations of the OXTR gene and childhood adversity in BPD suggests that these genes convey developmental flexibility or 'differential susceptibility' to environmental contingencies, whereby BPD resides at the poor outcome end of the spectrum. Conclusions In view of the conflicting literature, it needs to be studied carefully whether OT can serve as a therapeutic agent given adjunct to psychotherapy in BPD. More research about the role of OT is also required with regard to the prevention of the non-genetic intergenerational transmission of BPD. Clarifying the role of OT in BPD may also benefit from research in non-human animals targeting the interaction between early adversity and OT availability more directly. Practitioner points The study of oxytocin can contribute to the understanding of the neurobiology of borderline personality disorder., Oxytocin is critically involved in attachment security, and methylation of the oxytocin receptor may play a role in the epigenetic modulation of early adversity., The intranasal application of oxytocin may be a useful therapeutic adjunct to psychotherapy., Insecure attachment and childhood adversity may produce differential neurobiological effects on the oxytocinergic system in borderline personality disorder., There is insufficient knowledge of how oxytocin interacts with vasopressin, testosterone, dopamine, and serotonin, which are also important key players in the experience of social reward and stress responsivity., It is unclear whether or not oxytocin could be beneficial in preventing the intergenerational (non-genetic) transmission of borderline personality traits. [ABSTRACT FROM AUTHOR]