Wednesday, February 17, 2010

Oxytocin and autism

Many science bloggers have tackled the oxytocin story, including yours truly over at my Complete Idiot's Guide to Biology blog. While the results of the study are interesting, I had two not-so-positive responses to the study. The first has to do with reality, and the second has to do with scientific interpretation.

My reality issue has to do with the way the study authors and the accompanying news release talk about autism. The abstract, for example, offers up this gem: "Individuals with high-functioning autism or with Asperger syndrome cannot understand or engage in social situations despite preserved intellectual abilities."

Pause. Deep breath. Like Temple Grandin's description of thoughts as video, my mind flashed on a million little visual examples of TH and other autistic children I know engaging in, and yea verily, even understanding social situations. It's not that they don't do it. It's that sometimes, they're not very good at it. And there is a difference.

The news release delivers a few other precious offerings. Here's one quote related to the above, both in terminology and error: "...patients retain normal intellectual and linguistic skills but are unable to engage spontaneously in social situations. Thus, during a conversation, these patients turn their heads and avoid eye contact with other people." It's a pity that even the people who are addressing interesting hypotheses underlying autism exhibit so little real understanding of it. As anyone who knows a person with autism can attest, that lack of eye contact is often exactly because the autistic person is engaging socially. Looking away clears out noisy visual inputs and allows conversational engagement. Geez, people.

At the close of the release, there's this, using that word that can make some of us, at least, shudder--the D-word: "They will in particular be studying the long-term effects of oxytocin on improving the everyday living disorders of autistic patients, (sic) and its efficacy at an early stage of the disease." There's so much about the connotation associated with that word that just doesn't seem to fit my personal experience with autism.

Finally, the case-control study--which addressed a very small group of individuals with variable diagnoses (e.g., HFA vs. Asperger's)--leaves me with a large, lingering question that requires more investigation, as the authors seem to acknowledge: Was the improvement that the autistic people presented in social interaction after whiffing oxytocin the result of reduced anxiety (oxytocin is known for this soothing effect) or some other, more direct effect on social ability? The authors describe the hormone as improving social learning. My vote right now is for reduced anxiety. From what I've seen and read, so much of what drives the social awkwardness in autism is attributable to anxiety.

There are other issues, of course. The whiff of oxytocin yields a transient, quickly fading effect. And oxytocin has been shown to improve trust in people to the extent that they continue to trust in the face of betrayal. Given that autistic people may already have some difficulty divining the ill-intended from the sincere...what "side effects" might oxytocin have here?