APEGO

POSGRADO PNIE
2019
 In Baby Mode
Anna von Hopffgarten
Scientific American Mind 28, 49 - 55 (2017)
Published online: 10 August 2017 | doi:10.1038/scientificamericanmind0917-49

After birth, a mother's brain reorients completely to care of

her infant.
The hormone oxytocin sensitizes her motivation and emotion centers
to her child.
The neural networks in her brain are also transformed structurally. For
example, during pregnancy the gray matter in the regions of the
frontal and temporal lobes shrinks. Superfluous synapses there may
also be removed at this time.
We know from animal studies that the number of nerve fibers that
respond to oxytocin and vasopressin increases in the brain of male
parents, which makes fathers especially nurturing.
 The Social Power of Touch
Lydia Denworth
Scientific American Mind 26, 30 - 39 (2015)
Published online: 11 June 2015 | doi:10.1038/scientificamericanmind0715-30

A set of nerve fibers called C-tactile (CT)

afferents appears to convey information about
pleasant touch.
Given how attuned these fibers are to human
touch, they may play a role in reinforcing social
connections.
The functioning of these nerves may someday
serve as a biomarker for conditions such as autism
and addiction
LA TEORÍA DEL APEGO
Para Bowlby (1958) el apego se
formaría a partir de la necesidad
del infante humano de mantener
proximidad con ciertas figuras
que le provean de lo necesario
para su supervivencia. Esta
necesidad daría lugar a un
sistema conductual de control
 The ties that bind
Melvin Konner

In all cultures, attachment behaviours — such as turning and

clinging to the primary caregiver in distress and privileging that
person by preferentially quieting the distress — becomes very
strong in the second half-year of life.
It is probably not a coincidence that in the brain, major
pathways of the limbic system become coated with myelin
during this phase of infancy. This improves the function of the
subcortical circuits that process emotion and their connections
to the frontal and cingulate cortex. Although there is no direct
evidence, it is reasonable to hypothesize that this facilitates the
infant's side of the bond.
The vasopressin V1a receptor
(V1aR) is expressed at higher
levels in the ventral forebrain of
monogamous than in
promiscuous vole species
Cuando este sistema se encuentra en
pleno funcionamiento el niño puede
controlar el acceso a las figuras de
apego y mantener un grado de
proximidad razonable, incluso en
situaciones que no conllevan una
amenaza grave.
Oxytocin promotes attention to social cues regardless of group
membership
MichaelaPfundmairClarissaZwargMarkusPaulusAnneRimpel
https://doi.org/10.1016/j.yhbeh.2017.03.006

Highlights
•Oxytocin increases gaze durations toward
social but not nonsocial stimuli.
•In-group- and out-group-related social
cues are fixated equally long under
oxytocin.
•Oxytocin seems to work by simple
illumination of social cues.
OXITOCINA Y CLAVES SOCIALES
The social saliency account proposes that oxytocin (OT) plays a major
role in modulating attentional shifts toward social cues at early stages of
processing. We investigated how OT promotes early attention toward
nonsocial and social stimuli and explored differences between in-group-
and out-group-related social cues. After participants intranasally self-
administered OT or placebo, they were eye-tracked while observing a
nonsocial and social cues that were assigned to the in- or out-group by a
minimal group paradigm. Participants under placebo did not differ in
their fixation durations between stimuli, whereas participants
administered OT increased gaze durations toward social but not
nonsocial stimuli. In this early stage of processing, no in-group bias
occurred: in-group- and out-group-related social cues were fixated
equally long. These findings support that OT works by a simple
illumination of social cues that seem to be processed
regardless of social identity aspects at early stages of
attention.
Oxytocin-Augmented Psychotherapy: Beware of Context
René Hurlemann1, 2
Neuropsychopharmacology volume 42, page 377 (2017

The hypothalamic peptide oxytocin modulates a wide range of social and

cognitive functions in humans and nonhuman primates. As a result,
much effort is currently being devoted to developing oxytocin into an
adjunct treatment for mental illness, with a particular focus on anxiety,
autism, and schizophrenia spectrum disorders.
In the field of imaging neuroscience, one of the most consistent findings
with oxytocin is an inhibition of human amygdala responses to fearful
facial expressions following exogenous administration of a single nasal
dose—an effect recently replicated in macaques (Liu et al, 2015). An
oxytocin-induced modulation of neural activity in the amygdala and
other regions is in line with observations that intranasal administration
yields increased cerebrospinal fluid concentrations of the peptide in
humans (Striepens et al, 2013) as well as macaques (Freeman et al,
2016), although much controversy still exists regarding the exact route
of brain penetration.
We recently reported that oxytocin may facilitate fear extinction by downregulating the
amygdala and concomitantly upregulating medial prefrontal cortex activity in healthy
volunteers (Eckstein et al, 2015), implicating the peptide as a potential adjunct treatment
during extinction-based psychotherapy to reduce fear renewal. Interestingly, in a follow-
up imaging study, oxytocin produced the opposite effect by promoting fear-conditioned
responses (Eckstein et al, 2016). Thus, depending on the timing of administration, i.e., prior to
versus after conditioning, the peptide can enhance the acquisition or extinction of fear, leading
to contrary behavioral outcomes. Another intriguing example in this vein is a social economics
experiment, in which volunteers could donate money for a charity project located in the Kongo
delta. Subjects treated with placebo devoted more money to saving the rainforest rather than
supporting the indigenous population living in that reserve. Under oxytocin treatment,
participants showed the opposite behavioral pattern, suggesting that administration of the
peptide can transiently alter altruistic attitudes and reward values, thereby shaping decisions
towards social priorities (Marsh et al, 2015). These results are in accord with current
concepts that the contextual framing of an experimental scenario interacts with oxytocin
and determines its effects in a top-down regulatory manner (Quattrocki and Friston,
2014). The latter is substantiated by our observation that oxytocin increased the hedonic
pleasure associated with social touch when heterosexual male volunteers were made believe
that a female experimenter performed the touch as opposed to a male (Scheele et al, 2014)
Contextual framing not only matters to ‘message makers’ in
journalism, advertising, or politics—it is also of crucial relevance to
psychotherapy, especially when interventions are trialled with
oxytocin. Converging evidence from a series of imaging
experiments carried out in our laboratory suggests that nasal
oxytocin evokes a shift in the neural activity away from the
amygdala to the anterior insula, pregenual anterior cingulate
cortex, and precuneus—areas that orchestrate the conscious
monitoring of what happens in and around us. Current attempts
to translate oxytocin neuroscience to psychotherapy thus face the
crucial caveat that therapeutic context should be strictly controlled
to avoid the risk of unfavorable outcomes.
SISTEMA CONDUCTUAL DE CONTROL
(BOWLY 1958)
TEORIA APEGO
Estas respuestas son
independientes pero serían
integradas a través de
sucesivas experiencias con los
cuidadores, que al ser
internalizadas, irían
conformando la conducta
global de apego.
APEGO
CONDUCTA DE APEGO
La conducta de apego se
refiere a cualquiera de las
diversas formas de conducta
que tiene como resultado el
logro o la conservación de la
proximidad con otro
individuo claramente
identificado al que se
considera mejor capacitado
para enfrentarse al mundo
VÍNCULO DE APEGO
El vínculo de apego es el
lazo afectivo por las personas
que tienen una significación
especial en su vida. Decir que
un niño o una persona tiene
apego a alguien significa que
está absolutamente dispuesto
a buscar la proximidad y el
contacto con ese individuo,
sobre todo ante la sensación
de inseguridad.
TEORÍA APEGO- ETOLOGÍA
La etología nos proporciona la bases para
esta conceptualización, basada en la teoría
del imprinting o troquelado, en la que el
animal en sus primeros momentos de vida
sigue al primer objeto grande que se le
aproxima, al que le asigna un rol
básicamente maternal de protección
BATESON 1990, LORENZ 1973
El elemento que tienen en
común todos estos tipos de
conductas es que buscan el
objetivo de obtener la
proximidad deseada (Bowlby,
1969).
La función biológica-evolutiva de la
conducta de apego sería la protección
frente a los animales de presa. De esta
forma, el poder lograr la conducta de
proximidad con la madre sería una de
las claves de la supervivencia de la cría
en las especies superiores
El rol activo en este acercamiento
lo tiene en un primer momento la
madre. El bebé lo provoca a través de
“señales” tales como el llanto, la
sonrisa, la mirada, el balbuceo, los
gestos y el llamado cuyo objetivo es
llevar a la madre hacia el hijo
Posteriormente, el niño
asume este rol desarrollando
las “conductas de
acercamiento” cuyo
objetivo es llevarlo a él hacia
la madre
FASES DEL APEGO (BOWLBY)
Fase de pre apego: (primeros dos meses). Orientación
y señales sin discriminación de figura. Serían aquellos
comportamientos de las primeras semanas de vida del bebé,
que forman parte de su bagaje genético y que se activan
frente a la presencia humana. Se caracteriza por la aparición
de un amplio repertorio de señales en el bebé que son, en su
mayoría, de carácter reflejo, aunque también posee otras
capacidades sensoriales y perceptivas que le permiten
comunicarse y conocer a las personas que le rodean.
Ejemplos de estas conductas serían orientar la mirada hacia
una persona, sonreírle, dejar de llorar, tratar de aferrar.
Fase de formación del apego (2 a 6 meses)
Durante estos meses, el bebé empieza a dar
muestras de poder diferenciar a las personas
familiares de las desconocidas, por lo que tiene
una mayor tendencia a iniciar interacciones
sociales con el cuidador o cuidadores principales.
Por lo tanto, los comportamientos reseñados en
la fase anterior se orientan ahora hacia el
cuidador
Fase clara de apego (seis meses a tres años)
En esta nueva etapa se producen una gran
cantidad de cambios que dan lugar a la
consolidación de la vinculación afectiva. No sólo
el sistema de apego (como conjunto de conductas
que se encuentra organizado en torno a una meta,
a saber la proximidad y el contacto físico con la
figura de apego) se consolida en esta fase.
SISTEMAS CONDUCTUALES
El sistema afiliativo recoge el
repertorio de conductas
encaminadas a la búsqueda de la
proximidad e interacción con
personas conocidas
El sistema exploratorio, favorecido por las nuevas
posibilidades de desplazamiento autónomo, contribuye a
que el niño pueda mostrar conductas encaminadas a
conocer y explorar el entorno físico. Se buscará en
consecuencia el mantenimiento de la proximidad con
una figura discriminada por medio de la locomoción y de
las señales. Cuando el niño logra moverse por si mismo,
agrega este nuevo repertorio conductual a sus recursos
para obtener la proximidad de la madre
SISTEMA EXPLORATORIO
Esta situación novedosa introduce el equilibrio
entre las conductas del niño orientadas hacia la
exploración y hacia la seguridad. Ambas son
imprescindibles para su desarrollo. En un proceso
normal, en función de la sucesión de conductas
de exploración-acercamiento el niño empieza a
construir el concepto de “base segura”: la madre
como elemento independiente, permanente en
tiempo y espacio, al que puede recurrir más allá
de no estar en contacto presente. 4
Formación de una relación
recíproca (tres años en adelante; este
tipo de interacción madre-hijo dura
toda la vida en los seres humanos).
Ainsworth plantea un interesante
vínculo entre las fases del apego de
Bowlby y las etapas cognitivas de
Piaget.
CONDUCTAS DE APEGO
NO SON PRIVATIVAS DE A
INFANCIA
SE MANTIENEN DURANTE TODA
LA VIDA DE LA PERSONA
VAN CAMBIANDO LAS
ESTRATEGIAS PARA OBTENER EL
APEGO.
APEGO SALUDABLE
1- Que los padres le
proporcionen al niño una base
segura
2- Que lo animen a explorar a
partir de ellos (Bowlby, 1979)
Scheme 1. The Strange Situation episodes (adapted from Ainsworth
et al., 1978)
Episode number Participants Length Short description 1 Mother, infant and
observer 30 sec. The observer introduces mother and infant into the room, then
he/she leaves the room 2 Mother and infant 3 min. Mother does not participate
while infant explores. If necessary, play activities are encouraged after 2 minutes.
3 Mother, infant and stranger 3 min. Stranger enters. First minute: stranger is
silent. Second minute: stranger converses with the mother. Third minute:
stranger approaches infant. After 3 minutes, mother leaves unobtrusively. 4
Infant and stranger 3 min. or less First separation episode. Stranger’s behavior is
adjusted to that of infant. 5 Mother and infant 3 min. or more First reunion
episode. Mother greets and/or comforts infant, then tries to engage him/her in
play. Mother leaves again, saying “bye-bye”. 6 Infant alone 3 min. or less Second
separation episode. 7 Infant and stranger 3 min. or less Continuation of second
separation episode. Stranger enters and adjusts behavior to that of infant. 8
Mother and infant 3 min. or more Second reunion episode: mother greets infant,
picks him/her up and comforts him/her, then tries to engage him/her in play.
AISWORTH, M (1969)
APEGO SEGURO
En el Apego Seguro, los niños usaban a la figura
de apego como una base segura a partir de la cual
explorar el ambiente. Cuando se enfrentaban a
eventos estresantes (como la separación en un
ambiente desconocido), se acercaban o realizaban
algún tipo de señal que les permitiera aumentar el
grado de proximidad con la figura de apego.
Cuando este era obtenido volvía a continuar con
su exploración
APEGO ANSIOSO-EVITATIVO
En el Apego Ansioso/Evitativo, los niños
que enfrentaban un momento de separación
con sus madres eran relativamente
indiferentes cuando aquellas retornaban: no
las saludaban, ignoraban sus intentos de
tomar contacto y actuaban sin darle mayor
importancia a su presencia.
APEGO ANSIOSO-AMBIVALENTE
En el caso del Apego Ansioso/Ambivalente,
se observaron comportamientos
combinados de ansiedad y acercamiento.
Cuando estos niños se juntaban con sus
madres luego de una breve separación
emitían señales de ansiedad paralelamente a
su comportamiento de apego
Al relevar poblaciones infantiles sometidas a
condiciones de alto riesgo (víctimas de maltrato,
madres psiquiátricas, etc), Main y Solomon
introdujeron en 1986 un cuarto tipo de codificación
del apego: el estilo Desorganizado/Desorientado.
Estos niños parecen no poseer una estrategia
consistente para manejar el alejamiento y la
proximidad. Muestran signos de depresión clínica y
combinaciones de comportamiento evitativo, hostil y
de apego (Main, Hesse & Goldwin, 2008).
OXITOCINA
Beyond its physiological functions in the periphery,
animal studies provide evidence for a major role of OXT
in behavioral adaptation to pregnancy and motherhood.
Characteristic maternal behaviors (pup-grooming, hover
over offspring and respond latency) are impaired, if OXT
availability is diminished (Higuchi and Kaba,
1997; Olazabal and Young, 2005; Pedersen et al, 2006).
Furthermore, maternal OXT functioning influences
reciprocal affective behaviors between mother and
offspring in mammalian species (Nelson and Panksepp,
1998).
Recently, this association was also shown in
humans. Parents showing more affectionate and
stimulatory behaviors in interactions with their
children were characterized by higher plasma
OXT concentrations (Gordon et al, 2010).
Further, Feldman et al. (2007) reported
associations between prepartum-assessed OXT
concentrations and postpartum maternal
adaptation.
The maternal plasma OXT level,
measured during early and late
pregnancy, as well as in the first
month postpartum, predicted
maternal behavior (mother's gaze at
infant, mother vocalizations and
affectionate touch) in interaction with
the child
A study assessing plasma OXT twice during
pregnancy showed higher postpartum maternal–
fetal attachment-scores in women with a OXT rise
between the first and third trimester compared
with women with stable or decreasing patterns of
OXT (Levine et al, 2007). In non-pregnant
women, OXT is known to promote interpersonal
relationships and enhance feelings of love and trust
(Heinrichs and Domes, 2008).
On the basis of current evidence, lower
OXT levels in pregnancy could result in
impaired emotional adaptation to
motherhood, which is a major risk factor
for PPD development and subsequently
affects the quality of maternal behavior
(Murray et al, 1993; Stein et al, 2010).
The PVN is a major site of convergence and integration for neural
communication relating to stress, affective disorders, and
cardiovascular regulation, with effects on the hypothalamic
pituitary-adrenal (HPA) axis and autonomic function (Herman
2012). Oxytocin is co-localized in a subset of neurons in the PVN
with major adaptive or stress hormones, such as corticotropin
releasing hormone (CRH), which regulates the HPA axis and which
also has been implicated in some of the detrimental effects of
chronic stress(Aguileraetal.2008).Oxytocin may be co-released
with CRH as an adaptive response to a variety of challenges, both
positive and negative (Carter et al. 2008, Neumann & Landgraf
2012).
Oxytocin can be released in a coordinated
fashion,within the brain and at the posterior
pituitary, into the general
circulation(Neumann&Landgraf2012).It is
likely that the abilityof oxytocin to have
exceptionally broad and synchronized
behavioral and physiological consequences is
related to this capacity for movement
throughout the brain and body (Stoop 2012).
VASOPRESINA
The biological actions of vasopressin, which include
water conservation, probably facilitated survival and the
transition to terrestrial living, and may have been co-
opted across evolution to regulate defensive behaviors
and aggression(Ferris2008,Frank&Landgraf2008).
Vasopressin is critical to social adaptation in a demanding
world,with a behavioral profile that is associated with
attachment to and defense of self, family, and other
member so four social networks(Carter1998).
VASOPRESINA
Vasopressin also may synergize with CRH
(Aguilera et al. 2008) to increase stress
reactivity, anxiety,and repetitive
behaviors,such as territorial marking in
rodents(Ferris2008).Vasopressin also has
been associated with defensive aggression
and emotional dysregulation (Albers 2012)
VASOPRESINA
This peptide is synthesized in brain regions
that regulate biological rhythms and may
play a role in sleep disturbances and
insomnia—perhaps contributing to
disorders such as PTSD. It is plausible that
oxytocin is protective against PTSD (Olff
2012), possibly through its capacity to
counteract some of the hyperarousal
associated with vasopressin
RECEPTORES OXITOCINA-VASOPRESINA
Receptors for both oxytocin and
vasopressin are abundant in areas of
the nervous system that regulate
social, emotional, and adaptive
behaviors including the amygdala,
the HPAaxis, and the autonomic
nervous system
MATERNAL OXITOCINA-FETAL GABA
Maternal oxytocin acts as a signaling mechanism
between the mother and fetus).Of particular
importance to cortical and hippocampal
functioning is gamma-aminobutyric acid
(GABA). Maternal oxytocin released during
birth triggers a switch in GABA signaling in the
fetal brain from excitatory to inhibitory.
Inhibitory GABA is necessary for
cognitive functions
 Maternal oxytocin apparently inhibits fetal
neurons and concurrently increases their
resistance to hypoxia,which can serve to protect
cortical tissue during birth.The birth-related
surge in oxytocin also helps to regulate the
synchronization of the fetal hippocampal neurons,
possibly facilitating the transition from prenatal
to postnatal life (Crepel etal. 2007, Khazipov etal.
2008). Such changes have long-term consequences
for emotional and cognitive functions and the
growth of the nervous system.
.Delivering a large baby, which involves
prenatal maternal investment, cervical
stimulation, and the release of oxytocin, as well
as stress and pain, may increase the attachment
between the mother and offspring. As one
example, the success of precocial mammals such as
sheep, whose infants must follow the mother
immediately following birth, depends on high levels of
cortical-motoric maturation as well as selective
attachment to the mother, who is the infant’s source of
food and protection
In socially monogamous or communal
species, care of the young often extends
beyond the maternal-infant
unit(Hrdy2009).In this context it is useful
to note that interacting with an infant can
release oxytocin in adult males, including
humans (Feldman 2012)
Ocitocina: hormona del amor
En el inicio de una relación amorosa se
produce un efecto fisiológico, que
resulta del interjuego entre la oxitocina
y la vasopresina, que tiene como
resultado la activación del sistema
nervioso simpático sin la retracción del
sistema nervioso parasimpático.
Resumen sistema oxitocina-vasopresina
La oxitocina es a una molécula con un espectro único e
inusualmente amplio de acciones con efectos biológicos y
conductuales. Actúa sobre tejidos y receptores antiguos y que han
evolucionado con distintas funciones. Entendiendo éste sistema
nos abrirá una ventana a la compresión de la evolución y
epigenética del cerebro humano.
Hay abundante evidencia que sostiene la importancia de la
interacción cuidador-cría en el modelado de las experiencias
individuales. Zhang & Meaney 2010.
El sistema nervioso parece ser especialmente sensitivo a la
presencia o no de oxitocina-vasopresina, con consecuencias
epigenéticas, lo cual puede ayudar a entender las diferencias
individuales en las conductas y estrategias de afrontamiento.
Resumen
Ante estas evidencias resulta importante actuar con precaución en
los tratamiento farmacológicos.
A través de la evolución de los vertebrados los efectos de las
moléculas tipo oxitocina han sido cruciales a la supervivencia y
reproducción. En humanos modernos, la acción de la oxitocina
facilita el nacimiento y directa o indirectamente influencia la
anatomía cerebral, permitiendo el desarrollo de la neocorteza y
con ello la cognición y el lenguaje. El cuerpo y el cerebro de los
mamíferos es modelado por la ocitocina.
La ocitocina juega un importante rol en los sistemas sensorial,
autonómico, integrativo, visceral y motor.
Ayuda a modular el tono emocional en la infancia temprana.
Oxytocin Pathways and the Evolution of Human Behavior
C. Sue Carter
Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill,
North Carolina 27599; and Department of Psychology, Northeastern University, Boston,
Massachusetts 02115; email: sue_carter@med.unc.edu

“Simplemente sugiero que el

Homo Sapiens, con su elevado
nivel de dependencia a las
relaciones sociales y
cogniciones, no podría haber
evolucionado sin la oxitocina”