Alcohol does not influence trust in others or oxytocin, but increases positive affect and risk-taking: a randomized, controlled, within-subject trial

Abstract

Background
Alcohol consumption to facilitate social interaction is an important drinking motive. Here, we tested whether alcohol influences trust in others via modulation of oxytocin and/or androgens. We also aimed at confirming previously shown alcohol effects on positive affect and risk-taking, because of their role in facilitating social interaction.

Methods
This randomized, controlled, within-subject, parallel group, alcohol-challenge experiment investigated the effects of alcohol (versus water, both mixed with orange juice) on perceived trustworthiness via salivary oxytocin (primary and secondary endpoint) as well as testosterone, dihydrotestosterone, positive affect, and risk-taking (additional endpoints). We compared 56 male participants in the alcohol condition (1.07 ± 0.18 per mille blood alcohol concentration) with 20 in the control condition.

Results
The group (alcohol versus control condition) × time (before [versus during] versus after drinking) interactions were not significantly associated with perceived trustworthiness (η ² < 0.001) or oxytocin (η ² = 0.003). Bayes factors provided also substantial evidence for the absence of these effects (BF 01 = 3.65; BF 01 = 7.53). The group × time interactions were related to dihydrotestosterone (η ² = 0.018 with an increase in the control condition) as well as positive affect and risk-taking (η ² = 0.027 and 0.007 with increases in the alcohol condition), but not significantly to testosterone.

Discussion
The results do not verify alcohol effects on perceived trustworthiness or oxytocin in male individuals. However, they indicate that alcohol (versus control) might inhibit an increase in dihydrotestosterone and confirm that alcohol amplifies positive affect and risk-taking. This provides novel mechanistic insight into social facilitation as an alcohol-drinking motive.

Full text

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European Archives of Psychiatry and Clinical Neuroscience (2024) 274:311–320
https://doi.org/10.1007/s00406-023-01676-w
ORIGINAL PAPER
Alcohol does notinfluence trust inothers oroxytocin, butincreases
positive affect andrisk‑taking: arandomized, controlled,
within‑subject trial
LeonardP.Wenger1 · OliverHamm1· ChristianeMühle2· SabineHomann1· IrisReinhard3 · PatrickBach1·
JohannesKornhuber2 · GeorgW.Alpers4· FalkKiefer1· TagridLeménager1· BerndLenz1
Received: 24 May 2023 / Accepted: 8 August 2023 / Published online: 14 September 2023
© The Author(s) 2023
Abstract
Background Alcohol consumption to facilitate social interaction is an important drinking motive. Here, we tested whether
alcohol influences trust in others via modulation of oxytocin and/or androgens. We also aimed at confirming previously
shown alcohol effects on positive affect and risk-taking, because of their role in facilitating social interaction.
Methods This randomized, controlled, within-subject, parallel group, alcohol-challenge experiment investigated the effects
of alcohol (versus water, both mixed with orange juice) on perceived trustworthiness via salivary oxytocin (primary and
secondary endpoint) as well as testosterone, dihydrotestosterone, positive affect, and risk-taking (additional endpoints). We
compared 56 male participants in the alcohol condition (1.07 ± 0.18 per mille blood alcohol concentration) with 20 in the
control condition.
Results The group (alcohol versus control condition) × time (before [versus during] versus after drinking) interactions were
not significantly associated with perceived trustworthiness (η2 < 0.001) or oxytocin (η2 = 0.003). Bayes factors provided also
substantial evidence for the absence of these effects (BF01 = 3.65; BF01 = 7.53). The group × time interactions were related to
dihydrotestosterone (η2 = 0.018 with an increase in the control condition) as well as positive affect and risk-taking (η2 = 0.027
and 0.007 with increases in the alcohol condition), but not significantly to testosterone.
Discussion The results do not verify alcohol effects on perceived trustworthiness or oxytocinin male individuals. However,
they indicate that alcohol (versus control) might inhibit an increase in dihydrotestosterone and confirm that alcohol amplifies
positive affect and risk-taking. This provides novel mechanistic insight into social facilitation as an alcohol-drinking motive.
Keywords Alcohol· Trustworthiness· Oxytocin· Positive affect· Risk-taking· Social facilitation
Introduction
Alcohol is among the most culturally meaningful substances
that people use throughout history to induce specific bodily
states [1, 2]. However, since consuming alcohol is a major
health risk, it is necessary to consider relevant drinking
motives [3]. An important reason for alcohol consumption
is facilitation of social interaction—especially in males [4].
Alcohol may exert its socially facilitating effects by
increasing perceived trustworthiness of others. Trustwor-
thiness determines the degree of trust that is seen in other
individuals [5]. Trust involves the expectation of mutually
benevolent interaction and forms a central precondition for
the emergence of social interactions and relationships [6–8].
Consequently, a lack of trust in the persons present hinders
social interactions. An influence of alcohol consumption on
* Leonard P. Wenger
Leonard.Wenger@zi-mannheim.de
1 Department ofAddictive Behavior andAddiction Medicine,
Medical Faculty Mannheim, Central Institute ofMental
Health, Heidelberg University, J5,68159Mannheim,
Germany
2 Department ofPsychiatry andPsychotherapy,
Universitätsklinikum Erlangen andFriedrich-Alexander
University Erlangen-Nürnberg (FAU), Erlangen, Germany
3 Department ofBiostatistics, Medical Faculty Mannheim,
Central Institute ofMental Health, Heidelberg University,
Mannheim, Germany
4 Department ofPsychology, School ofSocial Sciences,
University ofMannheim, Mannheim, Germany
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312 European Archives of Psychiatry and Clinical Neuroscience (2024) 274:311–320
1 3
perceived trustworthiness is suggested by the fact that social
anxiety is both associated with an increased prevalence of
alcohol use disorder (AUD) and negatively associated with
trust and perceived trustworthiness regarding presented faces
[9–13]. Consequently, it is assumed that socially anxious indi-
viduals consume alcohol, partly because this increases their
trust in interaction partners and, as a result, facilitates social
interaction. To our knowledge, there is a gap in research on
whether alcohol influences perceived trust in others.
It is possible that the prosocial hormone oxytocin [14–17]
mediates the hypothesized alcohol-induced increase in per-
ceived trustworthiness, since intranasal administration of
oxytocin increases perceived trustworthiness regarding pre-
sented faces as well as interpersonal trust [18, 19]. Previ-
ous studies associated oxytocin concentrations with alcohol
consumption and AUD [20, 21]. In this regard, a previous
study [22] identified higher oxytocin blood concentrations in
patients with AUD (than in same-sex controls) at the time of
hospital admission for detoxification, which decreased by the
time of the follow-up survey (approximately 5 days later) and
then did no longer significantly differ from those of same-sex
controls. This observation may suggest that elevated oxytocin
concentrations in early abstinent (defined as 24–72 h of absti-
nence) patients with AUD result from acute alcohol intoxica-
tion. This assumption is supported by a positive correlation
between blood alcohol and oxytocin concentrations in males
of this study. However apart from associative findings, the
literature cannot conclusively answer the question whether
alcohol consumption in an experimental setting leads to an
increase in oxytocin concentration. Although some experi-
mental studies have failed to demonstrate a significant effect
of alcohol consumption on the oxytocin blood concentration
[23–26], these few studies are subject to several limitations.
First, the participants did not reach blood alcohol concen-
trations of more than about 0.9 per mille and often much
less, which might have been too low to induce a significant
increase in oxytocin concentration [22, 27]. Also, many pre-
vious studies did not control for food and fluid intake as well
as sexual or high physical activity prior to the experiment,
which may have reduced the impact of alcohol and influenced
the oxytocin concentration [28–30]. Moreover, some previ-
ous studies were limited due to small sample sizes.
Main aims of the study: The goal of this study was to
establish that in male social drinkers, an alcohol challenge
(versus water; both mixed with orange juice) increases the
behavioral endpoint perceived trustworthiness and that
the hypothesized association between alcohol concentra-
tion and trustworthiness is mediated by salivary oxytocin
concentrations. We aimed to overcome the above reported
limitations of the literature. We used a male sample for sev-
eral reasons: central preliminary findings such as the asso-
ciation between alcohol and oxytocin blood concentrations
exclusively emerged in males [22]. In line with this, studies
further indicate that oxytocin is more relevant to alcohol use
in males than females [31, 32].
Additional aims of the study: In addition, administration of
testosterone has been shown to reduce perceived trustworthi-
ness of others [33, 34] and alcohol intake was demonstrated
to decrease testosterone concentrations [35, 36]. However,
we lack experimental data on how alcohol intake influences
dihydrotestosterone (DHT) concentrations, which is a metabo-
lite of testosterone and has a higher affinity to the androgen
receptor than testosterone [37]. Therefore, we also explored
the effects of alcohol on testosterone and DHT concentrations
as well as a potential mediation effect regarding perceived
trustworthiness. Finally, we aimed to confirm previous find-
ings on how alcohol influences positive affect and risk-taking,
since multiple studies demonstrated that alcohol administra-
tion increases positive affect and risk-taking [2, 38–41], both
of which exert prosocial effects [42–48] and may, thus, be
involved in alcohol-induced facilitation of social interaction.
We did not examine negative affect since we did not sample
depressed participants and hence, potential floor effects would
have prevented the detection of an alcohol-related decrease.
Experimental procedures
Study description
The study was conducted at the Central Institute of Mental
Health (CIMH) Mannheim, Germany. The Ethics Commit-
tee II of the Heidelberg University approved the project (ID:
2021-608)and all participants provided written informed
consent and received 50 euros each for their participation.
The study with its primary and secondary endpoints per-
ceived trustworthiness and oxytocin concentrations has
been preregistered in the German Clinical Trials Register
(DRKS00026599). Of 79 participants who were recruited
via the CIMH website and social media, 76 were analyzed
after being randomized to the experimental (n = 56) and
control conditions (n = 20). The randomization was based
on a single sequence of random numbers. Participants in
the experimental and control conditions did not significantly
differ in any sociodemographic characteristic (Table1).
Inclusion criteria were male sex, minimum age of 18
years, and being a social drinker, which was defined as
regularly consuming alcohol in social contexts with blood
alcohol concentrations of approximately 1.5 per mille [49].
To overcome limitations of previous studies, further criteria
were defined (for an overview see Supplementary Appendix
SA1). Among others, these included abstaining from drink-
ing more than 0.5 L of fluid as well as sexual activity and
high physical activity before the assessment on the day of
the experiment. Also, subjects were meant to eat their last
meal no later than 3h before the start of the experiment.
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313European Archives of Psychiatry and Clinical Neuroscience (2024) 274:311–320
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During a screening interview prior to the experiment, sub-
jects were instructed to adhere to these guidelines. However,
asking the subjects about their adherence on the day of the
experiment revealed that only 41 participants (53.95%) had
actually complied. We, thus, conducted sensitivity analyses.
In a randomized, controlled, within-subject, paral-
lel group, alcohol-challenge experiment, the study sub-
jects consumed an alcohol (Vodka) orange juice mix in
the alcohol condition and a water orange juice mix in the
control condition (for further details see the study flow
diagram in Fig.1). The conditions were identical apart
from the consumed beverage. The subjects were surveyed
between 2 and 4 pm. There were three time points of
measurement, with perceived trustworthiness, positive
affect, and risk-taking, measured at the first and third time
points, and salivary oxytocin, testosterone, DHT, as well
as breath alcohol concentration measured at all three time
points. The mean time span from the start of the first to
the end of the third time point was M = 101.64 min. The
consumed total mass of liquid was kept equal at 1200 g
Table 1 Sociodemographic
characteristics of the study
participants in the alcohol and
control conditions
The table shows the valid number of subjects analyzed (N), means (M) or relative frequencies (F), standard
deviations (SD), and the results of #t, §Welch, and +χ2 tests. AUDIT, Alcohol Use Disorders Identification
Test; BMI, Body Mass Index
a The reported amount of pure alcohol corresponds to a total liquor mass (g) of M = 274.37 (SD = 29.86)
and a total liquor volume (mL) of M = 293.39 (SD = 31.93)
b Kein Schulabschluss, cHauptschul- oder Realschulabschluss, d(Fach)Abitur/allgemeine Hochschulreife,
eLehre/Berufsausbildung, f(Fach)Hochschulabschluss/Staatsexamen
Alcohol condition Control condition Alcohol versus
control condi-
tion
n M/F SD n M/F SD t or χ2p
Age (years) 56 23.09 2.82 20 24.70 6.63 −1.05 0.304§
Weight (kg) 56 80.29 11.53 20 85.45 12.91 −1.67 0.100#
BMI (kg/m2) 56 23.53 2.56 20 24.74 3.32 −1.68 0.098#
AUDIT score 56 9.11 3.17 20 8.80 3.90 0.32 0.754§
Mass of pure alcohol applied during the
experiment (g)a
56 93.89 10.22
Blood alcohol concentration (per mille)
First time point 56 0.00 0.00
Second time point 56 0.53 0.15
Third time point 56 1.07 0.18
Marital status 56 20 2.87 0.339+
Single 34 60.71 12 60.00
In a relationship 22 39.29 7 35.00
Married 0 0.00 1 5.00
Divorced 0 0.00 0 0.00
Other 0 0.00 0 0.00
Educational achievement 56 20 1.22 0.785+
No high school diplomab0 0.00 0 0.00
Junior high school diplomac1 1.78 1 5.00
High school diplomad38 67.86 14 70.00
Job traininge4 7.14 2 10.00
University degreef13 23.21 3 15.00
Other 0 0.00 0 0.00
Main occupation 56 20 1.24 0.832+
Undergraduate 49 87.50 17 85.00
Trainee 1 1.79 0 0.00
Working full time 5 8.93 3 15.00
Job-seeking 0 0.00 0 0.00
Other 1 1.79 0 0.00
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314 European Archives of Psychiatry and Clinical Neuroscience (2024) 274:311–320
1 3
between the participants of the alcohol and control condi-
tions. Between the first and second as well as the second
and third time point, participants consumed 600 g of liq-
uid each. Based on previous findings [22], the amount of
vodka was calculated individually in grams to theoretically
evoke blood alcohol concentrations of 1.5 per mille [50]
(for details see Supplementary Appendix SA2).
Survey ofproblematic alcohol consumption
andalcohol expectancies
Problematic alcohol consumption was surveyed using the
German version of the Alcohol Use Disorder Identification
Test (AUDIT) [51]. The extent to which people expect that
socially beneficial effects can be achieved through alcohol
consumption was captured using a self-created measure
that presented the participants with three self-descriptive
statements. For each item, the subjects had to indicate on
a five-point Likert-scale how much the given statement
applied to them. The individual item responses were added
up to a total score (for details see Supplementary Appendix
SA3).
Survey ofperceived trustworthiness, positive affect,
andrisk‑taking
The paradigm for assessing perceived trustworthiness was
adopted from Theodoridou etal. [19]. The subjects were
each presented with the same 30 pictures of people with
neutral facial expressions in random order (see https:// www.
kdef. se/ downl oad-2/). For each picture, they had to indicate
on a five-point Likert-scale how trustworthy they considered
the person depicted. The individual item responses were
added up to a total score. Positive affect was measured using
the Positive and Negative Affect Schedule (PANAS) [52]
and risk-taking using the Expected Involvement subscale of
an adapted and translated version of the Cognitive Appraisal
of Risky Events questionnaire (CARE) [53].
Quantification ofblood alcohol andsalivary
oxytocin, testosterone, andDHT concentrations
The blood alcohol concentration was calculated from breath
alcohol content, using the AlcoTrue® M device (5040112002)
by bluepoint MEDICAL (Selmsdorf, Germany). Saliva was
Fig. 1 Study flow diagram
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315European Archives of Psychiatry and Clinical Neuroscience (2024) 274:311–320
1 3
collected using salivettes according to instructions (e.g.,
abstain from eating 1 h prior to saliva collection). Two saliva
samples of 2 min each were collected at each of the three time
pointsandstored at −20 °C for up to sixmonths.After thawing,
the samples were centrifuged at 1000 g for 2 min.The super-
natant was used for hormone quantification. Salivary oxytocin,
testosterone, and DHT concentrations were quantified using
the Cayman Chemicals Oxytocin ELISA kit (500440, Cayman
Chemicals, Ann Arbor, MI, USA), the Demeditec Diagnostics
Testosteron frei im Speichel ELISA kit (DES6622, Demed-
itec Diagnostics GmbH, Kiel, Schleswig–Holstein, Germany),
and the Tecan 5-alpha Dihydrotestosterone (DHT) ELISA kit
(DB52021, IBL International GmbH, a Tecan Group Com-
pany, Hamburg, Hamburg, Germany), respectively, according
to the manual’s instructions. For oxytocin, 50 µL were applied
in parallel to a standard curve ranging from 6 to 7,500 pg/mL.
Testosterone was quantified in 100 µl with a standard curve
from 5 to 1,000 pg/mL. For DHT, 50 µl and a standard curve
from 12.5 to 2,500 pg/mL were used. All measurements were
performed blinded and within one assay run.
Data preparation andstatistical analyses
After completion of the data collection, the final dataset con-
tained 79 cases. We removed all cases that had to be excluded
due to different reasons (e.g., persons who had arrived already
intoxicated or persons who indicated that their data should
not be used), N = 76 cases (alcohol condition, n = 56; control
condition, n = 20) remained in the dataset.
Alcohol-induced changes in perceived trustworthiness, pos-
itive affect, and risk-taking, as well as oxytocin, testosterone,
and DHT concentrations were analyzed using two-factorial
analyses of covariance (ANCOVA) with the within-subjects
factor time (1 versus 3 or 1 versus 2 versus 3), the between-
subjects factor group (alcohol versus control condition), and
the AUDIT score as a covariate. For models with a signifi-
cant group x time interaction, paired t tests separately for the
alcohol and control conditions were calculated to compare the
first and third time point. Because it was not possible to blind
alcohol administration, correlations between the respective
change from the first to the third time point in the alcohol
condition and participants’ alcohol expectancies were calcu-
lated to control for potential expectancy effects. For models
with a non-significant group x time interaction, Bayes factors
were calculated to further evaluate the given absence of an
effect. Structural equation modeling was used to assess the
mediation hypothesis. Data were analyzed using R-Studio
2021.09.1 Build 372 (Posit PBC, Boston, MA, USA) and
visualized using GraphPad Prism 8.4.3 (Graph Pad Software
Inc., San Diego, CA, USA).
Results
Main aims: nosignificant alcohol‑related changes
inperceived trustworthiness andsalivary oxytocin
concentration
Meansand standard deviations regarding perceived trust-
worthiness and oxytocin at the three time points within the
experimental and control groups are displayed in Table2.
The two-factorial ANCOVA revealed a non-significant
group x time interaction regarding perceived trustworthi-
ness (F(1, 73) = 0.06, p = 0.803, η2 < 0.001) and oxytocin
(F(1.57, 109.67) = 0.41, p = 0.616, η2 = 0.003). Also, Bayes
factors provide substantial evidence in favor of the absence
of an interaction effect for both perceived trustworthiness
(BF01 = 3.65) and oxytocin (BF01 = 7.53). Besides, there
was a significant main effect of time on perceived trust-
worthiness (F(1, 73) = 5.85, p = 0.018, η2 = 0.010), with a
decrease from time point 1 to time point 3. For full model
results, see Supplementary Table ST1.
A structural equation model was specified within the
alcohol condition, which included the indirect effect of
the blood alcohol concentration via oxytocin on per-
ceived trustworthiness. For each variable, the difference
value from the first to the third time point was used. The
oxytocin model revealed no significant indirect effect of
alcohol concentration via oxytocin concentration on per-
ceived trustworthiness (z = −0.09, p = 0.933, β = −0.001,
CI [−0.014, 0.044]).
Additional aims
Group‑dependent changes insalivary DHT concentration,
withoutalcohol‑related changes insalivary testosterone
concentration
Means, standard deviations, and standard errors regarding
salivary testosterone, and DHT concentrations at the three
time points within the experimental and control groups are
displayed in Table2.
The two-factorial ANCOVA revealed no significant
group x time interaction regarding testosterone (F(1.94,
139.96) = 0.65, p = 0.521, η2 = 0.002). Also, Bayes factors
provide substantial evidence in favor of the absence of an
interaction effect for testosterone (BF01 = 6.37). Regard-
ing DHT, there was a significant group x time interaction
(F(1.86, 134.01) = 5.62, p = 0.006, η2 = 0.018). Paired t
tests showed no significant change in the alcohol condi-
tion (t(54) = −0.45, p = 0.658, dz = −0.06), but an increase
in the control condition (t(19) = 2.98, p = 0.008, dz = 0.67).
For full model results, see Supplementary Table ST1.
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316 European Archives of Psychiatry and Clinical Neuroscience (2024) 274:311–320
1 3
Structural equation models were specified within the
alcohol condition, which included the indirect effect of
the blood alcohol concentration via testosterone or DHT
on perceived trustworthiness. For each variable, the differ-
ence value from the first to the third time point was used.
The testosterone model revealed no significant indirect
effects of alcohol concentration via testosterone concentra-
tion on perceived trustworthiness (z =−0.885, p = 0.376,
β = −0.028, CI [−0106, 0.015]). Similarly, the DHT model
revealed no significant indirect effect of alcohol concentra-
tion via DHT concentration on perceived trustworthiness
(z = −0.830, p = 0.407, β = −0.035, CI [−0.156, 0.011]).
Alcohol‑related changes inpositive affect andrisk‑taking
Means and standard deviations regarding positive affect and
risk-taking at the first and third time point within the experi-
mental and control groups are displayed in Table2.
Regarding positive affect, the two-factorial ANCOVA
revealed a significant group x time interaction (F(1,
73) = 10.38, p = 0.002, η2 = 0.027; Fig.2a). Accordingly,
paired t tests showed a significant increase in the alcohol
condition (t(55) = 4.10, p < 0.001, dz = 0.55), but not in the
control condition (t(19) = −1.25, p = 0.226, dz = −0.28). Also
in terms of risk-taking, the two-factorial ANCOVA revealed
a significant group x time interaction (F(1, 73) = 9.69,
p = 0.003, η2 = 0.007; Fig.2b). Accordingly, paired t tests
showed a significant increase in the alcohol condition
(t(55) = 3.83, p < 0.001, dz = 0.51), but not in the control con-
dition (t(19) = −1.46, p = 0.161, dz = −0.33). For full model
results, see Supplementary Table ST1.
The participants’ alcohol expectancies showed no sig-
nificant correlation with the change in positive affect
(t(54) = 1.39, p = 0.170, r = 0.19) or risk-taking
(t(54) = −0.75, p = 0.455, r = −0.10) suggesting that there
were no or only minor expectancy effects.
Sensitivity analyses
Since several participants indicated that they had not adhered
to the guidelines on the day of the experiment, all analyses
were recalculated excluding these subjects. In these sensi-
tivity analyses, the significant findings of the whole sample
persisted (for details, see Supplementary Table ST2).
Table 2 Means and standard
deviations at the different time
points in the alcohol and control
conditions
EP = endpoints; n = number of participants with available data; M = mean; SD = standard deviation; pos-
sible range of instruments: perceived trustworthiness (30–150), positive affect (1–5), risk-taking (30–210).
For the analysis of the oxytocin concentration and the testosterone as well as DHT concentrations, three or
one additional subject(s), respectively, were excluded because of missing values for at least one of the three
time points
Time
point
Alcohol condition Control condition
nM SD nM SD
Main EP
Perceivedtrustworthiness 1 56 95.18 13.96 20 95.70 14.13
3 56 92.25 17.23 20 91.80 14.29
Oxytocinconcentra-
tion(in pg/mL)
1 54 682 1169 19 383 354
2 54 1000 2662 19 934 2025
3 54 811 1776 19 1122 1737
Additional EP
Testosteroneconcentra-
tion(in pg/mL)
1 55 343 149 20 289 141
2 55 380 220 20 340 144
3 55 366 215 20 359 155
DHTconcentration(in
pg/mL)
1 55 743 289 20 699 257
2 55 774 411 20 726 281
3 55 728 329 20 905 502
Positive affect 1 56 3.36 0.67 20 3.14 0.60
3 56 3.69 0.82 20 2.96 0.59
Risk-taking 1 56 89.77 18.94 20 89.10 22.11
3 56 95.25 23.15 20 86.75 22.33
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317European Archives of Psychiatry and Clinical Neuroscience (2024) 274:311–320
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Discussion
The present study examined the effects of alcohol admin-
istration on perceived trustworthiness and oxytocin con-
centration (primary and secondary endpoints), as well as
on testosterone and DHT concentrations, positive affect,
and risk-taking (additional endpoints). We were not able
to verify our main hypothesis that alcohol (versus water)
increases perceived trustworthiness via modulation of oxy-
tocin. However, we detected an overall decrease in perceived
trustworthiness over time in both the alcohol and the con-
trol condition. This might be explained by boredom that
worsened subjects' stimulus-related attitudes after repeated
presentation of the same stimuli [54]. We are also tempted
to speculate that the study setting might have produced the
feeling of competitionand stress in the participants that
could have deteriorated ratings of trustworthiness. The find-
ing in combination with the results of the Bayesian analysis
suggests that alcohol consumption does not facilitate social
interaction through an increase in trust in others. There were
also no indications of methodological artifacts such as a ceil-
ing effect.
An alternate explanation for the null finding emerges by
considering that alcohol has a stronger positive-euphoric
effect when it occurs in naturalistic-social versus artifi-
cially isolated drinking contexts [55]. The alcohol effect
on perceived trustworthiness might manifest particularly in
naturalistic-social drinking contexts. In the present study,
the participants consumed alcohol in an artificially isolated
laboratory context. In the trustworthiness task, pictures of
individuals with neutral facial expressions were presented
and the participants were asked to judge without interaction.
Therefore, future research is needed to translate this project
in a more real-life experiment (e.g., through virtual reality
[56] or ecological momentary assessments [57]).
Also, oxytocin concentrations did not significantly
increase in the alcohol versus the control condition. The
absence of alcohol-induced effects was supported by the
results of Bayesian analyses, providing substantial evidence
in favor of the lack of alcohol-related changes in oxytocin. In
the present study, we addressed a population of social drink-
ers and quantified oxytocin in saliva samples in contrast to
patients with AUD and blood serum sampling of oxytocin
in the Lenz etal. investigation [22], which might explain
the discrepancy concerning oxytocin. Besides, dysregulated
concentrations of the soluble blood oxytocin receptor have
recently been reported in patients with AUD [58]. Hence, it
will be interesting to include this receptor in future studies
on the effects of alcohol on the oxytocin system.
Similar to oxytocin, testosterone concentrations did not
significantly change in the alcohol versus the control condi-
tion, which was again supported by the results of Bayes-
ian analyses. For both oxytocin and testosterone, the lack
of alcohol-related effects might, among others, be due to
the induced alcohol concentration in the present study
(M = 1.07). Regarding oxytocin, previous work suggests that
alcohol-induced increases might be found at higher alcohol
concentrations (largely above 1 per mille [22]), indicating
that alcohol concentrations in the present study might have
been too low to induce changes in oxytocin. Regarding tes-
tosterone, recent studies indicate that while low to moderate
amounts of alcohol increase testosterone, high amounts of
alcohol can be associated with a decrease in testosterone
concentrations [59]. Given these findings, the present study
might have failed to demonstrate an alcohol-induced change
Fig. 2 Group x time interaction on positive affect (A) and risk-taking
(B). The alcohol condition versus control condition x time interac-
tions were qualified by a significant increase in positive affect and
risk-taking in the alcohol condition. PANAS, Positive and Negative
Affect Schedule; CARE, Cognitive Appraisal of Risky Events ques-
tionnaire. Time 1 = prior to alcohol/water consumption (M = 0.00/M
= 0.00 per mille); Time 3 = after alcohol/water consumption (M
= 1.07/M = 0.00 per mille). The figure shows means and standard
errors of the mean. ***p < .001
Content courtesy of Springer Nature, terms of use apply. Rights reserved.

318 European Archives of Psychiatry and Clinical Neuroscience (2024) 274:311–320
1 3
in testosterone because the induced alcohol concentration
fell in between these opposing effects.
Interestingly, DHT did not change over time in the alco-
hol condition, while it increased in the control condition. We
are tempted to speculate that the study setting might have
produced a feeling of competition in the participants which
is supported by the observed reduction of perceived trust-
worthiness over time and which can increase androgen con-
centrations [60, 61]. This study’s results suggest that poten-
tial environment effects on androgens might be inhibited by
acute alcohol consumption. Future studies should implement
alcohol challenges in other study settings to validate these
assumptions. Also, it should be examined whether potential
alcohol effects are due to alcohol-related decreases in DHT,
which might be suggested by different non-experimental
findings [62, 63].
This study verified our predefined hypotheses that alcohol
increases positive affect and risk-taking. The results agree
with the findings of McCollam etal. [40] and Lane etal.
[41]. With the PANAS and CARE, the present study used
alternative instruments and added external validity to the
earlier findings.
Strengths andlimitations
The present study eliminated several limitations of previ-
ous studies on the effect of alcohol consumption on oxy-
tocin concentration. We provided a larger sample size and
controlled for food and water intake as well as sexual and
high physical activity prior to the experiment. Even though
several subjects did not adhere to the guidelines on the day
of the experiment, the results persisted even when these sub-
jects were excluded. To our knowledge, this study was the
first experiment investigating the effects of a mean blood
alcohol concentration above one per mille on perceived
trustworthiness and oxytocin. However, the overall find-
ings are limited to the range of blood alcohol concentra-
tions evoked, which were between 0.6 and 1.48 (M = 1.07)
per mille. Since blood alcohol concentrations were not
calculated from plasma samples but inferred from breath
alcohol content, the findings are also limited in this regard.
Due to the specific taste of alcohol and its typical physi-
ological effects after high doses, this study could not be
blinded. However, additional analyses suggested that the
findings regarding positive affect and risk-taking were not
due to expectancy effects. For reasons explained earlier, the
experiment was limited to males. Future studies are needed
to investigate whether alcohol challenges influence per-
ceived trustworthiness, oxytocin, testosterone, and DHT in
females. The same applies to people of older age, since the
current sample was rather young (M = 23.51). Also, it should
be examined whether the present results transfer to plasma
oxytocin measurements, since salivary oxytocin might be
a weak surrogate for plasmatic oxytocin [64]. Moreover, it
remains to be shown if further measures of trust in others
than self-reports (e.g., economic games [18]) are also non-
responsive to alcohol consumption.
Conclusion
The present randomized, controlled, within-subject, par-
allel group, alcohol-challenge experiment contributes to a
better understanding of how alcohol may facilitate social
interaction. A blood alcohol concentration of 1.07 per mille
increased positive affect and risk-taking but did not signifi-
cantly influence perceived trustworthiness of others, oxy-
tocin, or testosterone concentrations. As far as we know,
this study is the first to suggest that alcohol may inhibit
environmentally induced DHT increases. The results provide
further insight in the role of social facilitation as an alcohol-
drinking motive, which might contribute to the development
of problematic alcohol use.
Supplementary Information The online version contains supplemen-
tary material available at https:// doi. org/ 10. 1007/ s00406- 023- 01676-w .
Acknowledgements We thank the study subjects for their participation
in this research project.
Author contributions Conceived and designed the experiments: LW,
OH, CM, IR, PB, TL, BL. Performed the experiments: LW, OH, CM.
Analyzed the data and wrote the paper: LW, BL. Commented on the
manuscript and provided intellectual input: OH, CM, SH, IR, PB, JK,
GWA, FK, TL.
Funding Open Access funding enabled and organized by Projekt
DEAL. This work was funded by intramural grants from the Depart-
ment of Addictive Behavior and Addiction Medicine at the Central
Institute of Mental Health. It was supported by the Deutsche Forschun-
gsgemeinschaft (DFG, German Research Foundation)—Project-ID
402170461-TRR265 [65]. C.M. is a member of the research training
group 2162 funded by the DFG (270949263/GRK2162/1). The funders
had no role in the study design, data collection, analysis, decision to
publish, or manuscript preparation.
Data availability Data are available upon request.
Declarations
Conflict of interest The authors declare that the research was conduct-
ed in the absence of any commercial, financial, non-financial or other
kind of relationships that could be construed as a potential conflict of
interest.
Ethical approval This study was conducted according to the Declara-
tion of Helsinki and the Guideline for Good Clinical Practice. This
study was reviewed and approved by the local ethics committee II at
Heidelberg University. All participants provided an informed consent.
Open Access This article is licensed under a Creative Commons
Attribution 4.0 International License, which permits use, sharing,
Content courtesy of Springer Nature, terms of use apply. Rights reserved.

319European Archives of Psychiatry and Clinical Neuroscience (2024) 274:311–320
1 3
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