Intranasal oxytocin improves emotion recognition for youth with autism spectrum disorders.
Abstract
Background A diagnostic hallmark of autism spectrum disorders is a qualitative impairment in social communication and interaction. Deficits in the ability to recognize the emotions of others are believed to contribute to this. There is currently no effective treatment for these problems.Methods In a double-blind, randomized, placebo-controlled, crossover design, we administered oxytocin nasal spray (18 or 24 IU) or a placebo to 16 male youth aged 12 to 19 who were diagnosed with Autistic or Asperger's Disorder. Participants then completed the Reading the Mind in the Eyes Task, a widely used and reliable test of emotion recognition.Results In comparison with placebo, oxytocin administration improved performance on the Reading the Mind in the Eyes Task. This effect was also shown when analysis was restricted to the younger participants aged 12 to 15 who received the lower dose.Conclusions This study provides the first evidence that oxytocin nasal spray improves emotion recognition in young people diagnosed with autism spectrum disorders. Findings suggest the potential of earlier intervention and further evaluation of oxytocin nasal spray as a treatment to improve social communication and interaction in young people with autism spectrum disorders.
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Young and Wang's neurobiological model of rodent pair bonding holds that concurrent activation of oxytocin, vasopressin, and dopamine receptor neurons during mating results in a conditioned partner preference, with oxytocin and vasopressin facilitating social cue processing and dopamine signaling reward.
“They argued that the concurrent activation of oxytocin, vasopressin, and dopamine receptor neurons during mating activities results in the formation of a conditioned partner preference. Specifically, oxytocin and vasopressin facilitate the processing of social cues necessary for partner recognition while dopamine plays a reinforcing role by signalling reward.”
From Could intranasal oxytocin be used to enhance relationships? Research imperatives, clinical policy, and ethical considerations (2013) · cites this paper as [38]
Several trials have shown that a single dose of intranasal oxytocin enhanced performance on measures of social cognition or motivation, compared with placebo, in persons with autism spectrum disorder.
“Several trials have shown that a single dose of intranasal oxytocin enhanced performance on measures of social cognition10,11 or motivation,12–14 as compared with placebo, in persons with autism spectrum disorder.”
From Intranasal Oxytocin in Children and Adolescents with Autism Spectrum Disorder (2021) · cites this paper as [10]
The neuromodulator oxytocin (OT) improves social deficits in ASD and other disorders accompanied by social deficits.
“The neuromodulator oxytocin (OT) has been shown to improve social deficits in both ASD and other disorders accompanied by social deficits (Guastella et al., 2010, 2010; Hollander et al., 2002, 2007; Yatawara et al., 2015; Young and Barrett, 2015).”
From Oxytocin enhances gaze-following responses to videos of natural social behavior in adult male rhesus monkeys (2016) · cites this paper as Guastella et al., 2010
Oxytocin may improve emotion recognition by directing attention to cues like the eye region.
“Oxytocin may affect emotion recognition by increasing attention toward specific relevant cues, such as the eye region of faces (34).”
From Epigenetic modification of <i>OXT</i> and human sociability (2016) · cites this paper as [34]
In individuals with autism, intranasal oxytocin increases emotion recognition and feelings of trust and willingness to interact socially.
“In individuals with autism, intranasal OT was shown to increase emotion recognition (13) and to increase feelings of trust and willingness to interact socially (16).”
From Chronic intranasal oxytocin causes long-term impairments in partner preference formation in male prairie voles (2013) · cites this paper as [13]
Intranasal oxytocin is currently in clinical trials and has been identified as a treatment for developmental disorders involving social dysfunction, including autism spectrum disorders, social anxiety, and schizophrenia.
“Intranasal OT, currently the subject of multiple clinical trials (clinicaltrials.gov), has been identified as a treatment for developmental disorders involving social dysfunction, including autism spectrum disorders (13), social anxiety (14), and schizophrenia (15).”
From Chronic intranasal oxytocin causes long-term impairments in partner preference formation in male prairie voles (2013) · cites this paper as [13]
The acute increase in pro-social behavior, specifically time spent in contact, in male prairie voles following intranasal oxytocin resembles findings in many human studies.
“The acute effects of intranasal OT that we found here resemble those found in many human studies, consisting of an increase in pro-social behavior and engagement (specifically time spent in contact in males)(13,15,64–66).”
From Chronic intranasal oxytocin causes long-term impairments in partner preference formation in male prairie voles (2013) · cites this paper as [13]
Oxytocin administration has been shown to increase emotion recognition in patients with autism.
“increase emotion recognition (Guastella et al., 2010)”
From Effects of intranasal oxytocin on social anxiety in males with fragile X syndrome (2012) · cites this paper as Guastella et al., 2010
Four studies showed positive short-term results of OXT administration on social responsiveness in children with ASD following 4 or 5 weeks of OXT administration.
“Although 4 studies showed positive short-term results of OXT administration on social responsiveness (following 4 or 5 weeks of OXT administration) [80–83]”
From An Update on Psychopharmacological Treatment of Autism Spectrum Disorder (2022) · cites this paper as [80]
Results of OXT studies in children have overall been more equivocal with mixed results.
“Results of OXT studies in children have overall been more equivocal with mixed results.”
From An Update on Psychopharmacological Treatment of Autism Spectrum Disorder (2022) · cites this paper as [80]
Oxytocin has been shown to increase gazing time on the eye region, and to improve performance on the Reading the Mind in the Eyes Task in adults and adolescents with ASD.
“For example, oxytocin has been shown to increase gazing time on the eye region33, and to improve performance on the Reading the Mind in the Eyes Task in adults and adolescents with ASD48,49.”
From Randomized clinical trial shows no substantial modulation of empathy-related neural activation by intranasal oxytocin in autism (2021) · cites this paper as [48]
Previous studies showing oxytocin effects on emotion recognition, empathy, or face processing in adults with ASD had an average sample size of 21.5 participants.
“Moreover, previous studies showing oxytocin effects on emotion recognition, empathy, or face processing in adults with ASD had an average sample size of 21.5 participants48,50,51,86–88.”
From Randomized clinical trial shows no substantial modulation of empathy-related neural activation by intranasal oxytocin in autism (2021) · cites this paper as [48]
In subjects diagnosed with autism, a single intranasal administration of OXT might improve, at least temporarily, emotion recognition abilities in the Reading the Mind in the Eyes test and the patients' ability to process socially relevant cues in a computer-based game.
“Moreover, in subjects diagnosed with autism, a single intranasal administration of OXT might be able to improve, at least temporarily, emotion recognition abilities in the Reading the Mind in the Eyes test and the patients' ability to process socially relevant cues in a computer-based game (Andari et al, 2010;Green and Hollander, 2010;Guastella et al, 2010).”
From Chronic and acute intranasal oxytocin produce divergent social effects in mice (2014) · cites this paper as Guastella et al, 2010
IN-OT enhances emotion recognition and theory of mind in ASD.
“IN-OT enhances emotion recognition and theory of mind in ASD (Aoki et al. 2014; Guastella et al. 2010), and gaze to the eyes in ASD and in healthy subjects (Auyeung et al. 2015).”
From A precision medicine approach to oxytocin trials (2017) · cites this paper as Guastella et al. 2010
Exogenous oxytocin has behavioural effects in humans, particularly in social deficit-related psychiatric disorders such as autism and schizophrenia.
“Exogenous oxytocin in humans also appears to have behavioural effects, particularly in such social deficit-related psychiatric disorders as autism and schizophrenia9–13.”
From Vascular RAGE transports oxytocin into the brain to elicit its maternal bonding behaviour in mice (2019) · cites this paper as [11]
OT's dampening effect on amygdala activity, regardless of emotional valence, may underlie reported improvements in social behavior and cognition after IN OT via these two levels of action.
“OT's dampening effect on amygdala activity, regardless of emotional valence, may underlie reported improvements in social behavior (Yatawara et al., 2015) and cognition (Davis et al., 2013; Guastella et al., 2010) after IN OT via these two levels of action.”
From Low dose intranasal oxytocin delivered with Breath Powered device dampens amygdala response to emotional stimuli: A peripheral effect-controlled within-subjects randomized dose-response fMRI trial (2016) · cites this paper as Guastella et al., 2010
Prior research using a similar sample size (n=16) demonstrated that intranasal oxytocin improves RMET performance in male adolescents with ASD.
“Prior research using a similar sample size (n=16) demonstrated that intranasal oxytocin improves RMET performance in male adolescents with ASD;19 however, we did not observe an effect on RMET performance in the present older sample of adult males with ASD.”
Previous research examining the impact of oxytocin in an ASD population reported scores of approximately 45% correct RMET items.
“For comparison, after placebo administration the present sample scored 65.7% correct on the RMET, whereas previous research examining the impact of oxytocin in an ASD population reported scores of approximately 45% correct RMET items.19”
Oxytocin enhances performance on the eyes task for 'easy' items.
“and 'easy' items (Guastella et al., 2010)”
From Oxytocin enhances pupil dilation and sensitivity to 'hidden' emotional expressions (2013) · cites this paper as Guastella et al., 2010
Previous studies indicate that the level of autistic traits moderates the effects of oxytocin on evaluation of others' emotions when the task is relatively difficult.
“Previous studies indicate that the level of autistic traits moderates the effects of oxytocin on the evaluation of others' emotions when the task is relatively difficult (Bartz et al., 2010;Guastella et al., 2010).”
From Oxytocin enhances pupil dilation and sensitivity to 'hidden' emotional expressions (2013) · cites this paper as Guastella et al., 2010
This finding is consistent with previous suggestions that oxytocin enhances performance on subjectively difficult tasks.
“This finding is consistent with previous suggestions that oxytocin enhances performance on subjectively difficult tasks (Domes et al., 2007;Guastella et al., 2010).”
From Oxytocin enhances pupil dilation and sensitivity to 'hidden' emotional expressions (2013) · cites this paper as Guastella et al., 2010
Oxytocin, relative to placebo, improves recognition and memory of social-emotional information in individuals with ASD.
“improves the recognition and memory of social–emotional information [173,174]”
From Social “wanting” dysfunction in autism: neurobiological underpinnings and treatment implications (2012) · cites this paper as [173]
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“For example, OT alters response to social cues (Zak et al., 2005) and has an effect on emotion recognition/theory of mind (Domes et al., 2007; Guastella et al., 2010b), fearful face processing (Evans et al., 2010), social anxiety (Heinrichs et al., 2003), paranoia (Legros et al., 1992), and trust…”
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- Authors
- Guastella, A. J., Einfeld, S. L., Gray, K. M., Rinehart, N. J., Tonge, B. J., Lambert, T. J., & Hickie, I. B.
- Affiliations
- The University of Sydney (AU)
- Monash University (AU)
- Corresponding author
- Guastella, Adam J.
- ORCID
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2010-04
- Volume
- 67
- Issue
- 7
- Pages
- 692-694
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W2051587828
- Cited by
- 962
- References
- 19
- Citations by year
- 2026: 20 · 2025: 21 · 2024: 33 · 2023: 40 · 2022: 64 · 2021: 56 · 2020: 51 · 2019: 47 · 2018: 56 · 2017: 68 · 2016: 70 · 2015: 95 · 2014: 99 · 2013: 85 · 2012: 74
- FWCI
- 67.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Brain & Mind Research Institute and National Health and Medical Research Council Project (570897)
- Topics
- Social Sciences › Psychology › Social Psychology › Neuroendocrine regulation and behavior
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
- Keywords
- intranasal oxytocin, autism spectrum disorder, Asperger syndrome, emotion recognition, social communication, Reading the Mind in the Eyes Test, adolescents, social cognition, early intervention
- MeSH terms
- Administration, Intranasal, Administration, Topical, Adolescent, Affect, Autistic Disorder, Child, Double-Blind Method, Female, Humans, Male, Oxytocin, Cross-Over Studies, Recognition, Psychology, Young Adult
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