Cited by 347Neuroendocrine regulation and behaviorOlfactory and Sensory Function StudiesPsychology Research and Bibliometrics

The DOI matches its Crossref record; 49 of the 51 references it cites were found in a registry or an index; 42 of the 62 sources its claims cite were checked for support.

Statistical and Methodological Considerations for the Interpretation of Intranasal Oxytocin Studies

Open access
Walum, Hasse, Waldman, Irwin D., Young, Larry J.·2016·Biological Psychiatry

Abstract

Over the last decade, oxytocin (OT) has received focus in numerous studies associating intranasal administration of this peptide with various aspects of human social behavior. These studies in humans are inspired by animal research, especially in rodents, showing that central manipulations of the OT system affect behavioral phenotypes related to social cognition, including parental behavior, social bonding, and individual recognition. Taken together, these studies in humans appear to provide compelling, but sometimes bewildering, evidence for the role of OT in influencing a vast array of complex social cognitive processes in humans. In this article, we investigate to what extent the human intranasal OT literature lends support to the hypothesis that intranasal OT consistently influences a wide spectrum of social behavior in humans. We do this by considering statistical features of studies within this field, including factors like statistical power, prestudy odds, and bias. Our conclusion is that intranasal OT studies are generally underpowered and that there is a high probability that most of the published intranasal OT findings do not represent true effects. Thus, the remarkable reports that intranasal OT influences a large number of human social behaviors should be viewed with healthy skepticism, and we make recommendations to improve the reliability of human OT studies in the future.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This paper argues that human intranasal oxytocin (IN-OT) studies are generally underpowered and that many published positive findings likely do not represent true effects. The authors use meta-analytic effect sizes, power calculations, positive predictive value estimates, and a survey of 2014 IN-OT papers to recommend larger, more transparent, and better-replicated studies.

Key findings

  • Across three published meta-analyses, the weighted mean effect size for healthy subjects was d=0.28 with median N=49, yielding average statistical power of 16%; clinical trials had median N=26, d=0.32, and power of 12%. To achieve 80% power, 352 healthy subjects or 310 clinical-trial participants would be needed.
  • Even with the largest observed effect size (d=0.48) and largest sample size in the meta-analyses (N=112), power was no higher than 70%; sample sizes of 49 and 26 could reliably detect only large effects (d=0.81 to d=1.14) at 80% power.
  • If pre-study odds R=0.10 and power is 16%, the positive predictive value (PPV) was no higher than 24%; with 10 independent tests and only one reported, PPV dropped to 17%.
  • In 33 IN-OT papers from 2014, 29 (88%) reported at least one positive finding, but only 62 of 357 tested effects (17%) were significant; only 3 papers mentioned multiple-comparison correction, and the average number of tests was 11. Vole studies using central OT/vasopressin manipulation had a summarized effect size of d=0.76 (30 experiments, 668 individuals), though median n=22 and power=0.43.

Methods

  • Reanalyzed data from three published meta-analyses of IN-OT effects, calculating sample-size-weighted average effect sizes for healthy subjects and clinical trials, then estimating power with G*Power and R simulations.
  • Examined 33 behavioral IN-OT papers published in 2014, recording positive findings, total tested effects, multiple-comparison correction, and number of tests, as described in supplemental information.
  • Estimated effect sizes from 30 independent vole partner-preference experiments (668 individuals total) to compare central OT/vasopressin manipulation with intranasal administration.

Limitations

  • The authors state that the true pre-study odds (R) for IN-OT studies cannot be determined with much certainty, and their PPV estimates assume no influence of bias, so actual PPV could be considerably lower.
  • They note that publication-bias tests in the IN-OT meta-analyses gave mixed results and may be unreliable because small sample sizes provide insufficient power and sample-size variability; they also state they cannot assess the independence of tests in the 2014 survey.
  • The vole effect-size analysis was underpowered (median n=22, 1−β=0.43), and the larger autism effect size (d=0.57) came from only four studies and should be interpreted cautiously. Evident from the text: the 2014 paper survey is treated as representative only conditionally, and the field-wide conclusions depend on that assumption.

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Integrity signals

Registry

Crossref · 10.1016/j.biopsych.2015.06.016

Cites

49 of 49 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

25 Own interpretation · 21 Own result · 12 Partly supported · 12 No full text of the sources · 10 Supported · 7 No basis given · 4 Supported so far · 1 Mixed support · 1 Sources not found · accuracy not yet measured

Show all 56 claims

  • Probably not a substantial claim. 25
  • It may state two separate claims as one. 16
  • The quote only partly states this claim. 1
37 of 37
  • The authors state this as an assumption.

    The pre-study odds (R) for behavioral intranasal oxytocin studies in humans is considerably lower than for phase III clinical trials.

    “It seems reasonable however to assume that it is considerably lower than for phase III clinical trials.”
  • The paper relies on this without support.

    The studies included in the meta-analyses are representative of the field of intranasal oxytocin studies.

    “If the studies included in the meta-analyses are representative of the field, statistical power values of 16% for studies investigating IN-OT effects in healthy subjects and 12% in clinical trials are certainly very low, but not very different from studies in neuroscience in general (average power = 21%) (14).”
  • The paper relies on this without support.

    Studying behavioral effects of oxytocin is at the moment a hot research topic, attracting many new research groups, and studies within this field have been published in very high impact journals such as Science and Nature.

    “Studying behavioral effects of OT is at the moment a hot research topic, attracting many new research groups, and studies within this field have been published in very high impact journals such as Science and Nature.”
  • The paper relies on this without support.

    Nasal sprays purportedly containing oxytocin are available on the internet for a variety of indications.

    “Nasal sprays purportedly containing OT are available on the internet for a variety of indications”
  • The paper relies on this without support.

    Parents are increasingly seeking intranasal oxytocin as a therapy for their children with autism.

    “parents are increasingly seeking IN-OT as a therapy for their children with autism.”
  • The paper relies on this without support.

    The 33 intranasal oxytocin papers published in 2014 are representative of the field of behavioral intranasal oxytocin studies.

    “We investigated to what extent low power is reflected in behavioral IN-OT studies by examining the proportion of positive effects published in 2014 (described in Supplemental information).”
  • The paper relies on this without support.

    OT enhances the salience and reinforcing value of social stimuli in animals.

    “Research in animals suggest that OT enhances the salience and reinforcing value of social stimuli”
  • The paper relies on this without support.

    The vole partner preference test results with central OT/vasopressin manipulation are informative about human IN-OT effect sizes.

    “Specifically, we focused on vole studies using the partner preference test to assess behavior, a literature well known by the authors.”
    “these results indicate that larger effect sizes can be achieved by more efficient routes of administration.”
8 of 8

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Metadata

Authors
Walum, H., Waldman, I. D., & Young, L. J.
Affiliations
Emory University (US)
Corresponding author
Walum, Hasse
Venue
Biological Psychiatry
Publisher
Elsevier BV
Published
2016-02
Volume
79
Issue
3
Pages
251-257
ISSN
0006-3223 (ISSN-L)
OpenAlex
W983974319
Cited by
347
References
51
Citations by year
2026: 16 · 2025: 18 · 2024: 12 · 2023: 16 · 2022: 21 · 2021: 35 · 2020: 35 · 2019: 38 · 2018: 46 · 2017: 53 · 2016: 40
FWCI
5.13
Type
journal article
Language
en
Open access
Locations
  • Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • NIH (R01MH096983, 1P50MH100023)
  • NIH OD (P51OD11132)
  • Swedish Brain Foundation
Topics
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroendocrine regulation and behavior
  • Life Sciences › Neuroscience › Sensory Systems › Olfactory and Sensory Function Studies
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Psychology Research and Bibliometrics
Keywords
intranasal oxytocin, social behavior, social cognition, statistical power, publication bias, reproducibility, research reliability, social bonding, parental behavior, individual recognition
MeSH terms
Administration, Intranasal, Animals, Brain, Humans, Oxytocin, Research Design, Social Behavior, Statistics as Topic, Reproducibility of Results

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