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Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients
Open accessAbstract
Background There are currently few preventive interventions available for posttraumatic stress disorder (PTSD). Intranasal oxytocin administration early after trauma may prevent PTSD, because oxytocin administration was previously found to beneficially impact PTSD vulnerability factors, including neural fear responsiveness, peripheral stress reactivity, and socioemotional functioning. Therefore, we investigated the effects of intranasal oxytocin administration early after trauma on subsequent clinician-rated PTSD symptoms. We then assessed whether baseline characteristics moderated the intervention's effects.Methods We performed a multicenter, randomized, double-blind, placebo-controlled clinical trial. Adult emergency department patients with moderate to severe acute distress (n = 120; 85% accident victims) were randomized to intranasal oxytocin (8 days/40 IU twice daily) or placebo (8 days/10 puffs twice daily), initiated within 12 days posttrauma. The Clinician-Administered PTSD Scale (CAPS) was administered at baseline (within 10 days posttrauma) and at 1.5, 3, and 6 months posttrauma. The intention-to-treat sample included 107 participants (oxytocin: n = 53; placebo: n = 54).Results We did not observe a significant group difference in CAPS total score at 1.5 months posttrauma (primary outcome) or across follow-up (secondary outcome). Secondary analyses showed that participants with high baseline CAPS scores receiving oxytocin had significantly lower CAPS scores across follow-up than participants with high baseline CAPS scores receiving placebo.Conclusions Oxytocin administration early after trauma did not attenuate clinician-rated PTSD symptoms in all trauma-exposed participants with acute distress. However, participants with high acute clinician-rated PTSD symptom severity did show beneficial effects of oxytocin. Although replication is warranted, these findings suggest that oxytocin administration is a promising preventive intervention for PTSD for individuals with high acute PTSD symptoms.
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TL;DR
In a multicenter randomized placebo-controlled trial, repeated intranasal oxytocin initiated early after trauma did not reduce clinician-rated PTSD symptoms overall in emergency department patients with acute distress. However, secondary moderator analyses found that oxytocin-treated participants with high acute PTSD symptom severity (baseline CAPS ≥45) had significantly lower PTSD symptoms across 6-month follow-up than placebo-treated participants.
Key findings
- No significant group difference in the primary outcome, CAPS total score at 1.5 months posttrauma: oxytocin n=43, mean 25.84 (SD 22.97) vs placebo n=48, mean 27.44 (SD 22.03); square-root transformed mean difference 0.23 (SE 0.45), t89=0.509, p=.612, Cohen’s d=0.107.
- Across follow-up, CAPS scores decreased significantly over time (B=-0.35, SE=0.05, t=-7.175, p<.001), but there was no significant overall intervention effect on intercept (B=-0.30, SE=0.37, t=-0.826, p=.409) or linear slope (B=0.04, SE=0.07, t=0.504, p=.614; Cohen’s d=0.133).
- Baseline CAPS total score significantly moderated the intervention effect on follow-up CAPS scores (baseline CAPS × intervention on intercept: B=-0.73, SE=0.30, t=-2.389, p=.017). For participants with baseline CAPS ≥45, oxytocin was associated with lower CAPS scores across follow-up than placebo (F1,106=8.212, p=.006, Cohen’s d=0.864); for baseline CAPS <45, no significant effect was found (F1,106=0.822, p=.367, Cohen’s d=-0.221).
- In exploratory pairwise comparisons among participants with baseline CAPS ≥45, oxytocin-treated participants also had lower IES-R (F1,107=8.181, p=.005, Cohen’s d=0.869), HADS-depression (F1,107=7.180, p=.014, Cohen’s d=0.752), and HADS-anxiety (F1,106=4.982, p=.038, Cohen’s d=0.623) scores across follow-up. Overall self-reported PTSD, anxiety, and depression symptoms did not show significant group differences (Cohen’s d: IES-R 0.195; HADS-anxiety 0.207; HADS-depression 0.113).
Methods
- Multicenter, double-blind, randomized placebo-controlled trial in three Amsterdam emergency departments; adults aged 18–65 with moderate to severe acute distress after trauma were screened, and 120 were randomized. The intention-to-treat sample included 107 participants (oxytocin n=53; placebo n=54); 85% were accident victims.
- Participants received intranasal oxytocin (40 IU/dose, twice daily for 8 days) or placebo (0.9% NaCl, 10 puffs twice daily), initiated within 12 days posttrauma. The Clinician-Administered PTSD Scale (CAPS) was administered at baseline within 10 days posttrauma and at 1.5, 3, and 6 months; primary outcome was CAPS total score at 1.5 months.
- Analyses were intention-to-treat in SPSS v22, with multiple imputation for missing outcome data and linear mixed models for follow-up CAPS, IES-R, and HADS scores. Moderator analyses examined sex, childhood trauma, peritraumatic/immediate distress, and baseline acute symptom severity; a preplanned interim analysis after 50% of planned inclusion found conditional power <.20 and recruitment was halted.
Limitations
- The paper states that inclusion was halted after the interim analysis showed low conditional power, resulting in a modest sample size; replication is important.
- The paper states considerable variability in baseline CAPS scores: only 40.2% scored above the CAPS ≥45 threshold; screeners may have had lower specificity for PTSD than previously reported, and PTSD screening positives declined from 19.8% at 1.5 months to 6.0% at 6 months. It also notes that 23% reported mental health care use during follow-up, which may have stimulated help-seeking and contributed to symptom decrease.
- The paper states that >80% of participants visited the ED because of accidents, so trauma type moderation could not be investigated; it also did not investigate different timing, dosage, or duration of oxytocin administration. Evident from the text: the beneficial findings in high acute PTSD symptom participants come from secondary and exploratory analyses and require replication.
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17 Not checked yet · 17 Own interpretation · 14 Own result · 9 Own method · 1 No basis given
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
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“IES-R, HADS-anxiety, and HADS-depression scores at follow-up also significantly decreased over time”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Self-reported PTSD and Anxiety and Depression Symptoms. IES-R, HADS-anxiety, and HADS-depression
plainn = 107 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“There was no significant difference in CAPS total score at 1.5 months posttrauma between oxytocin (n 5 43, mean [SD]: 25.84 [22.97]) and placebo (n 5 48, mean [SD]: 27.44 [22.03]; square root transformed mean difference [SE]: 0.23 [0.45], t 89 5 0.509, p 5 .612,95% confidence interval: -0.67 to 1.13, Cohen's d 5 0.107).”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Primary Outcome
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In the paper
“CAPS total scores significantly decreased from 1.5 to 6 months posttrauma (B [SE]: -0.35 [0.05], t 5 -7.175, p , .001)”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Secondary and Exploratory Outcomes
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In the paper
“IES-R, HADS-anxiety, and HADS-depression scores at follow-up also significantly decreased over time”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Self-reported PTSD and Anxiety and Depression Symptoms. IES-R, HADS-anxiety, and HADS-depression
plainn = 107 ·- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“IES-R, HADS-anxiety, and HADS-depression scores at follow-up also significantly decreased over time”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Self-reported PTSD and Anxiety and Depression Symptoms. IES-R, HADS-anxiety, and HADS-depression
plainn = 107 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“We observed no other significant moderators of intervention effects on CAPS total scores (Table 3).”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Secondary and Exploratory Outcomes
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In the paper
“only 40.2% of the participants scored above a previously established severity threshold optimally sensitive for PTSD [CAPS $ 45 (56)].”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
What the sources say
- Not checked yetcites [56] Weathers, 1999, Psychometric properties of nine scoring rules for the clinician administered PTSD scale, Psychol Assess source
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In the paper
“In addition, exploratory analyses showed that these participants also had lower selfreported PTSD, depression, and anxiety symptom severity across follow-up.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > DISCUSSION
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In the paper
“Our exploratory finding that oxytocin attenuated self-reported anxiety symptoms in individuals with high acute PTSD symptoms suggests that anxiolytic effects may underlie the observed effects on PTSD symptomatology.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
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“However, participants with high acute PTSD symptoms receiving oxytocin showed significantly lower PTSD symptom severity across follow-up compared to placebo.”
- Also stated in: § Biological Psychiatry · plain
“Participants with baseline Clinician-Administered PTSD Scale (CAPS) total scores $45 receiving oxytocin had significantly lower CAPS total scores across follow-up than participants with baseline CAPS total scores $45 receiving placebo (F 1,106 5 8.212, p 5 .006Bonferronicorrected)”
- Also stated in: § Biological Psychiatry · boosted
“demonstrate that oxytocin's effects on clinician-rated PTSD were sustained for a significant period of time.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
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- Also stated in: § Biological Psychiatry · plain
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In the paper
“(B) CAPS total scores across follow-up did not significantly differ between participants with baseline CAPS total scores ,45 receiving oxytocin and placebo (F 1,106 5 0.822, p 5 .367).”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
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“In conclusion, repeated intranasal oxytocin administration initiated early after trauma did not attenuate clinician-rated PTSD symptom severity in all recently trauma-exposed individuals with acute distress.”
- Also stated in: § Biological Psychiatry · plain
“CAPS (ITT) | | | -0.30 (0.37) -0.826 | .409 | -1.02 to 0.42”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
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“23% of participants reported mental health care use during the follow-up period.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
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“This indicates that the effects of a single oxytocin administration may differ from the effects of repeated administration”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Abstract
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“In rats, central oxytocin administration either immediately or 7 days after a severe stressor reduced PTSD-like behavior (freezing behavior, acoustic startle response, time spent in enclosed arms of elevated plus maze) 1 week later (26).”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Abstract
What the sources say
- Not checked yetcites [26] Cohen, 2010, Hippocampal microinfusion of oxytocin attenuates the behavioural response to stress by means of dynamic interplay with the glucocorticoid-catecholamine responses, J Neuroendocrinol source
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In the paper
“suggests that repeated oxytocin administration may be required to achieve clinically relevant effects regarding the prevention of PTSD.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Abstract
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In the paper
“Oxytocin administration early after trauma did not attenuate clinician-rated PTSD symptoms in all trauma-exposed participants with acute distress.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Abstract
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“The percentage of dropouts after intervention initiation did not significantly differ between conditions”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Baseline and Trial Characteristics
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“However, participants with high acute clinician-rated PTSD symptom severity did show beneficial effects of oxytocin.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Abstract
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“These results indicate that effects of oxytocin administration in recently trauma-exposed individuals may not be beneficial.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Abstract
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“Preclinical studies administering oxytocin once shortly after severe stress have provided mixed results.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Abstract
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“Individuals with high acute PTSD symptoms are at increased risk to subsequently be diagnosed with PTSD (60,61).”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
What the sources say
- Not checked yetcites [60] Classen, 1998, Acute stress disorder as a predictor of posttraumatic stress symptoms, Am J Psychiatry source
- Not checked yetcites [61] Harvey, 1999, The relationship between acute stress disorder and posttraumatic stress disorder: A 2-year prospective evaluation, J Consult Clin Psychol source
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“The current randomized controlled trial is the first to show efficacy of a pharmacological agent other than hydrocortisone in reducing PTSD symptom development (58,59).”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
What the sources say
- Not checked yetcites [58] Amos, 2014, Pharmacological interventions for preventing post-traumatic stress disorder (PTSD), Cochrane Database Syst Rev
- Not checked yetcites [59] Sijbrandij, 2015, Pharmacological prevention of post-traumatic stress disorder and acute stress disorder: A systematic review and meta-analysis, Lancet Psychiatry source
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In the paper
“All previous findings of effective PTSD prevention were observed in participants with increased risk for PTSD [i.e., caused by perceived life-threat (3), peritraumatic dissociation (4), or subthreshold acute stress disorder (5,6)].”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
What the sources say
- Not checked yetcites [3] Rothbaum, 2012, Early intervention may prevent the development of posttraumatic stress disorder: A randomized pilot civilian study with modified prolonged exposure, Biol Psychiatry source
- Not checked yetcites [4] Delahanty, 2013, The efficacy of initial hydrocortisone administration at preventing posttraumatic distress in adult trauma patients: A randomized trial, CNS Spectr source
- Not checked yetcites [5] Zohar, 2011, High dose hydrocortisone immediately after trauma may alter the trajectory of PTSD: Interplay between clinical and animal studies, Eur Neuropsychopharmacol source
- Not checked yetcites [6] Roberts, 2010, Early psychological interventions to treat acute traumatic stress symptoms, Cochrane Database Syst Rev
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In the paper
“However, the exact mechanisms underlying our observed effects of oxytocin in individuals with high acute PTSD symptoms cannot be inferred from these clinical data.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
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“We observed no differences in adverse event frequency between interventions, suggesting that oxytocin administration early after trauma is well tolerated.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > DISCUSSION
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“these findings suggest that oxytocin administration is a promising preventive intervention for PTSD for individuals with high acute PTSD symptoms.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Abstract
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In the paper
“Oxytocin administration had no effect on follow-up PTSD symptoms for individuals with relatively low acute PTSD symptom severity.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > DISCUSSION
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In the paper
“Intranasal oxytocin seems to only exert beneficial effects in individuals with suboptimal functioning in domains affected by oxytocin (16,32,65), although a solid neurobiological basis for this hypothesis is still lacking.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
What the sources say
- Not checked yetcites [16] Cardoso, 2014, A meta-analytic review of the impact of intranasal oxytocin administration on cortisol concentrations during laboratory tasks: Moderation by method and mental health, Psychoneuroendocrinology source
- Not checked yetcites [32] Bethlehem, 2014, The oxytocin paradox, Front Behav Neurosci source
- Not checked yetcites [65] Olff, 2013, The role of oxytocin in social bonding, stress regulation and mental health: An update on the moderating effects of context and interindividual differences, Psychoneuroendocrinology source
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In the paper
“the observation that oxytocin administration had differential effects dependent on acute PTSD symptom severity adds to a growing body of literature indicating that the presence and severity of psychiatric symptoms moderates central and peripheral effects of oxytocin administration (16,64).”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
What the sources say
- Not checked yetcites [16] Cardoso, 2014, A meta-analytic review of the impact of intranasal oxytocin administration on cortisol concentrations during laboratory tasks: Moderation by method and mental health, Psychoneuroendocrinology source
- Not checked yetcites [64] Dodhia, 2014, Modulation of resting-state amygdala-frontal functional connectivity by oxytocin in generalized social anxiety disorder, Neuropsychopharmacology source
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In the paper
“Consequently, our sample size was modest, and replicating our findings is important.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Our exploratory finding that oxytocin attenuated self-reported anxiety symptoms in individuals with high acute PTSD symptoms suggests that anxiolytic effects may underlie the observed effects on PTSD symptomatology.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
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In the paper
“Thus, our screeners for peritraumatic and immediate posttraumatic distress may have had lower specificity for PTSD than previously reported.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
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- Checkable: passes — It can be checked against evidence.
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- Based: passes — The paper gives a reason why it holds.
In the paper
“our finding of beneficial effects specifically in individuals with high acute PTSD symptoms adds to the growing recognition that selective prevention based upon individual risk estimation is more effective than nonselective prevention (62).”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
What the sources say
- Not checked yetcites [62] Sijbrandij, 2006, Emotional or educational debriefing after psychological trauma. Randomised controlled trial, Br J Psychiatry source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Also, selective prevention may diminish the risk for interference with adaptive recovery, as was previously observed for debriefing (62).”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
What the sources say
- Not checked yetcites [62] Sijbrandij, 2006, Emotional or educational debriefing after psychological trauma. Randomised controlled trial, Br J Psychiatry source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although replication is necessary, our findings indicate that intranasal oxytocin administration is a promising novel preventive intervention for individuals at increased risk for PTSD because of high acute symptom severity.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“because .80% of our participants visited the ED because of accidents, we could not investigate whether trauma type moderated oxytocin effects.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 14
- Probably not a substantial claim. 8
- The quote only partly states this claim. 1
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“without significant group differences in overall symptom severity or symptom decrease over time (Cohen's d 5 IES-R, 0.195; HADS-anxiety, 0.207; HADS-depression, 0.113; Table 2).”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Self-reported PTSD and Anxiety and Depression Symptoms. IES-R, HADS-anxiety, and HADS-depression
plainn = 107- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“in both treatment groups we observed a steady decrease in PTSD symptom severity over time: the percentage of participants screening positive for PTSD declined from 19.8% at 1.5 months posttrauma to 6.0% at 6 months posttrauma.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We observed no significant group differences in demographic, trauma and screening, or baseline clinical characteristics.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Baseline and Trial Characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In recently traumaexposed individuals, however, intranasal oxytocin within 10 days posttrauma increased amygdala reactivity to fearful faces (27) and decreased amygdala-ventrolateral prefrontal functional connectivity after a trauma reminder (28).”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Abstract
What the sources say
- Not checked yetcites [27] Frijling, 2016, Effects of intranasal oxytocin on amygdala reactivity to emotional faces in recently trauma-exposed individuals, Soc Cogn Affect Neurosci source
- Not checked yetcites [28] Frijling, 2016, Intranasal oxytocin affects amygdala functional connectivity after trauma script-driven imagery in distressed recently trauma-exposed individuals, Neuropsychopharmacology source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“participants receiving oxytocin reported having administered significantly more intranasal doses than those receiving placebo (Mann-Whitney U: 742.00, p 5 .017).”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Baseline and Trial Characteristics
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In addition, there were no significant group differences in subjective intervention allocation awareness, use of mental health care or psychopharmaceuticals (Table 1), or reported adverse events during the trial (Supplemental Table S2).”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Baseline and Trial Characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Analyses in completers only (oxytocin: n 5 39, placebo: n 5 40) showed comparable results (Table 2).”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Secondary and Exploratory Outcomes
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Accumulating evidence from studies in animals and in healthy and psychiatric human populations shows that oxytocin administration may modulate glucocorticoid (16) and autonomic stress reactivity (17), dampen anxiety and neural threat processing (18,19), and beneficially impact socioemotional processes and prosocial behavior (20,21) [but see also (22,23) for seemingly nonprosocial effects].”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Abstract
What the sources say
- Not checked yetcites [16] Cardoso, 2014, A meta-analytic review of the impact of intranasal oxytocin administration on cortisol concentrations during laboratory tasks: Moderation by method and mental health, Psychoneuroendocrinology source
- Not checked yetcites [17] Kubzansky, 2012, A heartfelt response: Oxytocin effects on response to social stress in men and women, Biol Psychol source
- Not checked yetcites [18] Kirsch, 2005, Oxytocin modulates neural circuitry for social cognition and fear in humans, J Neurosci source
- Not checked yetcites [19] Wigton, 2015, Neurophysiological effects of acute oxytocin administration: Systematic review and meta-analysis of placebo-controlled imaging studies, J Psychiatry Neurosci source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Notably, the need for effective and safe PTSD prevention is longstanding and ongoing, with no preventive interventions currently at the stage of widespread implementation (57).”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
What the sources say
- Not checked yetcites [57] Howlett, 2016, Prevention of trauma and stressor-related disorders: A review, Neuropsychopharmacology source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“As the interim analysis at 50% of planned inclusion indicated low conditional power to detect a significant effect of oxytocin on clinician-rated PTSD symptom severity at study completion, we halted inclusion.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“an online cognitive behavioral therapy-based intervention only reduced PTSD symptoms in participants with high acute PTSD symptoms (63).”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
What the sources say
- Not checked yetcites [63] Mouthaan, 2013, Internet-based early intervention to prevent posttraumatic stress disorder in injury patients: Randomized controlled trial, J Med Internet Res source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In addition, the oxytocin intervention was initiated within approximately 2 weeks posttrauma, and therefore it is also of interest for use in ED patients for whom immediate intervention is not feasible or in traumatized populations that are not immediately brought to the attention of health care professionals.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Therefore, we may have included more participants with relatively low PTSD risk than anticipated, potentially also explaining why we found a differential intervention effect dependent on clinician-rated acute PTSD severity instead of the hypothesized overall intervention effect.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This may be because our screening questionnaires were administered earlier after trauma than in previous validation studies.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Relative to placebo-treated individuals with high acute PTSD symptoms, oxytocin-treated participants with high acute PTSD symptoms had significantly lower PTSD symptom severity across the complete follow-up period up to 6 months posttrauma, indicating a long-term protective effect.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > DISCUSSION
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Previously, hydrocortisone (4,5) and prolonged exposure (3) initiated within 12 hours posttrauma in ED patients, and brief cognitive behavioral therapy within the first weeks posttrauma in patients with acute stress disorder (6), were found to reduce subsequent PTSD symptom severity.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
What the sources say
- Not checked yetcites [4] Delahanty, 2013, The efficacy of initial hydrocortisone administration at preventing posttraumatic distress in adult trauma patients: A randomized trial, CNS Spectr source
- Not checked yetcites [5] Zohar, 2011, High dose hydrocortisone immediately after trauma may alter the trajectory of PTSD: Interplay between clinical and animal studies, Eur Neuropsychopharmacol source
- Not checked yetcites [3] Rothbaum, 2012, Early intervention may prevent the development of posttraumatic stress disorder: A randomized pilot civilian study with modified prolonged exposure, Biol Psychiatry source
- Not checked yetcites [6] Roberts, 2010, Early psychological interventions to treat acute traumatic stress symptoms, Cochrane Database Syst Rev
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“we did not investigate whether a different timing, dosage, or duration of oxytocin administration would also be effective in reducing subsequent PTSD symptom severity.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“in rodents, central oxytocin administration before conditioned fear extinction improved social fear extinction (68) but impaired nonsocial fear extinction (69).”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
What the sources say
- Not checked yetcites [68] Zoicas, 2014, Brain oxytocin in social fear conditioning and its extinction: Involvement of the lateral septum, Neuropsychopharmacology source
- Not checked yetcites [69] Toth, 2012, Central administration of oxytocin receptor ligands affects cued fear extinction in rats and mice in a timepoint-dependent manner, Psychopharmacology (Berl) source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Rothbaum et al. (3) observed that rape victims benefitted most from early prolonged exposure compared to ED patients with other types of trauma exposure.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
What the sources say
- Not checked yetcites [3] Rothbaum, 2012, Early intervention may prevent the development of posttraumatic stress disorder: A randomized pilot civilian study with modified prolonged exposure, Biol Psychiatry source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“There is ongoing debate on pharmacodynamics of intranasal oxytocin administration (70)(71)(72)(73).”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
What the sources say
- Not checked yetcites [70] Carson, 2016, Improving research standards to restore trust in intranasal oxytocin, Biol Psychiatry source
- Not checked yetcites [71] Leng, 2016, Intranasal oxytocin: Myths and delusions, Biol Psychiatry source
- Not checked yetcites [72] Quintana, 2016, Intranasal oxytocin mechanisms can be better understood, but its effects on social cognition and behavior are not to be sniffed at, Biol Psychiatry source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This may indicate that participating in this trial stimulated participants to seek professional help relatively early, which could be an alternative explanation for the observed steady decrease in symptom severity.”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper relies on this without support.
It had not yet been investigated whether oxytocin administration early after trauma may prevent PTSD development.
“It has not yet been investigated whether oxytocin administration early after trauma may prevent PTSD development.”
The paper relies on this without support.
Actual clinical effects of oxytocin administration in recently trauma-exposed individuals were not investigated.
“However, actual clinical effects were not investigated.”
The paper relies on this without support.
This study is the largest published clinical randomized controlled trial on effects of intranasal oxytocin on psychiatric symptoms to date.
“This study is the largest published clinical randomized controlled trial on effects of intranasal oxytocin on psychiatric symptoms to date.”
The paper relies on this without support.
This is the first randomized controlled trial assessing whether sex, trauma history, and baseline symptom severity moderate the effects of repeated oxytocin administration.
“to the best of our knowledge, this is the first randomized controlled trial assessing whether sex, trauma history, and baseline symptom severity moderate the effects of repeated oxytocin administration.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“twice daily doses of 40 IU oxytocin for 8 days did not significantly attenuate the onset on PTSD compared to placebo among emergency department patients.”
From Augmenting Prolonged Exposure therapy for PTSD with intranasal oxytocin: a randomized, placebo-controlled pilot trial (2018) · cites this paper as van Zuiden et al., 2016
In the citing paper
“However, oxytocin was more effective among individuals who had more severe baseline PTSD severity in this sample.”
From Augmenting Prolonged Exposure therapy for PTSD with intranasal oxytocin: a randomized, placebo-controlled pilot trial (2018) · cites this paper as van Zuiden et al., 2016
In the citing paper
“Safety and feasibility of daily dosing has been demonstrated in other human OT studies including those with alcohol-dependent patients (Pedersen et al., 2013), patients with schizophrenia (Pedersen et al., 2011) and individuals with trauma exposure (van Zuiden et al., 2016).”
From Augmenting Prolonged Exposure therapy for PTSD with intranasal oxytocin: a randomized, placebo-controlled pilot trial (2018) · cites this paper as van Zuiden et al., 2016
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“Sex | 0.36 | 0.52 | .692 | -0.65 to 1.37 | -0.07 | 0.10 | .462 | -0.27 to 1.21”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
Reported -0.07 · recomputed 0.47
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“| Dropout (no follow-up at all) | 8 (15.1%) | 6 (11.3%) | .541 b |”
§ Intranasal Oxytocin to Prevent Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial in Emergency Department Patients > Biological Psychiatry
Reported 11.3 · recomputed 11.111111
Citations
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,845
The Hospital Anxiety and Depression Scale
Zigmond, A. S., & Snaith, R. P. (1983) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1983.tb09716.x · Cited by 47,139
A Global Measure of Perceived Stress
Cohen, S., Kamarck, T., & Mermelstein, R. (1983) · Journal of Health and Social Behavior · doi:10.2307/2136404 · Cited by 32,807
(1998) · The Journal of Clinical Psychiatry · Cited by 19,139
The development of a Clinician-Administered PTSD Scale
Blake, D. D., Weathers, F. W., Nagy, L. M., Kaloupek, D. G., Gusman, F. D., Charney, D. S., & Keane, T. M. (1995) · Journal of Traumatic Stress · doi:10.1002/jts.2490080106 · Cited by 5,024
Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis
Ozer, E. J., Best, S. R., Lipsey, T. L., & Weiss, D. S. (2003) · Psychological Bulletin · doi:10.1037/0033-2909.129.1.52 · Cited by 3,322
The Impact of Event Scale: Revised
Weiss, D. S. (2007) · Springer eBooks · doi:10.1007/978-0-387-70990-1_10 · Cited by 3,074
SPINHOVEN, P., ORMEL, J., SLOEKERS, P. P. A., KEMPEN, G. I. J. M., SPECKENS, A. E. M., & HEMERT, A. M. V. (1997) · Psychological Medicine · doi:10.1017/s0033291796004382 · Cited by 2,158
Oxytocin Modulates Neural Circuitry for Social Cognition and Fear in Humans
Kirsch, P., Esslinger, C., Chen, Q., Mier, D., Lis, S., Siddhanti, S., Gruppe, H., Mattay, V. S., Gallhofer, B., & Meyer-Lindenberg, A. (2005) · The Journal of Neuroscience · doi:10.1523/jneurosci.3984-05.2005 · Cited by 1,639
Social effects of oxytocin in humans: context and person matter
Bartz, J. A., Zaki, J., Bolger, N., & Ochsner, K. N. (2011) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2011.05.002 · Cited by 1,581
Research works printed but not linked: 1
- deRoon-Cassini, 2014, Prediction of chronic PTSD using early fMRI evidence of emotion dysregulation in trauma survivors, Biol Psychiatry, 75, 169S
Cited by
Sorted by citations
The Biology of Human Resilience: Opportunities for Enhancing Resilience Across the Life Span
Feder, A., Fred-Torres, S., Southwick, S. M., & Charney, D. S. (2019) · Biological Psychiatry · doi:10.1016/j.biopsych.2019.07.012 · Cited by 269
Quintana, D. S., Lischke, A., Grace, S., Scheele, D., Ma, Y., & Becker, B. (2021) · Molecular Psychiatry · doi:10.1038/s41380-020-00864-7 · Cited by 263
Wang, Z., Xiong, G., Tsang, W. C., Schätzlein, A. G., & Uchegbu, I. F. (2019) · Journal of Pharmacology and Experimental Therapeutics · doi:10.1124/jpet.119.258152 · Cited by 247
Sartori, S. B., & Singewald, N. (2019) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2019.107402 · Cited by 236
Lisieski, M. J., Eagle, A. L., Conti, A. C., Liberzon, I., & Perrine, S. A. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00196 · Cited by 233
Metadata
- Authors
- van Zuiden, M., Frijling, J. L., Nawijn, L., Koch, S. B. J., Goslings, J. C., Luitse, J. S., Biesheuvel, T. H., Honig, A., Veltman, D. J., & Olff, M.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- OLVG (NL)
- Arq Psychotrauma Expert Group (NL)
- ORCID
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2017-06
- Volume
- 81
- Issue
- 12
- Pages
- 1030-1040
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W2560374635
- Semantic Scholar
- bd1046552426fd73c914244a4959edc03a4d85fe
- Cited by
- 134
- References
- 74
- Citations by year
- 2026: 8 · 2025: 6 · 2024: 7 · 2023: 9 · 2022: 18 · 2021: 19 · 2020: 13 · 2019: 20 · 2018: 26 · 2017: 8
- FWCI
- 23.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Funders
- ZonMw (91210041)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroendocrine regulation and behavior
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- intranasal oxytocin, emergency department patients, placebo-controlled intervention, accident victims, intervention moderators
- MeSH terms
- Administration, Intranasal, Adolescent, Adult, Aged, Double-Blind Method, Emergency Service, Hospital, Female, Humans, Male, Middle Aged, Oxytocin, Stress Disorders, Post-Traumatic, Treatment Outcome, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-09, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-09 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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