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Cited by 192Neuroendocrine regulation and behaviorFace Recognition and PerceptionOlfactory and Sensory Function Studies

Meta-analysis of the effects of intranasal oxytocin on interpretation and expression of emotions

Open access
Leppanen, Jenni, Ng, Kah Wee, Tchanturia, Kate, Treasure, Janet·2017·Neuroscience & Biobehavioral Reviews
DOI 10.1016/j.neubiorev.2017.04.010
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Abstract

HighlightsSingle dose of intranasal oxytocin has little to no effect on emotional theory of mind or emotion expression among healthy or clinical adult populations.Intranasal oxytocin improved recognition of basic emotions, particularly fear, but only among healthy populations.Intranasal oxytocin improves sensitivity to recognise anger, but only among healthy populations.Effect of oxytocin may be dependent on social boundaries. Abstract Accurate interpretation and appropriate expression of emotions are key aspects of social‐cognition. Several mental disorders are characterised by transdiagnostic difficulties in these areas and, recently, there has been increasing interest in exploring the effects of oxytocin on social‐emotional functioning. This review consists of 33 studies. Fifteen of the studies included people with autism spectrum disorder, schizophrenia, borderline personality disorder, frontotemporal dementia, anorexia nervosa, bulimia nervosa, post‐traumatic stress disorder, depression, and opioid and alcohol dependence. We conducted ten meta‐analyses examining the effects of intranasal oxytocin on expression of emotions, emotional theory of mind, sensitivity to recognise basic emotions, and recognition of basic emotions. A single dose of intranasal oxytocin significantly improved the recognition of basic emotions, particularly fear, and increased the expression of positive emotions among the healthy individuals. Oxytocin did not significantly influence theory of mind or the expression of negative emotions among the healthy individuals. Finally, intranasal oxytocin did not significantly influence interpretation or expression of emotions among the clinical populations.

AI snapshot

Written from the paper’s full text.

TL;DR

This meta-analytic review pooled 33 studies and ten meta-analyses on single-dose intranasal oxytocin effects on emotion interpretation and expression in healthy and clinical adults. Oxytocin improved recognition of basic emotions, especially fear, and increased positive emotion expression only in healthy individuals, with no significant effects in mixed clinical populations.

Key findings

  • Basic emotion recognition improved overall after excluding one outlier (ES = 0.18, p = 0.002), and among healthy individuals (ES = 0.13, p = 0.022); the clinical effect approached significance (ES = 0.27, p = 0.069).
  • Fear recognition improved overall (ES = 0.21, p = 0.003), driven by healthy individuals (ES = 0.24, p = 0.009); clinical fear recognition was not significant (ES = 0.16, p = 0.295).
  • Oxytocin increased expression of positive emotions in healthy individuals (ES = 0.25, p = 0.022), but not negative emotions in healthy individuals (ES = 0.10, p = 0.585) or positive/negative emotions in clinical populations.
  • Theory of mind was not significantly affected overall (ES = 0.09, p = 0.256), and no significant effects were found for anger, sadness, surprise, happiness, or emotion recognition sensitivity.

Methods

  • Systematic review and ten meta-analyses of 33 studies; 15 included clinical populations (ASD, schizophrenia, BPD, FTD, anorexia nervosa, bulimia nervosa, PTSD, depression, opioid/alcohol dependence).
  • Included single-dose intranasal oxytocin vs placebo studies in adults, with random allocation or randomized crossover order; excluded repeated-dose, long-term, child/adolescent, and non-social tasks.
  • Used multivariate random-effects models in R with Metafor, Hedges’ g or standardized mean change, meta-regressions for moderators, and Begg’s/Rosenthal’s tests for publication bias.

Limitations

  • The paper states most included studies were underpowered; no between-subjects study met the ≥80% power requirement, while five within-subjects studies did.
  • The paper states several studies had ceiling effects (accuracy ≥85%), seven meta-analyses had between-study heterogeneity, and in three the source was not identified; no correction for multiple comparisons was applied.
  • The paper states the positive emotion expression finding was not robust (fail-safe N = 1 vs criterion 30), and publication bias was evident for emotion recognition sensitivity; the expression meta-analysis included only four studies, and clinical groups were heterogeneous with few studies per disorder.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.neubiorev.2017.04.010

Cites

85 of 85 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

0 of 49 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Oxytocin did not significantly influence expression of negative emotions among healthy individuals.

    “Oxytocin did not significantly influence theory of mind or the expression of negative emotions among the healthy individuals.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The included studies' tasks and outcome measures are comparable enough to be pooled in meta-analyses.
  • Findingown data

    Among the mixed clinical population, oxytocin-induced improvement on basic emotion recognition approached significance with a small effect size.

    “Among the mixed clinical population oxytocininduced improvement on basic emotion recognition approached significance with a small effect size (ES = 0.27, Z = 1.82, p = 0.069, 95% CI [-0.02, 0.57], k = 9, N of levels = 5).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The included studies' tasks and outcome measures are comparable enough to be pooled in meta-analyses.
    • Rests on an assumption: The diverse clinical populations included in the 'clinical' category are comparable enough to be combined in meta-analyses.
  • Findingown data

    There was significant between-study heterogeneity in the theory of mind meta-analysis.

    “There was evidence of significant between-study heterogeneity (Q = 65.85,p < 0.0001, I 2 = 58.42%)”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The included studies' tasks and outcome measures are comparable enough to be pooled in meta-analyses.
  • Findingown data

    Oxytocin did not significantly influence theory of mind among healthy individuals.

    “Oxytocin did not significantly influence theory of mind or the expression of negative emotions among the healthy individuals.”
    • Also stated in: § 4.1 Study characteristics · plain
      “Healthy: ES = 0.07, Z = 0.76, p = 0.447, 95% CI [-0.10, 0.24], k = 13, N of levels = 9”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The included studies' tasks and outcome measures are comparable enough to be pooled in meta-analyses.
  • Findingown data

    There was no evidence of significant between-study heterogeneity in the anger recognition meta-analysis.

    “There was no evidence of significant between-study heterogeneity (Q = 21.16,p = 0.219, I 2 = 3.45e-09%)”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The included studies' tasks and outcome measures are comparable enough to be pooled in meta-analyses.
  • May combine two claims. 33
  • The quote only partly states this claim. 1
  • Classified as probably not a substantial claim. 22

  • May combine two claims.

    Findingown data

    With the outlier present, the meta-analysis yielded no significant effect of oxytocin on happiness recognition but significant between-study heterogeneity (ES = 0.31, Z = 1.26, p = 0.207, 95% CI [-0.17, 0.79], k = 20, N of levels = 12, Q = 93.93, p < 0.0001, I2 = 93.34%).

    “The metaanalysis with the outlier present yielded no significant effect of oxytocin on the recognition of happiness, but there was significant between-study heterogeneity (ES = 0.31, Z = 1.26, p = 0.207, 95% CI [-0.17, 0.79], k = 20, N of levels = 12, Q = 93.93,p < 0.0001, I 2 = 93.34%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    A full model including proportion female, age, and dose significantly explained between-study heterogeneity (Qm = 8.80, p = 0.032) leaving no significant residual heterogeneity (Qr = 14.33, p = 0.158).

    “These variables were, thus, entered into a full model which significantly explained the between-study heterogeneity (Qm = 8.80, p = 0.032) leaving no significant residual heterogeneity (Qr = 14.33, p = 0.158).”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data

    After removing the outlier, oxytocin did not significantly improve recognition of happiness (ES = 0.08, Z = 1.07, p = 0.284, 95% CI [-0.07, 0.23], k = 19, N of levels = 12).

    “Overall, oxytocin did not significantly improve the recognition of happiness (ES = 0.08, Z = 1.07, p = 0.284, 95% CI [-0.07, 0.23], k = 19, N of levels = 12).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    A meta-regression revealed the outlier significantly explained between-study heterogeneity (Qm = 51.44, p < 0.0001) leaving no significant residual heterogeneity (Qr = 28.36, p = 0.057).

    “A meta-regression revealed that the outlier significantly explained the between-study heterogeneity (Qm = 51.44,p < 0.0001) leaving no significant residual heterogeneity (Qr = 28.36,p = 0.057).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    There were no differential effects on happiness recognition among healthy (ES = 0.10, Z = 1.18, p = 0.237, 95% CI [-0.06, 0.26], k = 15, N of levels = 10) or mixed clinical populations (ES = -0.07, Z = -0.23, p = 0.821, 95% CI [-0.72, 0.57]).

    “When the healthy and clinical groups were inspected separately, there were no differential effects among the healthy (ES = 0.10, Z = 1.18, p = 0.237, 95% CI [-0.06, 0.26], k = 15, N of levels = 10), or mixed clinical populations (ES = -0.07,Z = -0.23,p = 0.821, 95% CI [-0.72, 0.57]).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    All studies used standardised stimuli to assess emotion recognition sensitivity.

    “All studies used standardised stimuli to assess emotion recognition sensitivity.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Any cases where eligibility remained in question were brought to the whole team for further discussion and assessment.

    “Any cases where eligibility remained in question were brought to the whole team for further discussion and assessment.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductcitation

    Influential studies and extreme outliers were identified by inspecting Cook's distance plots and standardised residuals, with outliers defined as z-score > 1.96.

    “Influential studies and extreme outliers were identified by inspecting Cook's distance plots and the standardised residuals of each individual study.Where the z-score of the standardised residuals exceeded 1.96, the study was deemed to be an outlier (Viechtbauer and Cheung, 2010).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Viechtbauer and Cheung, 2010

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    Study design and conductown data

    The meta-analyses were conducted with a multivariate random effects model with an autoregressive structure to account for correlations arising from multiple outcomes from the same sample.

    “The meta-analyses were conducted with a multivariate random effects model with an autoregressive structure using the rma.mv function in Metafor to account for correlations arising from multiple outcomes from the same sample.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductcitation

    According to the power calculation, between-subjects studies should have at least 64 participants per group and within-subjects studies at least 34 participants total to have adequate power (≥80%) to detect a moderate difference (ES ≥ 0.5).

    “According to the power calculation studies using between subjects design should have at least 64 participants in each group while studies using within subjects design should have at least 34 participants altogether, to have adequate statistical power (≥80%) to reliably detect a moderate difference (ES ≥ 0.5) between the two groups or conditions.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    None of the between-subjects studies met the requirement for adequate power, but five within-subjects studies did.

    “None of the studies that used between subjects design met the requirement for adequate power, but five of the studies that used within subjects design did meet this requirement.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    All studies used standardised stimuli to assess emotion recognition accuracy.

    “All studies used standardised stimuli to assess emotion recognition accuracy.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    Publication bias was investigated with Begg's rank correlation test and Rosenthal's file drawer analysis.

    “Publication bias was investigated with Begg's rank correlation test for funnel plot asymmetry (Begg and Mazumdar, 1994) and where significant effects were present Rosenthal's file drawer analysis was also conducted (Rosenthal, 1979).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Begg and Mazumdar, 1994 source

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    • cites Rosenthal, 1979 source

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    Study design and conductcitation

    The statistical power of each study was assessed by comparing sample sizes against a power calculation conducted with G*Power.

    “Finally, the statistical power of each study included in the review was assessed by comparing the sample sizes in these studies against that recommended by a power calculation conducted with G*Power (Faul et al., 2007).”
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    • cites Faul et al., 2007 source

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    Study design and conductown data

    Full text articles were assessed for eligibility by two authors (J.L. and K.W.N.).

    “Full text articles were then assessed for eligibility followed by final screening and assessment by two authors (J.L. and K.W.N.).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    People with eating disorders, depression, schizophrenia, and autism spectrum disorders have similar difficulties in accurate interpretation of emotions, including recognition of basic emotions in faces and tone of voice with small effect sizes and in emotional theory of mind with medium to large effect sizes.

    “Meta-analyses have found that people with eating disorders (EDs), depression, schizophrenia, and autism spectrum disorders (ASD) have similar difficulties in accurate interpretation of emotions, including recognition of basic emotions in faces and tone of voice with small effect sizes and in emotional theory of mind with medium to large effect sizes (Bora and Berk, 2016;Bora and Köse, 2016;Caglar-”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Bora and Berk, 2016

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    • cites Bora and Köse, 2016

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    • cites Caglar-Nazali et al., 2014 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Only studies that both authors agreed on were included in the final systematic review and meta-analyses.

    “Only studies that both authors agreed on were included in the final systematic review and meta-analyses.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The impact of outliers on the pooled effect size estimate was tested by conducting the meta-analysis with the outlier present followed by a meta-regression.

    “To test the impact of any outliers on the pooled effect size estimate, we conducted the meta-analysis with the outlier present followed by a meta-regression to examine whether the outlier significantly explained the between study heterogeneity.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Overall there were no significant effects of intranasal oxytocin on interpretation or expression of emotions among the mixed clinical population.

    “Although, the oxytocininduced improvement in basic emotion recognition approached significance, overall there were no significant effects on intranasal oxytocin on the interpretation or expression of emotions among the mixed clinical population.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    A few previous meta-analytic reviews have found that intranasal oxytocin improves recognition of anger and happiness, and increases ingroup trust among healthy individuals with small effect sizes.

    “A few previous meta-analytic reviews have found that intranasal oxytocin improves recognition of anger and happiness, and increases ingroup trust among healthy individuals with small effect sizes (Shahrestani et al., 2013;van Ijzendoorn and Bakermans-Kranenburg, 2012).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Shahrestani et al., 2013 source

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    • cites van Ijzendoorn and Bakermans-Kranenburg, 2012

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  • May combine two claims.

    Interpretationown data

    The oxytocin-induced increase in the expression of positive emotions was not robust, and it is likely that there was substantial publication bias present.

    “However, it is of importance to note that the oxytocin-induced increase in the expression of positive emotions was not robust, and it is likely that there was substantial publication bias present.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    The social boundaries hypothesis is consistent with the present findings and is supported by several behavioural studies using investment and trust games.

    “Although this hypothesis has not been previously linked to the effects of oxytocin on social-emotional processing, it is consistent with the present findings and is supported by several behavioural studies using investment and trust games.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites De Dreu and Kret, 2016

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    • cites Ten Velden et al., 2017 source

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    Premisecitation

    Recent systematic reviews suggest that the effects of intranasal oxytocin may be modulated by social boundaries.

    “Recent systematic reviews have attempted to explain the recent emergence of similar seemingly contradictory findings by suggesting that the effects of intranasal oxytocin may be modulated by social boundaries (Olff et al., 2013;Zik and Roberts, 2015).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Olff et al., 2013 source

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    • cites Zik and Roberts, 2015

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  • May combine two claims.

    Interpretationown data

    The meta-analyses revealed that a single dose of intranasal oxytocin significantly improved recognition of basic emotions, particularly fear, but only among healthy individuals with small to negligible effect sizes.

    “The meta-analyses revealed that a single dose of intranasal oxytocin significantly improved the recognition of basic emotions, particularly fear, but only among healthy individuals with small to negligible effect sizes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Begg's test revealed evidence of significant publication bias in emotion recognition sensitivity (T = -0.74, p < 0.0001), indicating small studies finding large effects were more likely to be published.

    “Begg's rank correlation test of funnel plot asymmetry revealed evidence of significant publication bias (T = -0.74,p < 0.0001; Supplementary Figure 26) indicating that small studies finding large effects were more likely to be published.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    There were substantial differences in effect size estimates between studies that included the same patient group, suggesting that there may be individual differences within the diagnostic groups that modulate the effects of oxytocin.

    “However, there were also substantial differences in effect size estimates between studies that included the same patient group, suggesting that there may be individual differences within the diagnostic groups that modulate the effects of oxytocin.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    The present findings showed that intranasal oxytocin improved recognition of basic emotions, largely driven by significant improvement in fear recognition and nearly significant improvement in disgust recognition.

    “The present findings also showed that intranasal oxytocin improved recognition of basic emotions, which appeared to be largely driven by oxytocin-induced significant improvement in fear recognition and nearly significant improvement in disgust recognition.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Rosenthal's fail-safe N for fear recognition was 59, exceeding the criterion (5n+10 = 55), suggesting the effect was quite robust.

    “Rosenthal's file drawer analysis revealed a fail-safe N of 59, suggesting that 59 additional studies reporting no effect of oxytocin would be needed to reduce the observed effect to null.This exceeds Rosenthal's criterion for this meta-analysis (5n+10 = 55), suggesting the effect was quite robust.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Recent systematic reviews suggest that the effects of oxytocin on social-emotional functioning may be moderated by contextual and individual differences.

    “A few recent systematic reviews have also suggested that the effects of oxytocin on social-emotional functioning may be moderated by contextual and individual differences (Bartz et al., 2011;Olff et al., 2013).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Bartz et al., 2011

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    • cites Olff et al., 2013 source

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    Interpretationcitation

    The oxytocin-induced increase in the expression of positive emotions in healthy individuals is in line with findings from previous systematic reviews and suggests that oxytocin plays an important role in facilitating prosocial behaviour in humans.

    “The oxytocin-induced increase in the expression of positive emotions in healthy individuals is in line with findings from previous systematic reviews and suggests that oxytocin plays an important role in facilitating prosocial behaviour in humans (Bakermans-Kranenburg and van Ijzendoorn, 2013;Churchland and Winkielman, 2012;Guastella and MacLeod, 2012).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Bakermans-Kranenburg and van Ijzendoorn, 2013

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    • cites Churchland and Winkielman, 2012

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    • cites Guastella and MacLeod, 2012

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  • May combine two claims.

    Premisenone given

    No meta-analyses to date have investigated the effects of a single dose of oxytocin on recognition of all six basic emotions, other aspects of emotion interpretation, including theory of mind or sensitivity to recognise basic emotions, or on emotion expression among healthy individuals.

    “However, to our knowledge no meta-analyses to date have investigated the effects of a single dose of oxytocin on recognition of all six basic emotions, other aspects of emotion interpretation, including theory of mind or sensitivity to recognise basic emotions, or on emotion expression among healthy individuals.”
    Quote in the paperSubstantial claim

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    Premisecitation

    Large-scale cohort studies have documented that clinical populations have interindividual variability with substantial heterogeneity in types of comorbidity and aetiological risk.

    “Large-scale cohort studies have documented that clinical populations have interindividual variability with substantial heterogeneity in types of comorbidity and aetiological risk (Lamers et al., 2010;Melartin et al., 2002;Sterling et al., 2008;Wessman et al., 2009).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Lamers et al., 2010 source

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    • cites Melartin et al., 2002 source

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    • cites Sterling et al., 2008 source

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  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    The meta-analysis of emotion expression consisted of only four studies, so the finding should be interpreted with caution.

    “However, this meta-analysis consisted of only four studies and, thus, this finding should be interpreted with caution.”
    Quote in the paperSubstantial claim

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    Interpretationreasoning

    One possible explanation for no significant effects in the mixed clinical population is that the different disorders included were too heterogeneous and there were too few studies with the same disorder group to draw firm conclusions.

    “One possible explanation is that the different disorders included in the mixed clinical group were too heterogeneous and that there were too few studies with the same disorder group to draw firm conclusions.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    There was no significant effect of intranasal oxytocin on interpretation or expression of emotions among the mixed clinical population.

    “There was no significant effect of intranasal oxytocin on interpretation or expression of emotions among the mixed clinical population.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    There has also been some suggestion that oxytocin has important effects in the periphery, moderating cardiovascular functioning and the peripheral cortisol response, which may influence social behaviour.

    “There has also been some suggestion that oxytocin has important effects in the periphery, moderating cardiovascular functioning and the peripheral cortisol response, which may influence social behaviour (Cardoso et al., 2014b;Gutkowska et al., 2014).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Cardoso et al., 2014b

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    • cites Gutkowska et al., 2014 source

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    Premisecitation

    Factors such as attachment style and experience of early parental care have been found to moderate the effects of oxytocin; those scoring low on attachment avoidance and harsh parenting showed greater oxytocin-induced increase in social cooperation and positive response to crying infants.

    “Factors such as attachment style and experience of early parental care have been found to moderate the effects of oxytocin; those scoring low on attachment avoidance and harsh parenting showed greater oxytocin-induced increase in social cooperation and positive response to crying infants (Bakermans-Kranenburg et al., 2011;Fang et al., 2014;Olff et al., 2013).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Bakermans-Kranenburg et al., 2011

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    • cites Fang et al., 2014 source

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    • cites Olff et al., 2013 source

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  • May combine two claims.

    Interpretationown data

    Intranasal oxytocin significantly improved recognition of basic emotions, particularly fear, and increased the expression of positive emotions, but only among the healthy individuals.

    “Intranasal oxytocin significantly improved recognition of basic emotions, particularly fear, and increased the expression of positive emotions, but only among the healthy individuals.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Some important questions have been raised regarding if and how intranasal oxytocin accesses the brain and in what quantities.

    “Some important questions have also been raised regarding if and how intranasal oxytocin accesses the brain and in what quantities (Leng and Ludwig, 2016).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Leng and Ludwig, 2016 source

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  • May combine two claims.

    Study design and conductown data

    Seven of the meta-analyses in the present review had evidence of between-study heterogeneity and in three of them the source of the heterogeneity could not be identified.

    “Seven of the meta-analyses in the present review had evidence of between-study heterogeneity and in three of them we were unable to identify the source of the heterogeneity.”
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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    These criticisms have become increasingly important to address in the light of recent replication failures.

    “These criticisms have become increasingly important to address in the light of recent replication failures (Lane et al., 2015;Radke and de Bruijn, 2015).”
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    • cites Lane et al., 2015 source

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    • cites Radke and de Bruijn, 2015 source

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  • May combine two claims.

    Interpretationreasoning

    Although steps were taken to combat the issue of multiple comparisons by investigating robustness of all significant findings and advising caution, the presence of false positive findings cannot be ruled out.

    “Although we took steps to combat this issue by investigating the robustness of all significant findings and advising caution when interpreting the moderator analyses, the presence of false positive findings cannot be ruled out.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    There has recently been some doubt regarding the effects of intranasal oxytocin on social-emotional functioning in general and criticism directed at the lack of compelling theoretical framework to explain the contradictory findings reported thus far.

    “There has also recently been some doubt regarding the effects of intranasal oxytocin on social-emotional functioning in general and criticism directed at the lack of compelling theoretical framework to explain the contradictory findings reported thus far (Lane et al., 2016;Leng and Ludwig, 2016).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Lane et al., 2016 source

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    • cites Leng and Ludwig, 2016 source

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    Premisecitation

    There are a number of methodological obstacles, such as individual differences in the nasal cavity physiology, the nasal spray formulations used, and the devices used to deliver the drug, that need to be considered.

    “For instance, there are a number of methodological obstacles, such as individual differences in the nasal cavity physiology, the nasal spray formulations used, and the devices used to deliver the drug, that need to be considered (Quintana et al., 2016).”
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    • cites Quintana et al., 2016 source

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    Interpretationreasoning

    Even though presence of ceiling effects did not have significant impact on the present findings, such effects make it difficult to find the true effect of the drug or intervention because performance is already at maximum.

    “Even though presence of ceiling effects did not have significant impact on the present findings, such effects make it difficult to find the true effect of the drug or intervention because performance is already at maximum.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Inadequate power has been suggested to be a particularly big problem in oxytocin research and the potential source of the wide range of different and sometimes contradictory findings arising from different studies.

    “This has been suggested to be a particularly big problem in oxytocin research and the potential source of the wide range of different and sometimes contradictory findings arising from different studies (Walum et al., 2016).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Walum et al., 2016 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    The impact of these factors were not explored or reported in majority of the studies included in the present review, meaning that it was not possible to explore their impact on the meta-analyses.

    “The impact of these factors were not explored or reported in majority of the studies included in the present review meaning that it was not possible for us to explore the impact of these factors had on the meta-analyses.”
    Quote in the paperSubstantial claim
47 of 47

  • The paper relies on this without support.

    The included studies' tasks and outcome measures are comparable enough to be pooled in meta-analyses.

    “Altogether ten meta-analyses were conducted to investigate the effects of a single dose of intranasal oxytocin on interpretation and expression of emotions.”

  • The paper relies on this without support.

    The diverse clinical populations included in the 'clinical' category are comparable enough to be combined in meta-analyses.

    “The clinical category included people with ASD, schizophrenia, depression, anorexia nervosa (AN), bulimia nervosa (BN), BPD, behavioural variant of frontotemporal dementia (FTD), alcohol dependence disorder, and opioid dependence disorder.”
2 of 2

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?

  • Evidence suggests oxytocin may selectively affect processing of fearful facial expressions.

    “coupled with evidence suggesting that OXT may have a selective effect on the processing of fearful facial expressions (Fischer-Shofty, Shamay-Tsoory, Harari & OXYTOCIN, EMPATHY AND EYE-GAZE 6 Levkovitz, 2010; Leppanen, 2017)”

    From Oxytocin increases attention to the eyes and selectively enhances self-reported affective empathy for fear (2017) · cites this paper as Leppanen, 2017

  • Emotion discrimination abilities in mice are dependent on the OXT system.

    “we have demonstrated that emotion discrimination abilities in mice are dependent on the OXT system”

    From Oxytocin Signaling in the Central Amygdala Modulates Emotion Discrimination in Mice (2019) · cites this paper as [36]

  • In humans, alterations in amygdala responses to positive and negative emotions have been reported in neuropsychiatric conditions such as autism and schizophrenia, in association with OXTR genetic variants or following intranasal OXT.

    “In humans, alterations in amygdala responses to positive and negative emotions have been reported in neuropsychiatric conditions, such as autism and schizophrenia [72,73], in association with OXTR genetic variants [41,102] or following intranasal OXT [33,36,38,103].”

    From Oxytocin Signaling in the Central Amygdala Modulates Emotion Discrimination in Mice (2019) · cites this paper as [36]

  • OXT has been associated with social cognitive functions, such as emotion recognition in humans.

    “OXT has been associated with social cognitive functions, such as emotion recognition [8-10, 33-36, 38, 39].”

    From Oxytocin Signaling in the Central Amygdala Modulates Emotion Discrimination in Mice (2019) · cites this paper as [36]

  • Intranasal oxytocin administration modulates emotion processing.

    “These results are also consistent with a growing body of research indicating that intranasal oxytocin administration modulates emotion processing2,3,53,54”

    From Oxytocin pathway gene networks in the human brain (2019) · cites this paper as [53]

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Not confirmedz = 1.1reported p = .275 · recomputed p = .271

    “Z = 1.10, p = .275”

  • Consistentz = 1.14reported p = .256 · recomputed p = .254

    “Z = 1.14, p = .256”

  • Consistentz = 0.76reported p = .447 · recomputed p = .447

    “Z = 0.76, p = .447”

  • Consistentz = 0.74reported p = .457 · recomputed p = .459

    “Z = 0.74, p = .457”

  • Consistentz = 2.56reported p = .011 · recomputed p = .010

    “Z = 2.56, p = .011”

  • Consistentz = 3.09reported p = .002 · recomputed p = .002

    “Z = 3.09, p = .002”

  • Consistentz = 2.3reported p = .022 · recomputed p = .021

    “Z = 2.30, p = .022”

  • Consistentz = 1.82reported p = .069 · recomputed p = .069

    “Z = 1.82, p = .069”

  • Consistentz = 1.03reported p = .305 · recomputed p = .303

    “Z = 1.03, p = .305”

  • Consistentz = 0.71reported p = .476 · recomputed p = .478

    “Z = 0.71, p = .476”

  • Consistentz = 2.95reported p = .003 · recomputed p = .003

    “Z = 2.95, p = .003”

  • Consistentz = 2.63reported p = .009 · recomputed p = .009

    “Z = 2.63, p = .009”

  • Consistentz = 1.05reported p = .295 · recomputed p = .294

    “Z = 1.05, p = .295”

  • Consistentz = 1.73reported p = .083 · recomputed p = .084

    “Z = 1.73, p = .083”

  • Consistentz = 0.53reported p = .594 · recomputed p = .596

    “Z = 0.53, p = .594”

  • Consistentz = -0.16reported p = .874 · recomputed p = .873

    “,Z = -0.16,p = .874”

  • Consistentz = 1.26reported p = .207 · recomputed p = .208

    “Z = 1.26, p = .207”

  • Consistentz = 1.07reported p = .284 · recomputed p = .285

    “Z = 1.07, p = .284”

  • Consistentz = 1.18reported p = .237 · recomputed p = .238

    “Z = 1.18, p = .237”

  • Consistentz = -0.23reported p = .821 · recomputed p = .818

    “,Z = -0.23,p = .821”

  • Consistentz = -1.45reported p = .146 · recomputed p = .147

    “,Z = -1.45,p = .146”

  • Consistentz = -1.24reported p = .216 · recomputed p = .215

    “,Z = -1.24,p = .216”

  • Consistentz = -1.25reported p = .212 · recomputed p = .211

    “,Z = -1.25,p = .212”

  • Consistentz = -0.42reported p = .674 · recomputed p = .674

    “,Z = -0.42,p = .674”

  • Consistentz = -1.64reported p = .1 · recomputed p = .101

    “,Z = -1.64,p = .100”

  • Consistentz = 0.87reported p = .385 · recomputed p = .384

    “Z = 0.87, p = .385”

  • Consistentz = 2.29reported p = .022 · recomputed p = .022

    “Z = 2.29, p = .022”

  • Consistentz = 0.55reported p = .585 · recomputed p = .582

    “Z = 0.55, p = .585”

  • Consistentz = 0.13reported p = .896 · recomputed p = .897

    “Z = 0.13, p = .896”

29 of 29

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Kanat anger confidence interval is not centered on its effect estimate

    Minor

    The reported effect is −0.15, but the midpoint of its stated 95% confidence interval is 0.40. That discrepancy is far greater than rounding and is inconsistent with the other approximately symmetric effect-size intervals in the table.

    Reported -0.15 · recomputed 0.4

  • Kim happiness confidence interval is not centered on its effect estimate

    Minor

    The reported effect is 0.03, while the midpoint of its stated 95% confidence interval is −0.28. The discrepancy is too large to be rounding.

    Reported 0.03 · recomputed -0.28

  • Conflicting counts for the basic-emotion recognition meta-analysis

    Minor

    The methods say the overall basic-emotion recognition meta-analysis included fifteen studies, but the results say it initially included seventeen and retained sixteen after one outlier was removed.

3 of 3

Cites

Flagged first, then by citations

4 of the 89 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. Greco, 2013, Meta-analysis: pitfalls and hints. Heart, Lung and Vessels, 5, 219
  2. Simon, 2012, Oxytocin influences response bias in men but not women in a signal detection emotion perception task, Neuropsychopharmacology, 38, S357

Cited by

Sorted by citations

Related

Authors
Leppanen, J., Ng, K. W., Tchanturia, K., & Treasure, J.
Affiliations
  • Singapore General Hospital (SG)
  • Ilia State University (GE)
  • King's College London (GB)
ORCID
Venue
Neuroscience & Biobehavioral Reviews
Publisher
Elsevier BV
Published
2017-07
Volume
78
Pages
125-144
ISSN
0149-7634 (ISSN-L)
DOI
10.1016/j.neubiorev.2017.04.010
OpenAlex
W2609733346
Semantic Scholar
0a10ae032aac7e7ebdac5c7885aeb383a83e8195
Cited by
188
References
89
Citations by year
2026: 15 · 2025: 11 · 2024: 15 · 2023: 19 · 2022: 22 · 2021: 20 · 2020: 22 · 2019: 28 · 2018: 23 · 2017: 11
FWCI
3.54
Type
journal article
Language
en
Open access
Licence
Locations
  • Neuroscience & Biobehavioral Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (submittedVersion, cc-by-nc-nd)
  • OSF Preprints (OSF Preprints) (submittedVersion)
Funders
  • Psychiatry Research Trust
  • Singapore General Hospital
  • Swiss Anorexia Foundation
  • National Institute for Health Research (NIHR)
  • Mental Health Biomedical Research at South London
  • Maudsley NHS Foundation Trust
  • King’s College London
Topics
  • Social Sciences › Psychology › Social Psychology › Neuroendocrine regulation and behavior
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Face Recognition and Perception
  • Life Sciences › Neuroscience › Sensory Systems › Olfactory and Sensory Function Studies
Keywords
intranasal oxytocin, emotion recognition, emotional expression, theory of mind, social cognition, basic emotions, fear recognition, anger recognition, autism spectrum disorder, schizophrenia, borderline personality disorder, frontotemporal dementia, eating disorders, post-traumatic stress disorder, depression, opioid use disorder, alcoholism
MeSH terms
Autism Spectrum Disorder, Administration, Intranasal, Emotions, Facial Expression, Humans, Oxytocin

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.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-08.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-08.

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.

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