Intranasal oxytocin, social cognition and neurodevelopmental disorders: A meta-analysis
Abstract
Deficits in social cognition are pervasive and characteristic of neurodevelopmental disorders (NDDs). Clinical trials of intranasal oxytocin (IN-OT) to improve social cognition have yielded inconclusive results. The current study is a meta-analysis of randomized controlled trials (RCTs) considering the effect of IN-OT on social cognitive domains across a range of NDDs. Medline, PsychINFO and Scopus were searched for RCTs published through to July 25, 2017. Seventeen studies met inclusion criteria, comprising 466 participants with a NDD. Meta-analysis using a random-effects model, revealed that IN-OT had no significant effect on emotion recognition (Hedges' g=0.08), a moderate but non-significant effect on empathy (Hedges' g=0.49), and a small, significant effect on theory of mind (ToM) (Hedges' g=0.21). Meta-regression indicated that the effect of IN-OT on social cognition was not moderated by the diagnosis or age of participants, or the dose or frequency of IN-OT administration. The results highlight a need for more well-designed RCTs, as it remains difficult to draw conclusions about the potential for IN-OT to improve social cognition in NDDs. The promise of IN-OT should be considered tentative.
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The inconsistent results among these investigations may have been due to limited power or differences in participant age, oxytocin formulation or dose, treatment duration, outcome measures, or analytic methods.
“The inconsistent results among these various investigations may have been the result of limited power or differences in participant age, oxytocin formulation or dose, treatment duration, outcome measures, or analytic methods.22–24”
From Intranasal Oxytocin in Children and Adolescents with Autism Spectrum Disorder (2021) · cites this paper as [24]
The sample is larger than the average sample size of previous studies examining oxytocin effects on brain function in ASD and comparable to the average sample size in clinical trials examining oxytocin effects across different neurodevelopmental disorders.
“However, it must be noted that our sample is larger than the average sample size of previous studies examining oxytocin effects on brain function in ASD44, and comparable to the average sample size in clinical trials examining oxytocin effects across different neurodevelopmental disorders83.”
From Randomized clinical trial shows no substantial modulation of empathy-related neural activation by intranasal oxytocin in autism (2021) · cites this paper as [83]
Intranasal oxytocin has no significant effect on emotion recognition and empathy.
“Importantly, our findings are in line with recent meta-analytical evidence indicating that intranasal oxytocin only leads to small but non-significant changes in overall social cognition in ASD44, but has no significant effect on emotion recognition and empathy83.”
From Randomized clinical trial shows no substantial modulation of empathy-related neural activation by intranasal oxytocin in autism (2021) · cites this paper as [83]
Our findings are in line with recent meta-analytical evidence indicating that intranasal oxytocin only leads to small but non-significant changes in overall social cognition in ASD, but has no significant effect on emotion recognition and empathy.
“Importantly, our findings are in line with recent meta-analytical evidence indicating that intranasal oxytocin only leads to small but non-significant changes in overall social cognition in ASD44, but has no significant effect on emotion recognition and empathy83.”
From Randomized clinical trial shows no substantial modulation of empathy-related neural activation by intranasal oxytocin in autism (2021) · cites this paper as [83]
In clinical samples, no meta-analytic effect of OT was found on physiological, attentional, or behavioral measures relevant to threat, interpretation or expression of emotion, emotion recognition, or empathy.
“In clinical samples, no meta-analytic effect was found in physiological, attentional, or behavioral measures relevant to threat (Leppanen et al., 2018), the interpretation or expression of emotion (Leppanen et al., 2017), emotion recognition or empathy (Keech et al., 2018).”
From Null results of oxytocin and vasopressin administration across a range of social cognitive and behavioral paradigms: Evidence from a randomized controlled trial (2019) · cites this paper as Keech et al., 2018
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Intranasal Oxytocin in Children and Adolescents with Autism Spectrum Disorder
Sikich, L., Kolevzon, A., King, B. H., McDougle, C. J., Sanders, K. B., Kim, S.-J., Spanos, M., Chandrasekhar, T., Trelles, M. D. P., Rockhill, C. M., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2103583 · Cited by 314 · see citing works
Links between the neurobiology of oxytocin and human musicality
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Dietary Interventions for Autism Spectrum Disorder: A Meta-analysis
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Mayer, A. V., Wermter, A.-K., Stroth, S., Alter, P., Haberhausen, M., Stehr, T., Paulus, F. M., Krach, S., & Kamp-Becker, I. (2021) · Scientific Reports · doi:10.1038/s41598-021-94407-x · Cited by 23 · see citing works
- Authors
- Keech, B., Crowe, S., & Hocking, D. R.
- Affiliations
- La Trobe University (AU)
- Corresponding author
- Hocking, Darren R.
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2018-01
- Volume
- 87
- Pages
- 9-19
- ISSN
- 0306-4530 (ISSN-L)
- OpenAlex
- W2762583473
- Cited by
- 145
- References
- 90
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 12 · 2023: 11 · 2022: 18 · 2021: 19 · 2020: 13 · 2019: 38 · 2018: 14
- FWCI
- 2.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- Victoria University Research Repository (Victoria University) (submittedVersion)
- Swinburne figshare (Swinburne University of Technology) (submittedVersion)
- Funders
- Australian Research Council (DE160100042)
- Topics
- Social Sciences › Psychology › Social Psychology › Neuroendocrine regulation and behavior
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
- Keywords
- intranasal oxytocin, social cognition, neurodevelopmental disorders, emotion recognition, empathy, theory of mind, autism spectrum disorder
- MeSH terms
- Administration, Intranasal, Cognition, Emotions, Empathy, Humans, Interpersonal Relations, Oxytocin, Social Behavior, Theory of Mind, Neurodevelopmental Disorders, Social Skills
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.
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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