Cited by 119Neuroendocrine regulation and behaviorOlfactory and Sensory Function StudiesStress Responses and Cortisol

The DOI matches its Crossref record; 141 of the 146 references it cites were found in a registry or an index, and 1 are not checked yet; none of the 90 sources its claims cite is checked for support yet.

Sex, Receptors, and Attachment: A Review of Individual Factors Influencing Response to Oxytocin

Open access
MacDonald, Kai S.·2013·Frontiers in Neuroscience

Abstract

As discussed in the larger review in this special issue (MacDonald and Feifel), intranasal oxytocin (OT) is demonstrating a growing potential as a therapeutic agent in psychiatry. Importantly, research suggests that a variety of individual factors may influence a person's response to OT. In this mini-review, I provide a review of three: (1) sex and hormonal status; (2) genetic variation in aspects of the OT system (i.e., OT receptors); and (3) attachment history. Each of these factors will be important to monitor as we strive to develop a richer understanding of OT's role in human development, brain-based disease, and the potential for individualized, OT-targeted treatments.

Checked 2026-10-09 · 1 reference not checked yet

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This mini-review argues that sex and hormonal status, genetic variation in the oxytocin system (OTR and CD38), and early attachment history are individual factors that may moderate response to intranasal oxytocin. It concludes that clinical evidence for these moderators is sparse and requires larger therapeutic trials.

Key findings

  • Sex and hormonal status: animal and human evidence indicates sex-specific oxytocin effects; in a randomized, double-blind, within-subjects crossover trial of intranasal oxytocin (40 IU BID for 3 weeks) in generalized anxiety disorder, there was a trend-level dose-by-gender effect, with males showing significant HAM-A improvement on oxytocin while females showed higher HAM-A scores during treatment. Three multi-week schizophrenia studies had male-biased recruitment (62 males treated vs. 13 females) and none showed a sex-by-drug effect.
  • Genetic variation: OTR and CD38 variants have been linked to personality, social behavior, stress/maltreatment responses, brain anatomy/function, and disease states such as schizophrenia and autism; however, no published studies have examined genetic variation in the OT system in relation to clinical response to oxytocin in psychiatrically ill patients. Examples include moderation of subjective responses to infant faces by OTR rs53576G, associations of OTR rs53576, rs2254298, and rs2228485 with Reading the Mind in the Eyes Test performance, and modulation of neural responses to emotional faces by OXTR rs2268498.
  • Attachment history: early attachment experiences may shape the central OT system through epigenetic and neuroplastic changes, and intranasal oxytocin effects can be moderated by parental love-withdrawal and attachment representations. The only published clinical study cited in this area found that patients with borderline personality disorder and anxious attachment showed less trust than those with more secure attachment after intranasal oxytocin.
  • Overall, the review presents these three factors as candidate moderators of oxytocin response, but emphasizes that clinical trial evidence remains limited.

Methods

  • Design: narrative mini-review of three individual factors influencing response to intranasal oxytocin: sex and hormonal status, genetic variation in aspects of the OT system (OTR and CD38), and attachment history.
  • Data or sample: no primary data or new sample; the paper synthesizes animal studies, human neurotypical studies, genetic and imaging studies, and clinical trials, including cited trials in generalized anxiety disorder, schizophrenia, and borderline personality disorder.
  • Main analysis: narrative synthesis of cited literature; no systematic search, meta-analysis, or new statistical analysis is reported.

Limitations

  • The paper states that given the paucity of clinical trials with intranasal oxytocin, the suggestion that these factors moderate clinical response should be viewed with circumspection, and larger-scale therapeutic trials are needed.
  • The paper states that no published studies have examined genetic variation in the OT system in relation to clinical response to oxytocin in psychiatrically ill patients, and that evidence for early experience impacting OT response in clinical populations is sparse, with only one published study in borderline personality disorder.
  • Evident from the text: as a mini-review, it does not report a systematic search or formal quality appraisal, and it notes replicability and effect-size concerns, including failed associations in some OTR studies.

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Integrity signals

Registry

Crossref · 10.3389/fnins.2012.00194

Cites

141 of 146 references verified4 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Figures

Figure 1 Three individual factors which mediate response to oxytocin are (1) sex and hormonal status; (2) genetic variations in the oxytocin receptor and CD38 system; and (3) early attachment experiences. The extent to which these factors play a role in a person’s response to oxytocin-targetted therapeutics for brain-based disease requires further exploration (see MacDonald and Feifel in this special section).
Figure 1 Three individual factors which mediate response to oxytocin are (1) sex and hormonal status; (2) genetic variations in the oxytocin receptor and CD38 system; and (3) early attachment experiences. The extent to which these factors play a role in a person’s response to oxytocin-targetted therapeutics for brain-based disease requires further exploration (see MacDonald and Feifel in this special section).CC BY · PubMed Central

Verification

Claims the paper makes

47 Not checked yet · 6 Own interpretation · 1 No basis given

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Show all 37 claims

  • It may state two separate claims as one. 15
  • The quote only partly states this claim. 1
  • Probably not a substantial claim. 1
17 of 17
  • The paper relies on this without support.

    No published studies have examined the role of genetic variation in the oxytocin system to a psychiatrically ill person's clinical response to oxytocin.

    “Though no published studies have examined the role of genetic variation in the OT system to a psychiatrically ill person’s clinical response to OT”
  • The paper relies on this without support.

    Evidence that early experience impacts oxytocin response in clinical populations is sparse.

    “To date, in keeping with the general trend noted throughout this and the accompanying larger review (MacDonald and Feifel, this issue) the evidence that early experience impacts OT response in clinical populations is sparse.”
2 of 2

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Metadata

Authors
MacDonald, K. S.
Affiliations
University of California San Diego (US)
Corresponding author
MacDonald, Kai S.
Venue
Frontiers in Neuroscience
Published
2013
Volume
6
Pages
194-194
ISSN
  • 1662-453X (ISSN-L)
  • 1662-4548
OpenAlex
W2134862200
Cited by
119
References
143
Citations by year
2026: 2 · 2025: 2 · 2024: 1 · 2023: 3 · 2022: 7 · 2021: 8 · 2020: 8 · 2019: 10 · 2018: 10 · 2017: 7 · 2016: 19 · 2015: 15 · 2014: 14 · 2013: 12
FWCI
30.02
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Frontiers in Neuroscience (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroendocrine regulation and behavior
  • Life Sciences › Neuroscience › Sensory Systems › Olfactory and Sensory Function Studies
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Keywords
oxytocin, intranasal oxytocin, oxytocin receptor, sex differences, hormonal status, genetic variation, attachment history, individual differences in treatment response, human development

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