Glucocorticoids enhance in vivo exposure-based therapy outcome in spider phobia

Soravia, Leila M.; Heinrichs, Markus; Winzeler, Livia; Fisler, Melanie; Schmitt, Wolfgang; Horn, Helge; Dierks, Thomas; Strik, Werner; Hofmann, Stefan G.; de Quervain, Dominique J.-F. (2014). Glucocorticoids enhance in vivo exposure-based therapy outcome in spider phobia. Depression and anxiety, 31(5), pp. 429-435. Wiley 10.1002/da.22219

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BACKGROUND: Preclinical and clinical studies indicate that the administration of glucocorticoids may promote fear extinction processes. In particular, it has been shown that glucocorticoids enhance virtual reality based exposure therapy of fear of heights. Here, we investigate whether glucocorticoids enhance the outcome of in vivo exposure-based group therapy of spider phobia. METHODS: In a double blind, block-randomized, placebo-controlled, between-subject study design, 22 patients with specific phobia of spiders were treated with two sessions of in vivo exposure-based group therapy. Cortisol (20 mg) or placebo was orally administered 1 hr before each therapy session. Patients returned for a follow-up assessment one month after therapy. RESULTS: Exposure-based group therapy led to a significant decrease in phobic symptoms as assessed with the Fear of Spiders Questionnaire (FSQ) from pretreatment to immediate posttreatment and to follow-up. The administration of cortisol to exposure therapy resulted in increased salivary cortisol concentrations and a significantly greater reduction in fear of spiders (FSQ) as compared to placebo at follow-up, but not immediately posttreatment. Furthermore, cortisol-treated patients reported significantly less anxiety during standardized exposure to living spiders at follow-up than placebo-treated subjects. Notably, groups did not differ in phobia-unrelated state-anxiety before and after the exposure sessions and at follow-up. CONCLUSIONS: These findings indicate that adding cortisol to in vivo exposure-based group therapy of spider phobia enhances treatment outcome.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > UPD Murtenstrasse
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Management
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Psychiatric Neurophysiology [discontinued]

UniBE Contributor:

Soravia, Leila; Winzeler, Livia; Fisler, Melanie; Schmitt, Wolfgang; Horn, Helge Joachim; Dierks, Thomas and Strik, Werner

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1091-4269

Publisher:

Wiley

Language:

English

Submitter:

Daniela Zurkinden

Date Deposited:

10 Apr 2014 10:44

Last Modified:

19 Jan 2018 16:31

Publisher DOI:

10.1002/da.22219

PubMed ID:

24265104

Uncontrolled Keywords:

Phobia, cortisol, exposure, fear memory, glucocorticoids, group therapy

BORIS DOI:

10.7892/boris.48399

URI:

https://boris.unibe.ch/id/eprint/48399

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