Hydrocortisone as an adjunct to brief cognitive-behavioural therapy for specific fear: Endocrine and cognitive biomarkers as predictors of symptom improvement.
Adolescent
Adult
Animals
Biomarkers
/ metabolism
Cognitive Behavioral Therapy
/ methods
Combined Modality Therapy
Double-Blind Method
Female
Follow-Up Studies
Glucocorticoids
/ administration & dosage
Humans
Hydrocortisone
/ administration & dosage
Implosive Therapy
/ methods
Male
Phobic Disorders
/ therapy
Spiders
Treatment Outcome
Young Adult
Cognitive-behaviour therapy
glucocorticoids
hydrocortisone
specific phobia
threat processing
Journal
Journal of psychopharmacology (Oxford, England)
ISSN: 1461-7285
Titre abrégé: J Psychopharmacol
Pays: United States
ID NLM: 8907828
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
pubmed:
29
4
2021
medline:
27
1
2022
entrez:
28
4
2021
Statut:
ppublish
Résumé
Glucocorticoid (GC) administration prior to exposure-based cognitive-behavioural therapy (CBT) has emerged as a promising approach to facilitate treatment outcome in anxiety disorders. Further components relevant for improved CBT efficacy include raised To investigate hydrocortisone as an adjunct to CBT for spider fear and the modulating role of threat bias change and endogenous short-term and long-term GCs for treatment response. Spider-fearful individuals were randomized to receiving either 20 mg of hydrocortisone ( Self-report, behavioural and threat processing indices improved following CBT. Hydrocortisone augmentation resulted in greater improvement of self-report spider fear and stronger increase in speed when approaching a spider, but not on threat bias. Neither threat bias nor endogenous GCs predicted symptom change, and no interactive effects with hydrocortisone emerged. Preliminary evidence indicated higher hair cortisone as predictor of a stronger threat bias reduction. Our data extend earlier findings by suggesting that GC administration boosts the success of exposure therapy for specific fear even with a low-level therapist involvement. Future studies corroborating our result of a predictive hair GC relationship with threat bias change in larger clinical samples are needed.
Sections du résumé
BACKGROUND
BACKGROUND
Glucocorticoid (GC) administration prior to exposure-based cognitive-behavioural therapy (CBT) has emerged as a promising approach to facilitate treatment outcome in anxiety disorders. Further components relevant for improved CBT efficacy include raised
AIMS
OBJECTIVE
To investigate hydrocortisone as an adjunct to CBT for spider fear and the modulating role of threat bias change and endogenous short-term and long-term GCs for treatment response.
METHODS
METHODS
Spider-fearful individuals were randomized to receiving either 20 mg of hydrocortisone (
RESULTS/OUTCOMES
RESULTS
Self-report, behavioural and threat processing indices improved following CBT. Hydrocortisone augmentation resulted in greater improvement of self-report spider fear and stronger increase in speed when approaching a spider, but not on threat bias. Neither threat bias nor endogenous GCs predicted symptom change, and no interactive effects with hydrocortisone emerged. Preliminary evidence indicated higher hair cortisone as predictor of a stronger threat bias reduction.
CONCLUSIONS/INTERPRETATION
CONCLUSIONS
Our data extend earlier findings by suggesting that GC administration boosts the success of exposure therapy for specific fear even with a low-level therapist involvement. Future studies corroborating our result of a predictive hair GC relationship with threat bias change in larger clinical samples are needed.
Identifiants
pubmed: 33908295
doi: 10.1177/02698811211001087
pmc: PMC8278554
doi:
Substances chimiques
Biomarkers
0
Glucocorticoids
0
Hydrocortisone
WI4X0X7BPJ
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
641-651Références
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