Hydrocortisone as an adjunct to brief cognitive-behavioural therapy for specific fear: Endocrine and cognitive biomarkers as predictors of symptom improvement
Research output: Contribution to journal › Research article › Contributed › peer-review
Contributors
Abstract
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 endogenous GCs and reductions in information-processing biases to threat.
AIMS: 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: Spider-fearful individuals were randomized to receiving either 20 mg of hydrocortisone ( n = 17) or placebo ( n = 16) one hour prior to single-session predominantly computerised exposure-based CBT. Spider fear was assessed using self-report and behavioural approach measures at baseline, 1-day and 1-month follow-up. Threat processing was assessed at baseline and 1-day follow-up. Cortisol and cortisone were analysed from hair and saliva samples at baseline.
RESULTS/OUTCOMES: 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: 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.
Details
Original language | English |
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Pages (from-to) | 641-651 |
Number of pages | 11 |
Journal | Journal of psychopharmacology |
Volume | 35 |
Issue number | 6 |
Publication status | Published - Jun 2021 |
Peer-reviewed | Yes |
External IDs
WOS | 000651159800001 |
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Scopus | 85105507600 |
PubMed | 33908295 |
PubMedCentral | PMC8278554 |
ORCID | /0000-0002-1171-7133/work/142254999 |
Keywords
Keywords
- 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