Anxiety Disorders

Everyone feels anxious now and then. It’s a normal emotion. For example, you may feel nervous when faced with a problem at work, before taking a test, or before making an important decision. Anxiety disorders are different, though. They are a group of mental illnesses; the distress they cause can keep you from carrying on with your life normally.
Bochum-based psychologists have studied how the application of the stress hormone cortisol affects exposure therapy for anxiety disorders. The researchers knew from earlier studies that extinction learning, which constitutes the foundation of exposure therapy, can be reinforced by administering cortisol. However, the team headed by Professor Armin Zlomuzica at Zentrum für Psychotherapie (psychotherapy center) at Ruhr-Universität Bochum (RUB) has demonstrated with a group of arachnophobics that an application of cortisol after exposure is not beneficial for the patients.

The stress hormone cortisol

“Various studies have shown that extinction can accelerate or reinforced in healthy individuals by administering the stress hormone cortisol,” says Armin Zlomuzica. In these studies, patients always took cortisol prior to the therapy. The team from Bochum has now tested what happens if the drug is administered after exposure to the triggering object. The idea was that they would able to use the pharmaceutical agent after successful exposure; thus reinforcing only the positive therapy outcomes.

50 individuals with arachnophobia took part in the study. Half of them administered a cortisol tablet following exposure therapy, the other half given a placebo. Before and after exposure; the researchers recorded the severity of each participant’s fear of spiders. To this end, the patients assessed their own fear subjectively; in addition, a behavioral approach; in order to gain an objective measure of each patient’s phobia.

Spider in a terrarium

In the process, a therapist presents a spider in a terrarium and asks the patient to get as close to it as possible. Immediately after therapy, most of the patients able to approach the spider more closely than before. The researchers from Bochum are primarily interested in the long-term effects. This is why they repeated the behavioral approach test one month and six months after exposure therapy and in two different contexts; in the room where the therapy had taken place; in a different room with a different terrarium and a different supervisor.
“Our study has shown that the learned behavior was much more strongly linked to the context following the application of the drug, which is not what they want in the long term,” explains Armin Zlomuzica. Patients who administered cortisol were more likely to relapse when they encountered a spider in a different context. Accordingly, administering cortisol after exposure therapy does not appear to have any benefits for the patients.