Augmentation of Exposure Therapy With D-Cycloserine for Social Anxiety Disorder

Hofmann, S.; Meuret, Alicia E.; Smits, Jasper A.J.; Simon, Naomi M.; Pollack, Mark H.; Eisenmenger, Katherine; Shiekh, Michael; Otto, Michael W.

doi:10.1001/archpsyc.63.3.298

Cited by 528 publications

(399 citation statements)

References 59 publications

(82 reference statements)

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“…In no case was there an enhancement of therapeutic efficacy by DCS. There were several procedural differences between this study and those of Ressler et al 328 and Hofmann et al 332 that may have contributed to the failure to replicate the findings of those earlier studies, although the use of a nonclinical population and/or possible floor effects may be the most significant factors. Additional work is required to determine if the therapeutic efficacy of DCS is observable only in severely impaired clinical populations, as Guastella et al 333 suggest.…”

Section: Dcs Facilitates Exposure Therapycontrasting

confidence: 56%

“…332 In this study participants were assigned randomly to groups receiving placebo or DCS before each of four individual or group therapy sessions in which participants were asked to engage in increasingly challenging public speaking episodes (speaking in front of other group participants, an audience composed of research confederates, and a video camera). At the conclusion of therapy and at a 1-month follow-up, participants receiving DCS showed significantly larger improvements relative to participants receiving placebo, as measured by clinician-administered and self-report instruments.…”

Section: Dcs Facilitates Exposure Therapymentioning

confidence: 99%

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Mechanisms of fear extinction

2006

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Excessive fear and anxiety are hallmarks of a variety of disabling anxiety disorders that affect millions of people throughout the world. Hence, a greater understanding of the brain mechanisms involved in the inhibition of fear and anxiety is attracting increasing interest in the research community. In the laboratory, fear inhibition most often is studied through a procedure in which a previously fear conditioned organism is exposed to a fear-eliciting cue in the absence of any aversive event. This procedure results in a decline in conditioned fear responses that is attributed to a process called fear extinction. Extensive empirical work by behavioral psychologists has revealed basic behavioral characteristics of extinction, and theoretical accounts have emphasized extinction as a form of inhibitory learning as opposed to an erasure of acquired fear. Guided by this work, neuroscientists have begun to dissect the neural mechanisms involved, including the regions in which extinction-related plasticity occurs and the cellular and molecular processes that are engaged. The present paper will cover behavioral, theoretical and neurobiological work, and will conclude with a discussion of clinical implications. Molecular Psychiatry (2007) 12, 120-150.

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Section: Dcs Facilitates Exposure Therapycontrasting

confidence: 56%

Section: Dcs Facilitates Exposure Therapymentioning

confidence: 99%

Mechanisms of fear extinction

2006

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“…Pharmacological agents might be useful not only for increasing memory retention but also for unlearning phobias and addictions (Pitman et al 2002;Hofmann et al 2006;Ressler et al 2004). Potentially, the combination of different drugs administered at different times could give users a more fine-grained control of their learning processes, perhaps even the ability to deliberately select specific memories that they want to retain or get rid of.…”

Section: Drugsmentioning

confidence: 99%

Cognitive Enhancement: Methods, Ethics, Regulatory Challenges

2009

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Cognitive enhancement takes many and diverse forms. Various methods of cognitive enhancement have implications for the near future. At the same time, these technologies raise a range of ethical issues. For example, they interact with notions of authenticity, the good life, and the role of medicine in our lives. Present and anticipated methods for cognitive enhancement also create challenges for public policy and regulation.

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“…Treatment consisted of a 5-week CBT protocol for social anxiety disorder (Hofmann, 2004), which has been employed in previous and ongoing studies examining pharmacological augmentation of CBT for social anxiety disorder (Guastella et al, 2008;Hofmann et al, 2006;Hofmann, Otto, Pollack, & Smits, 2015). The first session consists of psychoeducation about Attention bias and CBT 10 social anxiety disorder and rationale for exposure therapy, while sessions 2-5 consist of public speaking exposure exercises.…”

Section: Cbtmentioning

confidence: 99%

Attention bias dynamics and symptom severity during and following CBT for social anxiety disorder.

Davis¹,

Rosenfield²,

Bernstein³

et al. 2016

Journal of Consulting and Clinical Psychology

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Objective: Threat-related attention bias figures prominently in contemporary accounts of the maintenance of anxiety disorders, yet longitudinal intervention research relating attention bias to anxiety symptom severity is limited. Capitalizing on recent advances in the conceptualization and measurement of attention bias, we aimed to examine the relation between attention bias, indexed using trial-level bias scores (TLBSs) to quantify temporal dynamics reflecting dysregulation of attentional processing of threat (as opposed to aggregated mean bias scores) and social anxiety symptom severity over the course of cognitive–behavioral therapy (CBT) and 1-month follow-up. Method: Adults with social anxiety disorder (N = 39) assigned to either yohimbine- or placebo-augmented CBT completed measures of attention bias and social anxiety symptom severity weekly throughout CBT (5 sessions) and at 1-week and 1-month posttreatment. Results: TLBSs of attention bias temporal dynamics showed stronger psychometric properties than mean aggregated scores and were highly interrelated, in line with within-subject temporal variability fluctuating in time between attentional overengagement and strategic avoidance from threat. Attention bias toward threat and temporal variability in attention bias (i.e., attentional dysregulation), but not attention bias away from threat, significantly reduced over the course of CBT. Cross-lag analyses revealed no evidence of a causal relation between reductions in attentional dysregulation leading to symptom severity reduction, or vice versa. Observed relations did not vary as a function of time. Conclusions: We found no evidence for attentional dysregulation as a causal mechanism for symptom reduction in CBT for social anxiety disorders. Implications for future research are discussed.

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Augmentation of Exposure Therapy With D-Cycloserine for Social Anxiety Disorder

Abstract: The pilot data provide preliminary support for the use of short-term dosing of d-cycloserine as an adjunctive intervention to exposure therapy for SAD.

Cited by 528 publications

References 59 publications

Mechanisms of fear extinction

Mechanisms of fear extinction

Cognitive Enhancement: Methods, Ethics, Regulatory Challenges

Attention bias dynamics and symptom severity during and following CBT for social anxiety disorder.

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