{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T12:25:01Z","timestamp":1789907101001,"version":"4.0.1"},"reference-count":68,"publisher":"National Academy of Sciences","issue":"16","content-domain":{"domain":["www.pnas.org"],"crossmark-restriction":true},"short-container-title":["Proc. Natl. Acad. Sci. U.S.A."],"published-print":{"date-parts":[[2011,4,19]]},"abstract":"<jats:p>Behavioral exposure therapy of anxiety disorders is believed to rely on fear extinction. Because preclinical studies have shown that glucocorticoids can promote extinction processes, we aimed at investigating whether the administration of these hormones might be useful in enhancing exposure therapy. In a randomized, double-blind, placebo-controlled study, 40 patients with specific phobia for heights were treated with three sessions of exposure therapy using virtual reality exposure to heights. Cortisol (20 mg) or placebo was administered orally 1 h before each of the treatment sessions. Subjects returned for a posttreatment assessment 3\u20135 d after the last treatment session and for a follow-up assessment after 1 mo. Adding cortisol to exposure therapy resulted in a significantly greater reduction in fear of heights as measured with the acrophobia questionnaire (AQ) both at posttreatment and at follow-up, compared with placebo. Furthermore, subjects receiving cortisol showed a significantly greater reduction in acute anxiety during virtual exposure to a phobic situation at posttreatment and a significantly smaller exposure-induced increase in skin conductance level at follow-up. The present findings indicate that the administration of cortisol can enhance extinction-based psychotherapy.<\/jats:p>","DOI":"10.1073\/pnas.1018214108","type":"journal-article","created":{"date-parts":[[2011,3,28]],"date-time":"2011-03-28T22:34:26Z","timestamp":1301351666000},"page":"6621-6625","update-policy":"https:\/\/doi.org\/10.1073\/pnas.cm10313","source":"Crossref","is-referenced-by-count":232,"title":["Glucocorticoids enhance extinction-based psychotherapy"],"prefix":"10.1073","volume":"108","author":[{"given":"Dominique J.-F.","family":"de Quervain","sequence":"first","affiliation":[{"name":"Division of Cognitive Neuroscience, Department of Psychology, and"},{"name":"Psychiatric University Clinics, University of Basel, 4055 Basel, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doroth\u00e9e","family":"Bentz","sequence":"additional","affiliation":[{"name":"Division of Cognitive Neuroscience, Department of Psychology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Michael","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology and Psychotherapy, University of Saarbr\u00fccken, 66123 Saarbr\u00fccken, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia C.","family":"Bolt","sequence":"additional","affiliation":[{"name":"Department of Psychology, King's College London Institute of Psychiatry, Denmark Hill, London SE5 8AF, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda K.","family":"Wiederhold","sequence":"additional","affiliation":[{"name":"Virtual Reality Medical Institute, 1150 Woluwe-Saint-Pierre, Belgium;"},{"name":"Virtual Reality Medical Center, San Diego, CA 92121;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Margraf","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology and Psychotherapy, Ruhr-Universit\u00e4t Bochum, 44301 Bochum, Germany; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank H.","family":"Wilhelm","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology, Psychotherapy, and Health Psychology, University of Salzburg, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"341","published-online":{"date-parts":[[2011,3,28]]},"reference":[{"key":"e_1_3_3_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0896-6273(02)01064-4"},{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2005.09.025"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1025048802629"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.actpsy.2007.11.007"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-7358(03)00033-3"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/1469-8986.00043"},{"key":"e_1_3_3_7_2","first-page":"131","volume-title":"Anxiety and the Anxiety Disorders","author":"Lang PJ","year":"1985","unstructured":"PJ Lang, AH Tuma, JD Maser, The cognitive psychophysiology of emotion: Fear and anxiety. Anxiety and the Anxiety Disorders (Erlbaum, Hillsdale, NJ), pp. 131\u2013170 (1985)."},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.99.1.20"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.PSY.0000073872.85623.0C"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2009.10.011"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2007.01.003"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2005.10.006"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psc.2009.05.008"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1301555"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(02)01546-9"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.63.3.298"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.61.11.1136"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2008.01.012"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.5139-04.2005"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrn2651"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0306-4530(99)00058-X"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yfrne.2009.03.002"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1038\/73873"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1038\/29542"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neulet.2004.08.046"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/0028-3908(68)90012-9"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.2397-06.2006"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1300899"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0509184103"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7967(01)00023-7"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7967(03)00139-6"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.68.6.1020"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.152.4.626"},{"key":"e_1_3_3_34_2","volume-title":"Virtual Reality Therapy for Anxiety Disorders","author":"Wiederhold BK","year":"2005","unstructured":"BK Wiederhold, MD Wiederhold Virtual Reality Therapy for Anxiety Disorders (American Psychological Association, Washington, D.C., 2005)."},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1089\/cpb.1998.1.45"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2006.08.023"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7894(77)80116-0"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0306-4530(00)00058-5"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/0091-3057(78)90127-2"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/0018-506X(77)90032-0"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1037\/0735-7044.120.1.217"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1037\/0735-7044.115.5.1002"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2005.03.005"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.161.8.1488"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.2007.164.6.967"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nlm.2004.09.001"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nlm.2007.07.005"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1038\/nature08637"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.1038\/nn.2271"},{"key":"e_1_3_3_50_2","first-page":"173","volume-title":"DIPS diagnostisches Interview bei psychischen St\u00f6rungen","author":"Schneider S","year":"2006","unstructured":"S Schneider, J Margraf DIPS diagnostisches Interview bei psychischen St\u00f6rungen (Springer, Berlin) 3, 173 (2006)."},{"key":"e_1_3_3_51_2","volume-title":"Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition","author":"American Psychiatric Association","year":"1994","unstructured":"; American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (APA, Washington, DC, 1994)."},{"key":"e_1_3_3_52_2","first-page":"225","article-title":"Measuring presence in virtual environments: A presence questionnaire","volume":"7","author":"Witmer BG","year":"1998","unstructured":"BG Witmer, MJ Singer, Measuring presence in virtual environments: A presence questionnaire. Presence (Camb Mass) 7, 225\u2013240 (1998).","journal-title":"Presence (Camb Mass)"},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(89)90091-0"},{"key":"e_1_3_3_54_2","first-page":"443","volume-title":"Angstdiagnostik","author":"M\u00fchlberger A","year":"2003","unstructured":"A M\u00fchlberger, Gefahrenerwartungsbogen bei Flugreisen. Angstdiagnostik, eds J Hoyer, J Margraf (Springer, Berlin), pp. 443\u2013445 (2003)."},{"key":"e_1_3_3_55_2","first-page":"406","volume-title":"Angstdiagnostik","author":"M\u00fchlberger A","year":"2003","unstructured":"A M\u00fchlberger, Angerwartungsbogen bei Flugreisen. Angstdiagnostik, eds J Hoyer, J Margraf (Springer, Berlin), pp. 406\u2013408 (2003)."},{"key":"e_1_3_3_56_2","volume-title":"State-Trait-Angstinventar theoretische Grundlagen und Handanweisung","author":"Laux L","year":"1981","unstructured":"L Laux State-Trait-Angstinventar theoretische Grundlagen und Handanweisung (Beltz Testgesellschaft, Weinheim, Germany, Deutsche Ausgabe Ed p 1 Testmappe. (1981)."},{"key":"e_1_3_3_57_2","doi-asserted-by":"publisher","DOI":"10.1159\/000258732"},{"key":"e_1_3_3_58_2","volume-title":"Beck Depressionsinventar (BDI)","author":"Hautzinger MBM","year":"1994","unstructured":"MBM Hautzinger, H Worall, F Keller Beck Depressionsinventar (BDI) (Huber, Bern, 1994)."},{"key":"e_1_3_3_59_2","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7916(72)90045-6"},{"key":"e_1_3_3_60_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8986.1981.tb03024.x"},{"key":"e_1_3_3_61_2","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen J","year":"1988","unstructured":"J Cohen Statistical Power Analysis for the Behavioral Sciences (Lawrence Erlbaum Associates, 2nd Ed, Hillsdale, NJ, 1988).","edition":"2"},{"key":"e_1_3_3_62_2","doi-asserted-by":"publisher","DOI":"10.1037\/1082-989X.1.2.170"},{"key":"e_1_3_3_63_2","doi-asserted-by":"publisher","DOI":"10.2307\/2531543"},{"key":"e_1_3_3_64_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-1-6"},{"key":"e_1_3_3_65_2","doi-asserted-by":"publisher","DOI":"10.3109\/10253890.2010.514671"},{"key":"e_1_3_3_66_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-008-1275-8"},{"key":"e_1_3_3_67_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-005-0143-z"},{"key":"e_1_3_3_68_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2009.07.009"}],"container-title":["Proceedings of the National Academy of Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/pnas.org\/doi\/pdf\/10.1073\/pnas.1018214108","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T19:37:30Z","timestamp":1649792250000},"score":1,"resource":{"primary":{"URL":"https:\/\/pnas.org\/doi\/full\/10.1073\/pnas.1018214108"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,3,28]]},"references-count":68,"journal-issue":{"issue":"16","published-print":{"date-parts":[[2011,4,19]]}},"alternative-id":["10.1073\/pnas.1018214108"],"URL":"https:\/\/doi.org\/10.1073\/pnas.1018214108","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.9441956.10079054","asserted-by":"object"}]},"ISSN":["0027-8424","1091-6490"],"issn-type":[{"value":"0027-8424","type":"print"},{"value":"1091-6490","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,3,28]]},"assertion":[{"value":"2011-03-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}