{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:31:07Z","timestamp":1777858267574,"version":"3.51.4"},"reference-count":53,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T00:00:00Z","timestamp":1619568000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013373","name":"nihr oxford biomedical research centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013373","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008162","name":"MQ: Transforming Mental Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008162","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["STE 2399\/1-1"],"award-info":[{"award-number":["STE 2399\/1-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Oxfordshire Health Services Research Committee","award":["OHSRC 1021"],"award-info":[{"award-number":["OHSRC 1021"]}]},{"DOI":"10.13039\/501100002957","name":"technische universit\u00e4t dresden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002957","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Psychopharmacol"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Spider-fearful individuals were randomized to receiving either 20\u2009mg 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results\/outcomes:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\/interpretation:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02698811211001087","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T07:56:42Z","timestamp":1619596602000},"page":"641-651","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Hydrocortisone as an adjunct to brief cognitive-behavioural therapy for specific fear: Endocrine and cognitive biomarkers as predictors of symptom improvement"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1171-7133","authenticated-orcid":false,"given":"Susann","family":"Steudte-Schmiedgen","sequence":"first","affiliation":[{"name":"Department of Psychotherapy and Psychosomatic Medicine, Technische Universit\u00e4t Dresden, Dresden, Germany"},{"name":"Department of 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