{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:42:52Z","timestamp":1791272572878,"version":"4.1.0"},"reference-count":65,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Robert Pfleger Stiftung"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>Patients with Panic Disorder (PD) show an abnormal stress-induced functioning of the Hypothalamic-Pituitary-adrenal (HPA)-axis. Different protocols for stress induction are of rather low relevance for the psychotherapeutic treatment. In practice, interoceptive exposure is often realized as Low Intensity Exercise (LIE), as compared to an incremental cycle exercise test to exhaustion. Currently, it is not known, whether LIE displays an effective interoceptive stressor 1.) leading to a significant anxiety induction; 2.) a comparable HPA- and Sympathetic-Adreno-Medullar (SAM)-axis response in both patients and healthy controls; 3.) stress responses under LIE are associated with treatment outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Patients and methods<\/jats:title>\n<jats:p>N = 20 patients with PD and n = 20 healthy controls were exposed to ten minutes of LIE on an exercise bike. LIE was applied as part of the interoceptive exposure, during an intensive Cognitive-Behavioral Therapy (CBT) in a day clinic. Heart rate was monitored and salivary cortisol samples collected. Before and after the LIE, state anxiety\/ arousal were assessed. In order to evaluate psychopathology, the Panic and Agoraphobia Scale, Mobility Inventory, Agoraphobic Cognitions Questionnaire and Body Sensations Questionnaire were applied, before (T1) and after five weeks (T2) of an intensive CBT.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>LIE led to a significant and similar heart rate increase in both groups. Cortisol decreased over time in both groups, especially in male patients. A higher psychopathology before, and after CBT, was associated with a significantly lower cortisol response under LIE.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In the present study, LIE led to a divergent stress response: while there was a significant heart rate increase, cortisol decreased over time, particularly in male patients. A lower reactivity of the HPA-axis seems to be associated with a lower treatment outcome, which may affect extinction based learning. The findings suggest, that interoceptive stimuli should be designed carefully in order to be potent stressors.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0273413","type":"journal-article","created":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T17:49:54Z","timestamp":1662054594000},"page":"e0273413","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Cortisol response under low intensity exercise during cognitive-behavioral therapy is associated with therapeutic outcome in panic disorder\u2013an exploratory study"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6292-0852","authenticated-orcid":true,"given":"Gloria-Beatrice","family":"Wintermann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9","family":"Noack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susann","family":"Steudte-Schmiedgen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Weidner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,9,1]]},"reference":[{"issue":"4","key":"pone.0273413.ref001","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1001\/archpsyc.63.4.415","article-title":"The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication.","volume":"63","author":"RC Kessler","year":"2006","journal-title":"Archives of general psychiatry"},{"key":"pone.0273413.ref002","volume-title":"Diagnostic and statistical manual of mental disorders","author":"APA APA","year":"2013"},{"issue":"2","key":"pone.0273413.ref003","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1111\/j.1440-1819.2005.01345.x","article-title":"Prediction of first episode of panic attack among white-collar workers.","volume":"59","author":"A Watanabe","year":"2005","journal-title":"Psychiatry and clinical neurosciences"},{"issue":"1","key":"pone.0273413.ref004","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1053\/comp.2002.29844","article-title":"Premorbid conditions and precipitating events in early-onset panic disorder.","volume":"43","author":"S Venturello","year":"2002","journal-title":"Comprehensive psychiatry"},{"key":"pone.0273413.ref005","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.ijpsycho.2016.06.008","article-title":"Predisposition or side effect of the duration: the reactivity of the HPA-axis under psychosocial stress in panic disorder.","volume":"107","author":"GB Wintermann","year":"2016","journal-title":"International journal of psychophysiology: official journal of the International Organization of Psychophysiology"},{"issue":"3","key":"pone.0273413.ref006","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.jpsychires.2010.07.002","article-title":"Stress hormones during flooding therapy and their relationship to therapy outcome in patients with panic disorder and agoraphobia","volume":"45","author":"A Siegmund","year":"2011","journal-title":"Journal of psychiatric research"},{"key":"pone.0273413.ref007","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.neures.2018.03.003","article-title":"Salivary alpha-amylase and cortisol responsiveness to stress in first episode, drug-naive patients with panic disorder","volume":"137","author":"M Altamura","year":"2018","journal-title":"Neuroscience research"},{"key":"pone.0273413.ref008","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.psyneuen.2016.11.036","article-title":"Cortisol stress reactivity across psychiatric disorders: A systematic review and meta-analysis.","volume":"77","author":"JV Zorn","year":"2017","journal-title":"Psychoneuroendocrinology"},{"issue":"1","key":"pone.0273413.ref009","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1002\/da.20220","article-title":"HPA axis activity in patients with panic disorder: review and synthesis of four studies.","volume":"24","author":"JL Abelson","year":"2007","journal-title":"Depression and anxiety"},{"issue":"3","key":"pone.0273413.ref010","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1152\/physrev.00041.2006","article-title":"Physiology and neurobiology of stress and adaptation: central role of the brain","volume":"87","author":"BS McEwen","year":"2007","journal-title":"Physiological reviews"},{"issue":"3","key":"pone.0273413.ref011","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/j.psyneuen.2009.08.003","article-title":"A striking pattern of cortisol non-responsiveness to psychosocial stress in patients with panic disorder with concurrent normal cortisol awakening responses.","volume":"35","author":"K Petrowski","year":"2010","journal-title":"Psychoneuroendocrinology"},{"issue":"1","key":"pone.0273413.ref012","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.ijpsycho.2013.01.002","article-title":"Blunted salivary and plasma cortisol response in patients with panic disorder under psychosocial stress","volume":"88","author":"K Petrowski","year":"2013","journal-title":"International journal of psychophysiology: official journal of the International Organization of Psychophysiology"},{"issue":"8","key":"pone.0273413.ref013","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1016\/j.psyneuen.2011.12.013","article-title":"Dissociation between ACTH and cortisol response in DEX-CRH test in patients with panic disorder.","volume":"37","author":"K Petrowski","year":"2012","journal-title":"Psychoneuroendocrinology"},{"issue":"2","key":"pone.0273413.ref014","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1159\/000283560","article-title":"Attenuated neuroendocrine response to hypoglycemic stress in patients with panic disorder","volume":"92","author":"D Jezova","year":"2010","journal-title":"Neuroendocrinology"},{"issue":"Suppl 1","key":"pone.0273413.ref015","first-page":"S445","article-title":"Cortisol as an indicator of hypothalmic-pitituary-adrenal axis dysregulation in patients with panic disorder: a literature review.","volume":"27","author":"K Jakuszkowiak-Wojten","year":"2015","journal-title":"Psychiatria Danubina"},{"issue":"11","key":"pone.0273413.ref016","doi-asserted-by":"crossref","first-page":"2515","DOI":"10.1038\/sj.npp.1301168","article-title":"Regulation of the hypothalamic-pituitary-adrenocortical system in patients with panic disorder","volume":"31","author":"A Erhardt","year":"2006","journal-title":"Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology"},{"issue":"1","key":"pone.0273413.ref017","first-page":"3","article-title":"The hypothalamic-pituitary-adrenal axis in anxiety and panic. Psychology &","volume":"3","author":"FG Graeff","year":"2010","journal-title":"Neuroscience"},{"issue":"1","key":"pone.0273413.ref018","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.cpr.2009.08.011","article-title":"Psychological treatment of panic disorder with or without agoraphobia: a meta-analysis.","volume":"30","author":"J Sanchez-Meca","year":"2010","journal-title":"Clinical psychology review"},{"issue":"12","key":"pone.0273413.ref019","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1017\/S0033291717003919","article-title":"Dismantling cognitive-behaviour therapy for panic disorder: a systematic review and component network meta-analysis.","volume":"48","author":"A Pompoli","year":"2018","journal-title":"Psychological medicine"},{"issue":"8","key":"pone.0273413.ref020","doi-asserted-by":"crossref","first-page":"e70315","DOI":"10.1371\/journal.pone.0070315","article-title":"The weight of cognitions in panic: the link between misinterpretations and panic attacks.","volume":"8","author":"K De Cort","year":"2013","journal-title":"PloS one"},{"issue":"3","key":"pone.0273413.ref021","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.beth.2013.03.006","article-title":"Anxiety sensitivity and interoceptive exposure: a transdiagnostic construct and change strategy.","volume":"44","author":"JF Boswell","year":"2013","journal-title":"Behavior therapy"},{"issue":"3","key":"pone.0273413.ref022","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1037\/a0023584","article-title":"Psychological treatment for panic disorder with agoraphobia: a randomized controlled trial to examine the role of therapist-guided exposure in situ in CBT","volume":"79","author":"AT Gloster","year":"2011","journal-title":"Journal of consulting and clinical psychology"},{"issue":"4","key":"pone.0273413.ref023","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1177\/0145445518772269","article-title":"Repeated Interoceptive Exposure in Individuals With High and Low Anxiety Sensitivity.","volume":"43","author":"K Holtz","year":"2019","journal-title":"Behavior modification"},{"key":"pone.0273413.ref024","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1016\/B978-141603197-0.10069-2","volume-title":"The Sports Medicine Resource Manual.","author":"PA Deuster","year":"2008"},{"issue":"9","key":"pone.0273413.ref025","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1016\/j.brat.2013.06.006","article-title":"Maximizing the efficacy of interoceptive exposure by optimizing inhibitory learning: a randomized controlled trial","volume":"51","author":"B Deacon","year":"2013","journal-title":"Behaviour research and therapy"},{"key":"pone.0273413.ref026","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.psyneuen.2016.11.030","article-title":"Effects of the cortisol stress response on the psychotherapy outcome of panic disorder patients.","volume":"77","author":"S Wichmann","year":"2017","journal-title":"Psychoneuroendocrinology"},{"key":"pone.0273413.ref027","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.psyneuen.2014.10.002","article-title":"Intra-individual psychological and physiological responses to acute laboratory stressors of different intensity.","volume":"51","author":"N Skoluda","year":"2015","journal-title":"Psychoneuroendocrinology"},{"issue":"3","key":"pone.0273413.ref028","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/0091-3057(93)90162-M","article-title":"Attenuated cortisol response to psychological stress but not to CRH or ergometry in young habitual smokers","volume":"44","author":"C Kirschbaum","year":"1993","journal-title":"Pharmacology, biochemistry, and behavior"},{"issue":"7","key":"pone.0273413.ref029","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1007\/BF03345606","article-title":"Exercise and circulating cortisol levels: the intensity threshold effect","volume":"31","author":"EE Hill","year":"2008","journal-title":"Journal of endocrinological investigation"},{"issue":"5","key":"pone.0273413.ref030","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1007\/s40279-015-0306-y","article-title":"Exercise-Induced Responses in Salivary Testosterone, Cortisol, and Their Ratios in Men: A Meta-Analysis.","volume":"45","author":"LD Hayes","year":"2015","journal-title":"Sports Medicine"},{"issue":"9","key":"pone.0273413.ref031","doi-asserted-by":"crossref","first-page":"e74655","DOI":"10.1371\/journal.pone.0074655","article-title":"Altered olfactory processing of stress-related body odors and artificial odors in patients with panic disorder.","volume":"8","author":"GB Wintermann","year":"2013","journal-title":"PloS one"},{"key":"pone.0273413.ref032","volume-title":"Strukturiertes Klinisches Interview f\u00fcr DSM-IV.:","author":"H-U Wittchen","year":"1997"},{"key":"pone.0273413.ref033","volume-title":"Expositionsbasierte Therapie der Panikst\u00f6rung mit Agoraphobie: Ein Behandlungsmanual","author":"T Lang","year":"2011"},{"issue":"4","key":"pone.0273413.ref034","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.3758\/BRM.41.4.1149","article-title":"Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses.","volume":"41","author":"F Faul","year":"2009","journal-title":"Behavior research methods"},{"issue":"6","key":"pone.0273413.ref035","doi-asserted-by":"crossref","first-page":"e5987","DOI":"10.1371\/journal.pone.0005987","article-title":"Induction of empathy by the smell of anxiety.","volume":"4","author":"A Prehn-Kristensen","year":"2009","journal-title":"PloS one"},{"issue":"9","key":"pone.0273413.ref036","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1093\/chemse\/bjh245","article-title":"Positive emotional priming of facial affect perception in females is diminished by chemosensory anxiety signals","volume":"29","author":"BM Pause","year":"2004","journal-title":"Chemical senses"},{"key":"pone.0273413.ref037","doi-asserted-by":"crossref","first-page":"311","DOI":"10.3389\/fendo.2020.00311","article-title":"Higher Circulating Cortisol in the Follicular vs. Luteal Phase of the Menstrual Cycle: A Meta-Analysis","volume":"11","author":"A Hamidovic","year":"2020","journal-title":"Frontiers in endocrinology"},{"key":"pone.0273413.ref038","volume-title":"Manual for the State-Trait Anxiety Inventory.","author":"CD Spielberger","year":"1983"},{"issue":"1","key":"pone.0273413.ref039","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/0005-7916(94)90063-9","article-title":"Measuring emotion: the Self-Assessment Manikin and the Semantic Differential","volume":"25","author":"MM Bradley","year":"1994","journal-title":"Journal of behavior therapy and experimental psychiatry"},{"issue":"2","key":"pone.0273413.ref040","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1097\/00004850-199506000-00003","article-title":"Assessing the efficacy of treatments for panic disorder and agoraphobia","volume":"10","author":"B. Bandelow","year":"1995","journal-title":"II. The Panic and Agoraphobia Scale. International clinical psychopharmacology"},{"issue":"1","key":"pone.0273413.ref041","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/0005-7967(85)90140-8","article-title":"The Mobility Inventory for Agoraphobia.","volume":"23","author":"DL Chambless","year":"1985","journal-title":"Behaviour research and therapy"},{"issue":"6","key":"pone.0273413.ref042","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1037\/0022-006X.52.6.1090","article-title":"Assessment of fear of fear in agoraphobics: the body sensations questionnaire and the agoraphobic cognitions questionnaire","volume":"52","author":"DL Chambless","year":"1984","journal-title":"Journal of consulting and clinical psychology"},{"key":"pone.0273413.ref043","volume-title":"Beck-Depressions-Inventar (BDI).","author":"M Hautzinger","year":"1994"},{"issue":"7","key":"pone.0273413.ref044","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1016\/S0306-4530(02)00108-7","article-title":"Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change.","volume":"28","author":"JC Pruessner","year":"2003","journal-title":"Psychoneuroendocrinology"},{"issue":"3","key":"pone.0273413.ref045","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1192\/bjp.bp.114.156554","article-title":"Anxiety and new onset of cardiovascular disease: critical review and meta-analysis.","volume":"208","author":"NM Batelaan","year":"2016","journal-title":"The British journal of psychiatry: the journal of mental science"},{"issue":"6","key":"pone.0273413.ref046","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1080\/02640410701716790","article-title":"Effects of exercise intensity on salivary antimicrobial proteins and markers of stress in active men","volume":"26","author":"JE Allgrove","year":"2008","journal-title":"Journal of sports sciences"},{"issue":"21","key":"pone.0273413.ref047","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1056\/NEJM198505233122102","article-title":"Evidence for two subtypes of Cushing\u2019s disease based on the analysis of episodic cortisol secretion","volume":"312","author":"E Van Cauter","year":"1985","journal-title":"The New England journal of medicine"},{"issue":"9","key":"pone.0273413.ref048","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1097\/PSY.0000000000000002","article-title":"Classification criteria for distinguishing cortisol responders from nonresponders to psychosocial stress: evaluation of salivary cortisol pulse detection in panel designs.","volume":"75","author":"R Miller","year":"2013","journal-title":"Psychosomatic medicine"},{"issue":"6","key":"pone.0273413.ref049","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1055\/s-2004-821068","article-title":"Cortisol\u2014essential adaptation hormone in exercise","volume":"25","author":"A Viru","year":"2004","journal-title":"International journal of sports medicine"},{"key":"pone.0273413.ref050","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.jpsychires.2014.07.008","article-title":"Effect of combined cognitive-behavioural therapy and endurance training on cortisol and salivary alpha-amylase in panic disorder","volume":"58","author":"J Plag","year":"2014","journal-title":"Journal of psychiatric research"},{"issue":"4","key":"pone.0273413.ref051","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1002\/da.22043","article-title":"Let\u2019s get physical: a contemporary review of the anxiolytic effects of exercise for anxiety and its disorders.","volume":"30","author":"GJ Asmundson","year":"2013","journal-title":"Depression and anxiety"},{"issue":"6","key":"pone.0273413.ref052","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1016\/j.janxdis.2007.09.010","article-title":"Promoting walking as an adjunct intervention to group cognitive behavioral therapy for anxiety disorders\u2014a pilot group randomized trial","volume":"22","author":"D Merom","year":"2008","journal-title":"Journal of anxiety disorders"},{"issue":"2","key":"pone.0273413.ref053","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/S0005-7967(03)00103-7","article-title":"Effects of aerobic exercise on anxiety sensitivity","volume":"42","author":"JJ Broman-Fulks","year":"2004","journal-title":"Behaviour research and therapy"},{"issue":"1\u20133","key":"pone.0273413.ref054","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.jad.2007.07.022","article-title":"Acute exercise reduces the effects of a 35% CO2 challenge in patients with panic disorder","volume":"107","author":"G Esquivel","year":"2008","journal-title":"Journal of affective disorders"},{"issue":"9","key":"pone.0273413.ref055","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1002\/da.22915","article-title":"Physical activity protects from incident anxiety: A meta-analysis of prospective cohort studies.","volume":"36","author":"FB Schuch","year":"2019","journal-title":"Depression and anxiety"},{"issue":"6","key":"pone.0273413.ref056","doi-asserted-by":"crossref","DOI":"10.5935\/MedicalExpress.2015.06.02","article-title":"Chronic effects of aerobic exercise on panic disorder: a systematic review of randomized and non-randomized trials.","volume":"2","author":"E Lattari","year":"2015","journal-title":"Medical Express"},{"key":"pone.0273413.ref057","doi-asserted-by":"crossref","first-page":"11","DOI":"10.2174\/1745017901814010011","article-title":"Effects of Aerobic Exercise on Anxiety Symptoms and Cortical Activity in Patients with Panic Disorder: A Pilot Study.","volume":"14","author":"E Lattari","year":"2018","journal-title":"Clinical practice and epidemiology in mental health: CP & EMH"},{"issue":"3","key":"pone.0273413.ref058","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1037\/0033-2909.130.3.355","article-title":"Acute stressors and cortisol responses: a theoretical integration and synthesis of laboratory research.","volume":"130","author":"SS Dickerson","year":"2004","journal-title":"Psychological bulletin"},{"issue":"2","key":"pone.0273413.ref059","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.psyneuen.2008.10.026","article-title":"Salivary cortisol as a biomarker in stress research.","volume":"34","author":"DH Hellhammer","year":"2009","journal-title":"Psychoneuroendocrinology"},{"issue":"1","key":"pone.0273413.ref060","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.biopsycho.2004.11.009","article-title":"Sex differences in HPA axis responses to stress: a review.","volume":"69","author":"BM Kudielka","year":"2005","journal-title":"Biological psychology"},{"key":"pone.0273413.ref061","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.psyneuen.2014.10.008","article-title":"High cortisol awakening response and cortisol levels moderate exposure-based psychotherapy success.","volume":"51","author":"AE Meuret","year":"2015","journal-title":"Psychoneuroendocrinology"},{"issue":"1","key":"pone.0273413.ref062","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1038\/nrn.2016.155","article-title":"Stress, glucocorticoids and memory: implications for treating fear-related disorders","volume":"18","author":"D de Quervain","year":"2017","journal-title":"Nature reviews Neuroscience"},{"issue":"16","key":"pone.0273413.ref063","doi-asserted-by":"crossref","first-page":"6621","DOI":"10.1073\/pnas.1018214108","article-title":"Glucocorticoids enhance extinction-based psychotherapy","volume":"108","author":"DJ de Quervain","year":"2011","journal-title":"Proceedings of the National Academy of Sciences of the United States of America"},{"issue":"5","key":"pone.0273413.ref064","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1002\/da.22219","article-title":"Glucocorticoids enhance in vivo exposure-based therapy of spider phobia","volume":"31","author":"LM Soravia","year":"2014","journal-title":"Depression and anxiety"},{"key":"pone.0273413.ref065","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.janxdis.2017.02.007","article-title":"Cortisol as a predictor of psychological therapy response in anxiety disorders-Systematic review and meta-analysis","volume":"47","author":"S Fischer","year":"2017","journal-title":"Journal of anxiety disorders"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0273413","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T17:51:28Z","timestamp":1662054688000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0273413"}},"subtitle":[],"editor":[{"given":"Walid Kamal","family":"Abdelbasset","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,9,1]]},"references-count":65,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9,1]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0273413","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,1]]}}}