The predictive value of cortisol in psychodynamic psychotherapy for social anxiety disorder: Extended results of the SOPHONET-Study

Publikationstyp:
Zeitschriftenaufsatz
Metadaten:
Autoren
  • Ileana Schmalbach
  • Michael Witthoeft
  • Bernhard Strauss
  • Peter Joraschky
  • Katja Petrowski
Autoren-URL
https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=fis-test-1&SrcAuth=WosAPI&KeyUT=WOS:001200757400001&DestLinkType=FullRecord&DestApp=WOS_CPL
DOI
10.1038/s41398-024-02882-3
Externe Identifier
  • Clarivate Analytics Document Solution ID: NM0R0
  • PubMed Identifier: 38605013
ISSN
2158-3188
Ausgabe der Veröffentlichung
1
Zeitschrift
TRANSLATIONAL PSYCHIATRY
Artikelnummer
ARTN 188
Datum der Veröffentlichung
2024
Status
Published
Titel
The predictive value of cortisol in psychodynamic psychotherapy for social anxiety disorder: Extended results of the SOPHONET-Study
Sub types
  • Article
Ausgabe der Zeitschrift
14

Datenquelle: Web of Science (Lite)

Andere Metadatenquellen:
Abstract
<jats:title>Abstract</jats:title><jats:p>Psychotherapy is an effective treatment for anxiety disorders (AD), yet a vast majority of patients do not respond to therapy, necessitating the identification of predictors to enhance outcomes. Several studies have explored the relationship between stress response and treatment outcome, as a potential treatment mechanism. However, the latter remains under-researched in patients with social anxiety disorder (SAD). We studied <jats:italic>N</jats:italic> = 29 patients undergoing psychodynamic psychotherapy (PDT) within the SOPHONET-Study. Stress reactivity (i.e., area under the curve with respect to the increase; AUCi) was induced by a standardized psychosocial stressor (Trier Social Stress Test; TSST) and assessed by means of adrenocorticotropic hormone (ACTH), blood and salivary cortisol samples before (t<jats:sub>1</jats:sub>) treatment. Samples of these biomarkers were taken −1 min prior stress exposure and six more blood samples were collected post-TSST ( + 1, + 10, + 20, + 30, + 45, + 60 min.). The participants were diagnosed with SAD based on the Structured Clinical Interview for DSM-IV (SCID) and completed the Liebowitz Social Anxiety Scale as well as the Beck Depression Inventory before (t<jats:sub>1</jats:sub>) and after psychotherapy (t<jats:sub>2</jats:sub>). Pre-treatment stress reactivity significantly predicted changes in depression (salivary <jats:italic>p</jats:italic> &lt; 0.001 and blood cortisol <jats:italic>p</jats:italic> = 0.001), as well as in avoidance behavior (blood cortisol <jats:italic>p</jats:italic> = 0.001). None of the biomarkers revealed significant results in fear or in the total LSAS-scores, except for ACTH with a trend finding (<jats:italic>p</jats:italic> = 0.06). Regarding therapy success, symptoms of social anxiety (<jats:italic>p</jats:italic> = 0.005) and depression (<jats:italic>p</jats:italic> &lt; 0.001) were significantly reduced from pre (t<jats:sub>1</jats:sub>) to post-treatment (t<jats:sub>2</jats:sub>). Our study showed that stress reactivity pre-treatment may serve as a predictor of psychotherapy outcome. In this regard, alterations in stress response relate to changes in symptoms of social anxiety and depression after PDT. This implies that patients with chronic stress might benefit from a targeted interventions during psychotherapy, especially to manage fear in social contexts.</jats:p>
Autoren
  • Ileana Schmalbach
  • Michael Witthöft
  • Bernhard Strauß
  • Peter Joraschky
  • Katja Petrowski
DOI
10.1038/s41398-024-02882-3
eISSN
2158-3188
Ausgabe der Veröffentlichung
1
Zeitschrift
Translational Psychiatry
Sprache
en
Artikelnummer
188
Online publication date
2024
Status
Published online
Herausgeber
Springer Science and Business Media LLC
Herausgeber URL
http://dx.doi.org/10.1038/s41398-024-02882-3
Datum der Datenerfassung
2024
Titel
The predictive value of cortisol in psychodynamic psychotherapy for social anxiety disorder: Extended results of the SOPHONET-Study
Ausgabe der Zeitschrift
14

Datenquelle: Crossref

Abstract
Psychotherapy is an effective treatment for anxiety disorders (AD), yet a vast majority of patients do not respond to therapy, necessitating the identification of predictors to enhance outcomes. Several studies have explored the relationship between stress response and treatment outcome, as a potential treatment mechanism. However, the latter remains under-researched in patients with social anxiety disorder (SAD). We studied N = 29 patients undergoing psychodynamic psychotherapy (PDT) within the SOPHONET-Study. Stress reactivity (i.e., area under the curve with respect to the increase; AUCi) was induced by a standardized psychosocial stressor (Trier Social Stress Test; TSST) and assessed by means of adrenocorticotropic hormone (ACTH), blood and salivary cortisol samples before (t<sub>1</sub>) treatment. Samples of these biomarkers were taken -1 min prior stress exposure and six more blood samples were collected post-TSST ( + 1, + 10, + 20, + 30, + 45, + 60 min.). The participants were diagnosed with SAD based on the Structured Clinical Interview for DSM-IV (SCID) and completed the Liebowitz Social Anxiety Scale as well as the Beck Depression Inventory before (t<sub>1</sub>) and after psychotherapy (t<sub>2</sub>). Pre-treatment stress reactivity significantly predicted changes in depression (salivary p < 0.001 and blood cortisol p = 0.001), as well as in avoidance behavior (blood cortisol p = 0.001). None of the biomarkers revealed significant results in fear or in the total LSAS-scores, except for ACTH with a trend finding (p = 0.06). Regarding therapy success, symptoms of social anxiety (p = 0.005) and depression (p < 0.001) were significantly reduced from pre (t<sub>1</sub>) to post-treatment (t<sub>2</sub>). Our study showed that stress reactivity pre-treatment may serve as a predictor of psychotherapy outcome. In this regard, alterations in stress response relate to changes in symptoms of social anxiety and depression after PDT. This implies that patients with chronic stress might benefit from a targeted interventions during psychotherapy, especially to manage fear in social contexts.
Addresses
  • Department of Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany. isteffen@uni-mainz.de.
Autoren
  • Ileana Schmalbach
  • Michael Witthöft
  • Bernhard Strauß
  • Peter Joraschky
  • Katja Petrowski
DOI
10.1038/s41398-024-02882-3
eISSN
2158-3188
Externe Identifier
  • PubMed Identifier: 38605013
  • PubMed Central ID: PMC11009385
Open access
true
ISSN
2158-3188
Ausgabe der Veröffentlichung
1
Zeitschrift
Translational psychiatry
Schlüsselwörter
  • Saliva
  • Humans
  • Hydrocortisone
  • Stress, Psychological
  • Anxiety
  • Adrenocorticotropic Hormone
  • Psychotherapy, Psychodynamic
  • Biomarkers
  • Phobia, Social
Sprache
eng
Medium
Electronic
Online publication date
2024
Open access status
Open Access
Paginierung
188
Datum der Veröffentlichung
2024
Status
Published
Publisher licence
CC BY
Datum der Datenerfassung
2024
Titel
The predictive value of cortisol in psychodynamic psychotherapy for social anxiety disorder: Extended results of the SOPHONET-Study.
Sub types
  • research-article
  • Journal Article
Ausgabe der Zeitschrift
14

Files

https://www.nature.com/articles/s41398-024-02882-3.pdf https://europepmc.org/articles/PMC11009385?pdf=render

Datenquelle: Europe PubMed Central

Abstract
Psychotherapy is an effective treatment for anxiety disorders (AD), yet a vast majority of patients do not respond to therapy, necessitating the identification of predictors to enhance outcomes. Several studies have explored the relationship between stress response and treatment outcome, as a potential treatment mechanism. However, the latter remains under-researched in patients with social anxiety disorder (SAD). We studied N = 29 patients undergoing psychodynamic psychotherapy (PDT) within the SOPHONET-Study. Stress reactivity (i.e., area under the curve with respect to the increase; AUCi) was induced by a standardized psychosocial stressor (Trier Social Stress Test; TSST) and assessed by means of adrenocorticotropic hormone (ACTH), blood and salivary cortisol samples before (t1) treatment. Samples of these biomarkers were taken -1 min prior stress exposure and six more blood samples were collected post-TSST ( + 1, + 10, + 20, + 30, + 45, + 60 min.). The participants were diagnosed with SAD based on the Structured Clinical Interview for DSM-IV (SCID) and completed the Liebowitz Social Anxiety Scale as well as the Beck Depression Inventory before (t1) and after psychotherapy (t2). Pre-treatment stress reactivity significantly predicted changes in depression (salivary p < 0.001 and blood cortisol p = 0.001), as well as in avoidance behavior (blood cortisol p = 0.001). None of the biomarkers revealed significant results in fear or in the total LSAS-scores, except for ACTH with a trend finding (p = 0.06). Regarding therapy success, symptoms of social anxiety (p = 0.005) and depression (p < 0.001) were significantly reduced from pre (t1) to post-treatment (t2). Our study showed that stress reactivity pre-treatment may serve as a predictor of psychotherapy outcome. In this regard, alterations in stress response relate to changes in symptoms of social anxiety and depression after PDT. This implies that patients with chronic stress might benefit from a targeted interventions during psychotherapy, especially to manage fear in social contexts.
Date of acceptance
2024
Autoren
  • Ileana Schmalbach
  • Michael Witthöft
  • Bernhard Strauß
  • Peter Joraschky
  • Katja Petrowski
Autoren-URL
https://www.ncbi.nlm.nih.gov/pubmed/38605013
DOI
10.1038/s41398-024-02882-3
eISSN
2158-3188
Externe Identifier
  • PubMed Central ID: PMC11009385
Ausgabe der Veröffentlichung
1
Zeitschrift
Transl Psychiatry
Schlüsselwörter
  • Humans
  • Phobia, Social
  • Psychotherapy, Psychodynamic
  • Hydrocortisone
  • Biomarkers
  • Adrenocorticotropic Hormone
  • Stress, Psychological
  • Saliva
  • Anxiety
Sprache
eng
Country
United States
Paginierung
188
PII
10.1038/s41398-024-02882-3
Datum der Veröffentlichung
2024
Status
Published online
Datum, an dem der Datensatz öffentlich gemacht wurde
2024
Titel
The predictive value of cortisol in psychodynamic psychotherapy for social anxiety disorder: Extended results of the SOPHONET-Study.
Sub types
  • Journal Article
Ausgabe der Zeitschrift
14

Datenquelle: PubMed

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