The association between estradiol levels, hormonal contraceptive use, and responsiveness to one-session-treatment for spider phobia in women

Psychoneuroendocrinology
Bronwyn M GrahamLars-Göran Ost

Abstract

Preclinical studies have demonstrated that conditioned fear extinction is impaired in females with low endogenous levels of the sex hormone estradiol, due to menstrual fluctuations or hormonal contraceptive use. As fear extinction is a laboratory model of exposure therapy for anxiety and trauma disorders, here we assessed the hypothesis that treatment outcomes may be diminished when exposure therapy occurs during periods of low estradiol. 90 women with spider phobia (60 cycling and 30 using hormonal contraceptives) underwent a one-session exposure treatment for spider phobia, following which, serum estradiol levels were assessed. A median split in estradiol level was used to divide cycling participants into two groups; lower and higher estradiol. Behavioral avoidance and self-reported fear of spiders were measured pre-treatment, post-treatment, and at a 12 week follow-up assessment. Women using hormonal contraceptives exhibited a significantly slower rate of improvement across treatment, greater behavioral avoidance at post-treatment and follow-up, and fewer self-initiated post-treatment exposure tasks, relative to both groups of cycling women, who did not differ. No group differences in self-reported fear were evident. Correla...Continue Reading

Citations

Oct 22, 2019·The European Journal of Neuroscience·Harriet L L Day, Carl W Stevenson
Aug 14, 2018·Depression and Anxiety·Leila Maria SoraviaAndrea Federspiel
Sep 13, 2019·Neurobiology of Learning and Memory·Samantha Tang, Bronwyn M Graham
May 16, 2018·Progress in Neuro-psychopharmacology & Biological Psychiatry·Bronwyn M Graham, Elliot Scott
Jan 26, 2020·Hormones and Behavior·Samantha Tang, Bronwyn M Graham
May 28, 2019·Neuroscience and Biobehavioral Reviews·E R VelascoR Andero
Aug 3, 2021·Journal of Anxiety Disorders·Sophie H Li, Bronwyn M Graham
Sep 9, 2021·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·Zhenfu WenMohammed R Milad

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