Details

Autor(en) / Beteiligte

• Lubin, Rebecca E.
• Fitzgerald, Hayley E.
• Rosenfield, David
• Carpenter, Joseph K.
• Papini, Santiago
• Dutcher, Christina D.
• Dowd, Sheila M.
• Hofmann, Stefan G.
• Pollack, Mark H.
• Smits, Jasper A.J.
• Otto, Michael W.

Titel

Using pre-treatment de novo threat conditioning outcomes to predict treatment response to DCS augmentation of exposure-based CBT

Ist Teil von

• Journal of psychiatric research, 2023-08, Vol.164, p.357-363

Ort / Verlag

England: Elsevier Ltd

Erscheinungsjahr

2023

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Over a decade and a half of research has resulted in inconsistent evidence for the efficacy of d-cycloserine (DCS), a partial glutamatergic N-methyl-D-aspartate agonist, for augmenting exposure-based cognitive behavioral therapy (CBT) for anxiety- and fear-based disorders. These variable findings have motivated the search for moderators of DCS augmentation efficacy. In this secondary analysis of a previous randomized clinical trial, we evaluated the value of de novo threat conditioning outcomes—degree of threat acquisition, extinction, and extinction retention—for predicting treatment response to exposure-based CBT for social anxiety disorder, applied with and without DCS augmentation in a sample of 59 outpatients. We found that average differential skin conductance response (SCR) during extinction and extinction retention significantly moderated the prediction of clinical response to DCS: participants with poorer extinction and extinction retention showed relatively improved treatment response with DCS. No such effects were found for expectancy ratings, consistent with accounts of DCS selectively aiding lower-order but not higher-order extinction learning. These findings provide support for extinction and extinction retention outcomes from threat conditioning as potential pre-treatment biomarkers for DCS augmentation benefits. Independent of DCS augmentation, the current study did not support threat conditioning outcomes as useful for predicting response to exposure-based CBT. •De novo threat extinction and retention predict clinical response to d-cycloserine.•Skin conductance but not expectancy provide prediction of clinical outcome.•Threat conditioning may provide a biomarker of the efficacy of cognitive enhancers.