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Rationale The administration of glucocorticoids (GC) as an adjunct to exposure represents a promising strategy to improve one-session exposure outcome in anxiety disorders. It remains to be determined whether similar effects can be induced with the use of acute stress. Furthermore, the possible modulation of exposure effects by hormonal factors (e.g., use of oral contraceptives (OCs)) was not explored so far. Objectives We investigated whether acute stress prior to one-session exposure for spider fear affects its efficacy in women using oral contraceptives (OC) relative to free-cycling (FC) women. In addition, effects of stress on generalization of exposure therapy effects towards untreated stimuli were examined. Methods Women with fears of spiders and cockroaches were randomly assigned to a Stress (n = 24) or No-Stress (n = 24) condition prior to one-session exposure. Of these 48 participants, 19 women used OC (n = 9 in the Stress, and n = 10 in the No-Stress group). All FC women had a regular menstrual cycle and were tested only in the follicular phase of their menstrual cycle. Pre-exposure stress induction was realized with the socially evaluated cold-pressor test. Exposure-induced changes towards treated and untreated fear stimuli were tested with behavioral approach tests for spiders and cockroaches and subjective fear and self-report measures. Results Acute stress did not influence exposure-induced reduction in fear and avoidance of the treated stimuli (spiders). Similarly, stress had no effect on the generalization of exposure-therapy effects towards untreated stimuli (cockroaches). Exposure-induced reduction in subjective fear and self-report measures for treated stimuli was less evident in women using OC specifically after pre-exposure stress. Women using OC had higher levels of subjective fear and scored higher in self-report measures at post-treatment (24 h after exposure) and follow-up (4 weeks after exposure). Conclusions OC intake may represent an important confounding factor in augmentation studies using stress or GC.

There is a lot of research about the connection of self-efficacy and anxiety disorders, especially for social phobia. In this new study, we would like to explore the link between general/specific self-efficacy and specific phobias, according to the categorization in the DSM 5 (animal, situational, natural environment and blood/injection/injury).

In experimental psychopathology research, the use of anticipatory fear cues (threat of shock) has proven to be a valuable methodology for inducing emotional arousal in healthy subjects. The "threat of scream" paradigm represents an extension of this methodology (Beaurenaut, M., Tokarski, E., Dezecache, G. et al., 2020) and is suitable for the study of cognitive processes under emotional arousal. In the present study, an online version of the threat of scream paradigm will be used to investigate the role of emotional activation in episodic memory. In episodic memory, memories of specific events (what) are stored in a spatial (where) and temporal (when) context (Tulving, 2002). The episodic memory task was created following an already established and frequently used virtual reality task (Zlomuzica et al., 2015; 2018) in which de novo events are presented. The present study aims to investigate how the different conditions in the threat of scream paradigm (anticipation of aversive sounds versus anticipation of no sounds) affect encoding in a computer-based episodic memory task. The sample includes healthy (no presence of acute or chronic neurological and/or mental illness) adults up to 50 years of age with corrected or normal vision. The study will take place online via the Qualtrics software.

The neurophysiological basis of consciousness is still unknown and one of the most challenging questions in the field of neuroscience and related disciplines. We propose that consciousness is characterized by the maintenance of mental representations of internal and external stimuli for the execution of cognitive operations. Consciousness cannot exist without working memory, and it is likely that consciousness and working memory share the same neural substrates. Here, we present a novel psychological and neurophysiological framework that explains the role of consciousness for cognition, adaptive behavior, and everyday life. A hypothetical architecture of consciousness is presented that is organized as a system of operation and storage units named platforms that are controlled by a consciousness center (central executive/online platform). Platforms maintain mental representations or contents, are entrusted with different executive functions, and operate at different levels of consciousness. The model includes conscious-mode central executive/online and mental time travel platforms and semiconscious steady-state and preconscious standby platforms. Mental representations or contents are represented by neural circuits and their support cells (astrocytes, oligodendrocytes, etc.) and become conscious when neural circuits reverberate, that is, fire sequentially and continuously with relative synchronicity. Reverberatory activity in neural circuits may be initiated and maintained by pacemaker cells/neural circuit pulsars, enhanced electronic coupling via gap junctions, and unapposed hemichannel opening. The central executive/online platform controls which mental representations or contents should become conscious by recruiting pacemaker cells/neural network pulsars, the opening of hemichannels, and promoting enhanced neural circuit coupling via gap junctions.

Anxiety disorders (ADs) are characterized by increased chronicity and comorbidity with other ADs. Although exposure is the most effective therapy option for ADs, some patients show poor treatment response and a heightened vulnerability for relapse after treatment completion. Hence, significant research effort needs to be devoted to improve the long-term effectiveness of exposure effects. Recent attempts to increase exposure therapy efficacy use strategies aimed at promoting the acquisition and retrieval of extinction memories. The present review illustrates the value and limitations of such extinction-based therapy approaches. We present and discuss recent findings from translational studies using cortisol and self-efficacy enhancement as an add-on to exposure therapy. We illustrate how the integration of findings from experimental research on fear extinction learning and self-efficacy could advance the development of more optimized treatments for ADs.

Great interest exists in maximizing exposure therapy efficacy in anxiety disorders. At the same time, reduced frequency and shortened duration of exposure sessions are required to meet the specific regularities in routine care settings. Extinction has emerged as the key mechanism of exposure treatment in anxiety disorders. Examining exposure treatment processes from the perspective of extinction learning might provide novel insights into variability in exposure treatment duration and outcome. The present study sought to examine the functional link between fear extinction, the ability to accomplish exposure in a predetermined time and exposure therapy outcome in specific phobia. Treatment-seeking individuals (N = 53) with spider phobia underwent a context-dependent fear conditioning paradigm prior to a standardized exposure. Spider-phobic participants who were able to complete exposure within the pre-determined time (i.e., completers) showed a more pronounced short- and long-term exposure therapy benefit. In the fear conditioning task, a more pronounced decline in CS-US contingency ratings during extinction (retrieval) was found in completers relative to non-completers. The failure to further extinguish US expectancy to the CSs in non-completers might offer a potential mechanistic explanation why non-completers have difficulties to accomplish all exposure steps in a fixed time and show less pronounced treatment gains. Our findings bear specific implications for the implementation of exposure treatment to routine care settings.

Contains fulltext : 234376.pdf (Publisher’s version ) (Open Access) Stress may potentiate the chronification of nicotine addiction, but the exact mechanisms remain elusive. We performed an explorative pilot study examining the effects of psychological stress, administered via the socially evaluated cold pressor task (SECPT), on implicit approach bias for smoking-related cues in smokers in the approach-avoidance task (AAT). Smokers (N=24) were subjected to the stress or control condition of the SECPT by using a within-subject design. Consistent with previous findings, a strong approach bias for smoking-related cues in the AAT was found in smokers. Exposure to stress did not affect the general bias for smoking-related cues in the AAT relative to the control condition of the SECPT. In additional explorative analyses, an interaction between carbon monoxide (CO) levels in expired air, cortisol levels, and stress on approach bias for smoking-related cues was found. Higher CO levels, possibly due to recent smoking, prior to stress exposure were associated with an approach bias for smoking-related cues. Our findings suggest that CO levels in interaction with stress can modulate implicit, automatic processing in the context of nicotine-addiction. Our findings might provide novel cues to how stress influences cigarette craving and smoking behavior. 11 p.

Hormonal contraceptive use can aggravate existing symptoms of anxiety and depression and influence the response to pharmacologic treatment. The impact of hormonal contraceptive use on non-pharmacological treatment efficacy in anxiety disorders is less well explored. Oral contraceptives, which suppress endogenous sex hormone secretion, can alter fear extinction learning. Fear extinction is considered the laboratory proxy of exposure therapy in anxiety disorders. This study set out to examine whether oral contraceptive use is related to exposure-based treatment response in specific phobia. We recruited spider-phobic women (n = 28) using oral contraceptives (OC) and free-cycling women (n =26, No-OC). All participants were subjected to an identical in-vivo exposure. Exposure-based symptom improvement was assessed with several behavioral and subjective indices at pre-treatment, post-treatment and six-weeks follow-up. No–OC women showed higher pre-exposure fear levels on the FSQ and SPQ. OC women showed slightly less pronounced exposure benefit compared to their free-cycling counterparts (No-OC woman) as reflected by lower levels of fear reduction from pre-treatment to follow-up on the subjective level. After correction for multiple testing, OC and No-OC women showed differences in self-report measures (SPQ, FAS and SBQ) from pre- to follow-up treatment but not from pre-to post-treatment. These findings implicate that oral contraceptive use can account for differential exposure-based fear symptom improvement. Our study highlights the importance of monitoring and managing hormonal contraceptives use in the context of non-pharmacological exposure-based interventions.

The administration of glucocorticoids (GC) as an adjunct to exposure might represent a promising strategy to improve exposure therapy outcome in anxiety disorders (AD). The beneficial effects, however, might be sex-dependent and/or further modulated by hormonal factors (e.g., contraceptive usage in women). In the present study, we investigated whether acute stress before exposure therapy affects its efficacy in women using oral contraceptives (OC) relative to free-cycling (FC) women. In addition, possible effects of stress on generalization of therapy effects towards untreated stimuli were examined. Women with fears of spiders and cockroaches were randomly assigned to a stress (n=24) or no-stress (n=24) group prior to a standardized one-session exposure. Acute stress did not influence exposure-induced reduction in fear and avoidance of the treated stimuli (spiders). However, stress led to a less pronounced beneficial exposure outcome for treated stimuli in OC women relative to FC women. This effect occurred on the level of subjective fear and self-report questionnaires at post-treatment (24 hours after exposure) and follow-up (4 weeks after exposure). No effects of stress on generalization of therapy effects towards untreated stimuli (cockroaches) were found. Our findings suggest that OC usage diminishes the beneficial effects of stress on exposure therapy outcome seen in FC women. We present first clinical findings regarding the interaction of stress (and possibly GCs) and OC in exposure therapy of AD. OC intake in women constitutes a crucial factor to be considered in augmentation studies using stress and GCs.

Behavioral disturbances related to emotional regulation, reward processing, cognition, sleep-wake regulation and activity/movement represent core symptoms of most common mental disorders. Increasing empirical and theoretical evidence suggests that normal functioning of these behavioral domains relies on fine graded coordination of neural and glial networks which are maintained and modulated by intercellular gap junction channels and unapposed pannexin or connexin hemichannels. Dysfunctions in these networks might contribute to the development and maintenance of psychopathological and neurobiological features associated with mental disorders. Here we review and discuss the evidence indicating a prominent role of gap junction channel and hemichannel dysfunction in core symptoms of mental disorders. We further discuss how the increasing knowledge on intercellular gap junction channels and unapposed pannexin or connexin hemichannels in the brain might lead to deeper mechanistic insight in common mental disorders and to the development of novel treatment approaches. We further attempt to exemplify what type of future research on this topic could be integrated into multidimensional approaches to understand and cure mental disorders.