102 Chapter 5 The inclusion of baseline testosterone as a control variable did not change the results (see Chapter 5 – Appendix 1 for details analysis). -25 0 25 50 75 Social Non social Stimulus AAT Effect score (ms) Treatment Placebo Testosterone A. Pre-treatment -25 0 25 50 75 Social Non social Stimulus AAT Effect score (ms) Treatment Placebo Testosterone B. Post-treatment Figure 5.2 Automatic avoidance tendencies displayed in mean AAT effect scores (in ms) per picture type (social/non-social) over time separated per group (Testosterone/Placebo). The AAT effect scores are calculated for display purposes only by subtracting the individual reaction times for pull movements from the individual reaction times for push movements. Negative AAT effect scores indicate stronger avoidance and positive AAT effect scores reflect stronger approach. As shown in the left panel (A) a pre-treatment avoidance bias towards social stimuli is shown while for non-social stimuli an approach bias is shown, for both the placebo and testosterone group. This pattern stays stable over time (right panel, B). Discussion This study provides preliminary findings to suggest that augmenting exposure therapy for SAD with testosterone administration may be most effective when targeted to individuals who present with strong avoidance tendencies. These results are consistent with theory and replicate and extend the findings of earlier experiments (Enter, Spinhoven, et al., 2016; Enter, Terburg, et al., 2016) and a clinical trial (Hutschemaekers et al., 2021). It is important to note that the moderating effect of social avoidance tendencies were only observed for one outcome, namely acute changes in fear. We are left speculating as to the reasons why the observed moderator effects did not emerge for the other outcomes – fear at the second session and changes social anxiety symptom severity. The latter may not be surprising as the parent trial did not show any effects of testosterone
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