127 Summary and General Discussion Delhay, 2019; Steenen et al., 2016). Moreover, research groups seem to struggle with similar questions regarding doses and timing of the drug as within this dissertation (Rosenfield et al., 2019). As such, it may be of interest to strive for collaborations between research groups that examine pharmacological enhancers. By doing so, research groups could use larger sample sizes, which are especially relevant to study individual differences and relevant moderators (see also Geniole & Carré, 2018, for a review regarding testosterone administration), aiding more personalized enhancement strategies in the future. Conclusion This dissertation aimed to test the potential of testosterone as an enhancer for exposure treatment for SAD. Endogenous and exogenous testosterone challenges were therefore combined with short exposure therapy protocols in individuals with SAD, resulting in three main conclusions: First, relatively high endogenous pre-exposure testosterone-reactivity was linked to better exposure-efficacy in terms of symptom-reduction. Second, exogenous testosterone administration did not affect exposure-efficacy at the level of symptom change but amplified exposure-relevant mechanisms in terms of in-session fear patterns. Third, those individuals with SAD who showed relatively high avoidance tendencies at pre-treatment, benefited more from the exogenous testosterone-enhanced exposure compared to their low avoidance counterparts in terms of stronger reductions in fear levels. Taken together, the results provide a promising starting point for the future investigation of the longer-term effects of repeated testosterone-enhancements in SAD. 6
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