52 Chapter 3 <.001, indicating symptom reduction from pre- to post treatment (Mpre = 74.80, SD = 22.73; Mpost = 66.01, SD = 24.58), and Gender, Estimate = -9.62(2.77), F(1,68) = 12.07, p <.001, indicating higher symptom levels for females (M = 75.63. SD = 23.91), compared to males (M = 57.53, SD = 18.85). Consistent with our hypothesis, testosterone reactivity significantly modulated the effect of Time as indicated by a significant Time x Testosterone Reactivity interaction, Estimate = -.56(0.25), F(1,66) = 5.08, p = .027. As can be seen in Figure 3.2A, higher testosterone reactivity was associated with stronger reductions in symptom severity relative to lower testosterone reactivity. Time LSAS total score + 1 SD Mean − 1 SD pre post A. Pre-treatment reactive testosterone 45 50 55 60 65 pre post B. Pre-treatment baseline testosterone Figure 3.2 Social anxiety symptoms over time (pre – post) as a function of pre-treatment reactive testosterone (A) and pre-treatment baseline testosterone (B). Self-reported social anxiety symptom (LSAS-total score) decreased more from pre- to post treatment in those patients who displayed stronger pretreatment testosterone increases (Panel A) and in those patients with low pretreatment baseline testosterone levels (Panel B). For display purposes only, testosterone levels are presented in three groups; with – 1 SD referring to those with testosterone levels of 1 SD or less below the mean, and with +1 SD referring to those participants that had high testosterone levels more than 1 SD above the mean. In addition, we repeated the same mixed models analysis but now with baseline testosterone. This analyses showed a main effect of Time, again confirming efficacy of exposure, Estimate = -9.14(1.62), F(1,67) = 31.81, p <.001. Specifically, symptom levels reduced from pre- to post-treatment. A main effect of Gender, Estimate = -9.45(2.74), F(1,69) = 11.91, p < 0.001 on the LSAS, indicated higher symptom levels for females compared to males. The interaction of baseline testosterone and Time, Estimate = 4.03(1.71), F(1,67) = 5.57, p = .021,
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