77 The enhancing effects of testosterone in exposure treatment for social anxiety disorder Placebo Testosterone start 2 4 6 8 end start 2 4 6 8 end 20 30 40 50 60 70 Time in minutes Subjective fear (in subjective units of distress - SUD) Baseline Testosterone Low Medium High A. Session 1 (enhanced session) Placebo Testosterone start 2 4 6 8 end start 2 4 6 8 end 20 30 40 50 60 70 Time in minutes Subjective fear (in subjective units of distress- SUD) Baseline Testosterone Low Medium High B. Session 2 (unenhanced transfer session) Figure 4.2 Subjective fear levels during exposure as a function of baseline testosterone per group (T/P). The figure illustrates the evolution of subjective fear levels during exposure with placebo (P) or testosterone (T) (session 1; A) and unenhanced exposure indicating transfer after P and T (session 2; B). Fear, expressed in subjective units of distress (SUDs), is displayed over time as a function of baseline-T. In order to visualize the interaction effect between baseline-T and time, we subdivided baseline-T into low (−1 SD), medium (mean), and high (+1 SD) values. Thus, the plot shows model-based predicted values, illustrating that high baseline-T is associated with higher SUD reactivity during testosterone-enhanced exposure (session 1), a pattern that largely transfers to the second unenhanced exposure (session 2). Note that for both groups there is no correlation between baseline-T and start SUDs in session 1 (rplacebo = −0.07, p = 0.73; rtestosterone = 0.06, p = 0.788) or session 2 (rplacebo = −0.03, p = 0.873; rtestosterone = 0.14, p = 0.472), indicating that effects are not driven by differences in start SUDs as a function of baseline-T but merely reflect differences in within-session fear patterns. 4
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