81 The enhancing effects of testosterone in exposure treatment for social anxiety disorder Chapter 4 – appendix 1 Details Methods and Materials Heart rate (explorative outcome) We adopted HR (as measured with a Polar RS800CX) as a psychophysiological index of the effects of exposure (see supplementary materials for details). The raw data of the R-R (inter-beat) intervals was analyzed using Kubios HRV Analysis Software (Tarvainen, Niskanen, Lipponen, Ranta-aho, & Karjalainen, 2014). Artefacts in R-R data were corrected using the software threshold-based artefact correction (0.25 seconds). Mean HR was calculated for a 2-minute resting period 15 minutes prior to each session and for 2-minute samples during speech delivery, resulting in a maximum of four samples per speech per participant (0-2 min, 2-4 min, 4-6 min, 6-8 min). Details on eligibility screening The raters conducting the MINI were psychology students who after having fulfilled courses of their bachelor or Master degree did an internship at treatment facility in Nijmegen and who as part of their training underwent a MINI training. The MINI administration was supervised by a registered psychologist, with whom they discussed every MINI administered in biweekly supervision meetings Procedure heart rate measurements A Polar RS800CX was used to assess resting-state heart rate (HR), i.e., during a 2-minute period before the start of the exposure sessions, and during speech delivery in each session (6-8 minutes). The device uses a transmitter consisting of a polyamide case with electrodes attached to an elastic belt fixated to the chest. Interbeat (R-R) intervals (IBI) were measured at a frequency of 1000 Hz in order to provide a temporal resolution of 1 ms for each R-R interval. The Polar RS800CX has been found to be an accurate, reliable, and valid measure to record heart rate variability (Tsitoglou, Koutedakis, Dinas, & Khadka, 2019; Vasconcellos et al., 2015; Williams et al., 2017). Polar Pro Trainer 5 software was used to transfer the HR recordings to a computer. The raw data was analyzed using Kubios HRV analysis software (Tarvainen et al., 2014). Artefacts in the R-R data were corrected using the threshold-based artefact correction of the Kubios software. This algorithm compares every IBI value to a local average interval. The local average is obtained by median filtering the IBI time series, and thus, the local average is not affected by single outliers in IBI time series. A threshold value of .25 seconds was selected. 4
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