title: Single dose testosterone administration alleviates gaze avoidance in women with Social Anxiety Disorder.
abstract: Gaze avoidance is one of the most characteristic and persistent social features in people with Social Anxiety Disorder (SAD). It signals social submissiveness and hampers adequate social interactions. Patients with SAD typically show reduced testosterone levels, a hormone that facilitates socially dominant gaze behavior. Therefore we tested as a proof of principle whether single dose testosterone administration can reduce gaze avoidance in SAD. In a double-blind, within-subject design, 18 medication-free female participants with SAD and 19 female healthy control participants received a single dose of 0.5mg testosterone and a matched placebo, at two separate days. On each day, their spontaneous gaze behavior was recorded using eye-tracking, while they looked at angry, happy, and neutral facial expressions. Testosterone enhanced the percentage of first fixations to the eye-region in participants with SAD compared to healthy controls. In addition, SAD patients' initial gaze avoidance in the placebo condition was associated with more severe social anxiety symptoms and this relation was no longer present after testosterone administration. These findings indicate that single dose testosterone administration can alleviate gaze avoidance in SAD. They support theories on the dominance enhancing effects of testosterone and extend those by showing that effects are particularly strong in individuals featured by socially submissive behavior. The finding that this core characteristic of SAD can be directly influenced by single dose testosterone administration calls for future inquiry into the clinical utility of testosterone in the treatment of SAD.
authors.affiliation: Radboud University Nijmegen, Behavioural Science Institute (BSI), 6500 HE, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, 6525 EN, Nijmegen, The Netherlands; Leiden University, Institute of Psychology, 2300 RB, Leiden, The Netherlands. Electronic address: d.enter@psych.ru.nl.
authors.forename: Dorien
authors.initials: D
authors.lastname: Enter
authors.affiliation: Utrecht University, Department of Psychology, 3584 CS, Utrecht, The Netherlands; University of Cape Town, Department of Psychiatry & Mental Health, Cape Town 7925, South Africa.
authors.forename: David
authors.initials: D
authors.lastname: Terburg
authors.affiliation: Leiden University, Institute of Psychology, 2300 RB, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, 2300 RC, Leiden, The Netherlands.
authors.forename: Anita
authors.initials: A
authors.lastname: Harrewijn
authors.affiliation: Leiden University, Institute of Psychology, 2300 RB, Leiden, The Netherlands; Leiden University Medical Center, Department of Psychiatry, 2300 RC, Leiden, The Netherlands.
authors.forename: Philip
authors.initials: P
authors.lastname: Spinhoven
authors.affiliation: Radboud University Nijmegen, Behavioural Science Institute (BSI), 6500 HE, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, 6525 EN, Nijmegen, The Netherlands.
authors.forename: Karin
authors.initials: K
authors.lastname: Roelofs
mesh_terms: D000293:Adolescent; D000328:Adult; D000728:Androgens / Q000494:pharmacology* / Q000627:therapeutic use; D016022:Case-Control Studies; D004311:Double-Blind Method; D053483:Eye Movement Measurements; D005133:Eye Movements; D005149:Facial Expression; D005260:Female; D005403:Fixation, Ocular / Q000187:drug effects*; D006801:Humans; D010698:Phobic Disorders / Q000188:drug therapy* / Q000523:psychology; D012919:Social Behavior; D013739:Testosterone / Q000494:pharmacology* / Q000627:therapeutic use; D014930:Women / Q000523:psychology*; D055815:Young Adult
chemical_list: D000728:Androgens; D013739:Testosterone
keywords: Eye movements; Gaze avoidance; Social Anxiety Disorder; Social Phobia; Social status; Testosterone