'Acrophobia' credit to satosphere on Flickr

Everyone experiences those little scary moments in life- walking around alone at night, seeing a spider, or having to talk in front of a large crowd for example. Only rarely does one of those fears interfere with daily life. When they do though, it is not a simple fear anymore, but a phobia, which is a form of anxiety disorder. Researchers have now found that cortisol (which, ironically, is a stress hormone) helps in the treatment of acrophobia, the fear of heights.

A phobia is the unreasonable fear of a certain object, animal or situation.  The main problem with phobias is that people try to avoid the feared object, and although this might first seem purposeful (as it allows phobics to avoid the fear), this behaviour does not allow them to actually overcome their fear. In order to combat a phobia, exposure to the feared object animal or situation is usually necessary. This is the most commonly used therapeutic method which has a relatively high success-rate, although the drawback of course is that exposure therapies are usually uncomfortable for the patient.

If someone has a phobia of heights, for example, then the therapy would first involve letting the patient imagine they are standing on a high building. When patients are able to cope with this, they would look at pictures taken from a skyscraper and finally they would try to actually go over bridges and up on buildings. The goal of those tasks is to make the fear response extinct through confronting the patients with the feared situation. The hormone cortisol has been previously shown to enhance the extinction process in animals and humans and also influence learning and memory in general. Now, a research team around Dominique de Quervain have found that the hormone cortisol not only promotes the extinction process, but also reduces anxiety during the exposure process.

In the study, forty patients with acrophobia were given three therapy sessions, and were administered either cortisol or a placebo an hour before. Therapy consisted of patients moving through a virtual reality height environment consisting of platforms connected by elevators and bridges (this kind of therapy was shown to be effective in previous studies). Several measures such as questionnaires, ratings of fear and physiological measures were taken before, during and after therapy sessions.

The results showed a significantly greater decrease in fear of height after the therapy in the cortisol group compared to the placebo group. Additionally, the cortisol group also showed less fear throughout the exposure.

The researchers point out that with these results they not only expect to gain more knowledge about the memory processes in fear, but also put some hope into new therapeutic strategies in treating anxiety disorders. Indeed, such a drug would probably motivate people with a phobia to undergo exposure therapy, because less intense fear reactions might be expected.


Judita Huber

Study can be found here: www.pnas.org/cgi/doi/10.1073/pnas.1018214108,

“Glucocorticoids enhance extinction-based psychotherapy” Proceedings of the National Academy of Sciences, March 28, 2011