Glucocorticoids do not reduce subjective fear in healthy subjects exposed to social stress

BACKGROUND: Previous experiments in patients with phobia have shown that the administration of glucocorticoids reduces fear in phobic situations. Extensive evidence indicates that elevated glucocorticoid levels inhibit memory retrieval processes. In patients with phobia, exposure to a phobic stimulus (socio-evaluative stress test) provokes retrieval of stimulus-associated fear memory that leads to a fear response. It is therefore possible that glucocorticoids reduce phobic fear by inhibiting retrieval of the previously acquired fear memory. Whether glucocorticoids reduce subjective fear also in healthy subjects exposed to a socially fearful situation is not known. METHOD: In a double-blind, placebo-controlled study, 50 healthy subjects underwent the same socio-evaluative stress test as used in a previous study in patients with social phobia. One hour before the stress test, subjects received 25mg cortisone or placebo orally. Psychological anxiety measures were repeatedly assessed. RESULTS: Although the stress situation robustly increased fear in this population of healthy subjects, cortisone treatment did not reduce subjective fear, physical discomfort or avoidance behavior when compared to placebo-treated subjects. CONCLUSION: The present study did not find evidence indicating that glucocorticoids reduce subjective fear in healthy subjects exposed to a socially fearful situation