Cognitive Enhancers as Adjuncts to Psychotherapy: Use of D-Cycloserine in Phobic Individuals to Facilitate Extinctionof Fear
Abstract
BACKGROUND: Traditional pharmacological approaches to treating psychiatric disorders focus on correcting presumed biochemical abnormalities. However, some disorders, particularly the anxiety-related disorders exemplified by specific phobia, have an emotional learning component to them that can be facilitated with psychotherapy. OBJECTIVE: To determine whether D-cycloserine (DCS), a partial agonist at the N-methyl-d-aspartate receptor that has previously been shown to improve extinction of fear in rodents, will also improve extinction of fear in human phobic patients undergoing behavioral exposure therapy. DESIGN: Randomized, double-blind, placebo-controlled trial examining DCS vs placebo treatment in combination with a precisely controlled exposure paradigm. SETTING: Participants were recruited from the general community to a research clinic. PARTICIPANTS: Twenty-eight subjects with acrophobia diagnosed by the Structured Clinical Interview for DSM-IV were enrolled. INTERVENTIONS: After we obtained pretreatment measures of fear, subjects were treated with 2 sessions of behavioral exposure therapy using virtual reality exposure to heights within a virtual glass elevator. Single doses of placebo or DCS were taken prior to each of the 2 sessions of virtual reality exposure therapy. Subjects, therapists, and assessors were blind to the treatment condition. Subjects returned at 1 week and 3 months posttreatment for measures to determine the presence and severity of acrophobia symptoms. MAIN OUTCOME MEASURES: Included were measures of acrophobia within the virtual environment, measures of acrophobia in the real world, and general measures of overall improvement. An objective measure of fear, electrodermal skin fluctuation, was also included during the virtual exposure to heights. Symptoms were assessed by self-report and by independent assessors at approximately 1 week and 3 months posttreatment. RESULTS: Exposure therapy combined with DCS resulted in significantly larger reductions of acrophobia symptoms on all main outcome measures. Subjects receiving DCS had significantly more improvement compared with subjects receiving placebo within the virtual environment (1 week after treatment, P</=.001; 3 months later, P</=.05). Subjects receiving DCS also showed significantly greater decreases in posttreatment skin conductance fluctuations during the virtual exposure (P</=.05). Additionally, subjects receiving DCS had significantly greater improvement compared with subjects receiving placebo on general measures of real-world acrophobia symptoms (acrophobia avoidance [P</=.02], acrophobia anxiety [P</=.01], attitudes toward heights [P</=.04], clinical global improvement [P</=.01], and number of self-exposures to real-world heights [P</=.01]); the improvement was evident early in treatment and was maintained at 3 months. CONCLUSION: These pilot data provide initial support for the use of acute dosing of DCS as an adjunct to exposure-based psychotherapy to accelerate the associative learning processes that contribute to correcting psychopathology.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
DCS is an NMDA glutamate receptor agonist and has been shown to increase the efficacy of exposure therapies for several anxiety disorders.
“DCS is an agonist of the N-methyl-D-aspartate (NMDA) glutamate receptor, and it has been shown to increase the efficacy of exposure therapies for a number of anxiety disorders (Hofmann, Sawyer, and Asnaani, 2012; Ressler, Rothbaum, Tannenbaum, Anderson, et al. 2004).”
From Advancing the treatment of anxiety disorders in transition‐age youth: a review of the therapeutic effects of unconscious exposure. (2025) · cites this paper as Ressler, Rothbaum, Tannenbaum, Anderson, et al. 2004
Participants who received D-cycloserine showed greater improvements than those who received a placebo in exposure therapy for acrophobia.
“Participants who received the drug (oral administration two to four hours before each session) showed greater improvements than those who received a placebo.”
From Mediators and Mechanisms of Change in Psychotherapy Research (2007) · cites this paper as Ressler et al. 2004
The effects of D-cycloserine-enhanced exposure therapy were evident one week and three months after treatment.
“The effects were evident one week and three months after treatment.”
From Mediators and Mechanisms of Change in Psychotherapy Research (2007) · cites this paper as Ressler et al. 2004
DCS combined with imaginal or virtual reality exposure therapy has been shown to reduce length of treatment for some anxiety disorders, including acrophobia, social phobia, and panic disorder.
“Recently, DCS combined with imaginal or virtual reality exposure (VRE) therapy has been shown to reduce length of treatment for some anxiety disorders, including acrophobia (Ressler et al, 2004), social phobia (Guastella et al, 2008; Hofmann et al, 2006), and panic disorder (Otto et al, 2010), which, like PTSD, include learned avoidance and cued emotional distress as salient symptoms.”
From D-cycloserine augmentation of exposure therapy for post-traumatic stress disorder: a pilot randomized clinical trial (2014) · cites this paper as Ressler et al, 2004
The choice of dosing regimen was based on the Ressler et al (2004) study, which showed no difference in efficacy between the 50 and 500 mg dose of DCS on enhancing exposure therapy outcomes.
“The choice of dosing regimen for our studies was based on the Ressler et al (2004) study, which showed that there was no difference in efficacy between the 50 and 500 mg dose of DCS on enhancing exposure therapy outcomes.”
From D-cycloserine augmentation of exposure therapy for post-traumatic stress disorder: a pilot randomized clinical trial (2014) · cites this paper as Ressler et al (2004)
Weekly dosing administered 90 min before exposure sessions has been effective in multiple animal and human fear extinction studies.
“We chose weekly dosing, administered 90 min before exposure sessions, as this regimen has been effective in multiple animal and human fear extinction studies (Ledgerwood et al, 2003; Ressler et al, 2004; Walker et al, 2002)”
From D-cycloserine augmentation of exposure therapy for post-traumatic stress disorder: a pilot randomized clinical trial (2014) · cites this paper as Ressler et al, 2004
These pilot data add to the literature showing that DCS-enhanced exposure therapy is effective for the treatment of anxiety disorders.
“These pilot data add to the literature showing that DCS-enhanced exposure therapy is effective for the treatment of anxiety disorders (Hofmann et al, 2006; Ressler et al, 2004).”
From D-cycloserine augmentation of exposure therapy for post-traumatic stress disorder: a pilot randomized clinical trial (2014) · cites this paper as Ressler et al, 2004
Our data, together with prior studies, form a pattern of evidence supporting that DCS may facilitate extinction learning.
“Our data, in conjunction with that of Ressler et al (2004), Hofmann et al (2006), and Otto et al (2010), form a compelling pattern of evidence supporting the hypothesis that DCS may facilitate extinction learning.”
From D-cycloserine augmentation of exposure therapy for post-traumatic stress disorder: a pilot randomized clinical trial (2014) · cites this paper as Ressler et al, 2004
DCS administration before or after exposure therapy was effective in alleviating symptoms of acrophobia, panic disorder, social anxiety disorder, and obsessive-compulsive disorder.
“Shortly thereafter, several groups reported that DCS administration before or after exposure therapy, a form of treatment based on the principles of fear extinction learning, was effective in alleviating the symptoms of acrophobia (67), panic disorder (68), social anxiety disorder (69, 70), and obsessive–compulsive disorder (71–73).”
From Conditioned fear associated phenotypes as robust, translational indices of trauma-, stressor-, and anxiety-related behaviors (2014) · cites this paper as [67]
The rationale for selecting 50 mg DCS was that this dose showed efficacy in previous work examining exposure enhancement with pre-session administration of DCS.
“The rationale for selecting 50 mg as the dose was that this dose showed efficacy in previous work examining exposure enhancement with pre-session administration of DCS (10, 11).”
From D-cycloserine enhancement of fear extinction is specific to successful exposure sessions: evidence from the treatment of height phobia (2013) · cites this paper as [10]
In humans, DCS administration can facilitate the loss of fear resulting from exposure that causes incomplete fear loss in controls.
“In humans, DCS administration can likewise facilitate the loss of fear resulting from exposure that causes incomplete fear loss in controls (acrophobia: Ressler, Rothbaum, Tannenbaum, Anderson, Graap, Zimand, Hodges, & Davis, 2004; social phobia: Guastella, Richardson, Lovibond, Rapee, Gaston, Mitchell, & Dadds, 2008; Hofmann, Meuret, Smits, Simon, Pollack, Eisenmenger, Shiekh, & Otto, 2006;”
From D-cycloserine facilitates context-specific fear extinction learning (2008) · cites this paper as Ressler, Rothbaum, Tannenbaum, Anderson, Graap, Zimand, Hodges, & Davis, 2004
DCS facilitates fear extinction in patients with anxiety disorders.
“Indeed, in clinical studies, Ressler et al (2004) and Hofmann et al (2006) have recently reported that DCS facilitates fear extinction in patients with anxiety disorders.”
From Effects of Single Prolonged Stress and D-Cycloserine on Contextual Fear Extinction and Hippocampal NMDA Receptor Expression in a Rat Model of PTSD (2008) · cites this paper as Ressler et al, 2004
DCS administration without extinction training cannot facilitate fear extinction.
“This, considered collectively with findings from animal studies, leads to the postulation that DCS administration without extinction training cannot facilitate fear extinction.”
From Effects of Single Prolonged Stress and D-Cycloserine on Contextual Fear Extinction and Hippocampal NMDA Receptor Expression in a Rat Model of PTSD (2008) · cites this paper as Ressler et al, 2004
Heresco-Levy et al (2002) used daily chronic dosing without exposure therapy, while Hofmann et al (2006) and Ressler et al (2004) used acute dosing with exposure therapy.
“Heresco-Levy et al (2002) used daily chronic dosing without exposure therapy, while Hofmann et al (2006) and Ressler et al (2004) used acute dosing with exposure therapy.”
From Effects of Single Prolonged Stress and D-Cycloserine on Contextual Fear Extinction and Hippocampal NMDA Receptor Expression in a Rat Model of PTSD (2008) · cites this paper as Ressler et al (2004)
Cites
An inventory for measuring depression
BECK, A. T. (1961) · Archives of General Psychiatry · doi:10.1001/archpsyc.1961.01710120031004 · Cited by 38,032 · see citing works
The Structured Clinical Interview for DSM-III-R (SCID): I: History, Rationale, and Description
Spitzer, R. L. (1992) · Archives of General Psychiatry · doi:10.1001/archpsyc.1992.01820080032005 · Cited by 4,336 · see citing works
Manual for the state-trait anxiety inventory (form Y) : "self-evaluation questionnaire"
Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970) · Consulting Psychologists Press eBooks · Cited by 2,352 · see citing works
Genetic enhancement of learning and memory in mice
Tang, Y., Shimizu, E., Dubé, G., Rampon, C., Kerchner, G. A., Zhuo, M., Liu, G., & Tsien, J. Z. (1999) · Nature · doi:10.1038/43432 · Cited by 1,867 · see citing works
Context, ambiguity, and unlearning: sources of relapse after behavioral extinction
Bouton, M. E. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01546-9 · Cited by 1,662 · see citing works
Barlow, D. H., Gorman, J. M., Shear, M. K., & Woods, S. W. (2000) · JAMA · doi:10.1001/jama.283.19.2529 · Cited by 953 · see citing works
Behavioral and Neural Analysis of Extinction
Myers, K. M., & Davis, M. (2002) · Neuron · doi:10.1016/s0896-6273(02)01064-4 · Cited by 918 · see citing works
Self-citationMiserendino, M. J. D., Sananes, C. B., Melia, K. R., & Davis, M. (1990) · Nature · doi:10.1038/345716a0 · Cited by 824 · see citing works
Self-citationWalker, D. L., Ressler, K. J., Lu, K.-T., & Davis, M. (2002) · The Journal of Neuroscience · doi:10.1523/jneurosci.22-06-02343.2002 · Cited by 815 · see citing works
Self-citationEffectiveness of computer-generated (virtual reality) graded exposure in the treatment of acrophobia
(1995) · American Journal of Psychiatry · doi:10.1176/ajp.152.4.626 · Cited by 694 · see citing works
Self-citationExtinction of fear-potentiated startle: blockade by infusion of an NMDA antagonist into the amygdala
Falls, W., Miserendino, M., & Davis, M. (1992) · The Journal of Neuroscience · doi:10.1523/jneurosci.12-03-00854.1992 · Cited by 673 · see citing works
Self-citationTextbook of psychopharmacology
Edwards, G. (1975) · Nature · doi:10.1038/258648b0 · Cited by 583 · see citing works
Virtual Reality Exposure Therapy for Vietnam Veterans With Posttraumatic Stress Disorder
Rothbaum, B. O., Hodges, L. F., Ready, D. J., Graap, K. M., & Alarcón, R. D. (2001) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v62n0808 · Cited by 531 · see citing works
Self-citationA controlled study of virtual reality exposure therapy for the fear of flying.
Rothbaum, B. O., Hodges, L., Smith, S., Lee, J. H., & Price, L. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.6.1020 · Cited by 501 · see citing works
Self-citationClassical Conditioning in Drug‐Dependent Humansa
OʼBRIEN, C. P., Childress, A. R., McLellan, A. T., & Ehrman, R. N. (1992) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1992.tb25984.x · Cited by 489 · see citing works
Marks, I. M., Swinson, R. P., Başoǧlu, M., Kuch, K., Noshirvani, H., O'Sullivan, G., Lelliott, P. T., Kirby, M., McNamee, G., Sengun, S., et al. (1993) · British Journal of Psychiatry · doi:10.1192/bjp.162.6.776 · Cited by 478 · cited 1× · see citing works
“In some cases, combining these modalities in traditional ways may even decrease the overall efficacy.(4,5) If the learning hypothesis is correct for some mental disorders, then another way to approach pharmacological treatment is to enhance the learning that occurs in psychotherapy.”
BackgroundGOFF, D. C., Tsai, G. E., Levitt, J. J., AMICO, E. T., Manoach, D. S., Schoenfeld, D., Hayden, D. L., McCarley, R. W., & Coyle, J. T. (1999) · Archives of General Psychiatry · doi:10.1001/archpsyc.56.1.21 · Cited by 436 · see citing works
Effects of D-cycloserine on extinction of conditioned freezing.
Ledgerwood, L., Richardson, R., & Cranney, J. (2003) · Behavioral Neuroscience · doi:10.1037/0735-7044.117.2.341 · Cited by 388 · see citing works
Santini, E., Muller, R. U., & Quirk, G. J. (2001) · The Journal of Neuroscience · doi:10.1523/jneurosci.21-22-09009.2001 · Cited by 358 · see citing works
d-Cycloserine: A ligand for the coupled glycine receptor has partial agonist characteristics
Hood, W. F., Compton, R. P., & Monahan, J. B. (1989) · Neuroscience Letters · doi:10.1016/0304-3940(89)90379-0 · Cited by 309 · see citing works
Kim, J. J., DeCola, J. P., Landeira-Fernández, J., & Fanselow, M. S. (1991) · Behavioral Neuroscience · doi:10.1037/0735-7044.105.1.126 · Cited by 295 · see citing works
Monahan, J. B., Handelmann, G. E., Hood, W. F., & Cordi, A. A. (1989) · Pharmacology Biochemistry and Behavior · doi:10.1016/0091-3057(89)90571-6 · Cited by 257 · see citing works
Foa, E. B., Franklin, M. E., & Moser, J. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01552-4 · Cited by 219 · see citing works
Comparison of self-report and overt-behavioral procedures for assessing acrophobia
Cohen, D. C. (1977) · Behavior Therapy · doi:10.1016/s0005-7894(77)80116-0 · Cited by 216 · see citing works
Palmar skin conductance measures in anxiety and phobic states
Lader, M. H. (1967) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(67)90021-9 · Cited by 204 · see citing works
Davis, M., & Myers, K. M. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01507-x · Cited by 200 · see citing works
Self-citationQuartermain, D., Mower, J., Rafferty, M. F., Herting, R. L., & Lanthorn, T. H. (1994) · European Journal of Pharmacology · doi:10.1016/0014-2999(94)90687-4 · Cited by 190 · see citing works
Hippocampus-dependent learning facilitated by a monoclonal antibody or D-cycloserine
Thompson, L. T., Moskal, J. R., & Disterhoft, J. F. (1992) · Nature · doi:10.1038/359638a0 · Cited by 182 · see citing works
Skin conductance correlates with perioperative stress
Storm, H., Myre, K., Rostrup, M., STOKLAND, O., Lien, M. D., & Raeder, J. C. (2002) · Acta Anaesthesiologica Scandinavica · doi:10.1034/j.1399-6576.2002.460721.x · Cited by 179 · see citing works
The NMDA antagonist MK-801 blocks the extinction of Pavlovian fear conditioning.
Baker, J. D., & Azorlosa, J. L. (1996) · Behavioral Neuroscience · doi:10.1037//0735-7044.110.3.618 · Cited by 179 · see citing works
Effect on memory processing by D-cycloserine, an agonist of the NMDA/glycine receptor
Flood, J. F., Morley, J. E., & Lanthorn, T. H. (1992) · European Journal of Pharmacology · doi:10.1016/0014-2999(92)90709-d · Cited by 153 · see citing works
d-Cycloserine enhances implicit memory in Alzheimer patients
Schwartz, B. L., Hashtroudi, S., Herting, R. L., Schwartz, P., & Deutsch, S. I. (1996) · Neurology · doi:10.1212/wnl.46.2.420 · Cited by 150 · see citing works
Subunit specificity and mechanism of action of NMDA partial agonist d-cycloserine
Sheinin, A., Shavit, S., & Benveniste, M. (2001) · Neuropharmacology · doi:10.1016/s0028-3908(01)00073-9 · Cited by 136 · see citing works
Improved Cognition in Alzheimer’s Disease With Short-Term D-Cycloserine Treatment
Tsai, G. E., Falk, W. E., Gunther, J. M., & Coyle, J. T. (1999) · American Journal of Psychiatry · doi:10.1176/ajp.156.3.467 · Cited by 129 · see citing works
IV glycine and oral d-cycloserine effects on plasma and CSF amino acids in healthy humans
D’Souza, D. C., Gil, R. B., Cassello, K., Morrissey, K., Abi‐Saab, D., White, J., Sturwold, R., Bennett, A., Karper, L. P., Zuzarte, E., et al. (2000) · Biological Psychiatry · doi:10.1016/s0006-3223(99)00133-x · Cited by 111 · see citing works
RS 67333 and D-cycloserine accelerate learning acquisition in the rat
Lelong‐Boulouard, V., Dauphin, F., & Boulouard, M. (2001) · Neuropharmacology · doi:10.1016/s0028-3908(01)00085-5 · Cited by 103 · see citing works
Abelson, J. L., & Curtis, G. C. (1989) · Behaviour Research and Therapy · doi:10.1016/0005-7967(89)90091-0 · Cited by 97 · see citing works
Matsuoka, N., & Aigner, T. G. (1996) · Journal of Pharmacology and Experimental Therapeutics · doi:10.1016/s0022-3565(25)20677-2 · Cited by 82 · see citing works
D-cycloserine for Alzheimer's disease
Jones, R. W., Laake, K., & Øksengård, A. R. (2002) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003153 · Cited by 72 · see citing works
Boje, K. M., Wong, G., & Skolnick, P. (1993) · Brain Research · doi:10.1016/0006-8993(93)91239-o · Cited by 69 · see citing works
Evaluation of Cycloserine in the Treatment of Alzheimer's Disease
Fakouhi, T. D., Jhee, S. S., Sramek, J. J., Benes, C. O., Schwartz, P., Hantsburger, G., Herting, R. L., Swabb, E. A., & Cutler, N. R. (1995) · Journal of Geriatric Psychiatry and Neurology · doi:10.1177/089198879500800405 · Cited by 51 · see citing works
A Preliminary Study of d -Cycloserine Treatment in Alzheimer's Disease
Tsai, G. E., Falk, W. E., & Gunther, J. M. (1998) · Journal of Neuropsychiatry · doi:10.1176/jnp.10.2.224 · Cited by 36 · see citing works
The partial NMDA agonist D -cycloserine stimulates LH secretion in healthy volunteers
van Berckel, B. N. M., Lipsch, C., Wied, C. C. G., Wynne, H. J. A., Blankenstein, M. A., van Ree, J. M., & Kahn, R. S. (1998) · Psychopharmacology · doi:10.1007/s002130050662 · Cited by 36 · see citing works
Learning and “unlearning” fears: preparedness, neural pathways, and patients
Otto, M. W. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01719-5 · Cited by 19 · see citing works
Emotional arousal does not affect delay eyeblink conditioning
Grillon, C., & Hill, J. (2003) · Cognitive Brain Research · doi:10.1016/s0926-6410(03)00141-1 · Cited by 11 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Glutamate receptor ion channels
Mayer, M. L. (2005) · Current Opinion in Neurobiology · doi:10.1016/j.conb.2005.05.004 · Cited by 3,645 · see citing works
Glutamate Receptor Ion Channels: Structure, Regulation, and Function
Traynelis, S. F., Wollmuth, L. P., McBain, C. J., Menniti, F. S., Vance, K. M., Ogden, K. K., Hansen, K. B., Yuan, H., Myers, S. J., & Dingledine, R. (2010) · Pharmacological Reviews · doi:10.1124/pr.109.002451 · Cited by 3,568 · see citing works
Contributions of the Amygdala to Emotion Processing: From Animal Models to Human Behavior
Phelps, E. A., & LeDoux, J. E. (2005) · Neuron · doi:10.1016/j.neuron.2005.09.025 · Cited by 3,203 · see citing works
Mediators and Mechanisms of Change in Psychotherapy Research
Kazdin, A. E. (2007) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.3.022806.091432 · Cited by 2,504 · see citing works
Synaptic Plasticity: Multiple Forms, Functions, and Mechanisms
Citri, A., & Malenka, R. C. (2008) · Neuropsychopharmacology · doi:10.1038/sj.npp.1301559 · Cited by 2,323 · see citing works
Uncertainty and anticipation in anxiety: an integrated neurobiological and psychological perspective
Grupe, D. W., & Nitschke, J. B. (2013) · Nature Reviews Neuroscience · doi:10.1038/nrn3524 · Cited by 2,007 · see citing works
Neural Mechanisms of Extinction Learning and Retrieval
Quirk, G. J., & Mueller, D. (2008) · Neuropsychopharmacology · doi:10.1038/sj.npp.1301555 · Cited by 1,645 · see citing works
Optimizing inhibitory learning during exposure therapy
Craske, M. G., Kircanski, K., Zelikowsky, M., Mystkowski, J., Chowdhury, N., & Baker, A. (2008) · Behaviour Research and Therapy · doi:10.1016/j.brat.2007.10.003 · Cited by 1,607 · see citing works
Hoffman, S. G., & Smits, J. A. J. (2008) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v69n0415 · Cited by 1,420 · see citing works
Myers, K. M., & Davis, M. (2007) · Molecular Psychiatry · doi:10.1038/sj.mp.4001939 · Cited by 1,277 · see citing works
Self-citationHarnessing neuroplasticity for clinical applications
Cramer, S. C., Sur, M., Dobkin, B. H., O'Brien, C., Sanger, T. D., Trojanowski, J. Q., Rumsey, J. M., Hicks, R., Cameron, J., Chen, D., et al. (2011) · Brain · doi:10.1093/brain/awr039 · Cited by 1,259 · see citing works
The ascent of mouse: advances in modelling human depression and anxiety
Cryan, J. F., & Holmes, A. (2005) · Nature Reviews Drug Discovery · doi:10.1038/nrd1825 · Cited by 1,198 · see citing works
Kazdin, A. E. (2008) · American Psychologist · doi:10.1037/0003-066x.63.3.146 · Cited by 1,112 · see citing works
Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., Van Ameringen, M., & the Canadian Anxiety Guidelines Initiative Group on behalf of the Anxiety Disorders Association of Canada/Association Canadienne des troubles anxieux and McGill University (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-s1-s1 · Cited by 1,090 · see citing works
“In a RCT (n=28), d-cycloserine as an adjunct to VRE resulted in significantly larger reductions of acrophobia symptoms compared with VRE alone [338].”
BackgroundResultTargeting abnormal neural circuits in mood and anxiety disorders: from the laboratory to the clinic
Ressler, K. J., & Mayberg, H. S. (2007) · Nature Neuroscience · doi:10.1038/nn1944 · Cited by 1,007 · see citing works
Self-citationAbramowitz, J. S., Taylor, S., & McKay, D. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60240-3 · Cited by 1,002 · see citing works
Foa, E. B., Hembree, E. A., Cahill, S. P., Rauch, S. A. M., Riggs, D. S., Feeny, N. C., & Yadin, E. (2005) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.73.5.953 · Cited by 931 · see citing works
Glutamate and Schizophrenia: Beyond the Dopamine Hypothesis
Coyle, J. T. (2006) · Cellular and Molecular Neurobiology · doi:10.1007/s10571-006-9062-8 · Cited by 917 · see citing works
Virtual reality exposure therapy for anxiety disorders: A meta-analysis
Powers, M. B., & Emmelkamp, P. M. G. (2008) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2007.04.006 · Cited by 904 · see citing works
Targeting the glutamatergic system to develop novel, improved therapeutics for mood disorders
Sanacora, G., Zarate, C. A., Krystal, J. H., & Manji, H. K. (2008) · Nature Reviews Drug Discovery · doi:10.1038/nrd2462 · Cited by 894 · see citing works
Carl, E., Stein, A. T., Levihn-Coon, A., Pogue, J. R., Rothbaum, B., Emmelkamp, P., Asmundson, G. J. G., Carlbring, P., & Powers, M. B. (2019) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2018.08.003 · Cited by 889 · see citing works
Self-citationWhat Is a “Mood Stabilizer”? An Evidence-Based Response
Bauer, M. S., & Mitchner, L. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.161.1.3 · Cited by 862 · see citing works
The use of virtual reality technology in the treatment of anxiety and other psychiatric disorders
Maples-Keller, J. L., Bunnell, B. E., Kim, S.-J., & Rothbaum, B. O. (2017) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000138 · Cited by 862 · see citing works
Self-citationResponse Variation following Trauma: A Translational Neuroscience Approach to Understanding PTSD
Yehuda, R., & LeDoux, J. E. (2007) · Neuron · doi:10.1016/j.neuron.2007.09.006 · Cited by 795 · see citing works
Extinction circuits for fear and addiction overlap in prefrontal cortex
Peters, J., Kalivas, P. W., & Quirk, G. J. (2009) · Learning & Memory · doi:10.1101/lm.1041309 · Cited by 736 · see citing works
Cognitive Enhancement: Methods, Ethics, Regulatory Challenges
Bostrom, N., & Sandberg, A. (2009) · Science and Engineering Ethics · doi:10.1007/s11948-009-9142-5 · Cited by 745 · see citing works
Understanding how and why psychotherapy leads to change
Kazdin, A. E. (2009) · Psychotherapy Research · doi:10.1080/10503300802448899 · Cited by 728 · see citing works
Prefrontal mechanisms in extinction of conditioned fear
Quirk, G. J., Garcia, R., & González-Lima, F. (2006) · Biological Psychiatry · doi:10.1016/j.biopsych.2006.03.010 · Cited by 682 · see citing works
Structure, Function, and Pharmacology of Glutamate Receptor Ion Channels
Hansen, K. B., Wollmuth, L. P., Bowie, D., Furukawa, H., Menniti, F. S., Sobolevsky, A. I., Swanson, G. T., Swanger, S. A., Greger, I. H., Nakagawa, T., et al. (2021) · Pharmacological Reviews · doi:10.1124/pharmrev.120.000131 · Cited by 686 · see citing works
Baldwin, D. S., Anderson, I. M., Nutt, D. J., Allgulander, C., Bandelow, B., den Boer, J. A., Christmas, D. M., Davies, S., Fineberg, N., Lidbetter, N., et al. (2014) · Journal of Psychopharmacology · doi:10.1177/0269881114525674 · Cited by 676 · see citing works
Contextual and temporal modulation of extinction: behavioral and biological mechanisms
Bouton, M. E., Westbrook, R. F., Corcoran, K. A., & Maren, S. (2006) · Biological Psychiatry · doi:10.1016/j.biopsych.2005.12.015 · Cited by 671 · see citing works
Fear Extinction and Relapse: State of the Art
Vervliet, B., Craske, M. G., & Hermans, D. (2013) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-050212-185542 · Cited by 671 · see citing works
Drug addiction: the neurobiology of disrupted self-control
Baler, R. D., & Volkow, N. D. (2006) · Trends in Molecular Medicine · doi:10.1016/j.molmed.2006.10.005 · Cited by 640 · see citing works
The Lancet Psychiatry Commission on psychological treatments research in tomorrow's science
Holmes, E. A., Ghaderi, A., Harmer, C. J., Ramchandani, P. G., Cuijpers, P., Morrison, A. P., Roiser, J. P., Bockting, C. L. H., O'Connor, R. C., Shafran, R., et al. (2018) · The Lancet Psychiatry · doi:10.1016/s2215-0366(17)30513-8 · Cited by 624 · see citing works
Mahan, A. L., & Ressler, K. J. (2011) · Trends in Neurosciences · doi:10.1016/j.tins.2011.06.007 · Cited by 616 · see citing works
Self-citationBickel, W. K., Jarmolowicz, D. P., Mueller, E. T., Koffarnus, M. N., & Gatchalian, K. M. (2012) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2012.02.004 · Cited by 604 · see citing works
Neural systems involved in fear and anxiety measured with fear-potentiated startle.
Davis, M. (2006) · American Psychologist · doi:10.1037/0003-066x.61.8.741 · Cited by 589 · see citing works
Self-citationTreatment of specific phobia in adults
Choy, Y., Fyer, A. J., & Lipsitz, J. D. (2007) · Clinical Psychology Review · doi:10.1016/j.cpr.2006.10.002 · Cited by 573 · see citing works
Augmentation of Exposure Therapy With D-Cycloserine for Social Anxiety Disorder
Hofmann, S. G., Meuret, A. E., Smits, J. A. J., Simon, N. M., Pollack, M. H., Eisenmenger, K., Shiekh, M., & Otto, M. W. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.3.298 · Cited by 560 · see citing works
Burgos-Robles, A., Vidal-Gonzalez, I., Santini, E., & Quirk, G. J. (2007) · Neuron · doi:10.1016/j.neuron.2007.02.021 · Cited by 516 · see citing works
A meta-analysis of D-cycloserine and the facilitation of fear extinction and exposure therapy
Norberg, M. M., Krystal, J. H., & Tolin, D. F. (2008) · Biological Psychiatry · doi:10.1016/j.biopsych.2008.01.012 · Cited by 510 · see citing works
Neurogenesis and generalization: a new approach to stratify and treat anxiety disorders
Kheirbek, M., Klemenhagen, K. C., Sahay, A., & Hen, R. (2012) · Nature Neuroscience · doi:10.1038/nn.3262 · Cited by 543 · see citing works
Mayford, M., Siegelbaum, S. A., & Kandel, E. R. (2012) · Cold Spring Harbor Perspectives in Biology · doi:10.1101/cshperspect.a005751 · Cited by 500 · see citing works
Changing Fear: The Neurocircuitry of Emotion Regulation
Hartley, C. A., & Phelps, E. (2010) · Neuropsychopharmacology · doi:10.1038/npp.2009.121 · Cited by 489 · see citing works
Effects of D-Cycloserine on Extinction: Translation From Preclinical to Clinical Work
Davis, M., Ressler, K., Rothbaum, B. O., & Richardson, R. (2006) · Biological Psychiatry · doi:10.1016/j.biopsych.2006.03.084 · Cited by 498 · see citing works
Self-citationKalisch, R., Korenfeld, E., Stephan, K. E., Weiskopf, N., Seymour, B., & Dolan, R. J. (2006) · The Journal of Neuroscience · doi:10.1523/jneurosci.2021-06.2006 · Cited by 493 · see citing works
Stress, glucocorticoids and memory: implications for treating fear-related disorders
de Quervain, D., Schwabe, L., & Roozendaal, B. (2017) · Nature Reviews Neuroscience · doi:10.1038/nrn.2016.155 · Cited by 484 · see citing works
Efficacy of Cognitive Behavioral Therapy for Anxiety Disorders: A Review of Meta-Analytic Findings
Olatunji, B. O., Cisler, J. M., & Deacon, B. J. (2010) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2010.04.002 · Cited by 483 · see citing works
From Pavlov to PTSD: The extinction of conditioned fear in rodents, humans, and anxiety disorders
VanElzakker, M. B., Kathryn Dahlgren, M., Caroline Davis, F., Dubois, S., & Shin, L. M. (2014) · Neurobiology of Learning and Memory · doi:10.1016/j.nlm.2013.11.014 · Cited by 482 · see citing works
Newman, M. G., Szkodny, L. E., Llera, S. J., & Przeworski, A. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.09.008 · Cited by 480 · see citing works
Implications of memory modulation for post-traumatic stress and fear disorders
Parsons, R. G., & Ressler, K. J. (2013) · Nature Neuroscience · doi:10.1038/nn.3296 · Cited by 476 · see citing works
Self-citationMemory and Brain Systems: 1969–2009
Squire, L. R. (2009) · Journal of Neuroscience · doi:10.1523/jneurosci.3575-09.2009 · Cited by 477 · see citing works
Impaired safety signal learning may be a biomarker of PTSD
Jovanovic, T., Kazama, A., Bachevalier, J., & Davis, M. (2012) · Neuropharmacology · doi:10.1016/j.neuropharm.2011.02.023 · Cited by 473 · see citing works
Self-citationRecent Progress in Virtual Reality Exposure Therapy for Phobias: A Systematic Review
Botella, C., Fernández-Álvarez, J., Guillén, V., García-Palacios, A., & Baños, R. (2017) · Current Psychiatry Reports · doi:10.1007/s11920-017-0788-4 · Cited by 460 · see citing works
Siegle, G. J., Ghinassi, F., & Thase, M. E. (2007) · Cognitive Therapy and Research · doi:10.1007/s10608-006-9118-6 · Cited by 444 · see citing works
How the Neurocircuitry and Genetics of Fear Inhibition May Inform Our Understanding of PTSD
Jovanović, T., & Ressler, K. J. (2010) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2009.09071074 · Cited by 441 · see citing works
Self-citationPharmacotherapy of Anxiety Disorders: Current and Emerging Treatment Options
Garakani, A., Murrough, J. W., Freire, R. C., Thom, R. P., Larkin, K., Buono, F. D., & Iosifescu, D. V. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.595584 · Cited by 440 · see citing works
Sotres-Bayon, F., Cain, C. K., & LeDoux, J. E. (2006) · Biological Psychiatry · doi:10.1016/j.biopsych.2005.10.012 · Cited by 433 · see citing works
Pittenger, C., Bloch, M. H., & Williams, K. (2011) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2011.09.006 · Cited by 426 · see citing works
Neural and cellular mechanisms of fear and extinction memory formation
Orsini, C. A., & Maren, S. (2012) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2011.12.014 · Cited by 429 · see citing works
50 years of hurdles and hope in anxiolytic drug discovery
Griebel, G., & Holmes, A. (2013) · Nature Reviews Drug Discovery · doi:10.1038/nrd4075 · Cited by 414 · see citing works
Behavioral and neurobiological mechanisms of pavlovian and instrumental extinction learning
Bouton, M. E., Maren, S., & McNally, G. P. (2020) · Physiological Reviews · doi:10.1152/physrev.00016.2020 · Cited by 399 · see citing works
Hofmann, S. G. (2008) · Clinical Psychology Review · doi:10.1016/j.cpr.2007.04.009 · Cited by 397 · see citing works
Norrholm, S. D., Jovanovic, T., Olin, I. W., Sands, L. A., Karapanou, I., Bradley, B., & Ressler, K. J. (2011) · Biological Psychiatry · doi:10.1016/j.biopsych.2010.09.013 · Cited by 397 · see citing works
Self-citationSingewald, N., Schmuckermair, C., Whittle, N., Holmes, A., & Ressler, K. J. (2015) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2014.12.004 · Cited by 390 · see citing works
“3 month follow-up Reduced fear symptoms in DCS group at all timepoints (Ressler et al., 2004)”
BackgroundMethodInfluentialSelf-citationRothbaum, B. O., Price, M., Jovanovic, T., Norrholm, S. D., Gerardi, M., Dunlop, B., Davis, M., Bradley, B., Duncan, E. J., Rizzo, A., et al. (2014) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2014.13121625 · Cited by 388 · see citing works
Self-citationD-Cycloserine Augmented Exposure Therapy for Obsessive-Compulsive Disorder
Kushner, M. G., Kim, S. W., Donahue, C. B., THURAS, P. D., Adson, D. E., Kotlyar, M., McCabe, J., Peterson, J., & Foa, E. B. (2007) · Biological Psychiatry · doi:10.1016/j.biopsych.2006.12.020 · Cited by 384 · see citing works
Enhancing Cannabinoid Neurotransmission Augments the Extinction of Conditioned Fear
Chhatwal, J. P., Davis, M., Maguschak, K. A., & Ressler, K. J. (2005) · Neuropsychopharmacology · doi:10.1038/sj.npp.1300655 · Cited by 376 · see citing works
Self-citationPsychiatry as a Clinical Neuroscience Discipline
Insel, T. R. (2005) · JAMA · doi:10.1001/jama.294.17.2221 · Cited by 375 · see citing works
Guastella, A. J., Howard, A. L., Dadds, M. R., Mitchell, P., & Carson, D. S. (2009) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2009.01.005 · Cited by 366 · see citing works
Extending animal models of fear conditioning to humans
Delgado, M. R., Olsson, A., & Phelps, E. A. (2006) · Biological Psychology · doi:10.1016/j.biopsycho.2006.01.006 · Cited by 366 · see citing works
Prefrontal Control of the Amygdala
Likhtik, E., Pelletier, J. G., Paz, R., & Paré, D. (2005) · The Journal of Neuroscience · doi:10.1523/jneurosci.2314-05.2005 · Cited by 361 · see citing works
Augmentation of Behavior Therapy With <scp>d</scp> -Cycloserine for Obsessive-Compulsive Disorder
Wilhelm, S., Buhlmann, U., Tolin, D. F., Meunier, S. A., Pearlson, G. D., Reese, H. E., Cannistraro, P., Jenike, M. A., & Rauch, S. L. (2008) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2007.07050776 · Cited by 358 · see citing works
Neurobehavioral perspectives on the distinction between fear and anxietyPreprint
Perusini, J. N., & Fanselow, M. S. (2015) · Learning & Memory · doi:10.1101/lm.039180.115 · Cited by 357 · see citing works
McNally, R. J. (2007) · Clinical Psychology Review · doi:10.1016/j.cpr.2007.01.003 · Cited by 348 · see citing works
The Science of Cognitive Therapy
Hofmann, S. G., Asmundson, G. J. G., & Beck, A. T. (2013) · Behavior Therapy · doi:10.1016/j.beth.2009.01.007 · Cited by 336 · see citing works
Long-term potentiation and long-term depression: a clinical perspective
Bliss, T. V. P., & Cooke, S. F. (2011) · Clinics · doi:10.1590/s1807-59322011001300002 · Cited by 333 · see citing works
Different mechanisms of fear extinction dependent on length of time since fear acquisition
Myers, K. M., Ressler, K. J., & Davis, M. (2006) · Learning & Memory · doi:10.1101/lm.119806 · Cited by 334 · see citing works
Self-citationDunsmoor, J. E., Niv, Y., Daw, N., & Phelps, E. A. (2015) · Neuron · doi:10.1016/j.neuron.2015.09.028 · Cited by 329 · see citing works
Extinction in human fear conditioning
Hermans, D., Craske, M. G., Mineka, S., & Lovibond, P. F. (2006) · Biological Psychiatry · doi:10.1016/j.biopsych.2005.10.006 · Cited by 328 · see citing works
Guastella, A. J., Richardson, R., Lovibond, P. F., Rapee, R. M., Gaston, J. E., Mitchell, P., & Dadds, M. R. (2008) · Biological Psychiatry · doi:10.1016/j.biopsych.2007.11.011 · Cited by 326 · see citing works
Volkow, N., & Li, T.-K. (2005) · Nature Neuroscience · doi:10.1038/nn1105-1429 · Cited by 324 · see citing works
The age of anxiety: role of animal models of anxiolytic action in drug discovery
Cryan, J. F., & Sweeney, F. F. (2011) · British Journal of Pharmacology · doi:10.1111/j.1476-5381.2011.01362.x · Cited by 313 · see citing works
Haglund, M., Nestadt, P. S., Cooper, N. S., Southwick, S. M., & Charney, D. S. (2007) · Development and Psychopathology · doi:10.1017/s0954579407000430 · Cited by 315 · see citing works
Single prolonged stress: toward an animal model of posttraumatic stress disorder
Yamamoto, S., Morinobu, S., Takei, S., Fuchikami, M., Matsuki, A., Yamawaki, S., & Liberzon, I. (2009) · Depression and Anxiety · doi:10.1002/da.20629 · Cited by 308 · see citing works
Cognitive enhancement as a treatment for drug addictions
Sofuoglu, M., DeVito, E. E., Waters, A. J., & Carroll, K. M. (2012) · Neuropharmacology · doi:10.1016/j.neuropharm.2012.06.021 · Cited by 296 · see citing works
EMDR and the Adaptive Information Processing ModelPotential Mechanisms of Change
Solomon, R. M., & Shapiro, F. (2008) · Journal of EMDR Practice and Research · doi:10.1891/1933-3196.2.4.315 · Cited by 293 · see citing works
Assessment and Treatment of Anxiety Disorders in Children and Adolescents
Wehry, A. M., Beesdo‐Baum, K., Hennelly, M. M., Connolly, S. D., & Strawn, J. R. (2015) · Current Psychiatry Reports · doi:10.1007/s11920-015-0591-z · Cited by 289 · see citing works
Meyerbröker, K., & Emmelkamp, P. M. G. (2010) · Depression and Anxiety · doi:10.1002/da.20734 · Cited by 290 · see citing works
Mataix-Cols, D., Fernández de la Cruz, L., Monzani, B., Rosenfield, D., Andersson, E., Pérez-Vigil, A., Frumento, P., de Kleine, R. A., Difede, J., Dunlop, B. W., et al. (2017) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2016.3955 · Cited by 288 · see citing works
Self-citationDevelopment of anxiety: the role of threat appraisal and fear learning
Britton, J. C., Lissek, S. M., Grillon, C., Norcross, M. A., & Pine, D. S. (2010) · Depression and Anxiety · doi:10.1002/da.20733 · Cited by 281 · see citing works
Sotres-Bayon, F., Bush, D. E. A., & LeDoux, J. E. (2007) · Neuropsychopharmacology · doi:10.1038/sj.npp.1301316 · Cited by 293 · see citing works
Fear extinction and BDNF: translating animal models of PTSD to the clinic
Andero, R., & Ressler, K. J. (2012) · Genes Brain & Behavior · doi:10.1111/j.1601-183x.2012.00801.x · Cited by 275 · see citing works
Self-citationResearch Review: A neuroscience framework for pediatric anxiety disorders
Pine, D. S. (2007) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2007.01751.x · Cited by 277 · see citing works
Seeking a Spotless Mind: Extinction, Deconsolidation, and Erasure of Fear Memory
Maren, S. (2011) · Neuron · doi:10.1016/j.neuron.2011.04.023 · Cited by 259 · see citing works
Glucocorticoids enhance extinction-based psychotherapy
de Quervain, D. J. ‐., Bentz, D., Michael, T., Bolt, O. C., Wiederhold, B. K., Margraf, J., & Wilhelm, F. H. (2011) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1018214108 · Cited by 263 · see citing works
Frewen, P., Dozois, D. J. A., & Lanius, R. A. (2007) · Clinical Psychology Review · doi:10.1016/j.cpr.2007.05.002 · Cited by 260 · see citing works
Efficacy of D-Cycloserine for Enhancing Response to Cognitive-Behavior Therapy for Panic Disorder
Otto, M. W., Tolin, D. F., Simon, N. M., Pearlson, G. D., Basden, S., Meunier, S. A., Hofmann, S. G., Eisenmenger, K., Krystal, J. H., & Pollack, M. H. (2010) · Biological Psychiatry · doi:10.1016/j.biopsych.2009.07.036 · Cited by 251 · see citing works
Feelings Into Words: Contributions of Language to Exposure Therapy
Kircanski, K., Lieberman, M. D., & Craske, M. G. (2012) · Psychological Science · doi:10.1177/0956797612443830 · Cited by 249 · see citing works
Hefner, K. R., Whittle, N., Juhasz, J., Norcross, M. A., Karlsson, R., Saksida, L. M., Bussey, T. J., Singewald, N., & Holmes, A. (2008) · Journal of Neuroscience · doi:10.1523/jneurosci.4904-07.2008 · Cited by 248 · see citing works
- Authors
- Ressler, K. J., Rothbaum, B. O., Tannenbaum, L., Anderson, P., Graap, K., Zimand, E., Hodges, L., & Davis, M.
- Affiliations
- Emory University (US)
- Virtually Better (US)
- University of North Carolina at Charlotte (US)
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2004-11-01
- Volume
- 61
- Issue
- 11
- Pages
- 1136
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W2156900283
- Cited by
- 1,063
- References
- 45
- Citations by year
- 2026: 4 · 2025: 13 · 2024: 14 · 2023: 17 · 2022: 54 · 2021: 20 · 2020: 20 · 2019: 31 · 2018: 35 · 2017: 53 · 2016: 30 · 2015: 52 · 2014: 62 · 2013: 74 · 2012: 79
- FWCI
- 82.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MH-047840, MH069884, K01MH069884)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- D-cycloserine, acrophobia, specific phobia, NMDA receptor partial agonist, fear extinction, virtual reality exposure therapy, nootropic drugs, adjunctive pharmacotherapy, skin conductance, anxiety disorders, fear learning, avoidance behavior, medication adherence
- MeSH terms
- Adult, Combined Modality Therapy, Cycloserine, Desensitization, Psychologic, Double-Blind Method, Extinction, Psychological, Fear, Female, Humans, Male, Middle Aged, Phobic Disorders, Pilot Projects, Placebos, Psychiatric Status Rating Scales, Receptors, N-Methyl-D-Aspartate, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
