The DOI matches its Crossref record; 47 of the 47 references it cites were found in a registry or an index.
Hypothalamus-pituitary-adrenal axis hyperresponsiveness is associated with increased social avoidance behavior in social phobia
Open accessAbstract
Background Social avoidance and inhibition in animals is associated with hyperresponsiveness of the glucocorticoid stress-system. In humans, the relation between glucocorticoid stress-reactivity and social avoidance behavior remains largely unexplored. We investigated whether increased cortisol stress-responsiveness is linked to increased social avoidance behavior in patients with social anxiety disorder (SAD).Methods Patients with SAD (n = 18) as well as two control groups of healthy participants (n = 22) and patients with posttraumatic stress disorder (PTSD; n = 17), respectively, performed a social approach-avoidance task (AA-task) in a baseline condition and in a social stress condition (provided by the Trier Social Stress Test). The AA-task is a computerized reaction-time task measuring the speed of manual approach and avoidance responses to visually presented social threat cues (angry faces). Salivary cortisol, blood pressure, and subjective anxiety were assessed throughout the experiment.Results Patients with SAD showed larger cortisol responses to the social stress test, as compared with healthy and PTSD control subjects. Most crucially, these increased cortisol responses were significantly correlated to the increase in social avoidance behavior measured by the AA-task in the social stress condition in SAD. An additional regression analysis showed that the cortisol responses predicted the stress-induced increase in social avoidance tendencies over and above the effects of blood pressure and subjective anxiety.Conclusions These findings provide the first evidence for a direct link between increased cortisol stress-responsiveness and social avoidance behavior in patients with SAD. The results support animal models of social avoidance and inhibition and might have important treatment implications.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
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?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The observed negative effect of fAM concentrations before social interactions on fGCM could be explained by a dual-hormone regulation through cortisol’s associations with stress and social dominance [64–66].”
From Socializing a group of male Asian elephants in a semi-captive facility in Lao PDR (2025) · cites this paper as [66]
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
An inventory for measuring depression
BECK, A. T. (1961) · Archives of General Psychiatry · doi:10.1001/archpsyc.1961.01710120031004 · Cited by 38,032
Kirschbaum, C., Pirke, K.-M., & Hellhammer, D. H. (2008) · Neuropsychobiology · doi:10.1159/000119004 · Cited by 6,093
Ekman, P. (1976) · Medical Entomology and Zoology · Cited by 4,345
Pruessner, J. C., Kirschbaum, C., Meinlschmid, G., & Hellhammer, D. H. (2003) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(02)00108-7 · Cited by 3,638
Psychotherapy by reciprocal inhibition
Wolpe, J. (1968) · Pavlovian Journal of Biological Science · doi:10.1007/bf03000093 · Cited by 3,406
Psychotherapy by Reciprocal Inhibition
Masserman, J. H. (1958) · Archives of Neurology And Psychiatry · doi:10.1001/archneurpsyc.1958.02340090135025 · Cited by 3,087
Martı́nez, A. M. (1998) · CTIT technical reports series · Cited by 2,791
A cognitive model of social phobia
Adrian Wells, A. (1995) · Research Explorer (The University of Manchester) · Cited by 2,701
Salivary cortisol in psychoneuroendocrine research: recent developments and applications
Kirschbaum, C., & Hellhammer, D. H. (1994) · Psychoneuroendocrinology · doi:10.1016/0306-4530(94)90013-2 · Cited by 2,107
Martı́nez, A. M. (1998) · Medical Entomology and Zoology · Cited by 1,982
Cited by
Sorted by citations
Handbook of Religion and Health
Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · doi:10.1093/oso/9780190088859.001.0001 · Cited by 1,160
Cortisol stress reactivity across psychiatric disorders: a systematic review and meta-analysis
Zorn, J. V., Schür, R. R., Boks, M. P., Kahn, R. S., Joëls, M., & Vinkers, C. H. (2017) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2016.11.036 · Cited by 697
Testosterone and cortisol jointly regulate dominance: evidence for a dual-hormone hypothesis
Mehta, P. H., & Josephs, R. A. (2010) · Hormones and Behavior · doi:10.1016/j.yhbeh.2010.08.020 · Cited by 574
The Neurobiology of Anxiety Disorders: Brain Imaging, Genetics, and Psychoneuroendocrinology
Martin, E. I., Ressler, K. J., Binder, E. B., & Nemeroff, C. B. (2009) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2009.05.004 · Cited by 623
Kudielka, B. M., & Wüst, S. (2010) · Stress · doi:10.3109/10253890902874913 · Cited by 424
Metadata
- Authors
- Roelofs, K., van Peer, J., Berretty, E., Jong, P. D., Spinhoven, P., & Elzinga, B. M.
- Affiliations
- Leiden University (NL)
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2009-02
- Volume
- 65
- Issue
- 4
- Pages
- 336-343
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W2032463135
- Cited by
- 236
- References
- 47
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 6 · 2023: 51 · 2022: 9 · 2021: 10 · 2020: 15 · 2019: 9 · 2018: 8 · 2017: 12 · 2016: 21 · 2015: 13 · 2014: 18 · 2013: 6 · 2012: 10
- FWCI
- 4.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroendocrine regulation and behavior
- Keywords
- social anxiety disorder, social avoidance, cortisol, hypothalamic-pituitary-adrenal axis, social stress, Trier Social Stress Test, approach-avoidance task, blood pressure, subjective anxiety, post-traumatic stress disorder
- MeSH terms
- Adult, Anxiety, Blood Pressure, Depressive Disorder, Female, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Male, Phobic Disorders, Pituitary-Adrenal System, Psychiatric Status Rating Scales, Surveys and Questionnaires, Reaction Time, Regression Analysis, Stress Disorders, Post-Traumatic
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
