Prescriptive variables for d-cycloserine augmentation of exposure therapy for
posttraumatic stress disorder.
Author(s): de Kleine RA(1), Hendriks GJ, Smits JA, Broekman TG, van Minnen A.
Affiliation(s): Author information:
(1)Radboud University Nijmegen, Behavioural Science Institute, NijCare, The
Netherlands; Center for Anxiety Disorders Overwaal, Institution for Integrated
Mental Health Care Pro Persona, Nijmegen, The Netherlands. Electronic address:
r.de.kleine@propersona.nl.
Publication date & source: 2014, J Psychiatr Res. , 48(1):40-6
In recent years, several studies have demonstrated efficacy of d-cycloserine
(DCS) enhanced exposure therapy across anxiety disorders. In this study we
examined person-level variables that predicted response to DCS enhanced exposure
therapy in a chronic, mixed trauma PTSD sample. The sample consisted of 67
treatment-seeking individuals, randomly allocated to receive exposure therapy
augmented with DCS (50 mg) or identical looking placebo. We examined the
following baseline predictors of treatment response: (1) demographic
characteristics (age, gender, marital status, and education); (2) clinical
characteristics (initial PTSD symptom severity, Axis I comorbidity, depression
symptom severity, and antidepressants use); (3) personality characteristics
(openness, conscientiousness, extraversion, agreeableness, and neuroticism).
Outcome was measured with the PTSD Symptom Scale, Self-Report, which was assessed
weekly during treatment. Two prescriptive variables were identified:
conscientiousness and extraversion. For high conscientious participants, those
who received DCS showed better outcome than those who received placebo. And for
low extraversion, DCS showed superior outcome relative to placebo. Education was
identified as a prognostic variable, it predicted response across both groups:
higher education was related to worse outcome. Our results provide support for
the influence of personality traits on DCS augmented exposure outcome and give
more insight into possible working mechanisms of this novel treatment strategy.
Ultimately, this may contribute to treatment matching strategies in order to
improve treatment efficacy of exposure therapy for PTSD.
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