Testosterone reduces eye contact avoidance in women with Social Anxiety Disorder

Taking an oral dose of testosterone relieves one of the major symptoms of Social Anxiety Disorder (SAD), according to findings of a study published in the journal Psychoneuroendocrinology.

SAD is an anxiety disorder affecting about 15 million Americans. People suffering from SAD experience intense fear of being judged even in normal social situations. Severe cases can make it difficult for sufferers to form friendships and romantic relationships, to hold a job, or to succeed in education.

It is thought that people with SAD are prone to seeing themselves as lower than others in the social hierarchy, and as a result they tend to behave in socially submissive, rather than a socially dominant manner. People with higher testosterone levels tend to engage in more socially dominant behaviors, and people with SAD tend to have relatively low testosterone levels, leading to the suggestion that raising testosterone levels might have potential as a therapy for SAD.

A team of scientists led by Dorien Enter, of Radboud University Nijmegen, tested this form of treatment in a sample of 18 women diagnosed with SAD, as well as in a control group of 19 healthy women. The women in the study were given either an oral dose of testosterone or a placebo.

After receiving the dose, participants were assessed on a laboratory measure of gaze avoidance, which is a characteristically socially submissive behavior that is common in SAD that involves avoiding making eye contact during social interactions. The women were shown a series of faces with happy, angry, or neutral expressions. A camera was used to measure the time it took for the women to look at the eyes of each face as they were presented.

Women with SAD who were given a placebo showed clear signs of gaze avoidance, fixing their eyes for shorter periods, particularly on angry faces. SAD sufferers who were given a dose of testosterone, on the other hand, showed no signs of gaze avoidance, behaving no differently from the non-SAD control group.

Interestingly, testosterone appeared to have exactly the opposite effect on women without SAD. These women showed significantly more gaze avoidance in comparison with those receiving the placebo.

The authors of the study conclude that testosterone probably decreased gaze avoidance in women with SAD by altering neural activity in the amygdala, a region of the brain related to socially dominant behavior. While it is too early to tell if testosterone would affect other socioemotional symptoms of SAD, in addition to gaze avoidance, it may hold out hope for the development of new therapies for a condition affecting millions.

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