7 February 2019

Exposure therapy is effective in about half of the patients with post-traumatic stress syndrome (PTSD). This percentage may possibly increase due to the targeted use of cortisol in the right patients. Benno Roozendaal received a TOP subsidy from ZonMw to investigate this. For this study he will collaborate with Erno Hermans, Robbert-Jan Verkes and Gert-Jan Hendriks.

Posttraumatic stress disorder (PTSD) is a serious psychiatric disorder, characterized by uncontrollable anxiety reactions. The disorder can be the result of drastic traumatic events earlier in life, such as sexual or physical abuse or war experiences. Exposure therapy is a therapy where patients recall the trauma, while in a safe environment. In this way an attempt is made to permanently reduce the anxiety of the patient.


Exposure therapy is one of the most common and effective treatments for PTSD. Nevertheless, it only works in about half of the patients. It’s unknown why it doesn’t work for others.

With the TOP grant, Benno Roozendaal and his colleagues will investigate whether the stress hormone cortisol can be used to predict the success of exposure therapy. Normally cortisol is released when someone ends up in a stressful situation. The hormone plays a role in the ability to respond well in the situation at hand.

Fear reduction

Roozendaal: "In some patients we see a weak cortisol response, especially in patients who have experienced traumatic experiences in early childhood. Apparently something is wrong with their stress response. We are going to investigate that now, first of all in rats. We examine whether a weakened cortisol response in these animals indeed leads to a weaker reduction of the anxiety reaction.”

“If so, it becomes interesting to investigate whether cortisol can cause anxiety reduction in patients with PTSD. And even more specifically: whether that has an effect especially in patients with such a disturbed, weaker cortisol response.”

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