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To approach or to avoid : neurobiological mechanisms in social anxiety Peer, J.M. van

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(1)To approach or to avoid : neurobiological mechanisms in social anxiety Peer, J.M. van. Citation Peer, J. M. van. (2009, December 8). To approach or to avoid : neurobiological mechanisms in social anxiety. Retrieved from https://hdl.handle.net/1887/14486 Version:. Not Applicable (or Unknown). License:. Licence agreement concerning inclusion of doctoral thesis in the Institutional Repository of the University of Leiden. Downloaded from:. https://hdl.handle.net/1887/14486. Note: To cite this publication please use the final published version (if applicable)..

(2) Chapter 3. Hypothalamus-Pituitary-Adrenal axis hyperresponsiveness is associated with increased social avoidance behavior in social phobia.   Š‡ ‘–‡–•‘ˆ–Š‹• Šƒ’–‡”ƒ”‡’—„Ž‹•Š‡†‹‹‘Ž‘‰‹ ƒŽ•› Š‹ƒ–”›ȋʹͲͲͻȌǡ͸ͷǡ͵͵͸Ǧ͵Ͷ͵ǡ †‘‹ǣͳͲǤͳͲͳ͸ȀŒǤ„‹‘’•› ŠǤʹͲͲͺǤͲͺǤͲʹʹ Ǥ‘‡Ž‘ˆ•ǡ ǤǤ˜ƒ‡‡”ǡǤ‡””‡––›ǡǤ†‡ ‘‰ǡŠǤ’‹Š‘˜‡ǡƬǤǤŽœ‹‰ƒ.

(3) Chapter3. Abstract  Background ‘ ‹ƒŽƒ˜‘‹†ƒ ‡ƒ†‹Š‹„‹–‹‘‹ƒ‹ƒŽ•‹•ƒ••‘ ‹ƒ–‡†™‹–ŠŠ›’‡””‡•’‘•‹˜‡‡••‘ˆ–Š‡ ‰Ž— ‘ ‘”–‹ ‘‹† •–”‡••Ǧ•›•–‡Ǥ

(4)  Š—ƒ•ǡ –Š‡ ”‡Žƒ–‹‘ „‡–™‡‡ ‰Ž— ‘ ‘”–‹ ‘‹† •–”‡••Ǧ ”‡ƒ –‹˜‹–› ƒ† •‘ ‹ƒŽ ƒ˜‘‹†ƒ ‡ „‡Šƒ˜‹‘” ”‡ƒ‹• Žƒ”‰‡Ž› —‡š’Ž‘”‡†Ǥ ‡ ‹˜‡•–‹‰ƒ–‡† ™Š‡–Š‡”‹ ”‡ƒ•‡† ‘”–‹•‘Ž•–”‡••Ǧ”‡•’‘•‹˜‡‡••‹•Ž‹‡†–‘‹ ”‡ƒ•‡†•‘ ‹ƒŽƒ˜‘‹†ƒ ‡ „‡Šƒ˜‹‘”‹’ƒ–‹‡–•™‹–Š•‘ ‹ƒŽƒš‹‡–›†‹•‘”†‡”ȋȌǤ  Methods ƒ–‹‡–•™‹–ŠȋnαͳͺȌǡƒ•™‡ŽŽƒ•–™‘ ‘–”‘Ž‰”‘—’•‘ˆŠ‡ƒŽ–Š›’ƒ”–‹ ‹’ƒ–•ȋnαʹʹȌ ƒ†’ƒ–‹‡–•™‹–Š’‘•––”ƒ—ƒ–‹ •–”‡••†‹•‘”†‡”ȋǣnαͳ͹Ȍǡ”‡•’‡ –‹˜‡Ž›ǡ’‡”ˆ‘”‡† ƒ•‘ ‹ƒŽƒ’’”‘ƒ ŠǦƒ˜‘‹†ƒ ‡–ƒ•ȋǦ–ƒ•Ȍ‹ƒ„ƒ•‡Ž‹‡ ‘†‹–‹‘ƒ†‹ƒ•‘ ‹ƒŽ•–”‡•• ‘†‹–‹‘ ȋ’”‘˜‹†‡† „› –Š‡ ”‹‡” ‘ ‹ƒŽ –”‡•• ‡•–ȌǤ Š‡ Ǧ–ƒ• ‹• ƒ ‘’—–‡”‹œ‡† ”‡ƒ –‹‘Ǧ–‹‡ –ƒ•ǡ ‡ƒ•—”‹‰ –Š‡ •’‡‡† ‘ˆ ƒ—ƒŽ ƒ’’”‘ƒ Š ƒ† ƒ˜‘‹†ƒ ‡ ”‡•’‘•‡• –‘ ˜‹•—ƒŽŽ› ’”‡•‡–‡† •‘ ‹ƒŽ –Š”‡ƒ– —‡• ȋƒ‰”› ˆƒ ‡•ȌǤ ƒŽ‹˜ƒ”› ‘”–‹•‘Žǡ „Ž‘‘† ’”‡••—”‡ ƒ†•—„Œ‡ –‹˜‡ƒš‹‡–›™‡”‡ƒ••‡••‡†–Š”‘—‰Š‘—––Š‡‡š’‡”‹‡–Ǥ  Results ƒ–‹‡–•™‹–Š•Š‘™‡†Žƒ”‰‡” ‘”–‹•‘Ž”‡•’‘•‡•–‘–Š‡•‘ ‹ƒŽ•–”‡••–‡•–ǡƒ• ‘’ƒ”‡† –‘ Š‡ƒŽ–Š› ƒ†  ‘–”‘Ž•Ǥ ‘•– ”— ‹ƒŽŽ›ǡ –Š‡•‡ ‹ ”‡ƒ•‡† ‘”–‹•‘Ž ”‡•’‘•‡• ™‡”‡ •‹‰‹ˆ‹ ƒ–Ž› ‘””‡Žƒ–‡†–‘–Š‡‹ ”‡ƒ•‡‹•‘ ‹ƒŽƒ˜‘‹†ƒ ‡„‡Šƒ˜‹‘”‡ƒ•—”‡†„›–Š‡Ǧ –ƒ•‹–Š‡•‘ ‹ƒŽ•–”‡•• ‘†‹–‹‘‹Ǥƒ††‹–‹‘ƒŽ”‡‰”‡••‹‘ƒƒŽ›•‹••Š‘™‡†–Šƒ– –Š‡ ‘”–‹•‘Ž ”‡•’‘•‡• ’”‡†‹ –‡† –Š‡ •–”‡••Ǧ‹†— ‡† ‹ ”‡ƒ•‡ ‹ •‘ ‹ƒŽ ƒ˜‘‹†ƒ ‡ –‡†‡ ‹‡•‘˜‡”ƒ†ƒ„‘˜‡–Š‡‡ˆˆ‡ –•‘ˆ„Ž‘‘†’”‡••—”‡ƒ†•—„Œ‡ –‹˜‡ƒš‹‡–›Ǥ  Conclusions Š‡•‡ ˆ‹†‹‰• ’”‘˜‹†‡ –Š‡ ˆ‹”•– ‡˜‹†‡ ‡ ˆ‘” ƒ †‹”‡ – Ž‹ „‡–™‡‡ ‹ ”‡ƒ•‡† ‘”–‹•‘Ž •–”‡••Ǧ”‡•’‘•‹˜‡‡•• ƒ† •‘ ‹ƒŽ ƒ˜‘‹†ƒ ‡ „‡Šƒ˜‹‘” ‹ ’ƒ–‹‡–• ™‹–Š Ǥ Š‡ ”‡•—Ž–• •—’’‘”– ƒ‹ƒŽ ‘†‡Ž• ‘ˆ •‘ ‹ƒŽ ƒ˜‘‹†ƒ ‡ ƒ† ‹Š‹„‹–‹‘ ƒ† ƒ› Šƒ˜‡ ‹’‘”–ƒ– –”‡ƒ–‡–‹’Ž‹ ƒ–‹‘•Ǥ. Ͷͺ.

(5) Cortisolreactivitypredictsavoidancebehaviorinsocialphobia. Introduction  ‘ ‹ƒŽƒš‹‡–›†‹•‘”†‡”ȋȌ‹•–Š‡‘•– ‘‘ƒš‹‡–›†‹•‘”†‡”ƒ†‹• Šƒ”ƒ –‡”‹œ‡† „› ’‡”•‹•–‡– ˆ‡ƒ” ƒ† ƒ˜‘‹†ƒ ‡ ‘ˆ •‘ ‹ƒŽ •‹–—ƒ–‹‘• ȋ ‘ˆƒ Ƭ ډ‡Ž•ǡ ʹͲͲ͸Ǣ ƒ—œœƒ ‡– ƒŽǤǡ ͳͻͻͷȌǤ ˜‘‹†ƒ ‡ „‡Šƒ˜‹‘”ǡ ‹ ’ƒ”–‹ —Žƒ”ǡ ’Žƒ›• ƒ ”— ‹ƒŽ ”‘Ž‡ ‹ –Š‡ ƒ‹–‡ƒ ‡‘ˆ–Š‡†‹•‘”†‡”ƒ†Š‹†‡”•‡š–‹ –‹‘‘ˆˆ‡ƒ”‹•‘ ‹ƒŽ•‹–—ƒ–‹‘•ȋŽƒ”Ƭ ‡ŽŽ•ǡͳͻͻͷǢ–ƒ‰‹‡”ǡ ‡‹†‡”‡‹ ŠǡƬ Š‡”‡ŽŽ‡ŠǦ‰‡ŽǡʹͲͲ͸ȌǤ‡•’‹–‡–Š‹•‹’‘”–ƒ– ”‘Ž‡ǡŽ‹––Ž‡‹•‘™ƒ„‘—––Š‡’•› Š‘„‹‘Ž‘‰‹ ƒŽ‡ Šƒ‹•• ‘–”‘ŽŽ‹‰•‘ ‹ƒŽƒ˜‘‹†ƒ ‡ ‹Ǥ . š–‡•‹˜‡ ”‡•‡ƒ” Š ‹ ’”‹ƒ–‡• Šƒ• •Š‘™ –Šƒ– •‘ ‹ƒŽŽ› ƒ˜‘‹†ƒ– „‡Šƒ˜‹‘” ‹•. ”‡Žƒ–‡† –‘ ‹ ”‡ƒ•‡† ƒ –‹˜ƒ–‹‘ ‘ˆ –Š‡ ›’‘–ŠƒŽƒ—•Ǧ‹–—‹–ƒ”›Ǧ†”‡ƒŽ ȋ ȌǦƒš‹•ǡ ƒ ‹’‘”–ƒ–•–”‡•••›•–‡ǡƒ –‹˜ƒ–‹‘‘ˆ™Š‹ Š”‡•—Ž–•‹–Š‡”‡Ž‡ƒ•‡‘ˆ ‘”–‹•‘Žȋƒ’‘Ž•›ǡ ͳͻͻͲȌǤ ‘” ‡šƒ’Ž‡ǡ ’”‹ƒ–‡• ™‹–Š ”‡Žƒ–‹˜‡Ž› Š‹‰Š „ƒ•ƒŽ ƒ† ”‡ƒ –‹˜‡ Ǧƒš‹• ƒ –‹˜‹–› •Š‘™‹ ”‡ƒ•‡†•‘ ‹ƒŽƒ˜‘‹†ƒ ‡ƒ†„‡Šƒ˜‹‘”ƒŽ‹Š‹„‹–‹‘ȋƒŽ‹‡–ƒŽǤǡͳͻͻͺ„Ǣƒ’‘Ž•›ǡ ͳͻͻͲȌǤ Ž•‘ ‹ ”ƒ–•ǡ ‹ ”‡ƒ•‡† ‰Ž— ‘ ‘”–‹ ‘‹† ƒ –‹˜‹–› ‹• ”‡Žƒ–‡† –‘ ‹ ”‡ƒ•‡† „‡Šƒ˜‹‘”ƒŽ ‹Š‹„‹–‹‘ǡ ’ƒ”–‹ —Žƒ”Ž› ‹ •‘ ‹ƒŽ •‹–—ƒ–‹‘• ȋƒ˜‹‰‡ŽŽ‹ ‡– ƒŽǤǡ ʹͲͲ͹Ǣ —‡œǡ ‡””‡ǡ • ‘”‹Š—‡Žƒǡ ‘„‡ƒǡ Ƭ ‡”ƒ†‡œǦ‡”—‡Žǡ ͳͻͻ͸ȌǤ —ƒ •–—†‹‡• Šƒ˜‡ •‹‹Žƒ”Ž› ‹†‹ ƒ–‡† –Šƒ– ‹ ”‡ƒ•‡† Ǧƒš‹• ƒ –‹˜‹–› ‹ Š‡ƒŽ–Š› ‹†‹˜‹†—ƒŽ• ‹• ƒ••‘ ‹ƒ–‡† ™‹–Š ‹ ”‡ƒ•‡†•‘ ‹ƒŽƒ˜‘‹†ƒ ‡ƒ†ˆ”‡‡œ‹‰”‡ƒ –‹‘•ȋ‘‡Ž‘ˆ•‡–ƒŽǤǡʹͲͲͷǢ‘‡Ž‘ˆ•ǡƒ˜‹•ǡ ‡”ƒ•ǡƒ‡Ž–ǡƬƒ ‘ǡʹͲͲ͹Ǣƒ ‘‡–ƒŽǤǡͳͻͻͺǡʹͲͲͲȌǤ ‘™‡˜‡”ǡ‘•–—†‹‡• Šƒ˜‡ ƒ††”‡••‡† –Š‡ ”‡Žƒ–‹‘•Š‹’ „‡–™‡‡ Ǧƒš‹• •–”‡••Ǧ”‡ƒ –‹˜‹–› ƒ† •‘ ‹ƒŽ ƒ˜‘‹†ƒ ‡„‡Šƒ˜‹‘”‹’ƒ–‹‡–•™‹–Šƒ†–Š‡• ƒ” ‡‹˜‡•–‹‰ƒ–‹‘•‘ ‘”–‹•‘Ž•–”‡••Ǧ ”‡ƒ –‹˜‹–› ‹ –Š‡•‡ ’ƒ–‹‡–• Šƒ˜‡ •Š‘™ ‹š‡† ”‡•—Ž–•Ǥ ‡ •–—†› ”‡’‘”–‡† ‹ ”‡ƒ•‡† ‘”–‹•‘Ž ”‡•’‘•‡• –‘ ƒ ’•› Š‘Ž‘‰‹ ƒŽ •–”‡••‘” ‹  ƒ• ‘’ƒ”‡† –‘ Š‡ƒŽ–Š› ‘–”‘Ž• ȋ‘†”‡ ‡– ƒŽǤǡ ʹͲͲʹȌǡ „—– ‘–Š‡” ‹˜‡•–‹‰ƒ–‹‘• ˆƒ‹Ž‡† –‘ ˆ‹† •— Š ‰”‘—’ †‹ˆˆ‡”‡ ‡ ȋ —”Žƒ‡–ƒŽǤǡʹͲͲͳǢ‡˜‹‡–ƒŽǤǡͳͻͻ͵Ǣƒ”–‡Ž‡–ƒŽǤǡͳͻͻͻȌǤ‘•–‹’‘”–ƒ–Ž›ǡ‹‘‡‘ˆ –Š‡Š—ƒ•–—†‹‡•‘™‡”‡–Š‡ ‘”–‹•‘Ž”‡•’‘•‡•”‡Žƒ–‡†–‘‘„Œ‡ –‹˜‡‡ƒ•—”‡•‘ˆ ‘˜‡”– •‘ ‹ƒŽ ˆ‡ƒ” „‡Šƒ˜‹‘”ǡ •— Š ƒ• •‘ ‹ƒŽ ƒ’’”‘ƒ Š ‘” ƒ˜‘‹†ƒ ‡ „‡Šƒ˜‹‘”Ǥ — Š †‹”‡ – ‘’ƒ”‹•‘ ‹• ”— ‹ƒŽ –‘ –‡•– –Š‡ ’”‘’‘•‡† ”‘Ž‡ ‘ˆ Š›’‡” ‘”–‹•‘Ž‹• ‹ –Š‡ ˆƒ‹Ž‹‰ ”‡‰—Žƒ–‹‘‘ˆ•‘ ‹ƒŽˆ‡ƒ”ƒ†ˆ‡ƒ”„‡Šƒ˜‹‘”‹ȋ ‡”ƒ•Ƭƒ ‘ǡʹͲͲ͸ȌǤ . Š‡ ƒ’’”‘ƒ ŠǦƒ˜‘‹†ƒ ‡ –ƒ• ȋǦ–ƒ•Ȍ ȋ‘––‡˜‡‡Ž Ƭ Šƒˆǡ ʹͲͲͶȌ ’”‘˜‹†‡• ƒ. ”‡Ž‹ƒ„Ž‡ –‘‘Ž –‘ ‹˜‡•–‹‰ƒ–‡ ‘˜‡”– •‘ ‹ƒŽ ƒ˜‘‹†ƒ ‡ „‡Šƒ˜‹‘” ƒ† Šƒ• „‡‡ •Š‘™ –‘ „‡. Ͷͻ.

(6) Chapter3. •‡•‹–‹˜‡ –‘ •‘ ‹ƒŽ ƒš‹‡–› ƒ† ‘”–‹•‘Ž ƒ‹’—Žƒ–‹‘• ‹ Š‡ƒŽ–Š› ’‘’—Žƒ–‹‘• ȋ ‡—‡”ǡ ‹ ǡ Ƭ ‡ ‡”ǡ ʹͲͲ͹Ǣ ‘‡Ž‘ˆ• ‡– ƒŽǤǡ ʹͲͲͷǢ ƒ ‡‡” ‡– ƒŽǤǡ ʹͲͲ͹ȌǤ —”‹‰ –Š‹• ‘’—–‡”‹œ‡† ”‡ƒ –‹‘ –‹‡ ȋȌ –ƒ•ǡ  •—„Œ‡ –• ƒ‡ ƒ’’”‘ƒ Š‹‰ ‘” ƒ˜‘‹†‹‰ ƒ”Ǧ ‘˜‡‡–•–‘˜‹•—ƒŽŽ›’”‡•‡–‡†’‹ –—”‡•‘ˆƒ‰”›ˆƒ ‹ƒŽ‡š’”‡••‹‘•Ǥ‰”›ˆƒ ‡•ˆ‘”ƒ ’‘–‡– –Š”‡ƒ– •–‹—Ž—• ‹ Š—ƒ ”‡•‡ƒ” Š ƒ† ‡Ž‹ ‹– ”‡Žƒ–‹˜‡Ž› Š‹‰Š ƒ –‹˜ƒ–‹‘ ‹ „”ƒ‹ ƒ”‡ƒ•‹˜‘Ž˜‡†‹–Š”‡ƒ–†‡–‡ –‹‘ǡ•— Šƒ•–Š‡ƒ›‰†ƒŽƒǡ‹’ƒ–‹‡–•™‹–ŠȋŠƒ‡– ƒŽǤǡʹͲͲ͸Ǣ–‡‹‡–ƒŽǤǡʹͲͲʹǢ–”ƒ—„‡‡–ƒŽǤǡʹͲͲͶȌǤ Š‡ƒ‹‘ˆ–Š‡’”‡•‡–•–—†›™ƒ•–‘–‡•––Š‡‡ˆˆ‡ –‘ˆ•–”‡••Ǧ‹†— ‡† ‘”–‹•‘Ž‘ –Š‡–‡†‡ ›–‘ƒ˜‘‹†ƒ‰”›ˆƒ ‡•‹Ǥ‘‹˜‡•–‹‰ƒ–‡–Š‡•’‡ ‹ˆ‹ ‹–›‘ˆ–Š‹•‡ˆˆ‡ –ǡ™‡ ƒ††‡†Šƒ’’›ˆƒ ‡•ƒ•‡‘–‹‘ƒŽ ‘–”‘Ž•–‹—Ž‹ƒ†‹ Ž—†‡†Š‡ƒŽ–Š›’ƒ”–‹ ‹’ƒ–•ƒ•™‡ŽŽ ƒ• ’ƒ–‹‡–• ™‹–Š ƒ‘–Š‡” ƒš‹‡–› †‹•‘”†‡” ȋ’‘•– –”ƒ—ƒ–‹  •–”‡•• †‹•‘”†‡”ǡ Ȍ ƒ• Š‡ƒŽ–Š›ƒ† Ž‹‹ ƒŽ ‘–”‘Ž‰”‘—’•ǡ”‡•’‡ –‹˜‡Ž›ǤŽŽ’ƒ”–‹ ‹’ƒ–• ‘†— –‡†–Š‡Ǧ–ƒ• ‹ƒ„ƒ•‡Ž‹‡ ‘†‹–‹‘ƒ†‹ƒ•‘ ‹ƒŽ•–”‡•• ‘†‹–‹‘ǡ‹†— ‡†„›–Š‡”‹‡”‘ ‹ƒŽ–”‡•• ‡•– ȋǣ ‹”• Š„ƒ— ‡– ƒŽǤǡ ͳͻͻ͵ȌǤ ‡ Š›’‘–Š‡•‹œ‡† ƒ ˆ‹†‹‰ ‘ˆ ‹ ”‡ƒ•‡† ‘”–‹•‘Ž ”‡•’‘•‡•–‘•‘ ‹ƒŽ•–”‡••Ǧ‹†— –‹‘‹’ƒ–‹‡–•™‹–Šǡƒ• ‘’ƒ”‡†™‹–Š„‘–ŠŠ‡ƒŽ–Š› ƒ†  ‘–”‘Ž •—„Œ‡ –•Ǥ ‘•– ”— ‹ƒŽŽ›ǡ ™‡ ‡š’‡ –‡† –Šƒ– –Š‡•‡ ‹ ”‡ƒ•‡† ‘”–‹•‘Ž ”‡•’‘•‡•‹ƒ”‡”‡Žƒ–‡†–‘ƒ‹ ”‡ƒ•‡†–‡†‡ ›–‘ƒ˜‘‹†ƒ‰”›ˆƒ ‡•‘–Š‡Ǧ –ƒ•Ǥ. MethodsandMaterials  Participants ‡‘‰”ƒ’Š‹ ˜ƒ”‹ƒ„Ž‡•ƒ†‰”‘—’ Šƒ”ƒ –‡”‹•–‹ •‘ˆ–Š‡–Š”‡‡’ƒ”–‹ ‹’ƒ–Ǧ‰”‘—’• ƒ”‡’”‡•‡–‡†‹ƒ„Ž‡͵ǤͳǤƒ–‹‡–•™‹–Š‰‡‡”ƒŽ‹œ‡†ƒ†Šƒ†„‡‡”‡ˆ‡””‡† ˆ‘”‘—–’ƒ–‹‡––”‡ƒ–‡––‘ƒ‰‡‡”ƒŽ’•› Š‹ƒ–”‹ Š‘•’‹–ƒŽƒ†™‡”‡†‹ƒ‰‘•‡†™‹–Š–Š‡ –”— –—”‡† Ž‹‹ ƒŽ

(7) –‡”˜‹‡™ ˆ‘” Ǧ

(8)  š‹•Ǧ

(9)  ‹•‘”†‡”• ȋ

(10) Ǧ‹Ȁ’ǣ ‹”•–ǡ ’‹–œ‡”ǡ. ‹„„‘ǡ Ƭ ‹ŽŽ‹ƒ•ǡ ͳͻͻ͸ȌǤ Ž›  ’ƒ–‹‡–• ™‹–Š ƒ Š‹•–‘”› ‘ˆ ‹–‡”’‡”•‘ƒŽ –”ƒ—ƒ ȋ’Š›•‹ ƒŽ ƒ†Ȁ‘” •‡š—ƒŽ ƒ„—•‡Ȍ ™‡”‡ ‹ Ž—†‡†ǡ „‡ ƒ—•‡ –Š‡› ƒ”‡ ƒŽ•‘ Šƒ”ƒ –‡”‹œ‡† „› ƒ”‡†ˆ‡ƒ”ƒ†ƒ˜‘‹†ƒ ‡‘ˆ•‘ ‹ƒŽ•‹–—ƒ–‹‘•Ǥ ‡ƒŽ–Š› ‘–”‘Žȋ Ȍ’ƒ”–‹ ‹’ƒ–•™‡”‡ ”‡ ”—‹–‡† ˜‹ƒ ƒ†˜‡”–‹•‡‡–• ‹ Ž‘ ƒŽ ‡™•’ƒ’‡”•Ǥ š Ž—•‹‘ ”‹–‡”‹ƒ ˆ‘” ’ƒ”–‹ ‹’ƒ–‹‘ ™‡”‡ǣƒ‰‡δͳͺ‘”ε͸ͷ›‡ƒ”•ǡŽ‡ˆ–ǦŠƒ†‡†‡••ǡ’•› Š‘–‹ †‹•‘”†‡”ǡ—•‡‘ˆ‡—”‘Ž‡’–‹ •ǡ •—„•–ƒ ‡—•‡Ȁƒ††‹ –‹‘ǡƒ Š”‘‹ †‹•‡ƒ•‡ǡ—•‡‘ˆ ‘”–‹ ‘•–‡”‘‹†•ƒš͸‘–Š•„‡ˆ‘”‡ ’ƒ”–‹ ‹’ƒ–‹‘ǡƒ†’”‡‰ƒ ›‘”„”‡ƒ•–ˆ‡‡†‹‰Ǥˆ–Š‡ʹʹ’ƒ–‹‡–•‘”‹‰‹ƒŽŽ›–‡•–‡†ǡ. ͷͲ.

(11) Cortisolreactivitypredictsavoidancebehaviorinsocialphobia Table3.1.‡‘‰”ƒ’Š‹ ƒ”‹ƒ„Ž‡•ƒ† ”‘—’Šƒ”ƒ –‡”‹•–‹ •. Variable. SAD n = 18. PTSD n = 17. HC n = 22. Gender (n: male/female). 9M/9F. 6M/11F. 9M/13F. 0.8 (X2). ns. Age (yrs). 32.2 (± 3.2). 35.8 (± 3.3). 39.9 (± 2.9). 1.5. Ns. Medication a Antidepressants Sedativesb Otherc Oral contraceptives Social anxiety (SPAI). 7N/11Y 6 4 1 4 156 (± 7.7)d. 4N/13Y 4 2 3 6 131 (± 7.9)d. 17N/5Y 0 0 2 4 89 (± 7.0)d. 12.2 (X2) .002. 21.9. <.001. Depression (BDI). 16.7 (± 2.5)e. 17.9 (± 2.6)f. 3.7 (± 2.3)ef. 10.9. <.001. Early trauma (TEQ) Emotional Physical Sexual. 3.6 (± 0.8) 1.6 (n = 8)h 0.6 (n = 3) 0.2 (n = 1). 7.4 (± 1.0)g 1.5 (n = 6) 1.9 (n = 9)i 2.0 (n = 9)j. 2.7 (± 0.8)g 0.5 (n = 5)h 0.5 (n = 4)i 0.1 ( n = 1)j. 7.9 2.0 4.2 12.9. <.001 .1 .020 <.001. TSST-modificationsk (n) Verbal encouragements Structured speech Speech terminated preterm. 11N/7Y 1 1 5. 11N/6Y 3 0 3. 21N/1Y 1 0 0. 6.8(X2). .033. F value p. Axis-1 comorbidityl (n) 2 2 0 Generalized anxiety d. 1 2 0 Obsessive compulsive d. Panic d. 0 3 0 Depressive d. 0 7 4 0 Dysthymic d. 1 1 ƒ–ƒˆ”‘“—‡•–‹‘ƒ‹”‡•ƒ”‡’”‡•‡–‡†‹‡ƒ• ‘”‡ƒ†Ǥ α•‘ ‹ƒŽƒš‹‡–›†‹•‘”†‡”Ǣα ’‘•––”ƒ—ƒ–‹  •–”‡•• †‹•‘”†‡”Ǣ  αŠ‡ƒŽ–Š› ‘–”‘Ž •—„Œ‡ –•Ǣ  α ‘Ǣ  α ›‡•Ǣ 

(12)  α‡  ‡’”‡••‹‘

(13) ˜‡–‘”›Ǣ

(14) α‘ ‹ƒŽŠ‘„‹ƒƒ†š‹‡–›

(15) ˜‡–‘”›Ǣᔃ—ƒ–‹ š’‡”‹‡ ‡•—‡•–‹‘ƒ‹”‡Ǣ†α †‹•‘”†‡”Ǥ a‘–ƒŽ —„‡”• †‘ ‘– ‘””‡•’‘†–‘ –Š‡ •— ‘ˆ –Š‡ ˆ‘—” •—„–›’‡•ǡ „‡ ƒ—•‡ ‘ˆ ‘˜‡”Žƒ’ ȋ’ƒ–‹‡–• ‹‰Š– —•‡‘”‡–Šƒ‘‡–›’‡‘ˆ‡†‹ ƒ–‹‘ȌǤ bƒ”–‹ ‹’ƒ–•”‡ˆ”ƒ‹‡†ˆ”‘–ƒ‹‰–Š‡†”—‰‹‹ƒŽŽ›ʹͶŠ‘—”•„‡ˆ‘”‡–Š‡‡š’‡”‹‡–Ǥ c

(16)  Ž—†‹‰‡†‹ ƒ–‹‘ˆ‘””‡•’‹”ƒ–‘”›–”ƒ –•ƒ†„Ž‘‘†’”‡••—”‡ ‘–”‘ŽǤ d–j‡ŽŽ•™‹–Š•‹‹Žƒ”•—’‡”• ”‹’–•†‹ˆˆ‡”•‹‰‹ˆ‹ ƒ–Ž›ˆ”‘‡ƒ Š‘–Š‡”ȋp<ǤͲͷȌǤ k‡‡Dz”‘ ‡†—”‡•dz•‡ –‹‘ˆ‘”ƒ†‡–ƒ‹Ž‡††‡• ”‹’–‹‘‘ˆ–Š‡”‹‡”‘ ‹ƒŽ–”‡••‡•–ȋȌ‘†‹ˆ‹ ƒ–‹‘•Ǥ l••‡••‡†™‹–Š–Š‡–”— –—”‡†Ž‹‹ ƒŽ

(17) –‡”˜‹‡™ˆ‘”Ǧ

(18) š‹•Ǧ

(19) ‹•‘”†‡”•ȋ

(20) Ǧ‹Ȁ’ȌǤ. . Ͷ’ƒ–‹‡–•Šƒ†–‘„‡‡š Ž—†‡†ȋ†—‡–‘‡š ‡••‹˜‡„Ž‘‘†’”‡••—”‡ǡnαͳǢ‹••‹‰Ǧ–ƒ• †ƒ–ƒ †—‡ –‘ –‡ Š‹ ƒŽ ’”‘„Ž‡ǡ n α ʹǢ ƒ† ‹‡†‹ƒ–‡ –‡”‹ƒ–‹‘ ƒˆ–‡” ‹–”‘†— –‹‘ ǡnαͳȌǡŽ‡ƒ˜‹‰ͳͺ’ƒ–‹‡–•ˆ‘”–Š‡ƒƒŽ›•‡•Ǥˆ–Š‡ʹͲ’ƒ–‹‡–•–‡•–‡†ǡ͵ ™‡”‡‡š Ž—†‡†ȋŠ‡ƒ”–”Š›–Š†‹•–—”„ƒ ‡•ǡnαͳǢ–‡ Š‹ ƒŽ’”‘„Ž‡•ǡnαʹȌǡŽ‡ƒ˜‹‰ƒ –‘–ƒŽ‘ˆͳ͹’ƒ–‹‡–•Ǥ‘‡‘ˆ–Š‡ʹʹ ’ƒ”–‹ ‹’ƒ–•™‡”‡‡š Ž—†‡†Ǥ ‡ˆ‘”‡–Š‡–‡•–†ƒ›ǡƒŽŽ’ƒ”–‹ ‹’ƒ–•™‡”‡‹•–”— –‡†–‘‹‹‹œ‡’Š›•‹ ƒŽ‡š‡” ‹•‡. ͷͳ.

(21) Chapter3. ƒ†‘––‘•‘‡†—”‹‰–Š‡Š‘—”’”‡ ‡†‹‰–Š‡‡š’‡”‹‡–ƒ†‘––‘–ƒ‡Žƒ”‰‡‡ƒŽ•ǡ ‘ˆˆ‡‡ǡ ƒ† †”‹• ™‹–Š Ž‘™ ’  †—”‹‰ –Š‡ ‹‰Š– ȋˆ”‘ ͺǣͲͲ  ‘Ȍ ƒ† ‘”‹‰ ’”‡ ‡†‹‰–Š‡–‡•–†ƒ›ǡ„‡ ƒ—•‡–Š‡•‡˜ƒ”‹ƒ„Ž‡• ƒƒˆˆ‡ – ‘”–‹•‘ŽŽ‡˜‡Ž•ǤŽŽ’ƒ”–‹ ‹’ƒ–• ƒ‰”‡‡†‘–Š‹•’”‘ ‡†—”‡ǡƒ†‘„‘†›”‡’‘”–‡††‹ˆˆ‹ —Ž–›™‹–Šƒ„•–ƒ‹‹‰ˆ”‘ ƒˆˆ‡‹‡ ‘” ‹ ‘–‹‡Ǥ ŽŽ ’ƒ”–‹ ‹’ƒ–• Šƒ† ‘”ƒŽ ‘” ‘””‡ –‡†Ǧ–‘Ǧ‘”ƒŽ ˜‹•‹‘ ƒ† ’”‘˜‹†‡† ™”‹––‡‹ˆ‘”‡† ‘•‡–ǤŠ‡•–—†›™ƒ•ƒ’’”‘˜‡†„›–Š‡Ž‘ ƒŽ‡–Š‹ • ‘‹––‡‡Ǥ  AAtask

(22)  –Š‹• ƒˆˆ‡ –Ǧ‡˜ƒŽ—ƒ–‹‘ –ƒ• ȋ‘––‡˜‡‡Ž Ƭ Šƒˆǡ ʹͲͲͶȌǡ ’ƒ”–‹ ‹’ƒ–• ”‡•’‘† –‘ ˜‹•—ƒŽŽ› ’”‡•‡–‡† ’‹ –—”‡• †‹•’Žƒ›‹‰ ‡‘–‹‘ƒŽ ˆƒ ‹ƒŽ ‡š’”‡••‹‘•ǡ „› ƒ‹‰ ƒ” ‘˜‡‡–•–‘™ƒ”†•ȋƒ”ǦˆŽ‡š‹‘‘”ƒ’’”‘ƒ ŠȌ‘”ƒ™ƒ›ˆ”‘ȋƒ”Ǧ‡š–‡•‹‘‘”ƒ˜‘‹†Ȍ –Š‡‹” ‘™ „‘†›Ǥ ‹‰Š–› ’‹ –—”‡• ™‹–Š ˆƒ ‹ƒŽ ‡š’”‡••‹‘• ȋƒ Ƭ ”‹‡•‡ǡ ͳͻ͹͸Ǣ —†“˜‹•–‡–ƒŽǤǡͳͻͻͺǢƒ”–‹‡œƬ‡ƒ˜‡–‡ǡͳͻͻͺǢƒ–•—‘–‘ƬƒǡͳͻͺͺȌ•‡”˜‡† ƒ••–‹—Ž‹Ǥ‘–Š–Š‡Šƒ’’›ƒ†ƒ‰”›‡š’”‡••‹‘•™‡”‡–ƒ‡ˆ”‘–Š‡•ƒ‡‘†‡Žȋ–‘–ƒŽ ‘ˆ ͶͲ ‘†‡Ž• ȏͷͲΨ ƒŽ‡ȐȌǤ Š‡ •–‹—Ž‹ ™‡”‡ •—„†‹˜‹†‡† ‹–‘ ˆ‘—” ˆ‹š‡† •‡”‹‡• ȋͳǦʹǦ ͳǦʹȌ ™‹–Š ‡ƒ Š ͳͲ Šƒ’’› ƒ† ͳͲ ƒ‰”› ‡š’”‡••‹‘• ˆ”‘ †‹ˆˆ‡”‡– ‘†‡Ž•Ǥ ƒ Š ’‹ –—”‡™ƒ•’”‡•‡–‡†‘ƒͳͷǦ‹ Š ‘’—–‡”• ”‡‡™‹–Šƒ˜‡”–‹ ƒŽ˜‹•—ƒŽƒ‰Ž‡‘ˆͳͶι ƒ† ƒ Š‘”‹œ‘–ƒŽ ˜‹•—ƒŽ ƒ‰Ž‡ ‘ˆ ͳͲǤ͹ιǤ Š‡ ƒ’’”‘ƒ Š ƒ† ƒ˜‘‹†ƒ ‡ ”‡•’‘•‡• ™‡”‡ ‰‹˜‡ „› ‡ƒ• ‘ˆ –Š”‡‡ ‘‡Ǧ„—––‘ „‘š‡• –Šƒ– ™‡”‡ ˆ‹š‡† –‘ ƒ ˜‡”–‹ ƒŽ •–ƒ† ȋ•‡‡ ‘––‡˜‡‡Ž ƒ† Šƒˆǡ ʹͲͲͶǡ ˆ‘” ƒ ’Š‘–‘‰”ƒ’Š ‘ˆ –Š‹• ‡š’‡”‹‡–ƒŽ •‡–Ǧ—’ȌǤ ƒ”–‹ ‹’ƒ–• ™‡”‡•‡ƒ–‡†–‘–Š‡Ž‡ˆ–‘ˆ–Š‡•–ƒ†ƒŽŽ‘™‹‰–Š‡–‘”‡•’‘†™‹–Š–Š‡‹””‹‰Š–Šƒ†Ǥ ‘” –Š‡ ”‡•–‹‰ ’‘•‹–‹‘ ‘ˆ –Š‡ ”‹‰Š– Šƒ† ’ƒ”–‹ ‹’ƒ–• ™‡”‡ ‹•–”— –‡† –‘ ’—•Š –Š‡ Š‘‡Ǧ „—––‘ ȋˆ‹š‡† ‹ –Š‡ ‹††Ž‡Ȍ Ž‘‘•‡Ž› ™‹–Š –Š‡ „ƒ  ‘ˆ –Š‡ ”‹‰Š– Šƒ† ƒ• Ž‘‰ ƒ• ‘ ”‡•’‘•‡™ƒ•‰‹˜‡ǡ‡•—”‹‰–Šƒ––Š‡‘˜‡‡–†‹•–ƒ ‡ˆ‘”ƒ’’”‘ƒ Šƒ†ƒ˜‘‹†ƒ ‡ ”‡•’‘•‡• ™‘—Ž† „‡ ‡“—ƒŽǤ ŽŽ •—„Œ‡ –• ”‡ ‡‹˜‡† ƒ ƒˆˆ‡ –Ǧ ‘‰”—‡– ƒ† ƒ ƒˆˆ‡ –Ǧ ‹ ‘‰”—‡– ‹•–”— –‹‘Ǧ„Ž‘  ‘ˆ –”‹ƒŽ•ǡ „‘–Š „‡ˆ‘”‡ ȋͳǦʹȌ ƒ† ƒˆ–‡” ȋͳǦʹȌ •–”‡••Ǧ ‹†— –‹‘Ǥ

(23)  ƒˆˆ‡ –Ǧ ‘‰”—‡– ‹•–”— –‹‘Ǧ„Ž‘ •ǡ ’ƒ”–‹ ‹’ƒ–• ™‡”‡ ‹•–”— –‡† –‘ ’”‡•• –Š‡ —’’‡” „—––‘ ȋƒ’’”‘ƒ Š ‘˜‡‡–Ȍ ‹ ”‡•’‘•‡ –‘ ƒ Šƒ’’› ˆƒ ‡ ƒ† –‘ ’”‡•• –Š‡ Ž‘™‡” „—––‘ ‹ ”‡•’‘•‡ –‘ ƒ ƒ‰”› ˆƒ ‡ ȋƒ˜‘‹†ƒ ‡ ‘˜‡‡–ȌǤ ˆˆ‡ –Ǧ‹ ‘‰”—‡– ‹•–”— –‹‘„Ž‘ •‹˜‘Ž˜‡†–Š‡‘’’‘•‹–‡•–‹—Ž—•Ǧ”‡•’‘•‡ƒ’’‹‰•ȋƒ’’”‘ƒ ŠǦƒ‰”›ǡ ƒ˜‘‹†ǦŠƒ’’›ȌǤ ‘ ”‡ˆ‡”‡ ‡ ™ƒ• ƒ†‡ ‹ –Š‡ ‹•–”— –‹‘• –‘ ‘‰”—‡ ‡ ƒ† ‹ ‘‰”—‡ ‡ǡ ƒ’’”‘ƒ Š ƒ† ƒ˜‘‹†ƒ ‡ǡ ‘” ƒ” ˆŽ‡š‹‘ ƒ† ‡š–‡•‹‘Ǥ Š‡ ‘”†‡” ‘ˆ ‹•–”— –‹‘•„‡ˆ‘”‡ƒ†ƒˆ–‡”•–”‡••Ǧ‹†— –‹‘™ƒ•ˆ—ŽŽ› ‘—–‡”„ƒŽƒ ‡†ƒ ”‘•••—„Œ‡ –•Ǥ. ͷʹ.

(24) Cortisolreactivitypredictsavoidancebehaviorinsocialphobia. ƒ Š ‹•–”— –‹‘Ǧ„Ž‘  ™ƒ• ’”‡ ‡†‡† „› ͳʹ ’”ƒ –‹ ‡ –”‹ƒŽ• ‘–ƒ‹‹‰ ’‹ –—”‡• ‘– ‹ Ž—†‡†‹–Š‡‡š’‡”‹‡–Ǥ”‹ƒŽ••–ƒ”–‡†™‹–ŠƒͳͲͲǦ•‡ ǦŽƒ•–‹‰„Žƒ ˆ‹šƒ–‹‘’‘‹–ƒ– –Š‡ ‡–‡”‘ˆ–Š‡• ”‡‡Ǥˆ–‡”ƒ‹–‡”˜ƒŽ‘ˆ͵ͲͲ•‡ ȋ„Žƒ• ”‡‡Ȍǡ–Š‡ˆƒ ‡Ǧ•–‹—Ž—• ™ƒ• ’”‡•‡–‡† ˆ‘” ͳͲͲ •‡ ǡ ™‹–Š ƒ ‹–‡”Ǧ–”‹ƒŽǦ‹–‡”˜ƒŽ ȋ

(25) 

(26) Ȍ ‘ˆ ͳͷͲͲ •‡ Ǥ Š‡  ȋ–‹‡ „‡–™‡‡ •–‹—Ž—•Ǧ‘•‡– ƒ† ”‡•’‘•‡Ȍ ™ƒ• ‡ƒ•—”‡† ™‹–Š ƒ ƒ —”ƒ › ‘ˆ  δ ʹ •‡ Ǥ . . TheTrierSocialStressTest Š‹•’•› Š‘Ž‘‰‹ ƒŽ ŠƒŽŽ‡‰‡–‡•– ‘•‹•–•‘ˆƒˆ”‡‡•’‡‡ Šȋͷ‹Ȍƒ†ƒ‡–ƒŽ ƒ”‹–Š‡–‹ –ƒ•ȋͷ‹Ȍǡ’‡”ˆ‘”‡†‹ˆ”‘–‘ˆƒƒ—†‹‡ ‡‘ˆ͵‹†‹˜‹†—ƒŽ•ƒ†’”‡ ‡†‡† „› ƒ ƒ–‹ ‹’ƒ–‹‘ ’Šƒ•‡ ȋͷ ‹Ȍǡ ‹ ™Š‹ Š ’ƒ”–‹ ‹’ƒ–• ’”‡’ƒ”‡ –Š‡ ’—„Ž‹  •’‡‡ ŠǤ —”‹‰ –Š‡ •’‡‡ Š ’ƒ”–‹ ‹’ƒ–• –ƒ‡ ‘ –Š‡ ”‘Ž‡ ‘ˆ ƒ Œ‘„ ƒ’’Ž‹ ƒ– ȋŒ‘„ †‡ˆ‹‹–‹‘ ‹• ’”‡†‡ˆ‹‡†ǡ „ƒ•‡† ‘ ™Šƒ– ‹• ŠƒŽŽ‡‰‹‰ ƒ† ”‡Ž‡˜ƒ– ˆ‘” –Š‡ ’ƒ”–‹ ‹’ƒ–Ǣ •‡‡ ‹”• Š„ƒ— ‡– ƒŽǤǡ ͳͻͻ͵ǡ ˆ‘” ‡šƒ – †‡• ”‹’–‹‘ȌǤ Š‹• ͳͷǦ‹ ’”‘–‘ ‘Ž Šƒ• „‡‡ ˆ‘—† ”‡’‡ƒ–‡†Ž› –‘ ‹†— ‡ •‹‰‹ˆ‹ ƒ– ‡†‘ ”‹‡ ƒ† ƒ”†‹‘˜ƒ• —Žƒ” ”‡•’‘•‡• ‹ ƒ’’”‘š‹ƒ–‡Ž› ͹Ͳ Ψ ‘ˆ –Š‡ ’ƒ”–‹ ‹’ƒ–• ȋ‹”• Š„ƒ— ‡– ƒŽǤǡ ͳͻͻ͵ȌǤ

(27)  ƒ•‡ ’ƒ”–‹ ‹’ƒ–• ”‡’‘”–‡†„‡‹‰—ƒ„Ž‡–‘’”‘ ‡‡†™‹–Š–Š‡ˆ”‡‡•’‡‡ Šǡ–Š‡›”‡ ‡‹˜‡†ƒ‘†‹ˆ‹‡†˜‡”•‹‘ ‘ˆ –Š‡ ǡ ™‹–Š —’ –‘ –Š”‡‡ ‡ƒ•—”‡• Š‡Ž’‹‰ ’ƒ”–‹ ‹’ƒ–• –‘ ˆ—Žˆ‹ŽŽ –Š‡ –ƒ•ǡ ™‹–Š‘—– †”‘’’‹‰ ‘—–Ǥ Š‡ ‡ƒ•—”‡• ™‡”‡ ‹ ˆ‹š‡† ‘”†‡” ƒ† –Š‡ ‡š– •–‡’ ™ƒ• ‘Ž› ƒ’’Ž‹‡† ‹ˆ ‡ ‡••ƒ”›ǣ ͳȌ ‰‹˜‹‰ ˜‡”„ƒŽ ‡ ‘—”ƒ‰‡‡–• †—”‹‰ –Š‡ ˆ”‡‡ •’‡‡ ŠǢ ʹȌ •–”— –—”‡† ‹–‡”˜‹‡™‹•–‡ƒ†‘ˆˆ”‡‡•’‡‡ Šǡ‹˜‘Ž˜‹‰†‹”‡ –“—‡•–‹‘•ƒ„‘—–Œ‘„ƒ’’Ž‹ ƒ–‹‘Ǣƒ†͵Ȍ ’”‡–‡” ƒ ‡ŽŽƒ–‹‘ ‘ˆ ˆ”‡‡ •’‡‡ Š ƒ† ‹‡†‹ƒ–‡ ‘–‹—ƒ–‹‘ ™‹–Š –Š‡ ‡–ƒŽ ƒ”‹–Š‡–‹ –ƒ•ǤŠ‡‘†‹ˆ‹ ƒ–‹‘•ƒ’’Ž‹‡†‹‡ƒ Š‰”‘—’ƒ”‡‹†‹ ƒ–‡†‹ƒ„Ž‡͵ǤͳǤ  Physiologicalandsubjectivemeasures ƒŽ‹˜ƒ”› ‘”–‹•‘Žǡ„Ž‘‘†’”‡••—”‡ǡƒ†•—„Œ‡ –‹˜‡ƒš‹‡–›™‡”‡‡ƒ•—”‡†–‘ƒ••‡•• ‰Ž— ‘ ‘”–‹ ‘‹†ǡ ƒ—–‘‘‹ ǡ ƒ† •—„Œ‡ –‹˜‡ •–”‡••Ǧ”‡•’‘•‡•ǡ ”‡•’‡ –‹˜‡Ž›Ǥ ŽŽ –Š”‡‡ •–”‡••Ǧ‡ƒ•—”‡•™‡”‡‘„–ƒ‹‡†ƒ–ͳͲƒ••‡••‡–’‘‹–•‘˜‡”ƒͳ͵ͲǦ‹’‡”‹‘†ƒ–Ǧ͸ͷǡǦ ͵ͷǡǦʹͷǡǦͳͲǡͲǡΪͳͷǡΪʹͷǡΪͶͲΪͷͲƒ†Ϊ͸ͷ‹ǡ”‡•’‡ –‹˜‡Ž›ǡ™‹–Š”‡ˆ‡”‡ ‡–‘–Š‡•–ƒ”– ‘ˆ–Š‡•–”‡••‘”ȋ•‡‡ ‹‰—”‡͵ǤͳȌǤŽŽƒ••‡••‡–•™‡”‡’‡”ˆ‘”‡†„‡–™‡‡ͳǣͲͲƒ† ͶǣͲͲǤ ‘ ƒ••‡•• ˆ”‡‡ ‘”–‹•‘Ž Ž‡˜‡Ž•ǡ •ƒŽ‹˜ƒ •ƒ’Ž‡• ™‡”‡ ‘„–ƒ‹‡† ™‹–Š ƒŽ‹˜‡––‡ ‘ŽŽ‡ –‹‘†‡˜‹ ‡•ȋƒ”•–‡†–ǡ‘‡Ž•†‘”ˆǡ ‡”ƒ›ȌǤŠ‡•ƒ’Ž‡•™‡”‡•–‘”‡†ƒ–ǦʹͲι. ͷ͵.

(28) Chapter3. „‡ˆ‘”‡ ƒ••ƒ›‹‰Ǥ ‹‘ Š‡‹ ƒŽ ƒƒŽ›•‹• ‘ˆ ˆ”‡‡ ‘”–‹•‘Ž ‹ •ƒŽ‹˜ƒ ™ƒ• ’‡”ˆ‘”‡† —•‹‰ ƒ ‘’‡–‹–‹˜‡ ‡Ž‡ –”‘ Š‡‹Ž—‹‡• ‡ ‡ ‹—‘ƒ••ƒ› ȋ

(29) Ǣ Ž‡ •›• ʹͲͳͲǡ ‘ Š‡ ‹ƒ‰‘•–‹ •ǡƒ•‡Žǡ™‹–•‡”Žƒ†Ȍǡƒ•†‡• ”‹„‡†‡Ž•‡™Š‡”‡ȋƒ‡‡–ƒŽǤǡʹͲͲ͵ȌǤŽ‘‘† ’”‡••—”‡ȋ†‹ƒ•–‘Ž‹ Ȍ™ƒ•‡ƒ•—”‡†ˆ”‘–Š‡‘†‘‹ƒ–ƒ”™‹–Šƒƒ—–‘ƒ–‹ „Ž‘‘† ’”‡••—”‡‘‹–‘”ȋ”‘ͷǦ

(30) Ȍ–Šƒ– ‘—Ž†„‡‹‹–‹ƒ–‡†ƒ—ƒŽŽ›Ǥ—„Œ‡ –‹˜‡ƒš‹‡–›™ƒ• ”ƒ–‡†‘ƒͳͲǦ ˜‹•—ƒŽƒƒŽ‘‰‡• ƒŽ‡”ƒ‰‹‰ˆ”‘Dz‘–ƒš‹‘—•dz–‘Dz˜‡”›ƒš‹‘—•dzǤ  Questionnaires Š‡ •‘ ‹ƒŽ ƒš‹‡–› •—„• ƒŽ‡ ‘ˆ –Š‡ ‘ ‹ƒŽ Š‘„‹ƒ ƒ† š‹‡–›

(31) ˜‡–‘”› ȋ

(32) ǣ ډ‡Ž•Ƭ‡‹–ŠǡͳͻͻͻǢ—”‡”‡–ƒŽǤǡͳͻͺͻȌ‹•ƒ͵ʹ‹–‡•‡ŽˆǦ”‡’‘”–• ƒŽ‡‡ƒ•—”‹‰•‘ ‹ƒŽ ƒš‹‡–›Ǥ ‘”‡•”ƒ‰‡ˆ”‘Ͳ–‘ͳͻʹǤŠ‡‡ ‡’”‡••‹‘

(33) ˜‡–‘”›ȋ

(34) Ǧ

(35)

(36) ǣ‡ ǡƒ”†ǡ ‡†‡Ž•‘Šǡ ‘ ǡ Ƭ ”„ƒ—‰Šǡ ͳͻ͸ͳǢ ‘—ƒǡ —–‡‹Œǡ Ž„‡”•ƒ‰‡Žǡ Ƭ ƒ †‡” Ž‘‡‰ǡ ͳͻͺͷȌ‹•ƒʹͳǦ‹–‡•‡ŽˆǦ”‡’‘”–“—‡•–‹‘ƒ‹”‡–Šƒ–‡ƒ•—”‡•†‡’”‡••‹˜‡•›’–‘•†—”‹‰ –Š‡ ’ƒ•– ™‡‡Ǥ  ‘”‡• ”ƒ‰‡ ˆ”‘ Ͳ –‘ ͸͵Ǥ Š‡ ”ƒ—ƒ–‹  š’‡”‹‡ ‡• Š‡ Ž‹•– ȋǣ ‹Œ‡Š—‹•ǡ ƒ †‡” ƒ”–ǡ Ƭ ”—‰‡”ǡ ʹͲͲʹȌ ‹• ƒ ʹ͸Ǧ‹–‡ •‡ŽˆǦ”‡’‘”– ‹˜‡–‘”› ƒ••‡••‹‰ ‡‘–‹‘ƒŽǡ’Š›•‹ ƒŽƒ†•‡š—ƒŽƒ„—•‡ǤŠ‡–‘–ƒŽ• ‘”‡”ƒ‰‡•ˆ”‘Ͳ–‘ʹ͸ǡ–Š‡‡‘–‹‘ƒŽ ƒ„—•‡• ‘”‡ˆ”‘Ͳ–‘͸ǡ–Š‡’Š›•‹ ƒŽƒ„—•‡• ‘”‡ˆ”‘Ͳ–‘ͷǡƒ†–Š‡•‡š—ƒŽƒ„—•‡• ‘”‡ ˆ”‘Ͳ–‘͸Ǥ  Procedure ŽŽ ’ƒ”–‹ ‹’ƒ–• ˜‹•‹–‡† –Š‡ Žƒ„ –™‹ ‡Ǥ  –Š‡ ˆ‹”•– ȋƒ••‡••‡–Ȍ †ƒ›ǡ ƒ –”ƒ‹‡† ’•› Š‘Ž‘‰‹•–ƒ†‹‹•–‡”‡†–Š‡

(37) Ǧ‹Ȁ’ȋʹͷȌƒ†–Š‡“—‡•–‹‘ƒ‹”‡•ȋ•‡‡ƒ„Ž‡͵ǤͳȌǤ –Š‡ •‡ ‘† ȋ–‡•–Ȍ †ƒ›ǡ ’ƒ”–‹ ‹’ƒ–• ƒ””‹˜‡† ƒ– –Š‡ Žƒ„‘”ƒ–‘”› ƒ– ͳǣͲͲ Ǥ ˆ–‡” –Š‡ ˆ‹”•– •‡”‹‡• ‘ˆ ’Š›•‹‘Ž‘‰‹ ƒŽ ƒ† •—„Œ‡ –‹˜‡ ƒ••‡••‡–•ǡ •—„Œ‡ –• ™‡”‡ ƒ†Œ—•–‡† –‘ –Š‡ ‡š’‡”‹‡–ƒŽ‡˜‹”‘‡–™‹–Šƒ”‡Žƒš‹‰‘˜‹‡ǤŠ‡„ƒ•‡Ž‹‡ƒ†‹‹•–”ƒ–‹‘‘ˆ–Š‡Ǧ –ƒ• –‘‘ ’Žƒ ‡ ƒˆ–‡” –Š‡ –Š‹”† ƒ••‡••‡– ȋǦʹͷ ‹ ™‹–Š ”‡ˆ‡”‡ ‡ –‘ –Š‡ ‘•‡– ‘ˆ –Š‡ •–”‡••‘”Ǣ ‹‰—”‡ ͵ǤͳȌǤ ˆ–‡” –™‘ ƒ††‹–‹‘ƒŽ ‘‰‹–‹˜‡ –‡•–• ȋƒ ƒ––‡–‹‘ ƒ† ƒ Ž‡ƒ”‹‰ –‡•–ǡ‘ˆ™Š‹ Š”‡•—Ž–•™‹ŽŽ„‡”‡’‘”–‡†‡Ž•‡™‡”‡Ȍ–Š‡‡š’‡”‹‡–‡”‹–”‘†— ‡†–Š‡ –Šƒ– ™ƒ• ƒ†‹‹•–‡”‡† „› –Š”‡‡ ‘–Š‡” ‡š’‡”‹‡–‡”• ȋƒ—†‹‡ ‡ȌǤ ˆ–‡” –Š‡ ǡ –Š‡ ƒ—†‹‡ ‡ ƒŽŽ‡†–Š‡‡š’‡”‹‡–‡”„ƒ ‹–‘–Š‡”‘‘ƒ†”‡“—‡•–‡†Š‹–‘ƒ†‹‹•–‡” –Š‡ ‘‰‹–‹˜‡ –‡•–•ǡ  ‹ Ž—†‹‰ –Š‡ Ǧ–ƒ•ǡ ƒ‰ƒ‹ ‹ –Š‡‹” ’”‡•‡ ‡ ȋΪ ʹͷ ‹ ™‹–Š ”‡ˆ‡”‡ ‡ –‘ ‘•‡– ȌǤ

(38)  –Š‹• ™ƒ›ǡ –Š‡ •‘ ‹ƒŽ ‡˜ƒŽ—ƒ–‹‘ ‘–‡š– ”‡ƒ‹‡† ’”‡•‡– †—”‹‰ –Š‡ •‡ ‘† ƒ†‹‹•–”ƒ–‹‘ ‘ˆ –Š‡ Ǧ–ƒ•Ǥ —„•‡“—‡–Ž›ǡ –Š‡ ƒ—†‹‡ ‡ Ž‡ˆ– –Š‡. ͷͶ.

(39) Cortisolreactivitypredictsavoidancebehaviorinsocialphobia. ”‘‘ ƒ† ”‡–—”‡† ˆ‘” ƒ †‡„”‹‡ˆ‹‰ ƒˆ–‡” –Š‡ Žƒ•– ’Š›•‹‘Ž‘‰‹ ƒŽ ƒ••‡••‡– Šƒ† –ƒ‡ ’Žƒ ‡Ǥ‡™‡‡ƒˆ–‡”–Š‡‡š’‡”‹‡–’ƒ–‹‡–•™‡”‡ ‘–ƒ –‡†ˆ‘”ƒ•‡ ‘††‡„”‹‡ˆ‹‰Ǥ  Statisticalanalyses ‡ƒ –‹‘ –‹‡ ‘—–Ž‹‡”• ™‡”‡ ˆ‹Ž–‡”‡† ™‹–Š ƒ δͳͷͲǦ ƒ† εͳͲͲͲ •‡  —–Ǧ‘ˆˆǤ ‘” ‡ƒ Š’ƒ”–‹ ‹’ƒ–ǡ–Š‡‡†‹ƒ‘ˆ–Š‡”‡ƒ‹‹‰•ȋͻ͹ΨȌˆ‘”–Š‡ ‘””‡ –”‡•’‘•‡•™‡”‡ ƒŽ —Žƒ–‡†Ȁ ‡ŽŽȋ†‡ˆ‹‡†„›‘†‹–‹‘ȏ„ƒ•‡Ž‹‡ǡ•–”‡••ȐǡƒŽ‡ ‡ȏŠƒ’’›ǡƒ‰”›ˆƒ ‡Ȑǡƒ† ‘˜‡‡–ȏƒ’’”‘ƒ Šǡƒ˜‘‹†ȐȌǤŠ‡‹ˆŽ—‡ ‡‘ˆ•–”‡••Ǧ‹†— –‹‘‘–Š‡•–”‡••‡ƒ•—”‡• ƒ† –Š‡ –ƒ• ’‡”ˆ‘”ƒ ‡ ™ƒ• –‡•–‡† ™‹–Š ”‡’‡ƒ–‡† ‡ƒ•—”‡• ƒŽ›•‡• ‘ˆ ƒ”‹ƒ ‡ ȋǦ”ȌǤ ‡ ƒ—•‡ ‰‡†‡” ƒ† —•‡ ‘ˆ ‡†‹ ƒ–‹‘ ƒ ‹ˆŽ—‡ ‡ –Š‡ ‘”–‹•‘Ž •–”‡••Ǧ ”‡•’‘•‡ ȋ‹”• Š„ƒ— ‡– ƒŽǤǡ ͳͻͻ͵Ȍ ƒ† „‡ ƒ—•‡ ‰”‘—’• †‹ˆˆ‡”‡† ™‹–Š ”‡•’‡ – –‘ –Š‡ Ǧ‘†‹ˆ‹ ƒ–‹‘•ǡ™‡ ‘–”‘ŽŽ‡†ˆ‘”–Š‡•‡˜ƒ”‹ƒ„Ž‡•‹ƒ•‡’ƒ”ƒ–‡ƒƒŽ›•‹•„›‹ Ž—†‹‰ ‰‡†‡”ǡ‡†‹ ƒ–‹‘ƒ†Ǧ‘†‹ˆ‹ ƒ–‹‘•ƒ• ‘˜ƒ”‹ƒ–‡•ȋȌǤ Š‡ –‘–ƒŽ ‘”–‹•‘Ž ”‡•’‘•‡ ˆ‘” ‡ƒ Š ’ƒ”–‹ ‹’ƒ– ™ƒ• ‘’—–‡† ™‹–Š –Š‡ ƒ”‡ƒ —†‡” –Š‡ —”˜‡ ™‹–Š ”‡ˆ‡”‡ ‡ –‘ –Š‡ ‰”‘—† ȋ‰ǣ •‡‡ ”—‡••‡”ǡ ‹”• Š„ƒ—ǡ ‡‹Ž• Š‹†ǡƬ ‡ŽŽŠƒ‡”ǡʹͲͲ͵Ǧˆ‘”—ŽƒʹȌǤŠ‡‡ˆˆ‡ –‘ˆ ‘”–‹•‘Ž”‡•’‘•‡•‘–Š‡ –ƒ• ’‡”ˆ‘”ƒ ‡ ‹  ™ƒ• ƒƒŽ›œ‡† „› ‡–‡”‹‰ –Š‡ ‹†‹˜‹†—ƒŽ ‘”–‹•‘Ž ”‡•’‘•‡• ȋ‰Ȍƒ•ƒ ‘–‹—‘—•ˆƒ –‘”‹–‘–Š‡ƒƒŽ›•‡•ȋƒƒŽ›•‹•‘ˆ ‘˜ƒ”‹ƒ ‡ǣ•‡‡ —††ǡ‡›ǡ Ƭ  Ž‡ŽŽƒ†ǡ ʹͲͲͳȌǤ‹‰‹ˆ‹ ƒ– ‹–‡”ƒ –‹‘• ‹ Ž—†‹‰ –Š‹• ˆƒ –‘”™‡”‡ˆ‘ŽŽ‘™‡† —’ „› ƒŽ —Žƒ–‹‰‡ƒ”•‘ ‘””‡Žƒ–‹‘•„‡–™‡‡–Š‹•ˆƒ –‘”ƒ†–Š‡™‹–Š‹Ǧ•—„Œ‡ –‡ˆˆ‡ –•ǤŠ‡ •’‡ ‹ˆ‹ ‹–› ‘ˆ –Š‡ ‡ˆˆ‡ – ‘ˆ ‘”–‹•‘Ž ƒ‘‰ ‘–Š‡” •–”‡•• ‡ƒ•—”‡• ™ƒ• –‡•–‡† —•‹‰ ƒ ƒ††‹–‹‘ƒŽŽ‹‡ƒ””‡‰”‡••‹‘ƒƒŽ›•‹•™‹–Š ‘”–‹•‘Žǡ„Ž‘‘†’”‡••—”‡ƒ†•—„Œ‡ –‹˜‡ƒš‹‡–› ȋƒŽŽ ‹ ‰Ȍ ƒ• ’”‡†‹ –‘”• ƒ† –Š‡ Dz•–”‡••Ǧ‹†— ‡† Šƒ‰‡ ‹ –ƒ• ’‡”ˆ‘”ƒ ‡dz ƒ• †‡’‡†‡–˜ƒ”‹ƒ„Ž‡Ǥ ‘”ƒŽŽƒƒŽ›•‡•ƒŽ’Šƒ™ƒ•ǤͲͷǤˆˆ‡ –Ǧ•‹œ‡•‘ˆ•‹‰‹ˆ‹ ƒ–”‡•—Ž–•ƒ”‡ ”‡’‘”–‡† ™‹–Š –Š‡ ƒ”–‹ƒŽ –ƒ “—ƒ”‡† ȋ2ȌǤ ‹–Š‹Ǧ•—„Œ‡ – ‡ˆˆ‡ –• ƒ”‡ ”‡’‘”–‡† ™‹–Š. ”‡‡Š‘—•‡Ǧ ‡‹••‡” ‘””‡ –‹‘Ǥ. Results  Stressmeasures ‡’ƒ”ƒ–‡ –™‘Ǧ™ƒ› • ” ™‡”‡ ‘†— –‡† ˆ‘” ‡ƒ Š ‘ˆ –Š‡ –Š”‡‡ •–”‡••Ǧ ‡ƒ•—”‡• ȋ ‘”–‹•‘Žǡ „Ž‘‘† ’”‡••—”‡ǡ ƒ† •—„Œ‡ –‹˜‡ ƒš‹‡–›Ȍ ™‹–Š ™‹–Š‹Ǧ•—„Œ‡ – ˆƒ –‘” ‹‡ȋͳͲƒ••‡••‡–’‘‹–•Ȍƒ†„‡–™‡‡Ǧ•—„Œ‡ –ˆƒ –‘” ”‘—’Ǥ. ͷͷ.

(40) Chapter3. Salivary cortisol (nmol/L). 14. 12. 10. SAD PTSD HC. 8. TSST 6. AA task. AA task. 4 -65. -35. -25. -10. 0. +15. +25. +40. +50. +65. Time (in minutes) with reference to onset TSST (Time 0). . Figure 3.1. ‘”–‹•‘Ž ”‡•’‘•‡• „‡ˆ‘”‡ ƒ† ƒˆ–‡” •–”‡•• ‡š’‘•—”‡ –Š‡ ”‹‡” ‘ ‹ƒŽ –”‡•• ‡•– ȋȌǤ ƒ–‹‡–•™‹–Š•‘ ‹ƒŽƒš‹‡–›†‹•‘”†‡”ȋȌŠƒ˜‡Žƒ”‰‡” ‘”–‹•‘Ž”‡•’‘•‡•–‘–Š‡–Šƒ„‘–Š ‘–”‘Ž ‰”‘—’• ‘ˆ Š‡ƒŽ–Š› •—„Œ‡ –• ȋ Ȍ ƒ† ’ƒ–‹‡–• ™‹–Š ’‘•––”ƒ—ƒ–‹  •–”‡•• †‹•‘”†‡” ȋȌǤ ǡ ƒ’’”‘ƒ ŠǦ ƒ˜‘‹†ƒ ‡Ǥ. . Cortisol ƒŽ›•‹•‘ˆ–Š‡–Š”‡‡•—„Œ‡ –Ǧ‰”‘—’•–‘‰‡–Š‡”›‹‡Ž†‡†ƒ–”‡†–‘™ƒ”†ƒƒ‹‡ˆˆ‡ – ‘ˆ ”‘—’ȋFȋʹǡͷͶȌαʹǤͷͶǡpαͲǤͲͺǡ2αͲǤͲͻǢ•‡‡ ‹‰—”‡͵ǤͳȌǤŠ‹•‡ˆˆ‡ –”‡ƒ‹‡†’”‡•‡– ™Š‡ ‘–”‘ŽŽ‹‰ ˆ‘” ‰‡†‡”ǡ ‡†‹ ƒ–‹‘ ƒ† Ǧ‘†‹ˆ‹ ƒ–‹‘•ǡ „› ƒ††‹‰ –Š‡•‡ ˜ƒ”‹ƒ„Ž‡•ƒ• ‘˜ƒ”‹ƒ–‡•–‘–Š‡ƒƒŽ›•‹•ȋFȋʹǡͷͳȌα͵ǤͳͺǡpαͲǤͲͷͲǡ 2αͲǤͳͳȌǤŠ‡Ǧ ‘†‹ˆ‹ ƒ–‹‘™ƒ•–Š‡‘Ž› ‘˜ƒ”‹ƒ–‡•Š‘™‹‰ƒ•‹‰‹ˆ‹ ƒ–ƒ‹‡ˆˆ‡ –ȋFȋͳǡͷͳȌαͶǤͷͳǡpα ͲǤͲ͵ͻǡ2 αͲǤͲͺȌǤ‘•–ǦŠ‘ Dz–™‘Ǧ ”‘—’dz ‘’ƒ”‹•‘•ȋ™Š‹Ž‡ ‘–”‘ŽŽ‹‰ˆ‘”–Š‡‡ˆˆ‡ –•‘ˆ Ǧ‘†‹ˆ‹ ƒ–‹‘Ȍ •Š‘™‡† •‹‰‹ˆ‹ ƒ– ”‘—’Ǧ‡ˆˆ‡ –• ˆ‘” DzǦ˜‡”•—•Ǧ dz ȋFȋͳǡ͵͹Ȍα ͶǤ͸ͳǡ p α ͲǤͲ͵ͺǡ 2 α ͲǤͳͳȌ ƒ† ˆ‘” DzǦ˜‡”•—•Ǧdz ȋFȋͳǡ͵ʹȌ α ͶǤͷ͸ǡ p α ͲǤͲͶͳǡ 2 α ͲǤͳ͵Ȍǡ„—–‘–ˆ‘”–Š‡Dz Ǧ˜‡”•—•Ǧdz ‘’ƒ”‹•‘ȋFȋͳǡ͵͸ȌαͲǤͳʹǡnsȌǤ‘•– ”— ‹ƒŽŽ›ǡƒ. ”‘—’u‹‡‹–‡”ƒ –‹‘‡‡”‰‡†ˆ‘”„‘–ŠDzǦ˜‡”•—•Ǧ dzȋFȋʹǡ͸ͲȌαͶǤͶͶǡpαͲǤͲʹʹǡ 2 αͲǤͳͳȌƒ†DzǦ˜‡”•—•ǦdzȋFȋʹǡͷ͵Ȍα͵Ǥ͵ͶǡpαͲǤͲͷͲǡ2 αͲǤͲͻȌ„—–‘–ˆ‘”–Š‡ Dz Ǧ˜‡”•—•Ǧ Dz ‘’ƒ”‹•‘ ȋFȋ͵ǡͻͺȌ α ͲǤͺ͸ǡ nsȌǤ Š‡•‡ ”‘—’ u ‹‡ ‹–‡”ƒ –‹‘• ™‡”‡ ‡š’Žƒ‹‡† „› –Š‡ ˆƒ – –Šƒ–  ’ƒ–‹‡–• Šƒ† Žƒ”‰‡” ‘”–‹•‘Ž ”‡•’‘•‡• –Šƒ „‘–Š ‘–”‘Ž ‰”‘—’• ƒˆ–‡” •–”‡••Ǧ‹†— –‹‘ ȋƒ••‡••‡– ͸ǦͳͲǢ Ǧ ǣ Fȋͳǡ͵͹Ȍ α ͶǤ͵͸ǡ p α ͲǤͲͶͶǡ 2 α ͲǤͳͳȌǢ Ǧǣ Fȋͳǡ͵ʹȌ α ͶǤ͹ͷǡ p α ͲǤͲ͵͹ǡ 2 α ͲǤͳ͵Ȍ „—– ‘– ƒ– „ƒ•‡Ž‹‡ ͷ͸.

(41) Cortisolreactivitypredictsavoidancebehaviorinsocialphobia. ȋƒ••‡••‡–ͳǦͷǣƒŽŽp>ͲǤ͵ͷȌȋ ‹‰—”‡͵ǤͳȌǤ —”–Š‡”ƒƒŽ›•‡•–‘”‡˜‡ƒŽ–Š‡‡ˆˆ‡ –•‘ˆǦ ‘†‹ˆ‹ ƒ–‹‘• ‹ –Š‡  ‰”‘—’ǡ †‡‘•–”ƒ–‡† –Šƒ–  ’ƒ–‹‡–• ™Š‘ ”‡ ‡‹˜‡† Ǧ ‘†‹ˆ ƒ–‹‘•ȋnα͹ȌŠƒ†•‹‰‹ˆ‹ ƒ–Ž›Ž‘™‡” ‘”–‹•‘Ž”‡•’‘•‡•ƒ• ‘’ƒ”‡†™‹–Š–Š‘•‡ ™Š‘—†‡”™‡––Š‡‘”‹‰‹ƒŽȋnαͳͳǣFȋͳǡʹͳȌαͶǤͳͲǡpαͲǤͲͷǡ2 αͲǤʹͳȌǤ ‘”–Š‹• ”‡ƒ•‘ǡ –Š‡ Ǧ˜‡”•—•Ǧ  ‘’ƒ”‹•‘ ›‹‡Ž†‡† ƒ •‹‰‹ˆ‹ ƒ– ”‘—’ u ‹‡ ‹–‡”ƒ –‹‘ǡ ‡‹–Š‡”™Š‡ ‘–”‘ŽŽ‹‰ˆ‘”Ǧ‘†‹ˆ‹ ƒ–‹‘•ȋ•‡‡’”‡ ‡†‹‰–‡š–Ȍ‘”™Š‡‡š Ž—†‹‰ ’ƒ”–‹ ‹’ƒ–•–Šƒ–”‡ ‡‹˜‡†Ǧ‘†‹ˆ‹ ƒ–‹‘•ȋFȋʹǡͶͷȌαͶǤ͵ͺǡpαͲǤͲʹͻǡ2 αͲǤͳ͵Ȍ„—– ‘–™Š‡Ǧ‘†‹ˆ‹ ƒ–‹‘•™‡”‡‘–ƒ ‘—–‡†ˆ‘”ȋFȋʹǡͷ͹ȌαͳǤʹʹǡnsȌǤ‹‹Žƒ”Ž›ǡ–Š‡. ”‘—’ u ‹‡ ‹–‡”ƒ –‹‘ ˆ‘” –Š‡ Ǧ˜‡”•—•Ǧ ‘’ƒ”‹•‘ ”‡ƒ‹‡† •‹‰‹ˆ‹ ƒ–ǡ ™Š‡–Š‡•—„Œ‡ –•™‹–ŠǦ‘†‹ˆ‹ ƒ–‹‘•™‡”‡‡š Ž—†‡†ȋFȋʹǡ͵ͶȌα͵ǤͶͲǡp=ͲǤͲͷǡ2α ͲǤͳͷȌ„—–‘–™Š‡Ǧ‘†‹ˆ‹ ƒ–‹‘•™‡”‡‘– ‘–”‘ŽŽ‡†ˆ‘”ȋFȋʹǡͷʹȌαʹǤͶͷǡnsȌǤ  Diastolicbloodpressure •‹‰‹ˆ‹ ƒ–ƒ‹‡ˆˆ‡ –‘ˆ‹‡ȋFȋ͹ǡ͵ͷʹȌαͳ͵ǤʹʹǡpδͲǤͲͲͳǡ2αͲǤʹͲȌ‹†‹ ƒ–‡† ‹ ”‡ƒ•‡†„Ž‘‘†’”‡••—”‡ƒˆ–‡”•–”‡••Ǧ‹†— –‹‘ƒ• ‘’ƒ”‡†™‹–Š„ƒ•‡Ž‹‡ǤŠ‡”‡™‡”‡ ‘‡ˆˆ‡ –•‹˜‘Ž˜‹‰ ”‘—’ȋƒŽŽpεͲǤʹȌǤ  Subjectiveanxiety Š‡”‡™‡”‡•‹‰‹ˆ‹ ƒ–ƒ‹‡ˆˆ‡ –•‘ˆ‹‡ȋFȋͷǡʹ͸͹ȌαͶͶǤͲͷǡpδͲǤͲͲͳǡ2αͲǤͶͷȌƒ†. ”‘—’ ȋFȋʹǡͷͶȌ α ͳʹǤͻͳǡ p δ ͲǤͲͲͳǡ 2 α ͲǤ͵ʹȌǤ Š‡•‡ ‡ˆˆ‡ –• ”‡ƒ‹‡† ’”‡•‡– ™Š‡ ‘–”‘ŽŽ‹‰ˆ‘” ‡†‡”ǡ‡†‹ ƒ–‹‘ƒ†Ǧ‘†‹ˆ‹ ƒ–‹‘„›‡–‡”‹‰–Š‡•‡˜ƒ”‹ƒ„Ž‡•ƒ• ‘˜ƒ”‹ƒ–‡• ‹–‘ –Š‡ ƒƒŽ›•‹• ȋƒŽŽ p δ ͲǤͲͷȌǤ ‘‡ ‘ˆ –Š‡ ‘˜ƒ”‹ƒ–‡• ›‹‡Ž†‡† ƒ •‹‰‹ˆ‹ ƒ– ‡ˆˆ‡ – ȋƒŽŽ p ε ͲǤ͵ȌǤ ‘•–ǦŠ‘   Dz–™‘Ǧ ”‘—’dz ‘’ƒ”‹•‘• ‹†‹ ƒ–‡† –Šƒ– „‘–Š ’ƒ–‹‡– ‰”‘—’• • ‘”‡† Š‹‰Š‡” –Šƒ Š‡ƒŽ–Š› ‘–”‘Ž• ȋDzǦ˜‡”•—•Ǧ dzǣ Fȋͳǡ͵ͺȌ α ʹ͸Ǥ͵ͻǡ p δ ͲǤͲͲͳǡ 2 α ͲǤͶͳǢ DzǦ˜‡”•—•Ǧ dzǣ Fȋͳǡ͵͹Ȍ α ͳͺǤ͸͹ǡ p δ ͲǤͲͲͳǡ 2 α ͲǤ͵ͶȌǡ „—– †‹† ‘– †‹ˆˆ‡”—–—ƒŽŽ›ȋDzǦ˜‡”•—•ǦdzǣFȋͳǡ͵͸ȌαͲǤͶ͸ǡnsȌǤ

(42) •—ǡ•–”‡••Ǧ‹†— –‹‘™ƒ••— ‡••ˆ—Žǡƒ•‡˜‹†‡ ‡†„›•‹‰‹ˆ‹ ƒ–‹‡Ǧ‡ˆˆ‡ –• ‘ ƒŽŽ •–”‡•• ‡ƒ•—”‡•Ǥ ‘•– ‹’‘”–ƒ–Ž›ǡ ‹ ƒ‰”‡‡‡– ™‹–Š ‘—” ˆ‹”•– Š›’‘–Š‡•‹•ǡ  ’ƒ–‹‡–• •Š‘™‡† •‹‰‹ˆ‹ ƒ–Ž› Žƒ”‰‡” •–”‡••Ǧ‹†— ‡† ‘”–‹•‘Ž Ž‡˜‡Ž•ǡ ƒ• ‘’ƒ”‡† ™‹–Š „‘–ŠŠ‡ƒŽ–Š›ƒ† ‘–”‘Ž•Ǥ

(43)  ‘–”ƒ•–ǡ•–”‡••Ǧ‹†— –‹‘†‹†‘–‡Ž‹ ‹–ȋƒ††‹–‹‘ƒŽȌ †‹ˆˆ‡”‡–‹ƒŽ‰”‘—’‡ˆˆ‡ –•ˆ‘”„Ž‘‘†’”‡••—”‡ƒ†•—„Œ‡ –‹˜‡ƒš‹‡–›Ǥ   ͷ͹.

(44) Chapter3. *. RT (in ms). 730. SAD. **. 710. 690. 670. 650. RT (in ms). 730. Baseline. PTSD. 710. Stress. Approach Avoid. 690. 670. 650. RT (in ms). 730. Baseline. Stress. Baseline. Stress. HC. 710. 690. 670. 650. . Figure3.2.‡ƒ –‹‘–‹‡•ȋǢ‹•‡ Ȍˆ‘”ƒ’’”‘ƒ Šƒ†ƒ˜‘‹†ƒ ‡‘˜‡‡–•–‘™ƒ”†•ƒ‰”›ˆƒ ‡•‘ –Š‡Ǧ–ƒ•‹’ƒ–‹‡–•™‹–Šǡ’ƒ–‹‡–•™‹–Šƒ† •—„Œ‡ –•Ǥ•‹‰‹ˆ‹ ƒ–‘†‹–‹‘ȋƒ•‡Ž‹‡ǡ –”‡••Ȍu‘˜‡‡–ȋ’’”‘ƒ Šǡ˜‘‹†Ȍ‹–‡”ƒ –‹‘ˆ‘”’ƒ–‹‡–•‹†‹ ƒ–‡†–Šƒ–•‘ ‹ƒŽ•–”‡••‹†— –‹‘ ”‡•—Ž–‡† ‹ ‹ ”‡ƒ•‡† Ǧ‡ˆˆ‡ –• ˆ‘” ƒ‰”› ˆƒ ‡•Ǥ ”‘—’• ‘Ž› †‹ˆˆ‡”‡† †—”‹‰ •–”‡•• ƒ† ‘– ƒ– „ƒ•‡Ž‹‡ǡ ‹†‹ ƒ–‹‰Žƒ”‰‡”Ǧ‡ˆˆ‡ –•ˆ‘”ƒ‰”›ˆƒ ‡•‹ǡƒ• ‘’ƒ”‡†™‹–Šƒ† Ǥ„„”‡˜‹ƒ–‹‘•ƒ•‹ ‹‰—”‡ͳǤȗ’δǤͲͷǢȗȗ’δǤͲͳ.  EffectsofstressinducedcortisolonthreatavoidanceinSAD ‘ –‡•– ‘—” •‡ ‘† Š›’‘–Š‡•‹• ȋ•–”‡••Ǧ‹†— ‡† ‘”–‹•‘Ž ’”‡†‹ –• ƒ˜‘‹†ƒ ‡ ‘ˆ ƒ‰”›ˆƒ ‡•‘–Š‡Ǧ–ƒ•‹Ȍ™‡ ‘†— –‡†ƒ–™‘Ǧ™ƒ›Ǧ”ˆ‘”–Š‡•ˆ‘” ͷͺ.

(45) Cortisolreactivitypredictsavoidancebehaviorinsocialphobia Table3.2.‡ƒ•ƒ†•ˆ‘”ƒ’’”‘ƒ Šƒ†ƒ˜‘‹†ƒ ‡”‡•’‘•‡•–‘ ƒ‰”›ƒ†Šƒ’’›ˆƒ ‡•‘–Š‡Ǧ –ƒ•ˆ‘”‡ƒ Š‰”‘—’‹„ƒ•‡Ž‹‡ƒ†•–”‡•• ‘†‹–‹‘•. ƒ•‡Ž‹‡    ƒ’’ ƒ˜  ƒ’’ ƒ˜ AngryFaceResponses.    ƒ’’ ƒ˜.  ƒ’’ ƒ˜. –”‡••  ƒ’’ ƒ˜. . ͸ͻͷ ȋʹͶȌ. . ͸͸ͻ ȋʹͲȌ. ͸͸͹ ȋʹͳȌ. ͹ʹͲ ȋͳͺȌ. ͸͹Ͷ ȋʹʹȌ. ͸ͺͲ ȋͳͻȌ. ͹Ǥͷȋ ʹǤͳȌ. . ͻǤ͸ ͻǤͶ ȋʹǤʹȌ ȋͳǤͻȌ. ͸Ǥͷ ȋͳǤͺȌ. ͹Ǥʹȋ ʹǤͷȌ. ͹ǤͶ ͻǤͷ  ͷǤ͵ ͶǤʹ ȋͳǤͺȌ ȋʹǤͷȌ ȋͳǤ͸Ȍ ȋʹǤʹȌ.   . ͹ͳ͵ ͸ͻ͵  ͹Ͳͺ ȋʹʹȌ ȋʹͶȌ ȋʹʹȌ   ͸Ǥʹ ͵Ǥͻ  ͸Ǥ͹ ȋʹǤͶȌ ȋʹǤͳȌ ȋʹǤͶȌ . ͹ͲͲ ȋʹ͵Ȍ.    ƒ’’ ƒ˜ . ͸͸ͳ ȋͳ͹Ȍ. ͸͹ͳ ȋʹͲȌ. HappyFaceResponses . ͸͸ͺ ͹Ͳͳ  ͸ͺ͵ ͹Ͳʹ  ͸͵ʹ ͸ͺ͵ ͸ͺͲ ͸ͻ͹ ͸ͻ͸ ͸ͺͶ  ͸͵ͷ ͸ͺͷ ȋʹͷȌ ȋ͵ͲȌ ȋʹ͸Ȍ ȋ͵ͳȌ ȋʹ͵Ȍ ȋʹ͹Ȍ ȋʹ͸Ȍ ȋʹ͸Ȍ ȋʹ͸Ȍ ȋʹ͹Ȍ ȋʹ͵Ȍ ȋʹͶȌ   ͶǤͶ ʹǤ͸  ͸Ǥ͸ ͷǤͺ  ͹Ǥ͸ ͶǤͳ ͸Ǥ͸ ͶǤ͸ ͶǤͻ ͷǤͻ  ͶǤ͵ ʹǤͺ ȋͳǤ͸Ȍ ȋͳǤ͹Ȍ ȋͳǤ͸Ȍ ȋͳǤ͹Ȍ ȋͳǤͶȌ ȋͳǤͷȌ ȋͳǤͶȌ ȋͳǤ͹Ȍ ȋͳǤͶȌ ȋͳǤ͹Ȍ ȋͳǤ͵Ȍ ȋͳǤ͸Ȍ ƒŽ—‡•’”‡•‡–‡†ƒ•‡ƒȋȌǤᔇƒ –‹‘–‹‡‹•‡ Ǣᇔ”‘””ƒ–‡•‹ΨǢƒ’’αƒ’’”‘ƒ ŠǢƒ˜α ƒ˜‘‹†Ǣ‘–Š‡”ƒ„„”‡˜‹ƒ–‹‘•ƒ•‹ƒ„Ž‡͵ǤͳǤ. . ƒ‰”› ˆƒ ‡•ǡ ™‹–Š ‘†‹–‹‘ ȋ„ƒ•‡Ž‹‡ǡ •–”‡••Ȍ ƒ† ‘˜‡‡– ȋƒ’’”‘ƒ Šǡ ƒ˜‘‹†Ȍ ƒ• ™‹–Š‹Ǧ•—„Œ‡ – ˆƒ –‘”• ƒ† –Š‡ ‹†‹˜‹†—ƒŽ ‘”–‹•‘Ž Ž‡˜‡Ž• ȋ‰Ȍ ƒ• ƒ ‘–‹—‘—• ˆƒ –‘”Ǥ Š‡”‡•—Ž–••Š‘™‡†ƒ•‹‰‹ˆ‹ ƒ–‘†‹–‹‘u‘˜‡‡–‡ˆˆ‡ –ȋFȋͳǡͳ͸ȌαͷǤͶͻǡpαͲǤͲ͵ʹǡ 2 α ͲǤʹ͸Ȍǡ ”‡ˆŽ‡ –‹‰ ƒ •‹‰‹ˆ‹ ƒ– ‡ˆˆ‡ – ‘ˆ ‘˜‡‡– †—”‹‰ •–”‡•• ȋFȋͳǡͳ͸Ȍ α ͺǤ͸͵ǡ pα ͲǤͲͲͻǡ2 αͲǤ͵ͶȌ„—–‘–ƒ–„ƒ•‡Ž‹‡ȋFȋͳǡͳ͸ȌαͲǤ͸ͶǡnsȌ‹ǤŠ‡•‡ˆ‹†‹‰•‹†‹ ƒ–‡ –Šƒ–’ƒ–‹‡–ƒ”‡ˆƒ•–‡”‹ƒ˜‘‹†‹‰–Šƒƒ’’”‘ƒ Š‹‰ƒ‰”›ˆƒ ‡•ȋǦ‡ˆˆ‡ –Ȍ‹–Š‡ •‘ ‹ƒŽ •–”‡•• ‘†‹–‹‘ ȋ•‡‡ ‹‰—”‡ ͵Ǥʹ ƒ† ƒ„Ž‡ ͵ǤʹȌǤ ‘•– ‹’‘”–ƒ–Ž›ǡ ƒ •‹‰‹ˆ‹ ƒ– ‘†‹–‹‘ u ‘˜‡‡– u ‘”–‹•‘Ž ‹–‡”ƒ –‹‘ ȋFȋͳǡͳ͸Ȍ α ͸Ǥͷͷǡ p = ͲǤͲʹͳǡ 2α ͲǤʹͻȌ ‹†‹ ƒ–‡† –Šƒ– –Š‡ ’ƒ–‹‡–•ǯ ‘”–‹•‘Ž Ž‡˜‡Ž• ‘””‡Žƒ–‡† •‹‰‹ˆ‹ ƒ–Ž› ™‹–Š –Š‡ •–”‡••Ǧ ‹†— ‡†‹ ”‡ƒ•‡‹Ǧ‡ˆˆ‡ –•Ǥ‡ƒ”•‘ ‘””‡Žƒ–‹‘•„‡–™‡‡–Š‡ ‘”–‹•‘ŽŽ‡˜‡Ž•ƒ†–Š‡ •–”‡••Ǧ‹†— ‡† Šƒ‰‡ ‹ Ǧ‡ˆˆ‡ –• ȋο Ǧ‡ˆˆ‡ –•Ȍ •Š‘™‡† –Šƒ– –Š‡ †‹”‡ –‹‘ ‘ˆ –Š‹• ‘””‡Žƒ–‹‘™ƒ•’‘•‹–‹˜‡ȋrαͲǤͷͶǡpαͲǤͲʹǢ•‡‡ ‹‰—”‡͵Ǥ͵Ȍǡ‹†‹ ƒ–‹‰–Šƒ–Š‹‰Š ‘”–‹•‘Ž Ž‡˜‡Ž•ƒ”‡ƒ••‘ ‹ƒ–‡†™‹–Šƒ‹ ”‡ƒ•‡†–‡†‡ ›–‘ƒ˜‘‹†•‘ ‹ƒŽ–Š”‡ƒ–‹ǤŠ‡”‡™ƒ• ‘ •— Š ”‡Žƒ–‹‘ ˆ‘” –Š‡  •—„Œ‡ –• ȋr α ǦͲǤͲ͸ǡ p α ͲǤ͹ͻǢ ‹‰—”‡ ͵Ǥ͵Ȍ ‘” ˆ‘” –Š‡  ‘–”‘Ž•—„Œ‡ –•ȋrαͲǤͳ͵ǡpαͲǤ͸͵ȌǤ‘–‡•–™Š‡–Š‡”–Š‡‘†‹–‹‘u‘˜‡‡–‡ˆˆ‡ –‹ ”‡ƒ‹‡†’”‡•‡–™Š‡ ‘–”‘ŽŽ‹‰ˆ‘” ‡†‡”ǡ‡†‹ ƒ–‹‘ƒ†Ǧ‘†‹ˆ‹ ƒ–‹‘•ǡ –Š‡•‡ ˜ƒ”‹ƒ„Ž‡• ™‡”‡ ‡–‡”‡† ƒ• ‘˜ƒ”‹ƒ–‡• ‹ –Š‡ –™‘Ǧ™ƒ› Ǧ”Ǥ ‘–Š –Š‡ ‘†‹–‹‘ u ‘˜‡‡– ȋFȋͳǡͳ͵Ȍ α ͶǤ͸Ͳǡ p = 0ǤͲͷǡ 2 α ͲǤʹ͸Ȍ ƒ† –Š‡ ‘†‹–‹‘ u ‘˜‡‡– u ‘”–‹•‘Ž ȋFȋͳǡͳ͵Ȍ α ͷǤͳ͹ǡ p = ͲǤͲͶͳǡ 2 α ͲǤʹͻȌ ‹–‡”ƒ –‹‘• ”‡ƒ‹‡† •‹‰‹ˆ‹ ƒ–ƒ†–Š‡”‡™‡”‡‘ƒ‹‡ˆˆ‡ –•ˆ‘”–Š‡ ‘˜ƒ”‹ƒ–‡•ȋƒŽŽpεͲǤʹȌǤ

(46) ƒ††‹–‹‘ǡ™‡. ͷͻ.

(47) Chapter3. .  AA-effect for angry faces. A. B. SAD patients. 300 250 200 150 100 50 0 -50 -100 -150 -200 -250. (r=.54, p=.02) 0. 500. 1000. 1500. 2000. Salivary cortisol (AUCg). Healthy controls. 300 250 200 150 100 50 0 -50 -100 -150 -200 -250. (r=-.06, p=.79) 0. 500. 1000. 1500. 2000. Salivary cortisol (AUCg). . Figure3.3.‘””‡Žƒ–‹‘„‡–™‡‡ ‘”–‹•‘ŽŽ‡˜‡Ž•ȋƒ”‡ƒ—†‡”–Š‡ —”˜‡ȏ‰ȐȌƒ†•–”‡••Ǧ‹†— ‡† Šƒ‰‡ ‹ƒ’’”‘ƒ ŠǦƒ˜‘‹†ƒ ‡‡ˆˆ‡ –ȋοǦ‡ˆˆ‡ –Ȍˆ‘”ƒ‰”›ˆƒ ‡•‹’ƒ–‹‡–•™‹–Š•‘ ‹ƒŽƒš‹‡–›†‹•‘”†‡”ȋȌ ȋȌ ƒ† Š‡ƒŽ–Š› ‘–”‘Ž ȋ Ȍ  •—„Œ‡ –• ȋȌǤ Š‡ • ƒ––‡” ’Ž‘– ‹  •Š‘™• –Šƒ– Š‹‰Š ‘”–‹•‘Ž Ž‡˜‡Ž• ƒ”‡ ƒ••‘ ‹ƒ–‡† ™‹–Š ‹ ”‡ƒ•‡† Ǧ‡ˆˆ‡ –• ƒˆ–‡” •–”‡•• ‹†— –‹‘ǡ ‹†‹ ƒ–‹‰ –Šƒ– Š‹‰Š ‰Ž— ‘ ‘”–‹ ‘‹† •–”‡••Ǧ ”‡•’‘•‹˜‡‡•• ‹  ‹• ƒ••‘ ‹ƒ–‡† ™‹–Š ƒ •–”‡••Ǧ‹†— ‡† ‹ ”‡ƒ•‡ ‹ –Š‡ –‡†‡ › –‘ ƒ˜‘‹†ƒ ‡ ƒ‰”› ˆƒ ‡•ǤŠ‡”‡™ƒ•‘•— Š‡ˆˆ‡ –‹ •—„Œ‡ –•ȋȌǤǦ‡ˆˆ‡ –ǡƒ’’”‘ƒ ŠǦƒ˜‘‹†ǢοǦ‡ˆˆ‡ –αȋȏDz ƒ’’”‘ƒ Š Ǧ  ƒ˜‘‹†dz ‹ •–”‡••Ȑ Ȃ ȏDz ƒ’’”‘ƒ Š ‹—•  ƒ˜‘‹†dz ƒ– „ƒ•‡Ž‹‡ȐȌǤ ‘•‹–‹˜‡ ο Ǧ‡ˆˆ‡ –• ‹†‹ ƒ–‡Žƒ”‰‡”Ǧ‡ˆˆ‡ –•ƒˆ–‡”•–”‡••ǡƒ• ‘’ƒ”‡†™‹–Š„ƒ•‡Ž‹‡Ǥǡ”‡ƒ –‹‘–‹‡Ǥ. . ‘–”‘ŽŽ‡† ˆ‘” †‡’”‡••‹‘ ”ƒ–‡• „› ‡–‡”‹‰ –Š‡ ‹†‹˜‹†—ƒŽ 

(48) Ǧ

(49)

(50)  –‘–ƒŽǦ• ‘”‡• ƒ• ƒ ‘˜ƒ”‹ƒ–‡‹–Š‡–™‘Ǧ™ƒ›Ǧ”Ǥ‘–Š–Š‡‘†‹–‹‘u‘˜‡‡–ȋFȋͳǡͳͷȌαͻǤͷͲǡp= ͲǤͲͲͺǡ2αͲǤ͵ͻȌƒ†–Š‡‘†‹–‹‘u‘˜‡‡–u‘”–‹•‘ŽȋFȋͳǡͳͷȌα͹ǤͶͷǡp=ͲǤͲͳͷǡ2α ͲǤ͵͸Ȍ‹–‡”ƒ –‹‘•”‡ƒ‹‡†•‹‰‹ˆ‹ ƒ–ƒ†–Š‡”‡™ƒ•‘ƒ‹‡ˆˆ‡ –ˆ‘”–Š‡†‡’”‡••‹‘Ǧ ”ƒ–‡•ȋFȋͳǡͳͷȌαͲǤ͹ͶǡnsȌǤ ‹ƒŽŽ›ǡ–‘–‡•–™Š‡–Š‡” ‘”–‹•‘Ž’”‡†‹ –‡†–Š‡•–”‡••Ǧ‹†— ‡† Šƒ‰‡‹Ǧ‡ˆˆ‡ –• ‘˜‡” ƒ† ƒ„‘˜‡ –Š‡ ‡ˆˆ‡ –• ‘ˆ „Ž‘‘† ’”‡••—”‡ ƒ† •—„Œ‡ –‹˜‡ ƒš‹‡–›ǡ –Š‡ ”‡Žƒ–‹˜‡ ‘–”‹„—–‹‘‘ˆ–Š‡•‡–Š”‡‡•–”‡••‡ƒ•—”‡•ȋƒŽŽ‹‰Ȍ‘–Š‡οǦ‡ˆˆ‡ –•™‡”‡–‡•–‡† ‹ƒ”‡‰”‡••‹‘ƒƒŽ›•‹•ǤŠ‡–‘–ƒŽ‘†‡Ž‡š’Žƒ‹‡†ƒ•–ƒ–‹•–‹ ƒŽŽ›•‹‰‹ˆ‹ ƒ–’ƒ”–‘ˆ͸ͺΨ ‘ˆ–Š‡˜ƒ”‹ƒ ‡‘ˆ–Š‡οǦ‡ˆˆ‡ –•ȋR2 αͲǤͶ͸ǡFȋ͵ǡͳ͸Ȍα͵Ǥ͸ͷǡpαͲǤͲͶʹȌƒ† ‘”–‹•‘Ž™ƒ• –Š‡‘Ž›•‹‰‹ˆ‹ ƒ–’”‡†‹ –‘”ȋ•‡‡ƒ„Ž‡͵Ǥ͵ȌǤ ‘‰‡–Š‡” –Š‡•‡ ˆ‹†‹‰• •—’’‘”– ‘—” •‡ ‘† Š›’‘–Š‡•‹• –Šƒ– •–”‡••Ǧ‹†— ‡† ‘”–‹•‘Ž‹•”‡Žƒ–‡†–‘ƒ‹ ”‡ƒ•‡‹•‘ ‹ƒŽƒ˜‘‹†ƒ ‡‹’ƒ–‹‡–•™‹–ŠǤ

(51) „‘–Š ‘–”‘Ž‰”‘—’•ǡ–Š‡•ƒ‡‘†‹–‹‘u‘˜‡‡–Ǧ”ˆ‘”–Š‡ƒ‰”› ˆƒ ‡”‡•’‘•‡•†‹†‘–›‹‡Ž†•‹‰‹ˆ‹ ƒ–‡ˆˆ‡ –•ȋƒŽŽpεͲǤͶǢ•‡‡ ‹‰—”‡͵ǤʹȌǤ‹•—ƒŽ. ͸Ͳ.

(52) Cortisolreactivitypredictsavoidancebehaviorinsocialphobia Table3.3.‡‰”‡••‹‘ƒƒŽ›•‹•’”‡†‹ –‹‰–Š‡•–”‡••Ǧ‹†— ‡†‹ ”‡ƒ•‡‹ƒ’’”‘ƒ ŠǦƒ˜‘‹†ƒ ‡‡ˆˆ‡ –•ˆ‘” ƒ‰”›ˆƒ ‡•ȋοǦ‡ˆˆ‡ –Ȍ‹’ƒ–‹‡–•™‹–ŠǤ. Predictor (Constant) ‘”–‹•‘Žȋ‰Ȍ ‹ƒ•–‘Ž‹ „Ž‘‘†’”‡••—”‡ȋ‰Ȍ —„Œ‡ –‹˜‡ƒš‹‡–›ȋ‰Ȍ. Beta  ͲǤ͸ͺ ͲǤͳͳ ͲǤͶͲ. T ǦͳǤͶ͸ ʹǤ͸ͷ ͲǤͶ͸ ͳǤ͹Ͷ. P ns ͲǤͲʹ ns ns. ‘–ƒŽ‘†‡ŽǣR2αͲǤͶ͸ȋFȋ͵ǡͳ͸Ȍα͵Ǥ͸ͷǡpαͲǤͲͶʹȌ ο Ǧ‡ˆˆ‡ –ǡ ƒ’’”‘ƒ ŠǦƒ˜‘‹†ƒ ‡ ‡ˆˆ‡ –• ˆ‘” ƒ‰”› ˆƒ ‡•Ǣ ǡ •‘ ‹ƒŽ ƒš‹‡–› †‹•‘”†‡”Ǣ ‰ǡ ƒ”‡ƒ —†‡” –Š‡ —”˜‡™‹–Š”‡ˆ‡”‡ ‡–‘–Š‡‰”‘—†Ǥ. . ‹•’‡ –‹‘‘ˆ ‹‰—”‡͵Ǥʹ•—‰‰‡•–•ƒ‰”‘—’†‹ˆˆ‡”‡ ‡‹Ǧ‡ˆˆ‡ –•‹–Š‡•–”‡••Ǧ ‘†‹–‹‘Ǥ ‡–‡•–‡†–Š‹•ƒ††‹–‹‘ƒŽŠ›’‘–Š‡•‹•ˆ‘”–Š‡•–”‡••Ǧ ‘†‹–‹‘™‹–Šƒ–™‘Ǧ™ƒ›Ǧ” ™‹–Š ™‹–Š‹ •—„Œ‡ –Ǧˆƒ –‘” ‘˜‡‡– ƒ† „‡–™‡‡Ǧ•—„Œ‡ – ˆƒ –‘” ”‘—’ ƒ† ‹†‡‡† ˆ‘—† ƒ •‹‰‹ˆ‹ ƒ– ”‘—’ u ‘˜‡‡– ‹–‡”ƒ –‹‘ ‹ –Š‡ •–”‡••Ǧ ‘†‹–‹‘ ȋFȋʹǡͷͶȌ α ͵Ǥ͹ͳǡp=ͲǤͲ͵ͳǡ2 αͲǤͳʹȌǡ‹†‹ ƒ–‹‰–Šƒ––Š‡‡ƒ”Ž‹‡””‡’‘”–‡†‘˜‡‡–Ǧ‡ˆˆ‡ –ˆ‘” ™ƒ• ‘– ’”‡•‡– ˆ‘”  ƒ†  ‰”‘—’• ȋƒŽŽ p ε ͲǤʹȌǤ Š‡”‡ ™ƒ• ‘ •— Š ‰”‘—’ †‹ˆˆ‡”‡ ‡ƒ–„ƒ•‡Ž‹‡ȋFȋʹǡͷͶȌαͲǤʹ͵ǡnsȌǤ Š‡”‡™‡”‡‘‡ˆˆ‡ –•‹˜‘Ž˜‹‰‘†‹–‹‘‘” ”‘—’ˆ‘”–Š‡Šƒ’’›ˆƒ ‡”‡•’‘•‡•ǡ ‘”ˆ‘”–Š‡‡””‘””ƒ–‡•ȋƒŽŽpεͲǤͳǢ•‡‡ƒ„Ž‡͵ǤʹȌǤ. Discussion  Š‡’—”’‘•‡‘ˆ–Š‡’”‡•‡–•–—†›™ƒ•–‘‹˜‡•–‹‰ƒ–‡–Š‡‡ˆˆ‡ –•‘ˆ•–”‡••Ǧ‹†— ‡† ‘”–‹•‘Ž ‘•‘ ‹ƒŽƒ˜‘‹†ƒ ‡„‡Šƒ˜‹‘”‹’ƒ–‹‡–•™‹–Š•‘ ‹ƒŽƒš‹‡–›†‹•‘”†‡”ȋȌǤŠ”‡‡ƒŒ‘” ˆ‹†‹‰• ‡‡”‰‡† ˆ”‘ –Š‡ ’”‡•‡– •–—†›Ǥ ‹”•–ǡ ’ƒ–‹‡–• ™‹–Š ǡ ƒ• ‘’ƒ”‡† ™‹–Š „‘–Š Š‡ƒŽ–Š› ƒ†  ‘–”‘Ž •—„Œ‡ –•ǡ •Š‘™‡† ‹ ”‡ƒ•‡† ‘”–‹•‘Ž ”‡•’‘•‡• –‘ •‘ ‹ƒŽ •–”‡••Ǧ‹†— –‹‘Ǥ ‡ ‘†ǡ •‘ ‹ƒŽ •–”‡•• ‡Ž‹ ‹–‡† ‹ ”‡ƒ•‡† ƒ˜‘‹†ƒ ‡ –‡†‡ ‹‡• –‘™ƒ”† •‘ ‹ƒŽ–Š”‡ƒ–•–‹—Ž‹‹Ǥ‘•– ”— ‹ƒŽŽ›ǡ–Š‡ ‘”–‹•‘Ž”‡•’‘•‡•’”‡†‹ –‡†–Š‡‹ ”‡ƒ•‡ ‹•‘ ‹ƒŽƒ˜‘‹†ƒ ‡–‡†‡ ‹‡•†—”‹‰•–”‡••‹’ƒ–‹‡–•™‹–ŠǤŠ‹•‡ˆˆ‡ –”‡ƒ‹‡† ƒˆ–‡” ‘–”‘ŽŽ‹‰ ˆ‘” ’‘••‹„Ž‡ ‘ˆ‘—†‡”• •— Š ƒ• ‰‡†‡” ƒ† ‡†‹ ƒ–‹‘Ǥ ‘”‡‘˜‡”ǡ ‘”–‹•‘Ž ’”‡†‹ –‡† •‘ ‹ƒŽ ƒ˜‘‹†ƒ ‡ „‡Šƒ˜‹‘” ‘˜‡” ƒ† ƒ„‘˜‡ –Š‡ ‡ˆˆ‡ –• ‘ˆ „Ž‘‘† ’”‡••—”‡ƒ†•—„Œ‡ –‹˜‡ƒš‹‡–›Ǥ —” ˆ‹†‹‰• ‘ˆ ‹ ”‡ƒ•‡† ‘”–‹•‘Ž •–”‡••Ǧ”‡ƒ –‹˜‹–› ‹  ‘ˆ‹” ˆ‹†‹‰• „› ‘†”‡ ‡– ƒŽǤ ȋʹͲͲʹȌǡ ‹†‹ ƒ–‹‰ ‹ ”‡ƒ•‡† ȋ’Žƒ•ƒȌ ‘”–‹•‘Ž ‹ ”‡•’‘•‡ –‘ ƒ ‡–ƒŽ ƒ”‹–Š‡–‹ Ȁ™‘”‹‰‡‘”›–ƒ•‹ǤŠ‡”‡•—Ž–• ‘–”ƒ•–™‹–Šˆ‹†‹‰•„›ƒ”–‡Ž‡–. ͸ͳ.

(53) Chapter3. ƒŽǤȋͳͻͻͻȌƒ†‡˜‹‡–ƒŽǤȋͳͻͻ͵Ȍ™Š‘ƒ’’Ž‹‡†ƒ’—„Ž‹ •’‡ƒ‹‰–ƒ•‹ƒ†‘Ž‡• ‡–ƒ† ƒ†—Ž–’ƒ–‹‡–•ǡ”‡•’‡ –‹˜‡Ž›ǤŽ•‘ —”Žƒ‡–ƒŽǤȋʹͲͲͳȌˆ‘—†‘†‹ˆˆ‡”‡–‹ƒŽ ‘”–‹•‘Ž ”‡•’‘•‡• ‘’ƒ”‹‰’ƒ–‹‡–•ƒ† •—„Œ‡ –•™Š‡•’‡ƒ‹‰‹ˆ”‘–‘ˆƒ ƒ‡”ƒ ȋƒŽ–Š‘—‰Š ‘’ƒ”‹•‘‘ˆ‘Ž›–Š‡ ‘”–‹•‘ŽǦ”‡•’‘†‡”•™‹–Š‹‡ƒ Š‰”‘—’›‹‡Ž†‡†Žƒ”‰‡” ‘”–‹•‘Ž Ž‡˜‡Ž• ˆ‘” Ǧ”‡•’‘†‡”•ȌǤ ‡ ’‘••‹„Ž‡ ‡š’Žƒƒ–‹‘ ˆ‘” –Š‡ ‘•‹‰‹ˆ‹ ƒ– ˆ‹†‹‰• ‹ ‘•– ‘ˆ –Š‡ ’”‡˜‹‘—• •–—†‹‡• ‹• –Šƒ– ’ƒ–‹‡–• ™‹–Š  –‡† –‘ •Š‘™ Ž‡•• ‘’Ž‹ƒ ‡ –‘ –Š‡ •–”‡••Ǧ’”‘–‘ ‘Ž –Šƒ Ǥ ‘‡ ‘ˆ –Š‡ ’”‡˜‹‘—• •–—†‹‡• ‘ •‘ ‹ƒŽ ‡˜ƒŽ—ƒ–‹‘Ǧ•–”‡•• ‹  ’”‘˜‹†‡† ‹ˆ‘”ƒ–‹‘ ‘ ’”‘–‘ ‘ŽǦ ‘’Ž‹ƒ ‡ ‘” †”‘’Ǧ‘—–Ǥ ‘™‡˜‡”ǡ ͹ ‘ˆ ‘—” ͳͺ  ’ƒ–‹‡–• ”‡’‘”–‡† „‡‹‰ —ƒ„Ž‡ –‘ ’”‘ ‡‡† ™‹–Š –Š‡  †—”‹‰ –Š‡ ’—„Ž‹  •’‡ƒ‹‰ –ƒ•Ǥ ‘ ’”‡˜‡– –Š‡•‡ ’ƒ–‹‡–• ˆ”‘ †”‘’’‹‰ ‘—–ǡ ™‡ ˆ‘”ƒŽ‹œ‡† —’ –‘ –Š”‡‡ ‹Ž† ‘†‹ˆ‹ ƒ–‹‘• ȋ‡Ǥ‰Ǥǡ ˜‡”„ƒŽ ‡ ‘—”ƒ‰‡‡–•ǡ •–”— –—”‡† ‹–‡”˜‹‡™ǡ ‘” ’”‡–‡” –‡”‹ƒ–‹‘ ‘ˆ –Š‡ ˆ”‡‡ •’‡‡ ŠȌǤ Š‡•‡ ’ƒ–‹‡–• ™Š‘ ‹‹–‹ƒŽŽ› ‡š’”‡••‡† –Š‡ Š‹‰Š‡•– †‹•–”‡•• †—”‹‰ –Š‡ –ƒ• •Š‘™‡† •‹‰‹ˆ‹ ƒ–Ž› Ž‘™‡” ‘”–‹•‘Ž ”‡•’‘•‡•–Šƒ–Š‘•‡™Š‘ ‘’Ž‡–‡†–Š‡–ƒ•™‹–Š‘—–‘†‹ˆ‹ ƒ–‹‘•Ǥ•ƒ”‡•—Ž–ǡ•‘‡ ‰”‘—’ †‹ˆˆ‡”‡ ‡• ‹ ‘”–‹•‘Ž ”‡•’‘•‡ ‘Ž› ‡‡”‰‡† ™Š‡ ‘–”‘ŽŽ‹‰ ˆ‘” –Š‡•‡ ‘†‹ˆ‹ ƒ–‹‘•Ǥ Š‹• ˆ‹†‹‰ ‹†‹ ƒ–‡• –Šƒ– ‡˜‡ ‹Ž† ’”‘–‘ ‘Ž ˜‹‘Žƒ–‹‘• ƒ› ”‹–‹ ƒŽŽ› ”‡†— ‡–Š‡ ‘”–‹•‘Ž”‡•’‘•‡•ƒ†•Š‘—Ž†„‡–ƒ‡‹–‘ƒ ‘—–‹ˆ—–—”‡•–—†‹‡•Ǥ ’ƒ–‹‡–••Š‘™‡†•‹‰‹ˆ‹ ƒ–ƒ˜‘‹†ƒ ‡–‡†‡ ‹‡•–‘ƒ‰”›ˆƒ ‡•‘–Š‡Ǧ –ƒ•ȋ•‡‡ƒŽ•‘ ‡—‡”‡–ƒŽǤǡʹͲͲ͹ȌǤŠ‹•‡ˆˆ‡ –™ƒ•’ƒ”–‹ —Žƒ”Ž›’”‘‘— ‡†‹ƒ ‘†‹–‹‘ ‘ˆ•‘ ‹ƒŽ‡˜ƒŽ—ƒ–‹‘Ǧ•–”‡••ȋƒ•‡ŽŽǡŽƒ”ǡŠŽ‡”•ǡƬŠ‡ǡͳͻͻͻǢ‘‡Ž‘ˆ•‡–ƒŽǤǡʹͲͲͷȌǡ‹ Ž‹‡ ™‹–Š ’”‡˜‹‘—• ˆ‹†‹‰• ‹ Š‹‰ŠŽ› ƒš‹‘—• •—„Œ‡ –•ǡǤ ‘•– ‹’‘”–ƒ–Ž›ǡ –Š‡ ’”‡•‡– •–—†› ‹• –Š‡ ˆ‹”•– –‘ •Š‘™ ƒ ”‡Žƒ–‹‘ „‡–™‡‡ ƒ ‘„Œ‡ –‹˜‡ ‡ƒ•—”‡ ‘ˆ •‘ ‹ƒŽ ƒ˜‘‹†ƒ ‡ „‡Šƒ˜‹‘”ƒ† ‘”–‹•‘Ž•–”‡••Ǧ”‡•’‘•‡•‹’ƒ–‹‡–•™‹–ŠǤ–”‡••Ǧ‹†— ‡†‹ ”‡ƒ•‡•‹ ƒ˜‘‹†ƒ ‡–‡†‡ ‹‡•™‡”‡’‘•‹–‹˜‡Ž› ‘””‡Žƒ–‡†–‘–Š‡ ‘”–‹•‘Ž”‡•’‘•‡•ǤŠ‹•ˆ‹†‹‰ •Š‘™• ƒ ‹–‡”‡•–‹‰ ’ƒ”ƒŽŽ‡Ž ™‹–Š ’”‹ƒ–‡ •–—†‹‡• †‡‘•–”ƒ–‹‰ •‘ ‹ƒŽ ˆ‡ƒ” „‡Šƒ˜‹‘”ǡ •— Š ƒ• •‘ ‹ƒŽ ƒ˜‘‹†ƒ ‡ ƒ† ˆ”‡‡œ‹‰ǡ –‘ „‡ ƒ••‘ ‹ƒ–‡† ™‹–Š ‹ ”‡ƒ•‡† ‘”–‹•‘Ž •–”‡••Ǧ ”‡ƒ –‹˜‹–›ȋƒŽ‹‡–ƒŽǤǡͳͻͻͺ„Ǣƒ’‘Ž•›ǡͳͻͻͲȌǤŠ‡ˆ‹†‹‰•ƒŽ•‘ˆ‹–™‹–Šˆ‹†‹‰•„›˜ƒ ‡‡”‡–ƒŽǤȋʹͲͲ͹Ȍ•Š‘™‹‰–Šƒ– ‘”–‹•‘Žƒ†‹‹•–”ƒ–‹‘”‡•—Ž–‡†‹‹ ”‡ƒ•‡†Ǧ‡ˆˆ‡ –• ‹Š‹‰Šȋƒ†‘–Ž‘™Ȍ•‘ ‹ƒŽŽ›ƒš‹‘—••—„Œ‡ –•Ǥ‘”–‹•‘ŽƒŽ•‘‹ ”‡ƒ•‡†–Š‡’”‘ ‡••‹‰‘ˆ –Š‡ ƒ‰”›ˆƒ ‡• ‹ –Š‡•‡ •—„Œ‡ –• ‘Ž›ǡ ƒ• ‡˜‹†‡ ‡† „›‹ ”‡ƒ•‡† ʹ ƒ’Ž‹–—†‡• ‹ –Š‡ ‡Ž‡ –”‘‡ ‡’ŠƒŽ‘‰”ƒ ȋ Ȍ ˆ‘” ƒ‰”›Ǧƒ˜‘‹† –”‹ƒŽ•ǡ ™Š‹ Š ƒ› ‹†‹ ƒ–‡ –Šƒ– ‘”–‹•‘Ž ˆƒ ‹Ž‹–ƒ–‡•–Š”‡ƒ–ƒ˜‘‹†ƒ ‡‹Š‹‰Šƒš‹‘—•‹†‹˜‹†—ƒŽ•ǤŠ‹•‹–‡”’”‡–ƒ–‹‘ˆ‹–•–Š‡‘”‹‡• •—‰‰‡•–‹‰–Šƒ– ‘”–‹•‘Ž’Žƒ›•ƒ‹’‘”–ƒ–”‘Ž‡‹–Š‡”‡‰—Žƒ–‹‘‘ˆ–Š‡•–”‡••Ǧ”‡•’‘•‡. ͸ʹ.

(54) Cortisolreactivitypredictsavoidancebehaviorinsocialphobia. ƒ†–Š‡•‡Ž‡ –‹‘‘ˆ„‡Šƒ˜‹‘”ƒŽ”‡•’‘•‡••— Šƒ•ƒƒ˜‘‹†ƒ ‡”‡•’‘•‡ȋ‘†”‡‡–ƒŽǤǡ ʹͲͲʹǢ ‡ Ž‘‡– ‡– ƒŽǤǡ ͳͻͻͻǢ ƒ’‘Ž•›ǡ ͳͻͻͲȌ ƒ† ‹‰Š– ‡š’Žƒ‹ ‘—” ˆ‹†‹‰• ‘ˆ ˆƒ•–‡” ƒ˜‘‹†ƒ ‡ƒ• ‘’ƒ”‡†–‘ƒ’’”‘ƒ Š”‡•’‘•‡•†—”‹‰•–”‡••ǤŽ–‡”ƒ–‹˜‡Ž›ǡ–Š‡”‡Žƒ–‹˜‡Ž› Žƒ”‰‡” ‘•–•ˆ‘”ƒ‰”›Ǧƒ’’”‘ƒ Š–”‹ƒŽ•‹–Š‡•‘ ‹ƒŽ•–”‡••Ǧ ‘–‡š–ƒ›”‡•—Ž–ˆ”‘–Š‡ †‹”‡ –‡ˆˆ‡ –•‘ˆ ‘”–‹•‘Ž‘’”‡ˆ”‘–ƒŽ‹Š‹„‹–‘”›ˆ— –‹‘‹‰Ǥˆˆ‡ –Ǧ‹ ‘‰”—‡–ƒ‰”›Ǧ ƒ’’”‘ƒ Š –”‹ƒŽ• ”‡“—‹”‡ –Š‡ ‹Š‹„‹–‹‘ ‘ˆ ƒ ƒ—–‘ƒ–‹  ”‡•’‘•‡Ǧ–‡†‡ › ȋƒ˜‘‹† ƒ‰”› ˆƒ ‡Ȍƒ†–Š‡•‡Ž‡ –‹‘‘ˆƒ ‘—–‡”Ǧ‹–—‹–‹˜‡”‡•’‘•‡ǡƒ†„‘–Šƒ”‡ˆ”‘–ƒŽˆ— –‹‘•ƒ• ‹†‹ ƒ–‡†„›ƒ”‡ ‡–ˆ

(55) Ǧ•–—†›—•‹‰–Š‡•ƒ‡Ǧ–ƒ•ȋ‘‡Ž‘ˆ•‡–ƒŽǤǡʹͲͲͻ„ȌǤ‡˜‡”ƒŽ •–—†‹‡• Šƒ˜‡ †‡‘•–”ƒ–‡† –Šƒ– •–”‡••ǦŽ‡˜‡Ž• ‘”–‹•‘Ž ƒ ‹’ƒ‹” ˆ”‘–ƒŽ ȋ‘ˆ–‡ •–”‡••Ǧ ‹””‡Ž‡˜ƒ–Ȍˆ— –‹‘••— Šƒ•™‘”‹‰‡‘”›ƒ†‹Š‹„‹–‘”› ‘–”‘Žȋ‡Ǥ‰Ǥǡ›‘•ǡ‘’‡œǡ ƒ‰ǡ Ƭ  Šƒ–œ„‡”‰ǡ ʹͲͲͲǢ ‘•‹ǡ Šƒ––‡”–‘ǡ ™‹•Š‡”ǡ Ƭ ƒ”ǡ ʹͲͲͲȌǤ  •‹‹Žƒ” ‡ Šƒ‹• ƒ› ƒŽ•‘ Šƒ˜‡ ƒ—•‡† –Š‡ Š‹‰Š  ‘•–• ˆ‘” –Š‡ ƒˆˆ‡ –Ǧ‹ ‘‰”—‡– ƒ‰”›Ǧ ƒ’’”‘ƒ Š–”‹ƒŽ•‹Ǥ •–”‡‰–Š‘ˆ–Š‡’”‡•‡–•–—†›‹•–Šƒ–•–”‡••Ǧ‹†— ‡† ‘”–‹•‘Ž™ƒ•‹˜‡•–‹‰ƒ–‡†‹ †‹”‡ – ”‡Žƒ–‹‘ ™‹–Š •‘ ‹ƒŽ ƒ˜‘‹†ƒ ‡ ’‡”ˆ‘”ƒ ‡ ‹ Ǥ Ž•‘ǡ ’‘••‹„Ž‡ Ǧ ‘†‹ˆ‹ ƒ–‹‘• ™‡”‡ ˆ—ŽŽ› ˆ‘”ƒŽ‹œ‡†Ǥ  Ž‹‹–ƒ–‹‘ ‹• –Š‡ ˆƒ – –Šƒ– ‘Ž› ˆ”‡‡ ‘”–‹•‘Ž ™ƒ• ‡ƒ•—”‡†Ǥ ‘™‡˜‡”ǡ –Š‡ ‡–Š‘†• –‘ ƒ••‡•• ‘–Š‡” Ǧƒš‹• ‡ƒ•—”‡• ȋ•— Š ƒ• ‘”–‹ ‘–”‘’‹Ǧ”‡Ž‡ƒ•‹‰Š‘”‘‡Ȍƒ”‡‹˜ƒ•‹˜‡ƒ†‘ˆ’‘–‡–‹ƒŽ–Š”‡ƒ–ˆ‘””‡“—‹”‹‰‰‘‘† ȋ•–”‡••Ǧˆ”‡‡Ȍ„ƒ•‡Ž‹‡ƒ••‡••‡–•ȋ‹”• Š„ƒ—‡–ƒŽǤǡʹͲͲ͵Ǣ‹”• Š„ƒ—Ƭ ‡ŽŽŠƒ‡”ǡ ͳͻͻͶȌǤŠ‡‡ˆˆ‡ –•‹œ‡•ˆ‘”–Š‡ ‘”–‹•‘ŽǦ”‡•’‘•‡•™‡”‡”‡Žƒ–‹˜‡Ž›•ƒŽŽƒ†–Š‡ˆƒ ––Šƒ– ™‡ ˆ‘—† ‘ •‹‰‹ˆ‹ ƒ– ‘”–‹•‘Ž ƒ† ƒ˜‘‹†ƒ ‡ ”‡•’‘•‡• ‹  ‘–”‘Ž• ƒ› „‡ ”‡Žƒ–‡† –‘ –Š‡ •‘ ‹ƒŽ ƒ–—”‡ ‘ˆ –Š‡  ƒ† –Š‡ Ǧ–ƒ•Ǥ ††‹–‹‘ƒŽ ”‡•‡ƒ” Š ‹ ‘–Š‡” ƒš‹‡–›†‹•‘”†‡”•—•‹‰†‹•‘”†‡”Ǧ•’‡ ‹ˆ‹ ƒ–‡”‹ƒŽ•‹•‡‡†‡†–‘‹†‡–‹ˆ›–Š‡•’‡ ‹ˆ‹ ‹–›‘ˆ –Š‡ ‡ˆˆ‡ –• ȋ ƒ”˜‡›ǡ ƒ–‹•ǡ ƒ•‡ŽŽǡ Ƭ Šƒˆˆ”ƒǡ ʹͲͲͶȌǤ Ž•‘ǡ ƒŽ–Š‘—‰Š ‘”–‹•‘Ž ’”‡†‹ –‡† ƒ •‹‰‹ˆ‹ ƒ– ’ƒ”– ‘ˆ –Š‡ Šƒ‰‡ ‹ ƒ’’”‘ƒ ŠǦƒ˜‘‹†ƒ ‡ –‡†‡ ‹‡• ‹  ’ƒ–‹‡–•ǡ ‘–Š‡” ‡Ž‡‡–• ‘ˆ –Š‡ •‘ ‹ƒŽ •–”‡•• ‘†‹–‹‘ ‹‰Š– Šƒ˜‡ ‘–”‹„—–‡† –‘ –Š‹• ‡ˆˆ‡ –ƒ•™‡ŽŽǤ —”–Š‡””‡•‡ƒ” Š‹•‡‡†‡†–‘†‹•‡–ƒ‰Ž‡–Š‡”‡Žƒ–‹˜‡ ‘–”‹„—–‹‘‘ˆǡˆ‘” ‡šƒ’Ž‡ǡ–Š‡’”‡•‡ ‡‘ˆ–Š‡ƒ—†‹‡ ‡†—”‹‰–Š‡•‡ ‘†ƒ†‹‹•–”ƒ–‹‘‘ˆ–Š‡Ǧ–ƒ• ˜‡”•—• –Š‡ ’”‡ ‡†‹‰ •–”‡••‘”Ǥ

(56)  ƒ††‹–‹‘ǡ ’‘••‹„Ž‡ ‰”‘—’ †‹ˆˆ‡”‡ ‡• ‹ •‡•‹–‹˜‹–› –‘ ”‡’‡ƒ–‡† ƒ†‹‹•–”ƒ–‹‘ ‘ˆ –Š‡ Ǧ–ƒ• ‹‰Š– Šƒ˜‡ ‘ˆ‘—†‡† –Š‡ ”‡•—Ž–• ƒ† •Š‘—Ž† „‡ƒ ‘—–‡†ˆ‘”‹ˆ—–—”‡•–—†‹‡•Ǥ ‹ƒŽŽ›ǡ™‡•Š‘—Ž†‘–‡–Šƒ––Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ ‘”–‹•‘Ž ƒ† •‘ ‹ƒŽ ƒ˜‘‹†ƒ ‡ ‹• ‘””‡Žƒ–‹‘ƒŽ ‹ ƒ–—”‡ǡ ƒŽŽ‘™‹‰ ‘ ƒ—•ƒŽ ‹–‡”’”‡–ƒ–‹‘•Ǥ. ͸͵.

(57) Chapter3. ‘ ‘ Ž—†‡ǡ–Š‡’”‡•‡–ˆ‹†‹‰•ˆ‘”–Š‡ˆ‹”•––‹‡•Š‘™–Šƒ–Š‹‰Š‰Ž— ‘ ‘”–‹ ‘‹† •–”‡••Ǧ”‡•’‘•‡• ‹  ƒ”‡ ƒ••‘ ‹ƒ–‡† ™‹–Š ‹ ”‡ƒ•‡† •‘ ‹ƒŽ ƒ˜‘‹†ƒ ‡ –‡†‡ ‹‡• †—”‹‰•‘ ‹ƒŽ‡š’‘•—”‡Ǥ˜‘‹†ƒ ‡„‡Šƒ˜‹‘”’Žƒ›•ƒ ”— ‹ƒŽƒ‹–ƒ‹‹‰”‘Ž‡‹ƒ† ˆ‘”• ƒ ƒŒ‘” –ƒ”‰‡– ˆ‘” Ž‹‹ ƒŽ ‹–‡”˜‡–‹‘•ǡ •— Š ƒ• ‡š’‘•—”‡Ǧ–Š‡”ƒ’›Ǥ —” †ƒ–ƒ •—‰‰‡•– –Šƒ– Š‹‰Š Ž‡˜‡Ž• ‘ˆ ‡†‘‰‡‘—• ‘”–‹•‘Ž †—”‹‰ •‘ ‹ƒŽ ‡š’‘•—”‡ ƒ› Š‹†‡” –Š‡ ‡š‡ —–‹‘‘ˆ–Š”‡ƒ–Ǧƒ’’”‘ƒ Š„‡Šƒ˜‹‘”ƒ†ƒ›‹ ”‡ƒ•‡–Š”‡ƒ–Ǧƒ˜‘‹†ƒ ‡„‡Šƒ˜‹‘”Ǥ ‹’‘”–ƒ– ‹’Ž‹ ƒ–‹‘ ƒ› „‡ –Šƒ– –Š‡ Ž‡˜‡Ž ‘ˆ •–”‡•• ȋƒ† •–”‡••Ǧ‹†— ‡† ‘”–‹•‘Žǡ ‹ ’ƒ”–‹ —Žƒ”Ȍ†—”‹‰‡š’‘•—”‡–Š‡”ƒ’›•Š‘—Ž†„‡‡’––‘ƒŽ‹‹–‹‘”†‡”–‘ƒ Š‹‡˜‡‘’–‹ƒŽ „‡‡ˆ‹–•ˆ”‘–Š‡–Š‡”ƒ’›ǤŠ‡•‡ˆ‹†‹‰•ƒ”‡‹Ž‹‡™‹–Š–Š‡•›•–‡ƒ–‹ †‡•‡•‹–‹œƒ–‹‘ ƒ’’”‘ƒ Š‘”‹‰‹ƒŽŽ›ˆ‘”—Žƒ–‡†„›‘Ž’‡ȋͳͻͷͺȌ”‡“—‹”‹‰–Š‡–Š‡”ƒ’‹•––‘‹‹–‹ƒ–‡‘Ž› •ƒŽŽ ƒ‘—–• ‘ˆ †‹•–”‡•• ‹ –Š‡ ’ƒ–‹‡–Ǥ • ƒ •–‡’ˆ—”–Š‡” ƒŽ‘‰ –Š‡•‡ Ž‹‡•ǡ‹†‹˜‹†—ƒŽ ‰Ž— ‘ ‘”–‹ ‘‹†•–”‡••Ǧ•‡•‹–‹˜‹–›‹‰Š–„‡ƒ••‡••‡†–‘–ƒ‹Ž‘”ƒ†ˆ‹‡–—‡’•› Š‘Ž‘‰‹ ƒŽ ƒ†’Šƒ”ƒ ‘Ž‘‰‹ ƒŽ‹–‡”˜‡–‹‘•‹’ƒ–‹‡–•™‹–ŠǤ. ͸Ͷ.

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