Treatment for public speaking fears

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D-cycloserine (DCS) is an antibiotic that has been used for the treatment of Tuberculosis over the last 40 years. Research indicates that DCS affects receptors in the brain known as N-methyl-D-aspartate (NMDA) receptors which are located in a region of the brain called the Amygdala. When the NMDA receptors become active (as occurs during extinction) this leads to a reduction in fear levels. Research suggests that DCS enhances the activity of these receptors, and as a result, enhances therapy techniques such as exposure (Guastella, Lovibond, Dadds, Mitchell & Richardson, 2007). To date, few studies have investigated the effects of DCS as an adjunct to exposure therapy using human participants, and of these none have done so using imaginal exposure therapy. The research thus far has focused primarily on the effects of DCS with in-vivo exposure on individuals. Yet, the same underlying processes appear to contribute to the success of both imaginal and in-vivo exposure therapy, i.e. the activation of anxiety and the formation of new associations in the brain through confrontation of the feared stimulus or situation. If DCS works by strengthening the formation or accessibility of new, non-threat associations (Guastella, Richardson, Lovibond, Rapee, Gaston, Mitchell & Dadds 2008), then it should also enhance the effects of imaginal exposure. Therefore there is good theoretical reason to see whether DCS has the same exposure enhancing properties when used as an adjunct to imaginal exposure therapy. In terms of its application in clinical settings, imaginal exposure therapy has several advantages compared to in-vivo exposure techniques, offering greater practicality and flexibility, particularly with regards to situations that are not readily accessible. Research also suggests that individuals experience less aversion when exposed to fearful images than when they are in direct contact with the feared object or situation (Hunt, Bylsma, Brock, Fenton, Goldberg, Miller, Tran & Urgelles, 2006). This relatively novel area of research has the potential to revolutionise the practice of psychotherapy and possibly offer new treatment options to individuals with public speaking anxiety and possibly other anxiety disorders. Aims of the study - 1. To replicate previous research which shows that DCS enhances in-vivo exposure therapy for individuals with public speaking anxiety 2. To extend previous research by showing that DCS enhances imaginal exposure therapy for individuals with public speaking anxiety 3. To determine whether the ability to conjure up a vivid image and become absorbed in that image increases anxiety levels as measured by self-report and physiological changes, and in turn, leads to positive treatment outcome 4. To determine whether competency in public speaking improves as treatment progresses

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