The purpose of this study is to determine whether power posing (i.e., holding poses
associated with dominance and power), compared to submissive posing or rest, prior to
exposure therapy for social anxiety disorder: 1) leads to a temporary increase in
testosterone levels and/or 2) facilitates exposure therapy outcomes.
- Outpatients between the ages of 18 to 70 years of age with a primary psychiatric
diagnosis (designated by the patient as the most important source of current distress)
of social anxiety disorder as defined by DSM-5 criteria, with fear of public speaking
endorsed as a primary concern.
- Willingness and ability to participate in the informed consent process and comply with
the requirements of the study protocol.
- Current use of testosterone enhancing products (i.e., gels, creams, or injections)
- A lifetime history of bipolar disorder, schizophrenia, psychosis, or delusional
disorders; organic brain syndrome, mental retardation or other cognitive dysfunction
that could interfere with capacity to engage in therapy; a history of substance or
alcohol abuse or dependence (other than nicotine) in the last 6 months.
- Entry of patients with other mood or anxiety disorders will be permitted in order to
increase accrual of a clinically relevant sample; however in cases where SAD is not
judged to be the predominant disorder, participants will not be eligible.
- Patients with significant suicidal ideation or who have enacted suicidal behaviors
within 6 months prior to intake will be excluded from study participation and referred
for appropriate clinical intervention.
- Patients using psychotropic medication (e.g., antidepressants, anxiolytics, beta
blockers) must be on a stable dose for three weeks prior to initiation of randomized
- Significant personality dysfunction likely to interfere with study participation.
- Patients with a current or past history of seizures.
- Any concurrent psychotherapy initiated within 3 months of baseline, or ongoing
psychotherapy of any duration directed specifically toward treatment of the SAD is
excluded. Prohibited psychotherapy includes CBT or psychodynamic therapy focusing on
exploring specific, dynamic causes of the phobic symptomatology and providing
management skills. General supportive therapy initiated > 3 months prior is
- Prior non-response to adequately delivered exposure (i.e., as defined by the patient's
report of receiving specific and regular exposure assignments as part of a previous
- Patients with a history of head trauma causing loss of consciousness, seizure or
ongoing cognitive impairment.
- Subjects with back pain issues or medical conditions that would make it difficult to
hold posture manipulations.
- Insufficient command of the English language.