Wednesday, January 28, 2009

D-Cycloserine and Evaluative Conditioning

by Tara Deliberto

I'd like to preface this blog post by saying that I've chosen this particular medium through which to share my thoughts with you because I am able to take leaps & bounds beyond the current state of research without having it irreversibly published for eternity and marring my name. In this post, I take two budding areas of research, combine them, and proceed to *attempt* (cut me some slack!) following the combination of facts to their logical conclusion.

So here are the two budding areas of psychological research:

1) The drug D-Cycloserine (DCS) is known to help enhance behavioral unlearning during psychological treatment. For example, while a person may have learned to fear spiders and subsequently developed a spider phobia, DCS will accelerate the speed at which the person unlearns the fear of spiders during behavior therapy. In this case, behavior therapy would involve repeated exposure to spiders until the fear subsides. In addition, DCS prolongs the effects of this type of behavioral therapy. This process is theorized to work by changing cognitive associations, not necessarily conscious thoughts, over time.

2) Along w/ DCS being a very exciting new avenue of research, psychologists have developed a new type of technique called Evaluative Conditioning that implements a computer task that helps retrain the mind's associations. For example, while a person with depression associates sadness w/ themselves, repeatedly asking the person to pair a smiley face with the word "me" during a computer task will help retrain the previous association so that the person now associates happiness w/ themselves.

With these facts in mind, I would argue it is worth studying the combined effects of DCS and Evaluative Conditioning. It seems to me that DCS will probably enhance the effects of Evaluative Conditioning. Right? The idea here being: since Evaluative Conditioning is used to retrain cognitive associations and DCS has been used to facilitate exposure therapy (i.e. unlearning behavior), which is hypothesized to work via changing associations, the use of DSC w/ Evaluative Conditioning could enhance the retraining of maladaptive associations. Of note, it would most likely only work if the evaluative conditioning stimuli were potent enough to instill fear in participants as DCS only facilitates fear learning. Perhaps the fear doesn't even have to be specific to what the person's pathology is - maybe watching a scary movie beforehand would suffice.

Initially I was thinking that lessening the role of the therapist could lead to the benefit (eventually & if it worked) to decreased cost of treatment; however, paying to use the computer program along w/ the cost of the medication could be prove to be steep. In any event, if the combined effects of DCS and Evaluative Conditioning statistically outperform other methods of treatment, that fact would be useful in and of itself.

On the other hand, if the combined effects prove to be on par with similar psychological treatments, the use of either combined DCS+EC or DCS+regular therapy should be evaluated for specific use in different populations. For example, people w/ autism may respond better to DCS+EC than DCS+regular therapy because of the removed social component. I do realize, though, that one could argue that removing the social component of treatment for people w/ autism could be detrimental because social interaction could facilitate increased social skill. However, to get rid of a troublesome fears quickly, a combined DCS+EC treatment could theoretically be useful. Furthermore, in addition to DCS+EC, a separate targeted social intervention treatment would probably be called for.

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