D-cycloserine enhances generalization of fear extinction in children

Simon P. Byrne*, Ronald M. Rapee, Rick Richardson, Gin S. Malhi, Michael Jones, Jennifer L. Hudson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)


Background For exposure therapy to be successful, it is essential that fear extinction learning extends beyond the treatment setting. d-Cycloserine (DCS) may facilitate treatment gains by increasing generalization of extinction learning, however, its effects have not been tested in children. We examined whether DCS enhanced generalization of fear extinction learning across different stimuli and contexts among children with specific phobias. Methods The study was a double-blind placebo-controlled randomized controlled trial among dog or spider phobic children aged 6-14. Participants ingested either 50 mg of DCS (n = 18) or placebo (n = 17) before receiving a single prolonged exposure session to their feared stimulus. Return of fear was examined 1 week later to a different stimulus (a different dog or spider), presented in both the original treatment context and an alternate context. Avoidance and fear were measured with Behavior Approach Tests (BATs), where the child was asked to increase proximity to the stimulus while reporting their fear level. Results There were no differences in BAT performance between groups during the exposure session or when a new stimulus was later presented in the treatment context. However, when the new stimulus was presented in a different context, relative to placebo, the DCS group showed less avoidance (P =.03) and less increase in fear (P =.04) with moderate effect sizes. Conclusions DCS enabled children to better retain their fear extinction learning. This new learning generalized to different stimuli and contexts.

Original languageEnglish
Pages (from-to)408-414
Number of pages7
JournalDepression and Anxiety
Issue number6
Publication statusPublished - 1 Jun 2015


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