Fear of flying

Fear of flying is a fear of being on an aeroplane (airplane), or other flying vehicle, such as a helicopter, while in flight. It is also referred to as flying phobia, flight phobia, aviophobia or aerophobia (although the last also means a fear of drafts or of fresh air).[1]

Acute anxiety caused by flying can be treated with anti-anxiety medication. The condition can be treated with exposure therapy, which works better when combined with cognitive behavioral therapy.[2][3]

Classification

Fear of flying is a specific phobia classified as such in the DSM-5.[4]

Symptoms

People with fear of flying experience intense, persistent fear or anxiety when they consider flying, as well as during flying. They will avoid flying if they can, and the fear, anxiety, and avoidance cause significant distress and impair their ability to function.[4] Take-off, bad weather, and turbulence appear to be the most anxiety provoking aspects of flying.[4]

The most extreme manifestations can include panic attacks or vomiting at the mere sight or mention of an aircraft or air travel.[2]

Around 60% of people with fear of flying report having some other anxiety disorder.[4]

Cause

The causes of flight phobia and the mechanisms by which it is maintained were not well understood as of 2016.[4][5] It is not clear if it is really one condition; it appears to be heterogenous. It appears that people get aerophobia from being or having claustrophobia to the small spaces inside the fuselage of the plane or helicopter. [6]

Diagnosis

The diagnosis is clinical. It is often difficult to determine if the specific phobia of fear of flight should be the primary diagnosis, or if fear of flying is a symptom of a generalized anxiety disorder or another anxiety disorder such as agoraphobia or claustrophobia.[6]

Management

Acute anxiety caused by flying can be treated with anti-anxiety medication. The condition can be treated with exposure therapy, including use of virtual reality equipment, which works better when combined with cognitive behavioral therapy. Relaxation techniques and education about aviation safety can also be helpful in combination with other approaches.[2][3]

Outcomes

Studies of interventions like CBT have reported rates of reduction in anxiety of around 80%, however there is little evidence that any treatment can completely eliminate fear of flying.[3]

Epidemiology

Estimates for prevalence have ranged between 2.5% and 40%; estimates on the lower end are probably generated through studies where the condition is diagnosed by a professional, and the higher end probably includes people who have diagnosed themselves.[4]

History

Fear of flying was first discussed in the biomedical literature by a doctor in the UK at the end of World War I, who called it "aero-neurosis" and was describing pilots and crew who were or became anxious about flying. It was not much discussed until the 1950s and rise of commercial air travel and the vogue in psychoanalysis. Starting in the 1970s fear of flying was addressed through behavioral and cognitive approaches.[6]

Society and culture

Immediately after the September 11 attacks, Americans chose to travel more by car instead of flying; because of the extra traffic, around 350 more people died in traffic accidents than would have normally occurred.[7]

Research directions

As of 2016 the causes of fear of flying as well as the psychological mechanisms through which it were persists had not been well researched. A few studies had looked at whether mechanisms like illusory correlation and expectancy bias were present in all or most people with fear of flying as well as other specific phobias; these studies have not led to clear outcomes.[4][5]

Research into the most effective ways to treat or manage fear of flying is difficult (as it is with other counselling or behavioral interventions) due to the inability to include a placebo or other control arm in such studies.[3]

See also

References

  1. ↑ "aerophobia". Merriam-Webster. Retrieved 20 July 2014.
  2. 1 2 3 Mulcahy, RA; Blue, RS; Vardiman, JL; Castleberry, TL; Vanderploeg, JM (2016). "Screening and Mitigation of Layperson Anxiety in Aerospace Environments". Aerospace medicine and human performance. 87 (10): 882–889. doi:10.3357/AMHP.4536.2016. PMID 27662351.
  3. 1 2 3 4 Oakes, M; Bor, R (November 2010). "The psychology of fear of flying (part II): a critical evaluation of current perspectives on approaches to treatment". Travel medicine and infectious disease. 8 (6): 339–63. doi:10.1016/j.tmaid.2010.10.002. PMID 21071281.
  4. 1 2 3 4 5 6 7 Clark, GI; Rock, AJ (2016). "Processes Contributing to the Maintenance of Flying Phobia: A Narrative Review". Frontiers in Psychology. 7: 754. doi:10.3389/fpsyg.2016.00754. PMC 4887486. PMID 27313550.
  5. 1 2 Wiemer, J; Pauli, P (August 2016). "Fear-relevant illusory correlations in different fears and anxiety disorders: A review of the literature". Journal of anxiety disorders. 42: 113–28. doi:10.1016/j.janxdis.2016.07.003. PMID 27454587.
  6. 1 2 3 Oakes, M; Bor, R (November 2010). "The psychology of fear of flying (part I): a critical evaluation of current perspectives on the nature, prevalence and etiology of fear of flying". Travel medicine and infectious disease. 8 (6): 327–38. doi:10.1016/j.tmaid.2010.10.001. PMID 21050826.
  7. ↑ "Afraid to Fly After 9/11, Some Took a Bigger Risk - In Cars". Wall Street Journal. March 23, 2004. Retrieved October 11, 2013.
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