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Title: Physiological reactivity to phobic stimuli in people with fear of flying
Author(s): B. Busscher, L.J. van Gerwen, P. Spinhoven and E.J.C. de Geus
Journal: Journal of Psychosomatic Research
Year: 2010
Volume: 69
Issue: 3
Pages: 309--317
Publisher address: VALK Fdn, NL-2300 AC Leiden, Netherlands Leiden Univ, Dept Clin Hlth & Neuropsychol, Leiden, Netherlands Leiden Univ, Dept Psychiat, Med Ctr, Leiden, Netherlands Vrije Univ Amsterdam, Dept Biol Psychol, Amsterdam, Netherlands
ISSN: 0022-3999
File URL: vuams-pubs/Busscher_2009.pdf
Keywords: Anxiety, Anxiety sensitivity, Aviophobics, Flight phobia, FLIGHT PHOBICS, Heart, Heart Rate, HEART-RATE, HEART-RATE-VARIABILITY, IMPEDANCE CARDIOGRAPHY, INTEROCEPTIVE AWARENESS, Netherlands, PANIC DISORDER, Pre-ejection period (PEP), RESPIRATORY SINUS ARRHYTHMIA, Respiratory sinus arrhythmia (RSA), SECRETORY IMMUNITY, SELF-REPORT, therapy, Time, TREATMENT PROGRAMS
Abstract: Objective: The nature of the relationship between physiological and subjective responses in phobic subjects remains unclear. Phobics have been thought to be characterized by a heightened physiological response (physiological perspective) or by a heightened perception of a normal physiological response (psychological perspective). Method: In this study, we examined subjective measures of anxiety, heart rate (HR), and cardiac autonomic responses to flight-related stimuli in 127 people who applied for fear-of-flying therapy at a specialized treatment center and in 36 controls without aviophobia. Results: In keeping with the psychological perspective, we found a large increase in subjective distress (eta(2)=.43) during exposure to flight-related stimuli in the phobics and no change in subjective distress in the controls, whereas the physiological responses of both groups were indiscriminate. However, in keeping with the physiological perspective, we found that, within the group of phobics, increases in subjective fear during exposure were moderately strong coupled to HR (r=.208, P=.022) and cardiac vagal P=.028) reactivity. In contrast to predictions by the psychological perspective, anxiety sensitivity did not modulate this coupling. Conclusion: We conclude that subjective fear responses and autonomic responses are only loosely coupled during mildly threatening exposure to flight-related stimuli. More ecologically valid exposure to phobic stimuli may be needed to test the predictions from the physiological and psychological perspectives. (C) 2010 Elsevier Inc. All rights reserved

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