Anxiety sensitivity moderates the relationship of changes in physiological arousal with flight anxiety during in vivo exposure therapy

Busscher, Bert; Spinhoven, Philip; Gerwen, Lucas J. Van; Geus, Eco J. C. de

doi:10.1016/j.brat.2012.10.009

Cited by 28 publications

(23 citation statements)

References 54 publications

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“…Bornas et al (117) investigated the impact of an exposure treatment on HRV in 20 patients, reporting that they exhibited a significant reduction ( p < 0.01) in HF HRV after six sessions of computer-assisted or virtual reality exposure over 3 weeks, and curiously that patients with lower pre-treatment HRV responded better to treatment. In contrast to these findings, Busscher et al (118) reported on the impact of exposure (two 1-h flights) on HRV in 50 flight phobics patients, observing a significant increase in RSA a finding associated with a large effect size, even after a relatively brief treatment. A possible explanation for this discrepancy could be the differential impact between virtual versus in vivo exposure on psychophysiological outcomes.…”

Section: Discussionmentioning

confidence: 89%

Anxiety Disorders are Associated with Reduced Heart Rate Variability: A Meta-Analysis

et al. 2014

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Background: Anxiety disorders increase risk of future cardiovascular disease (CVD) and mortality, even after controlling for confounds including smoking, lifestyle, and socioeconomic status, and irrespective of a history of medical disorders. While impaired vagal function, indicated by reductions in heart rate variability (HRV), may be one mechanism linking anxiety disorders to CVD, prior studies have reported inconsistent findings highlighting the need for meta-analysis.Method: Studies comparing resting-state HRV recordings in patients with an anxiety disorder as a primary diagnosis and healthy controls were considered for meta-analysis.Results: Meta-analyses were based on 36 articles, including 2086 patients with an anxiety disorder and 2294 controls. Overall, anxiety disorders were characterized by lower HRV [high frequency (HF): Hedges’ g = −0.29. 95% CI: −0.41 to −0.17, p < 0.001; time domain: Hedges’ g = −0.45, 95% CI: −0.57 to −0.33, p < 0.001] than controls. Panic disorder (n = 447), post-traumatic stress disorder (n = 192), generalized anxiety disorder (n = 68), and social anxiety disorder (n = 90), but not obsessive–compulsive disorder (n = 40), displayed reductions in HF HRV relative to controls (all ps < 0.001).Conclusion: Anxiety disorders are associated with reduced HRV, findings associated with a small-to-moderate effect size. Findings have important implications for future physical health and well-being of patients, highlighting a need for comprehensive cardiovascular risk reduction.

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Section: Discussionmentioning

confidence: 89%

Anxiety Disorders are Associated with Reduced Heart Rate Variability: A Meta-Analysis

et al. 2014

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“…70 AS is also reported to be related to the sympathetic and parasympathetic nervous systems. 71,72 This indicates that high AS may have an effect on the CVS via autonomic nervous system activity. The present study supports these findings and makes the additional contribution that these interactions may begin in adolescence, when pulse rate and blood pressure change quickly, along with similar pulse rate and blood pressure changes in the brain.…”

Section: Discussionmentioning

confidence: 98%

“…reported that higher AS score is associated with an increased likelihood of carotid plaque and arterial stiffness, indicating subclinical cardiovascular disease, independent of blood pressure and low‐density lipoprotein cholesterol levels . AS is also reported to be related to the sympathetic and parasympathetic nervous systems . This indicates that high AS may have an effect on the CVS via autonomic nervous system activity.…”

Section: Discussionmentioning

confidence: 99%

Anxiety sensitivity: Changes with puberty and cardiovascular variables

Akça

Türkoğlu

et al. 2014

Pediatrics International

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“…The symptoms of FP can encompass several diagnostic categories (such as panic disorder, agoraphobia, claustrophobia, or acrophobia), making diagnosis and treatment complex [2, 3]. Recent studies have established a lifetime prevalence of approximately 2.5 % of the adult population [4], although previous epidemiological studies reported prevalence estimates ranging from 10 to 40 % [5, 6].…”

Section: Introductionmentioning

confidence: 99%

“…Interference caused by this problem is diverse and varies depending on personal demands or needs, as well as patients’ geographical location. According to Busscher et al [2], 7 % of the population experience serious interference in daily life and social functioning due to FP. Personal consequences of suffering from FP may consist of limited professional opportunities or leisure options and changing or disrupted relationships, and it often causes shame and emotional distress when the person faces the thought of flying [4, 11, 12].…”

Section: Introductionmentioning

confidence: 99%

An Internet-based treatment for flying phobia (NO-FEAR Airlines): study protocol for a randomized controlled trial

et al. 2016

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BackgroundFlying phobia (FP) is a common and disabling mental disorder. Although in vivo exposure is the treatment of choice, it is linked to a number of limitations in its implementation. Particularly important, is the limited access to the feared stimulus (i.e., plane). Moreover, the economic cost of in vivo exposure should be specially considered as well as the difficulty of applying the exposure technique in an appropriate way; controlling important variables such as the duration of the exposure or the number of sessions. ICTs could help to reduce these limitations. Computer-assisted treatments have remarkable advantages in treating FP. Furthermore, they can be delivered through the Internet, increasing their advantages and reaching more people in need. The Internet has been established as an effective way to treat a wide range of mental disorders. However, as far as we know, no controlled studies exist on FP treatment via the Internet. This study aims to evaluate the efficacy of an Internet-based treatment for FP (NO-FEAR Airlines) versus a waiting list control group. Secondary objectives will be to explore two ways of delivering NO-FEAR Airlines, with or without therapist guidance, and study the patients’ acceptance of the program. This paper presents the study protocol.Methods/designThe study is a randomized controlled trial. A minimum of 57 participants will be randomly assigned to three conditions: a) NO-FEAR Airlines totally self-applied, b) NO-FEAR Airlines with therapist guidance, or c) a waiting list control group (6 weeks). Primary outcomes measures will be the Fear of Flying Questionnaire-II and the Fear of Flying Scale. Secondary outcomes will be included to assess other relevant clinical measures, such as the Fear and Avoidance Scales, Clinician Severity Scale, and Patient’s Improvement scale. Analyses of post-treatment flights will be conducted. Treatment acceptance and preference measures will also be included. Intention-to-treat and per protocol analyses will be conducted.DiscussionAn Internet-based treatment for FP could have considerable advantages in managing in vivo exposure limitations, specifically in terms of access to treatment, acceptance, adherence, and the cost-effectiveness of the intervention. This is the first randomized controlled trial to study this issue.Trial registrationClinicaltrials.gov: NCT02298478. Trial registration date 3 November 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-0996-1) contains supplementary material, which is available to authorized users.

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Anxiety sensitivity moderates the relationship of changes in physiological arousal with flight anxiety during in vivo exposure therapy

Cited by 28 publications

References 54 publications

Anxiety Disorders are Associated with Reduced Heart Rate Variability: A Meta-Analysis

Anxiety Disorders are Associated with Reduced Heart Rate Variability: A Meta-Analysis

Anxiety sensitivity: Changes with puberty and cardiovascular variables

An Internet-based treatment for flying phobia (NO-FEAR Airlines): study protocol for a randomized controlled trial

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