Psychological Distress and Physiological Reactivity During In Vivo Exposure in People With Aviophobia

Abstract

The results provide only weak support for emotional processing theory. Low self-reported anxiety during in vivo flight exposure was the best predictor of successful long-term therapy outcome.

The impact of affect labelling on responses to aversive flying-cues

“…Vignettes have been employed in a number of studies with the aim of generating salient first person perspectives of imagined situations in order to evaluate changes in cognitive-affective variables [ 53 – 54 ]. The flying-related vignette, henceforth labelled the “flight cue” was designed to elicit imagery of experiences that have been reported to be anxiety provoking for flying phobics (e.g., boarding a flight, taxi-out, take off, severe turbulence [ 28 ]). The neutral cue was designed to be matched for length and descriptive content and asked participants to imagine going to the cinema to see a film and the typical sensory input expected.…”

“…A cue-reactive effect is detected when there is a significant increase in, for example, anxiety from neutral to flight cue whilst controlling for baseline anxiety. In flying phobia, cue-reactivity has been demonstrated via measuring increases in self-reported distress and physiological markers of distress (e.g., heart rate and skin conductance [ 23 , 27 – 28 ]). For instance, in a sample of flying phobics, increases in subjective anxiety (though not physiological reactivity) were reported after viewing a flight safety demonstration video as compared to when viewing a neutral video [ 23 ].…”

“…For instance, in a sample of flying phobics, increases in subjective anxiety (though not physiological reactivity) were reported after viewing a flight safety demonstration video as compared to when viewing a neutral video [ 23 ]. Similarly, flying phobics exposed to a flight-related video as part of a treatment trial demonstrated increases in fear as measured by subjective report and respiratory sinus arrhythmia (indicating heart rate variability) as compared to when viewing a neutral video [ 28 ].…”

“…Disconfirmation of threat through exposure/behavioural experiments is regarded as a crucial component of successful treatment in flying phobia [ 28 ]. A promising strategy for optimizing exposure is affect labelling , which simply refers to putting one’s feelings into words in response to a fear-provoking stimuli [ 18 ].…”

Cognitive Coping as a Mechanism of Change in Cognitive-Behavioral Therapy for Fear of Flying: A Longitudinal Study With 3-Year Follow-Up

“…Other mechanisms of change, like exposure, could have led to anxiety reductions and consecutive changes in the use of coping strategies. Recently, it has been proposed that consolidation of treatment progress could benefit from postexposure cognitive interventions instead of preexposure cognitive therapy (Craske, Treanor, Conway, Zbozinek, & Vervliet, 2014;Busscher et al, 2015). Randomized controlled trials are needed to test this assumption.…”