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

Abstract：

OBJECTIVES:Exposure is regarded to be a crucial component of therapies for phobias. According to emotional processing theory, the success of exposure therapy is predicted by activation of subjective and physiological fear responses and their within-session habituation and between-session adaptation. This study tested this prediction for aviophobia. METHODS:Seventy-nine participants following a highly standardized treatment program for aviophobia provided self-reported and physiological (heart rate, respiratory sinus arrhythmia and pre-ejection period) measurements of fear activation, within-session habituation, and between-session adaptation during exposure to flight-related stimuli, a flight simulator, and during two real flights. Multiple regression analyses were conducted to examine whether these measurements predicted therapy outcome up to 3 years after finishing therapy, including number of flights flown in this period. RESULTS:Both subjective and physiological arousal measurements indicated strong fear activation and large within-session habituation and between-session adaptation during exposure. Flight anxiety measures showed large improvements up to 3 years after treatment (η between 0.72 and 0.91). Lower self-reported anxiety during flight exposure was associated with lower flight anxiety after exposure (R = 0.15) and more flights flown (R = 0.14). Within-flight habituation or between-session adaptation of self-reported anxiety had no relationship with treatment outcome. Within-flight habituation of HR reactivity (R = 0.10) and respiratory sinus arrhythmia reactivity (R = 0.11) was associated with lower flight anxiety directly after the flight, but not on flight anxiety 3 years after finishing therapy or on long-term flying behavior. CONCLUSIONS: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.

journal_name

Psychosom Med

journal_title

Psychosomatic medicine

authors

Busscher B,Spinhoven P,de Geus EJ

doi

10.1097/PSY.0000000000000209

subject

Has Abstract

pub_date

2015-09-01 00:00:00

pages

762-74

issue

eissn

0033-3174

issn

1534-7796

journal_volume

pub_type

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