Elsevier

Journal of Anxiety Disorders

Volume 11, Issue 3, May–June 1997, Pages 241-261
Journal of Anxiety Disorders

Clinical Characteristics of Flight Phobia*

https://doi.org/10.1016/S0887-6185(97)00009-1Get rights and content

Abstract

Sixty-six subjects with severe fear of flying were recruited by advertisement and compared to 21 controls without flying fears. Subjects were interviewed and given several questionnaires to determine DSM-III-R diagnoses, history of flying, and development and course of flying phobia. Our phobic sample had a mean age of 46 and was 89% female. Diagnostically, 27% met criteria for current Panic Disorder with Agoraphobia, and 17% criteria for that diagnosis in the past. These two groups were more concerned with internal or social anxiety stimuli during flight than the group who had never had panic attacks but met criteria for Simple Phobia (flying). All three groups were equally concerned about external dangers. Traumatic flight events were common in phobics and controls, but phobics reported reacting to these events more strongly. Our results suggest a vulnerability-stress model with several vulnerability factors, including cognitive ones. Treatment implications are discussed. © 1997 Elsevier Science Ltd

Section snippets

INTRODUCTION

Flying for business or personal reasons has become exceedingly common in developed countries like the USA, where other means of transportation are too slow to connect major population centers. But not all actual or intended passengers are happy to fly. Boeing estimates that 20% to 30% of the U.S. population are apprehensive about flying (Dean and Whitaker, 1980). Fear of flying can be a phobia with serious professional or personal consequences. In a recent survey in Sweden (Fredrikson et al.,

METHODS

Individuals were recruited by advertisements in local newspapers to participate in a study of flight phobia. The advertisements for phobic individuals read: “Afraid of flying? Stanford University and VA Medical Center are investigating flight phobia. Limited free treatment.” The advertisements for controls read: “Not afraid of flying? Stanford University and VA Medical Center are looking for controls in an investigation about flight phobia.” Respondents were prescreened by telephone by asking

Onset and Course of Development of Fear of Flying

Table 2 shows that groups did not differ significantly on most characteristics of their flying history. All individuals in the PDA group, significantly more than in the SPF group, reported having had one or more panic attacks during their last flight that fit the DSM-III-R definition of sudden anxiety attacks accompanied by at least four specified symptoms, disregarding whether attacks were truly unexpected. As indicated by the difference between number of flights during lifetime and before

DISCUSSION

The average flight phobic without Panic Disorder (PD) or a history of PD in our sample had her first flight at age 16, and had 10 return flights before she became intensely fearful of flying at the age of 25, developing the fear over 2 12 years. After becoming phobic she took an average of one round-trip flight per year for the next 16 years and then avoided flying completely for the last 3 years. This average pattern conceals large differences between individuals. For example, some of the

References (53)

  • R.G. Menzies et al.

    The etiology of fear of heights and its relationship to severity and individual response patterns

    Behaviour Research and Therapy

    (1993)
  • R.G. Menzies et al.

    The etiology of phobias: A nonassociative account

    Clinical Psychology Review

    (1995)
  • S.M. Miller

    Controllability and human stress: Method, evidence and theory

    Behaviour Research and Therapy

    (1979)
  • L.G. Öst et al.

    Acquisition of phobias and anxiety response patterns in clinical patients

    Behaviour Research and Therapy

    (1981)
  • L.G. Öst et al.

    Acquisition of agoraphobia. Mode of onset and anxiety response patterns

    Behaviour Research and Therapy

    (1983)
  • S.J. Rachman

    The conditioning theory of fear acquisition: A critical examination

    Behaviour Research and Therapy

    (1977)
  • W.T. Roth et al.

    Skin conductance habituation in panic disorder patients

    Biological Psychiatry

    (1990)
  • M.E.P. Seligman

    Phobias and preparedness

    Behavior Therapy

    (1971)
  • L.S. Stoler et al.

    Cognitive bias in symptomatic and recovered agoraphobics

    Behaviour Research and Therapy

    (1991)
  • American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed. rev.)....
  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington,...
  • A.T. Beck et al.

    An inventory for measuring depression

    Archives of General Psychiatry

    (1961)
  • Brown, D. (1996). Flying without fear. Oakland, CA: New Harbinger Publications,...
  • D.L. Chambless et al.

    Assessment of fear of fear in agoraphobics: The Body Sensations Questionnaire and the Agoraphobic Cognitions Questionnaire

    Journal of Consulting and Clinical Psychology

    (1984)
  • Clarke, J.C., & Jackson, J.A. (1983). Hypnosis and behavior therapy: The treatment of anxiety and phobias. New York:...
  • G.C.L. Davey

    Preparedness and phobias: Specific evolved associations or a generalized expectancy bias

    Behavioral & Brain Sciences

    (1995)
  • Cited by (61)

    View all citing articles on Scopus
    *

    This research was supported by the German Academic Exchange Service and the Department of Veterans Affairs.

    View full text