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Zuzanna Misiewicz, Tero Hiekkalinna, Tiina Paunio, Teppo Varilo, Joseph D Terwilliger, Timo Partonen, Iiris Hovatta
Acrophobia, an abnormal fear of heights, is a specific phobia characterized as apprehension cued by the occurrence or anticipation of elevated spaces. It is considered a complex trait with onset influenced by both genetic and environmental factors. Identification of genetic risk variants would provide novel insight into the genetic basis of the fear of heights phenotype and contribute to the molecular-level understanding of its aetiology. Genetic isolates may facilitate identification of susceptibility alleles due to reduced genetic heterogeneity...
December 20, 2016: Scientific Reports
Martin J Herrmann, Andrea Katzorke, Yasmin Busch, Daniel Gromer, Thomas Polak, Paul Pauli, Jürgen Deckert
BACKGROUND: Animal as well as human research indicated that the ventral medial prefrontal cortex (vmPFC) is highly relevant for fear extinction learning. Recently, we showed that targeting the vmPFC with high-frequency repetitive transcranial magnetic stimulation (rTMS) in a placebo-controlled study with 45 healthy controls induced higher prefrontal activity during extinction of conditioned stimuli (CS+) in the active compared to the sham stimulated group and better extinction learning as indicated by ratings, fear potentiated startles and skin conductance responses...
November 14, 2016: Brain Stimulation
Hans-Peter Kapfhammer, Werner Fitz, Doreen Huppert, Eva Grill, Thomas Brandt
The course of illness, the degree of social impairment, and the rate of help-seeking behavior was evaluated in a sample of individuals with visual height intolerance (vHI) and acrophobia. On the basis of a previously described epidemiological sample representative of the German general population, 574 individuals with vHI were identified, 128 fulfilled the DSM-5 diagnostic criteria of acrophobia. The illness of the majority of all susceptible individuals with vHI ran a year-long chronic course. Two thirds were in the category "persistent/worse", whereas only one third was in the category "improved/remitted"...
October 2016: Journal of Neurology
Julia Diemer, Nora Lohkamp, Andreas Mühlberger, Peter Zwanzger
Virtual reality (VR) exposure therapy is becoming increasingly established, but the mode of action is not well understood. One potential efficacy factor might be physiological arousal. To investigate arousal during VR exposure, we exposed 40 patients with acrophobia and 40 matched healthy controls to a VR height challenge and assessed subjective (fear ratings) and physiological (heart rate, skin conductance level, salivary cortisol) fear reactions. Patients experienced a significant increase of subjective fear, heart rate and skin conductance level...
January 2016: Journal of Anxiety Disorders
Samuel Hunley, Eugene Park, Matthew Longo, Stella Lourenco
Psychologists have long noted perceptual distortions associated with fear (e.g., Baddeley, 1972; Keinan, 1987). More recently, researchers have reported that participants high in acrophobic fear (i.e., fear of heights) show greater overestimation of vertical extents compared to participants low in acrophobic fear (e.g., Teachman et al. 2008; Stefanucci & Proffitt, 2009). In our study, we examined individual differences in trait claustrophobic fear (i.e., fear of enclosed or restrictive situations) in relation to horizontal distance perception...
2015: Journal of Vision
Fanny Levy, Pierre Leboucher, Gilles Rautureau, Roland Jouvent
Virtual reality therapy is already used for anxiety disorders as an alternative to in vivo and in imagino exposure. To our knowledge, however, no one has yet proposed using remote virtual reality (e-virtual reality). The aim of the present study was to assess e-virtual reality in an acrophobic population. Six individuals with acrophobia each underwent six sessions (two sessions per week) of virtual reality exposure therapy. The first three were remote sessions, while the last three were traditional sessions in the physical presence of the therapist...
June 2016: Journal of Telemedicine and Telecare
Thomas Brandt, Günter Kugler, Roman Schniepp, Max Wuehr, Doreen Huppert
This review shows that persons with visual height intolerance or acrophobia exhibit typical restrictions of visual exploration and imbalance during stance and locomotion when exposed to heights. Eye and head movements are reduced, and gaze freezes to the horizon. Eye movements tend to be horizontal saccades during stance and vertical saccades during locomotion. Body posture is characterized by a stiffening of the musculoskeletal system with increased open-loop diffusion activity of body sway, a lowered sensory feedback threshold for closed-loop balance control, and increased co-contraction of antigravity leg and neck muscles...
April 2015: Annals of the New York Academy of Sciences
Hans-Peter Kapfhammer, Doreen Huppert, Eva Grill, Werner Fitz, Thomas Brandt
The purpose of this study was to estimate the general population lifetime and point prevalence of visual height intolerance and acrophobia, to define their clinical characteristics, and to determine their anxious and depressive comorbidities. A case-control study was conducted within a German population-based cross-sectional telephone survey. A representative sample of 2,012 individuals aged 14 and above was selected. Defined neurological conditions (migraine, Menière's disease, motion sickness), symptom pattern, age of first manifestation, precipitating height stimuli, course of illness, psychosocial impairment, and comorbidity patterns (anxiety conditions, depressive disorders according to DSM-IV-TR) for vHI and acrophobia were assessed...
August 2015: European Archives of Psychiatry and Clinical Neuroscience
Helga Rodrigues, Ivan Figueira, Alessandra Lopes, Raquel Gonçalves, Mauro Vitor Mendlowicz, Evandro Silva Freire Coutinho, Paula Ventura
The treatment of anxiety is on the edge of a new era of combinations of pharmacologic and psychosocial interventions. A new wave of translational research has focused on the use of pharmacological agents as psychotherapy adjuvants using neurobiological insights into the mechanism of the action of certain psychological treatments such as exposure therapy. Recently, d-cycloserine (DCS) an antibiotic used to treat tuberculosis has been applied to enhance exposure-based treatment for anxiety and has proved to be a promising, but as yet unproven intervention...
2014: PloS One
Shari A Steinman, Bethany A Teachman
OBJECTIVE: Cognitive models of anxiety disorders posit that biases in interpretation maintain, and potentially cause, anxiety. This study tested whether it is possible to decrease height fear symptoms through cognitive bias modification for interpretations (CBM-I). Additionally, the clinical utility of CBM-I was tested by comparing it to an already established treatment: exposure therapy. METHOD: Extremely height fearful individuals (N = 110) participated in the study...
June 2014: Journal of Consulting and Clinical Psychology
E K Loken, J M Hettema, S H Aggen, K S Kendler
BACKGROUND: Although prior genetic studies of interview-assessed fears and phobias have shown that genetic factors predispose individuals to fears and phobias, they have been restricted to the DSM-III to DSM-IV aggregated subtypes of phobias rather than to individual fearful and phobic stimuli. METHOD: We examined the lifetime history of fears and/or phobias in response to 21 individual phobic stimuli in 4067 personally interviewed twins from same-sex pairs from the Virginia Adult Twin Study of Psychiatric and Substance Abuse Disorders (VATSPSUD)...
August 2014: Psychological Medicine
Thomas Brandt, Doreen Huppert
PURPOSE OF REVIEW: The aim of this review is, first, to cover the different aspects of visual height intolerance such as historical descriptions, definition of terms, phenomenology of the condition, neurophysiological control of gaze, stance and locomotion, and therapy, and, second, to identify warranted epidemiological and experimental studies. RECENT FINDINGS: Vivid descriptions of fear of heights can be found in ancient texts from the Greek, Roman, and Chinese classics...
February 2014: Current Opinion in Neurology
G Kugler, D Huppert, E Schneider, T Brandt
The life-time prevalence of visual height intolerance is 28 % in the general population. More than 50 % of those affected suffer from an impairment of daily behavior and quality of life when confronted with heights. Simultaneous measurements of spontaneous eye and head movements of these subjects while looking from a balcony revealed that visual exploration of the surroundings was restricted compared to that of control subjects. Spontaneous head movements were severely diminished and saccadic eye movements were reduced...
October 2013: Der Nervenarzt
Renato T Ramos, Danielle A de Mattos, J Thales S Rebouças, Ronald D Ranvaud
INTRODUCTION: The perception of comfort during air trips is determined by several factors. External factors like cabin design and environmental parameters (temperature, humidity, air pressure, noise, and vibration) interact with individual characteristics (anxiety traits, fear of flying, and personality) from arrival at the airport to landing at the destination. In this study, we investigated the influence of space and motion discomfort (SMD), fear of heights, and anxiety on comfort perception during all phases of air travel...
December 2012: Aviation, Space, and Environmental Medicine
Candyce D Tart, Pamela R Handelsman, Lindsey B Deboer, David Rosenfield, Mark H Pollack, Stefan G Hofmann, Mark B Powers, Michael W Otto, Jasper A J Smits
BACKGROUND: Pre-session administration of d-cycloserine (DCS) has been found to augment exposure therapy outcomes in a variety of anxiety disorders. To be able to enhance learning only for successful exposure sessions, it would be beneficial to have the option of administering DCS after rather than before the session, a strategy encouraged by pre-clinical work. We believe the present study is the first published report on the efficacy of post-session administration of DCS in humans. METHOD: Adults (N = 29) with a DSM-IV diagnosis of acrophobia were randomized to receive two sessions of virtual reality exposure therapy (VRE) in combination with placebo or 50 mg of DCS...
February 2013: Journal of Psychiatric Research
Shari A Steinman, Bethany A Teachman
Three studies were conducted to examine the psychometric properties of a new scale: the Heights Interpretation Questionnaire (HIQ). This scale was designed to measure height fear-relevant interpretation bias to help assess the relationship between biased interpretations and acrophobia symptoms. Studies 1 (N=553) and 2 (N=308) established the scale's factor structure and convergent and discriminant validity among two large undergraduate samples. Study 3 (N=48) evaluated the predictive validity of the HIQ by examining how well the scale predicted subjective distress and avoidance on actual heights...
October 2011: Journal of Anxiety Disorders
Dominique J-F de Quervain, Dorothée Bentz, Tanja Michael, Olivia C Bolt, Brenda K Wiederhold, Jürgen Margraf, Frank H Wilhelm
Behavioral exposure therapy of anxiety disorders is believed to rely on fear extinction. Because preclinical studies have shown that glucocorticoids can promote extinction processes, we aimed at investigating whether the administration of these hormones might be useful in enhancing exposure therapy. In a randomized, double-blind, placebo-controlled study, 40 patients with specific phobia for heights were treated with three sessions of exposure therapy using virtual reality exposure to heights. Cortisol (20 mg) or placebo was administered orally 1 h before each of the treatment sessions...
April 19, 2011: Proceedings of the National Academy of Sciences of the United States of America
Anja Siegmund, Fabian Golfels, Claudia Finck, Anna Halisch, Daniela Räth, Jens Plag, Andreas Ströhle
D-cycloserine (DCS)-augmented exposure therapy has proven efficacy in the treatment of acrophobia, social phobia, panic disorder and OCD. Here we studied whether DCS can also improve the effect of cognitive behavioral therapy (CBT) in patients with agoraphobia and panic disorder. To this end, 39 patients with the diagnoses of agoraphobia and panic disorder were treated with 11 sessions of CBT including three individual in-vivo exposure sessions (flooding), augmented with either 50mg of DCS (N=20) or placebo (N=19) in a randomized double blind design...
August 2011: Journal of Psychiatric Research
Carlos M Coelho, Guy Wallis
BACKGROUND: Acrophobia is one of the most prevalent phobias, affecting as many as 1 in 20 individuals. Of course, heights often evoke fear in the general population too, and this suggests that acrophobia might actually represent the hypersensitive manifestation of an everyday, rational fear. In this study, we assessed the role of sensory and cognitive variables in acrophobia. METHODS: Forty-five participants (Mean age 25.07 years, 71% female) were assessed using a booklet with self-reports as well as several behavioral measures...
September 2010: Depression and Anxiety
Aaron Baker, Jayson Mystkowski, Najwa Culver, Rena Yi, Arezou Mortazavi, Michelle G Craske
Clinically, there is wide subscription to emotional processing theory (EPT; Foa & Kozak, 1986) as a model of therapeutic effectiveness of exposure therapy: EPT purports that exposure is maximal when (1) fear is activated (IFA), (2) fear subsides within sessions (WSH), and (3) fear subsides between sessions (BSH). This study examined these assumptions, using in vivo exposure therapy for 44 students scoring high on acrophobia measures. Results indicated that no EPT variables were consistently predictive of treatment outcome...
November 2010: Behaviour Research and Therapy
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