Acrophobia
Acrophobia | |
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Some jobs require working at heights. | |
Pronunciation | |
Specialty | Psychiatry |
Acrophobia, also known as hipsophobia, is an extreme or irrational fear or phobia of heights, especially when one is not particularly high up. It belongs to a category of specific phobias, called space and motion discomfort, that share similar causes and options for treatment.
Most people experience a degree of natural fear when exposed to heights, known as the fear of falling. On the other hand, those who have little fear of such exposure are said to have a head for heights. A head for heights is advantageous for hiking or climbing in mountainous terrain and also in certain jobs such as steeplejacks or wind turbine mechanics.
People with acrophobia can experience a panic attack in high places and become too agitated to get themselves down safely. Approximately 2–5% of the general population has acrophobia, with twice as many women affected as men.[1] The term is from the Greek: ἄκρον, ákron, meaning "peak, summit, edge" and φόβος, phóbos, "fear".
Confusion with vertigo
This section needs expansion with: sources showing that acrophobia and vertigo are confused. You can help by adding to it. (April 2023) |
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Height vertigo is caused by a conflict between vision, vestibular and somatosensory senses.[2] This occurs when vestibular and somatosensory systems sense a body movement that is not detected by the eyes. More research indicates that this conflict leads to both motion sickness and anxiety.[3][4][5] Confusion may arise in differentiating between height vertigo and acrophobia due to the conditions' overlapping symptom pools, including body swaying and dizziness. Further confusion can occur due to height vertigo being a direct symptom of acrophobia. [6]
Causes
Traditionally, acrophobia has been attributed, like other phobias, to conditioning or a traumatic experience. Recent studies have cast doubt on this explanation.[7][5] Individuals with acrophobia are found to be lacking in traumatic experiences. Nevertheless, this may be due to the failure to recall the experiences, as memory fades as time passes.[8] To address the problems of self report and memory, a large cohort study with 1000 participants was conducted from birth; the results showed that participants with less fear of heights had more injuries because of falling.[9][5] Psychologists Richie Poulton, Simon Davies, Ross G. Menzies, John D. Langley, and Phil A. Silva sampled subjects from the Dunedin Multidisciplinary Health and Development Study who had been injured in a fall between the ages of 5 and 9, compared them to children who had no similar injury, and found that at age 18, acrophobia was present in only 2 percent of the subjects who had an injurious fall but was present among 7 percent of subjects who had no injurious fall (with the same sample finding that typical basophobia was 7 times less common in subjects at age 18 who had injurious falls as children than subjects that did not).[10]
More studies have suggested a possible explanation for acrophobia is that it emerges through accumulation of non-traumatic experiences of falling that are not memorable but can influence behaviours in the future. Also, fear of heights may be acquired when infants learn to crawl. If they fell, they would learn the concepts about surfaces, posture, balance, and movement.[5] Cognitive factors may also contribute to the development of acrophobia. People tend to wrongly interpret visuo-vestibular discrepancies as dizziness and nausea and associate them with a forthcoming fall.[11] A traumatic conditional event of falling may not be necessary at this point.
A fear of falling, along with a
Another possible contributing factor is a dysfunction in maintaining balance. In this case, the anxiety is both well-founded and secondary. The human balance system integrates
Some people are known to be more dependent on visual signals than others.[18] People who rely more on visual cues to control body movements are less physically stable.[19][5] An acrophobic, however, continues to over-rely on visual signals whether because of inadequate vestibular function or incorrect strategy. Locomotion at a high elevation requires more than normal visual processing. The visual cortex becomes overloaded, resulting in confusion. Some proponents of the alternative view of acrophobia warn that it may be ill-advised to encourage acrophobics to expose themselves to height without first resolving the vestibular issues. Research is underway at several clinics.[20] Recent studies found that participants experienced increased anxiety not only during elevation in height, but also when they were required to move sideways in a fixed height.[21]
A recombinant model of the development of acrophobia is very possible, in which learning factors, cognitive factors (e.g. interpretations), perceptual factors (e.g. visual dependence), and biological factors (e.g. heredity) interact to provoke fear or habituation.[5]
Assessment
ICD-10 and DSM-5 are used to diagnose acrophobia.[22] Acrophobia Questionnaire (AQ) is a self report that contains 40 items, assessing anxiety level on a 0–6 point scale and degree of avoidance on a 0–2 point scale.[23][24] The Attitude Towards Heights Questionnaires (ATHQ)[25] and Behavioural Avoidance Tests (BAT) are also used.[5]
However, acrophobic individuals tend to have biases in self-reporting. They often overestimate the danger and question their abilities of addressing height relevant issues.[26] A Height Interpretation Questionnaire (HIQ) is a self-report to measure these height relevant judgements and interpretations.[24] The Depression Scale of the Depression Anxiety Stress Scales short form (DASS21-DS) is a self report used to examine validity of the HIQ.[24]
Treatment
Traditional treatment of phobias is still in use today. Its underlying theory states that phobic anxiety is conditioned and triggered by a conditional stimulus. By avoiding phobic situations, anxiety is reduced. However, avoidance behaviour is reinforced through
There have been a number of studies into using
Many different types of medications are used in the treatment of phobias like fear of heights, including traditional anti-anxiety drugs such as
Prognosis
Some desensitization treatments produce short-term improvements in symptoms.[38] Long-term treatment success has been elusive.[38]
Epidemiology
Approximately 2–5% of the general population has acrophobia, with twice as many women affected as men.[39]
A related, milder form of visually triggered fear or anxiety is called visual height intolerance (vHI).[40] Up to one-third of people may have some level of visual height intolerance.[40] Pure vHI usually has smaller impact on individuals compared to acrophobia, in terms of intensity of symptoms load, social life, and overall life quality. However, few people with visual height intolerance seek professional help.[41]
See also
Citations
- S2CID 797073. Retrieved 12 September 2015.
- PMID 6969517.
- PMID 15842192.
- PMID 11388359.
- ^ PMID 19282142.
- PMID 15842192.
- PMID 7677717. 7677717.
- S2CID 37717355.
- PMID 9648329.
- PMID 9648329.
- PMID 9431729.
- PMID 11125722.
- ^ Gibson, Eleanor J.; Walk, Richard D. (1960). "The "Visual Cliff"". Scientific American. No. 202. pp. 67–71. Archived from the original on 6 April 2019. Retrieved 13 May 2013.
- S2CID 704084.
- PMID 15842192. Archived from the originalon 26 September 2007. Retrieved 10 September 2007.
- S2CID 144661241.
- PMID 6969515.
- S2CID 46272261.
- S2CID 32279602.
- PMID 15842192.
- PMID 18991529.
- PMID 28620340.
- ISSN 0005-7894.
- ^ PMID 21641766.
- PMID 2573337.
- PMID 7887882.
- ^ "APA PsycNet". psycnet.apa.org. Retrieved 15 April 2020.
- S2CID 46015274.
- PMID 4781961.
- PMID 6147365.
- PMID 19282142.
- S2CID 16225288.
- ^ PMID 9613029.
- ^ PMID 14975783.
- PMID 11710259.
- PMID 26355646.
- ISBN 9780199549351.
- ^ S2CID 9559825.
- S2CID 797073. Retrieved 12 September 2015.
- ^ S2CID 21302997.
- PMID 27383642.
General and cited sources
- Sartorius, N.; Henderson, A.S.; Strotzka, H.; Lipowski, Z.; Yu-cun, S.; You-xin, X.; Strömgren, E.; Glatzel, J.; et al. "The ICD-10 Classification of Mental and Behavioural Disorders Clinical descriptions and diagnostic guidelines" (PDF). World Health Organization. p. 114. Retrieved 23 June 2021.
External links
- "The scariest path in the world?", a direct test, video shot on El Camino del Rey, approaching Makinodromo
- "Fear of Heights"—A comprehensive guide with useful resources on Acrophobia known as Fear of Heights.