Abstract
BackgroundResponses to height may range from indifference to minor distress to severe symptoms of fear of heights (acrophobia); visual height intolerance (vHI) denotes the whole spectrum of symptoms. Although there are options to manage vHI, only a small part of persons affected by vHI are willing to seek professional help or confront their problem. Purpose of this study was to determine if persons with vHI, specifically those who show avoidant behavior towards heights (avoiders), score lower in their general self-efficacy (GSE) than those who confront vHI (confronters).MethodCross-sectional survey in 607 individuals living in the urban region of Munich, Germany, using a mailed questionnaire on presence or absence of vHI, confronting or avoiding behaviour, and GSE.ResultsOf all participants (mean age 53.9, 50.3% female), 407 reported life-time presence of vHI. Participants with vHI had a mean GSE score of 31.8 (SD 4.3) points (participants without vHI: 32.5, SD 4.3, p = 0.008 for difference). Among individuals with vHI, 23% reported confronting behavior. Confronters were significantly younger (p<.0001, 50.2 vs. 55.7 years), more likely to be female (p = 0.0039, 64.3% female), and had a higher GSE score (p = 0.0049, 32.5 vs. 31.1). Associations remained significant after multiple adjustment.ConclusionsOur study provides evidence for the association of GSE and vHI. These findings may have consequences for strategies of alleviation and therapy of vHI.
Highlights
The visual perception of heights generally elicits postural imbalance [1]
Responses to height may range from indifference to minor distress to severe symptoms of fear of heights; visual height intolerance denotes the whole spectrum of symptoms
Fear of heights is classified by the ICD-10 [3] and DSM-V [4] criteria as a specific phobia
Summary
The visual perception of heights generally elicits postural imbalance [1]. This is a common physiological response. One might define three distinct conditions: physiological postural imbalance that affects everyone, vHI, and acrophobia as a specific phobia with symptoms of a panic attack. While acrophobia can be regarded as a significant clinical problem, the presence of vHI might reasonably be the motivation to participate in non-clinical training programs, arguably for those individuals who are interested in mountaineering despite their condition. This idea of a clinical distinction between vHI and acrophobia based on severity and relevance, was recently contradicted by findings from a populationbased study where 23% of individuals with vHI reported symptoms that reached the intensity level of panic attacks [6]. These findings may have consequences for strategies of alleviation and therapy of vHI
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