Abstract
BackgroundAviophobia (the fear of flying) can greatly impact the daily life functioning of people with the condition. Traditional exposure-based treatment is hampered by the limited availability of airplane practice situations, which is a result of economical and practical concerns. Easily accessible and low-cost virtual reality exposure therapy may address these challenges.ObjectiveThe purpose of our study is to investigate the effectiveness of ZeroPhobia: Aviophobia (a self-help mobile app–based treatment) in reducing flight anxiety symptoms and depressive and anxiety symptoms. We will also investigate the effects of usage intensity, the sense of immersion, inherent absorption ability, and perceived user-friendliness on the treatment effect.MethodsParticipants (N=114) who are aged 18-64 years and experience at least mild symptoms of aviophobia will be recruited from the general Dutch population and randomized into a treatment group or waitlist control group. By using their own phones and rudimentary mobile virtual reality headsets, participants will receive six modules of psychoeducation and cognitive behavioral therapy, which will include six levels of virtual reality exposure therapy over a period of 6 weeks. Assessments will be conducted at baseline, posttest (ie, after 6 weeks), and 3- and 12-month follow-ups. The primary outcome measure of our study is the Flight Anxiety Situations Questionnaire. The secondary outcome measures include anxiety and depression measures and additional covariates (including usage intensity, the degree of immersion, etc). We will test treatment effectiveness by conducting an intention-to-treat analysis and estimating average treatment effects on the treated. The mechanisms of treatment effect will also be explored.ResultsThe study was funded on September 25, 2018. Ethical approval was received on October 11, 2019. Recruitment closed on May 7, 2020.ConclusionsOur study will further the scientific understanding and clinical implications of technology’s current ability to aid in providing effective, accessible treatment for the fear of flying.Trial RegistrationNetherlands Trial Registry NL70238.029.19; https://www.trialregister.nl/trial/8257.International Registered Report Identifier (IRRID)DERR1-10.2196/22008
Highlights
Aviophobia, or the fear of flying, is one of the most common specific phobias
The study was funded on September 25, 2018
An estimated 10%-35% of people from Western Europe and North America experience enough flight anxiety that they avoid flying or do so with great discomfort and fear [2]. This avoidance, which is a common characteristic of specific phobia, perpetuates this fear, and results in interruptions to one’s ability to live life
Summary
Aviophobia, or the fear of flying, is one of the most common specific phobias. It has a lifetime prevalence rate of approximately 13.2% [1]. An estimated 10%-35% of people from Western Europe and North America experience enough flight anxiety that they avoid flying or do so with great discomfort and fear [2]. This avoidance, which is a common characteristic of specific phobia, perpetuates this fear, and results in interruptions to one’s ability to live life. Anxiety toward flying can be rooted in a fear of heights (acrophobia) or a fear of small or inescapable spaces (claustrophobia) Such anxiety can result from fears of a plane crashing or the inability to have control over a flight experience [2].
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