title: Physiological reactivity to phobic stimuli in people with fear of flying.
abstract: OBJECTIVE
  The nature of the relationship between physiological and subjective responses in phobic subjects remains unclear. Phobics have been thought to be characterized by a heightened physiological response (physiological perspective) or by a heightened perception of a normal physiological response (psychological perspective).
  
  
  METHODS
  In this study, we examined subjective measures of anxiety, heart rate (HR), and cardiac autonomic responses to flight-related stimuli in 127 people who applied for fear-of-flying therapy at a specialized treatment center and in 36 controls without aviophobia.
  
  
  RESULTS
  In keeping with the psychological perspective, we found a large increase in subjective distress (eta(2)=.43) during exposure to flight-related stimuli in the phobics and no change in subjective distress in the controls, whereas the physiological responses of both groups were indiscriminate. However, in keeping with the physiological perspective, we found that, within the group of phobics, increases in subjective fear during exposure were moderately strong coupled to HR (r =.208, P=.022) and cardiac vagal (r =.199, P=.028) reactivity. In contrast to predictions by the psychological perspective, anxiety sensitivity did not modulate this coupling.
  
  
  CONCLUSIONS
  We conclude that subjective fear responses and autonomic responses are only loosely coupled during mildly threatening exposure to flight-related stimuli. More ecologically valid exposure to phobic stimuli may be needed to test the predictions from the physiological and psychological perspectives.
authors: VALK Foundation, Leiden, The Netherlands. b.h.busscher@umail.leidenuniv.nl
authors: Bert
authors: B
authors: Busscher
authors: Lucas J
authors: LJ
authors: van Gerwen
authors: Philip
authors: P
authors: Spinhoven
authors: Eco J C
authors: EJ
authors: de Geus
mesh_terms: D000704:Analysis of Variance; D001007:Anxiety / Q000503:physiopathology* / Q000523:psychology; D001341:Autonomic Nervous System / Q000503:physiopathology*; D005239:Fear / Q000523:psychology; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D010698:Phobic Disorders / Q000503:physiopathology* / Q000523:psychology; D012044:Regression Analysis; D011795:Surveys and Questionnaires