Acrophobia

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Acrophobia
SpecialtyPsychiatry
SymptomsPanic attacks

Acrophobia 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 both 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 those hiking or climbing in mountainous terrain and also in certain jobs such as steeplejacks or Thatchers.

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. The term is from the Greek: ἄκρον, ákron, meaning "peak, summit, edge" and φόβος, phóbos, "fear".

Confusion with vertigo[edit | edit source]

"Vertigo" is often used (incorrectly) to describe a fear of heights, but it is more accurately a spinning sensation that occurs when one is not actually spinning. It can be triggered by looking down from a high place, by looking straight up at a high place or tall object, or even by watching something (i.e. a bird) go past at high speed, but this alone does not describe vertigo. True vertigo can be triggered by almost any type of movement (e.g. standing up, sitting down, walking) or change in visual perspective (e.g. squatting down, walking up or downstairs, looking out of the window of a wagon). Vertigo is called height vertigo when the sensation of vertigo is triggered by heights.

Height vertigo is caused by a conflict between vision, vestibular and somatosensory senses. This occurs when vestibular and somatosensory systems sense a body movement that is not detected by the eyes. More research indicate that this conflict lead to both motion sickness and anxiety.

Causes[edit | edit source]

Traditionally, acrophobia has been attributed, like other phobias, to conditioning or a traumatic experience. Though some recent studies have cast doubt on this explanation. Individuals with acrophobia are found to be lacking in traumatic experiences. Nevertheless, this may due to the failure to recall the experiences, as memory fades as time passes. Some research shows that those with less fear of heights had more injuries because of falling. 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. Coginitive 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. A traumatic conditional event of falling may not be necessary at this point.

A fear of falling, along with a fear of loud noises, is one of the most commonly suggested inborn or "non-associative" fears. This theory holds is that a fear of heights is an evolved adaptation to a world where falls posed a significant danger. If this fear is inherited, it is possible that people can get rid of it by frequent exposure of heights in habituation. In other words, acrophobia could be attributed to the lack of exposure in early times. The degree of fear varies and the term phobia is reserved for those at the extreme end of the spectrum. Researchers have argued that a fear of heights is an instinct found in many mammals, including domestic animals and humans. While an innate cautiousness around heights is helpful for survival, an extreme fear can interfere with the activities of everyday life, such as climbing a ladder, standing on a chair, or even walking up a flight of stairs.

Treatment[edit | edit source]

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 situation, anxiety is reduced. However, avoidance behaviour is reinforced through negative reinforcement. Wolpe developed a technique called "systematic desensitization to help participants avoid "avoidance". Research results have suggested that even with a decrease in therapeutic contact densensitization is still very effective. However, other studies have shown that therapists play an essential role in acrophobia treatment. Treatments like reinforced practice and self-efficacy treatments also emerged.

Many different types of medications are used in the treatment of phobias like fear of heights, including traditional anti-anxiety drugs such as benzodiazepines, and newer options like antidepressants and beta-blockers.

Prognosis[edit | edit source]

Some desensitization treatments produce short-term improvements in symptoms.

Epidemiology[edit | edit source]

True acrophobia is uncommon.

A related, milder form of visually triggered fear or anxiety is called visual height intolerance (vHI). Up to one-third of people may have some level of visual height intolerance. Pure vHI usually has smaller impact on individuals compared to acrophobia, in terms of intensity of syptoms load, social life, and overall life quality. However, only a few people with visual height intolerance seek professional help.

See also[edit | edit source]

External links[edit | edit source]