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Abstract
A review of the literature suggests that fear of flying is quite prevalent in the United States population, with 10–20% of the population experiencing some anxiety about flying. In treating fear of flying, most studies have used exposure therapy, whether imaginal or in vivo. A new form of exposure therapy, virtual reality graded exposure therapy (VRGET), appears from case studies to offer some advantage to more traditional exposure therapies. Since no controlled study has shown this treatment to be efficacious, this study investigated the efficacy of VRGET as compared to imaginal exposure therapy (IET) in the treatment of fear of flying. Subjective units of discomfort levels (SUDS), self-report questionnaire scores, and physiological indices were used as measurements.
Participants were given two sessions of relaxation training, followed by six sessions of exposure therapy, either imaginal or virtual. Three groups, with 10 participants in each group, were included in the study: virtual reality with no physiological feedback (VRGETno), virtual reality with physiological feedback (VRGETpm), and imaginal exposure with no physiological feedback (IET). Contrary to what was expected, the JET and VRGET groups showed no statistically significant differences on questionnaire scores when measured after two sessions of relaxation training or after six sessions of exposure. The groups did differ significantly, however, on flying behavior at three-month follow-up. Eighty-percent of the VRGETno group, 100% of the VRGETpm group, and 10% of the IET group could fly without medication or alcohol at follow-up. Also interesting was the fact that all those who could fly without medication or alcohol at follow-up showed synchrony between SUDS and skin resistance levels, providing support for Rachman's theory of synchrony.
The IET group encountered quite a large dropout rate, with only 37.5% of those who participated in an intake session completing treatment. The present study seems to indicate that VRGET may offer distinct advantages over IET in the treatment of fear of flying. As compared to in vivo exposure, VRGET may also offer the advantages of controllability, time and cost savings, and confidentiality.
