Limits...
Visual height intolerance and acrophobia: distressing partners for life

View Article: PubMed Central - PubMed

ABSTRACT

The course of illness, the degree of social impairment, and the rate of help-seeking behavior was evaluated in a sample of individuals with visual height intolerance (vHI) and acrophobia. On the basis of a previously described epidemiological sample representative of the German general population, 574 individuals with vHI were identified, 128 fulfilled the DSM-5 diagnostic criteria of acrophobia. The illness of the majority of all susceptible individuals with vHI ran a year-long chronic course. Two thirds were in the category “persistent/worse”, whereas only one third was in the category “improved/remitted”. Subjects with acrophobia showed significantly more traumatic triggers of onset, more signs of generalization to other height stimuli, higher rates of increasing intensity of symptom load, higher grades of social impairment, and greater overall negative impact on the quality of life than those with pure vHI. An unfavorable course of illness in pure vHI was predicted by major depression, agoraphobia, social phobia, posttraumatic stress, initial traumatic trigger, and female sex; an unfavorable course in acrophobia was predicted by major depression, chronic fatigue, panic attacks, initial traumatic trigger, social phobia, other specific phobic fears, and female sex. Help-seeking behavior was astonishingly low in the overall sample of individuals with vHI. The consequences of therapeutic interventions if complied with at all were quite modest. In adults pure vHI and even more so acrophobia are by no means only transitionally distressing states. In contrast to their occurrence in children they are more often persisting and disabling conditions. Both the utilization of and adequacy of treatment of these illnesses pose major challenges within primary and secondary neurological and psychiatric medical care.

No MeSH data available.


Related in: MedlinePlus

Course of illness in individuals with pure visual height intolerance (n = 446) vs. acrophobia (n = 128)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC5037147&req=5

Fig1: Course of illness in individuals with pure visual height intolerance (n = 446) vs. acrophobia (n = 128)

Mentions: As regards the course of illness in general, after the first occurrence of vHI symptoms the illness spontaneously improved in 31 % of individuals, persisted on a constant level of intensity in 52 %, and worsened in 13 % in the further course (4 % could not report on the course of vHI symptoms [4]. Figure 1 gives an overview comparing the general course of illness in the subgroups of pure vHI vs acrophobia. Although individuals with pure vHI seemed to have a more favorable course overall (improved/remitted: 31 %; worse/persistent: 69 %) than individuals with acrophobia (improved/remitted: 23 %; worse/persistent: 77 %), this tendency did not reach the level of statistical significance set in advance (χ2 = 2452; p = 0.071). If the rates of increasing intensity of symptom load during the course were measured, a significantly more unfavorable development was observed in individuals with acrophobia vs pure vHI (χ2 = 4.659; p = 0.023).


Visual height intolerance and acrophobia: distressing partners for life
Course of illness in individuals with pure visual height intolerance (n = 446) vs. acrophobia (n = 128)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037147&req=5

Fig1: Course of illness in individuals with pure visual height intolerance (n = 446) vs. acrophobia (n = 128)
Mentions: As regards the course of illness in general, after the first occurrence of vHI symptoms the illness spontaneously improved in 31 % of individuals, persisted on a constant level of intensity in 52 %, and worsened in 13 % in the further course (4 % could not report on the course of vHI symptoms [4]. Figure 1 gives an overview comparing the general course of illness in the subgroups of pure vHI vs acrophobia. Although individuals with pure vHI seemed to have a more favorable course overall (improved/remitted: 31 %; worse/persistent: 69 %) than individuals with acrophobia (improved/remitted: 23 %; worse/persistent: 77 %), this tendency did not reach the level of statistical significance set in advance (χ2 = 2452; p = 0.071). If the rates of increasing intensity of symptom load during the course were measured, a significantly more unfavorable development was observed in individuals with acrophobia vs pure vHI (χ2 = 4.659; p = 0.023).

View Article: PubMed Central - PubMed

ABSTRACT

The course of illness, the degree of social impairment, and the rate of help-seeking behavior was evaluated in a sample of individuals with visual height intolerance (vHI) and acrophobia. On the basis of a previously described epidemiological sample representative of the German general population, 574 individuals with vHI were identified, 128 fulfilled the DSM-5 diagnostic criteria of acrophobia. The illness of the majority of all susceptible individuals with vHI ran a year-long chronic course. Two thirds were in the category “persistent/worse”, whereas only one third was in the category “improved/remitted”. Subjects with acrophobia showed significantly more traumatic triggers of onset, more signs of generalization to other height stimuli, higher rates of increasing intensity of symptom load, higher grades of social impairment, and greater overall negative impact on the quality of life than those with pure vHI. An unfavorable course of illness in pure vHI was predicted by major depression, agoraphobia, social phobia, posttraumatic stress, initial traumatic trigger, and female sex; an unfavorable course in acrophobia was predicted by major depression, chronic fatigue, panic attacks, initial traumatic trigger, social phobia, other specific phobic fears, and female sex. Help-seeking behavior was astonishingly low in the overall sample of individuals with vHI. The consequences of therapeutic interventions if complied with at all were quite modest. In adults pure vHI and even more so acrophobia are by no means only transitionally distressing states. In contrast to their occurrence in children they are more often persisting and disabling conditions. Both the utilization of and adequacy of treatment of these illnesses pose major challenges within primary and secondary neurological and psychiatric medical care.

No MeSH data available.


Related in: MedlinePlus