Acrophobia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Acrophobia (from Greek ἄκρος, meaning "summit") is an extreme or irrational fear of heights. It belongs to a category of specific phobias, called space and motion discomfort that share both similar etiology and options for treatment.

Acrophobia can be dangerous, as sufferers can experience a panic attack in a high place and become too agitated to get themselves down safely. Some acrophobics also suffer from urges to throw themselves off high places, despite not being suicidal.

"Vertigo" is often used, incorrectly, to describe the fear of heights, but it is more accurately described as a spinning sensation, which may be caused by looking down from a high place, as well as by some other stimuli. Vertigo is qualified as height vertigo when referring to dizziness triggered by heights.

Etiology

Traditionally, acrophobia has been attributed, like other irrational fears, to conditioning or a traumatic experience involving heights. Recent studies have cast doubt on this explanation;[1] fear of falling, along with fear of loud noises, is one of the most commonly suggested inborn or non-associative fears. The newer non-association theory is that fear of heights is an evolved adaptation to a prehistory where falls posed a significant danger. The degree of fear varies and the term phobia is reserved for those at the extreme end of the spectrum. It has been argued by researchers that fear of heights is an instinct found in many mammals, including domestic animals and human beings. There have been experiments showing toddler babies and cats of various ages being terrified of venturing onto a glass floor with a view of a few meters of 'fall-space' below it. [2]An extreme fear however can interfere with the challenges of everyday life, such as climbing up a flight of stairs or a ladder, or standing on a chair, table, (etc.).

A possible contributing factor is dysfunction in maintaining balance. In this case the anxiety is both well founded and secondary. The human balance system integrates proprioceptive, vestibular and nearby visual cues to reckon position and motion.[3][4] As height increases visual cues recede and balance becomes poorer even in normal people. [5] However most people respond by shifting to more reliance on the proprioceptive and vestibular branches of the equilibrium system.

An acrophobic, on the other hand, continues to overrely on visual signals whether because of inadequate vestibular function or incorrect strategy. Locomotion at a high elevation requires more than normal visual processing. The visual cortex becomes overloaded resulting in confusion. Some proponents of the alternative view of acrophobia warn that it may be ill-advised to encourage acrophobics to expose themselves to height without first resolving the vestibular issues. Research is underway at several clinics.[6]

References

  1. Menzies, RG (1995). "The etiology of acrophobia and its relationship to severity and individual response patterns". Behaviour Research and Therapy (31): 499–501. 7677717. Retrieved 2007-09-10. Unknown parameter |coauthors= ignored (help)
  2. Primary sources
  3. Furman, Joseph M (2005). "Acrophobia and pathological height vertigo: indications for vestibular physical therapy?". Physical Therapy. Retrieved 2007-09-10. Unknown parameter |month= ignored (help)
  4. Jacob, Rolf G (1993). "Discomfort with space and motion: A possible marker of vestibular dysfunction assessed by the situational characteristics questionnaire". Journal of Psychopathology and Behavioral Assessment. 15 (4): 299–324. 0882-2689. Retrieved 2007-09-10. Unknown parameter |month= ignored (help); Unknown parameter |coauthors= ignored (help)
  5. "The mechanism of physiological height vertigo. I. Theoretical approach and psychophysics". Acta Otolaryngol. (5-6). 89. Check date values in: |date= (help)
  6. Whitney, SL (2005). "Acrophobia and pathological height vertigo: indications for vestibular physical therapy?". Physical Therapy. 85 (5): 443–458. 15842192. Retrieved 2007-09-10. Unknown parameter |month= ignored (help); Unknown parameter |coauthors= ignored (help)

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