Effectiveness of cognitive behavioral therapy integrated with systematic desensitization, cognitive behavioral therapy combined with eye movement desensitization and reprocessing therapy, and cognitive behavioral therapy combined with virtual reality exposure therapy methods in the treatment of flight anxiety: a randomized trial

Maria Teresa Triscari, Palmira Faraci, Dario Catalisano, Valerio D'Angelo, Viviana Urso, Maria Teresa Triscari, Palmira Faraci, Dario Catalisano, Valerio D'Angelo, Viviana Urso

Abstract

The purpose of the research was to compare the effectiveness of the following treatment methods for fear of flying: cognitive behavioral therapy (CBT) integrated with systematic desensitization, CBT combined with eye movement desensitization and reprocessing therapy, and CBT combined with virtual reality exposure therapy. Overall, our findings have proven the efficacy of all interventions in reducing fear of flying in a pre- to post-treatment comparison. All groups showed a decrease in flight anxiety, suggesting the efficiency of all three treatments in reducing self-report measures of fear of flying. In particular, our results indicated significant improvements for the treated patients using all the treatment programs, as shown not only by test scores but also by participation in the post-treatment flight. Nevertheless, outcome measures maintained a significant effect at a 1-year follow-up. In conclusion, combining CBT with both the application of eye movement desensitization and reprocessing treatment and the virtual stimuli used to expose patients with aerophobia seemed as efficient as traditional cognitive behavioral treatments integrated with systematic desensitization.

Keywords: EMDR; VRET; aerophobia; cognitive behavioral therapy; fear of flying; flight anxiety.

Figures

Figure 1
Figure 1
Average scores on the FAM and FAS subscales at CBT-SD, CBT-EMDR, and CBT-VRET pre-treatment. Abbreviations: FAM, Flight Anxiety Modality; FAS, Flight Anxiety Situations; CBT-SD, cognitive behavioral therapy integrated with systematic desensitization; CBT-EMDR, cognitive behavioral therapy combined with eye movement desensitization and reprocessing therapy; CBT-VRET, cognitive behavioral therapy combined with virtual reality exposure therapy; GFA, Generalized Flight Anxiety; AFA, Anticipatory Flight Anxiety; I-FA, In-Flight Anxiety; SM, Somatic Modality; CM, Cognitive Modality; Ts, total score.
Figure 2
Figure 2
Average scores on the FAM and FAS subscales at CBT-SD, CBT-EMDR, and CBT-VRET post-treatment. Abbreviations: FAM, Flight Anxiety Modality; FAS, Flight Anxiety Situations; CBT-SD, cognitive behavioral therapy integrated with systematic desensitization; CBT-EMDR, cognitive behavioral therapy combined with eye movement desensitization and reprocessing therapy; CBT-VRET, cognitive behavioral therapy combined with virtual reality exposure therapy; GFA, Generalized Flight Anxiety; AFA, Anticipatory Flight Anxiety; I-FA, In-Flight Anxiety; SM, Somatic Modality; CM, Cognitive Modality; Ts, total score.
Figure 3
Figure 3
Average scores on the FAM and FAS subscales at CBT-SD, CBT-EMDR, and CBT-VRET follow-up measures. Abbreviations: FAM, Flight Anxiety Modality; FAS, Flight Anxiety Situations; CBT-SD, cognitive behavioral therapy integrated with systematic desensitization; CBT-EMDR, cognitive behavioral therapy combined with eye movement desensitization and reprocessing therapy; CBT-VRET, cognitive behavioral therapy combined with virtual reality exposure therapy; GFA, Generalized Flight Anxiety; AFA, Anticipatory Flight Anxiety; I-FA, In-Flight Anxiety; SM, Somatic Modality; CM, Cognitive Modality; Ts, total score.
Figure 4
Figure 4
Average scores on the FAM and FAS subscales at CBT-SD (n=22), CBT-EMDR (n=22), and CBT-VRET (n=21) pre-test, post-test, and follow-up. Abbreviations: FAM, Flight Anxiety Modality; FAS, Flight Anxiety Situations; CBT-SD, cognitive behavioral therapy integrated with systematic desensitization; CBT-EMDR, cognitive behavioral therapy combined with eye movement desensitization and reprocessing therapy; CBT-VRET, cognitive behavioral therapy combined with virtual reality exposure therapy; GFA, Generalized Flight Anxiety; AFA, Anticipatory Flight Anxiety; I-FA, In-Flight Anxiety; SM, Somatic Modality; CM, Cognitive Modality; Ts, total score.

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