Skip to main content
SpringerLink
Log in

Consequences of visual height intolerance for quality of life: a qualitative study

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

Visual height intolerance (vHI) occurs when a trigger causes the apprehension of losing balance and falling. Depending on the severity of vHI, an avoidance behavior may develop in about 50 % of the thus afflicted, and it can have considerable impact on their daily life and interpersonal interactions. It seems obvious that such experiences may be impairing and distressing, but this has not yet been examined systematically. Objective of this study was to examine the consequences of vHI for quality of life.

Methods

A qualitative, phenomenological exploratory approach was chosen. Individual face-to-face interviews were conducted with individuals who had reported in a previous study that they were susceptible to vHI. The interview transcripts were segregated into distinct meaning units, which were used to create a coding guideline with meta- and subcodes. Meaning units were then systematically extracted and assigned to the appropriate codes. Weights and links were used to assign priorities for interpretation.

Results

Eighteen participants were interviewed (mean age 53, range 30–73; 11 females). Data analysis resulted in 29 meta-codes and 115 subcodes. Responses indicated that vHI can be very disabling and has a relevant impact on quality of life and daily activities of the affected persons, including their family life and behavior towards partner, children and friends.

Conclusion

Relevant topics for further quantitative studies were identified, for example, strategies of compensation and the influence of vHI on family life. Other quantitative studies should determine whether comorbidities and the typologies found in this study have consequences for individual therapeutic approaches.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Brandt, T., Arnold, F., Bles, W., & Kapteyn, T. S. (1980). The mechanism of physiological height vertigo. I. Theoretical approach and psychophysics. Acta Oto-Laryngologica, 89(5–6), 513–523.

    Article  PubMed  CAS  Google Scholar 

  2. Brandt, T., Strupp, M., & Huppert, D. (2012). Height intolerance: An underrated threat. Journal of Neurology, 259(4), 759–760.

    Article  PubMed  Google Scholar 

  3. Huppert, D., Grill, E., & Brandt, T. (2013). Down on heights? One in three has visual height intolerance. Journal of Neurology, 260(2), 597–604.

    Article  PubMed  Google Scholar 

  4. World Health Organsiation. (1993). The ICD-10 Classification of mental and behavioral disorders. Clinical Description and Diagnostic Guidelines. Geneva: WHO.

    Google Scholar 

  5. American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders. In C. O. N. A. Statistics (Ed.). Washington DC: American Psychiatric Press.

  6. LeBeau, R. T., Glenn, D., Liao, B., Wittchen, H.-U., Beesdo-Baum, K., Ollendick, T., et al. (2010). Specific phobia: A review of DSM-IV specific phobia and preliminary recommendations for DSM-V. Depression and Anxiety, 27(2), 148–167.

    Article  PubMed  Google Scholar 

  7. Menzies, R. G., & Clarke, J. C. (1995). Danger expectancies and insight in acrophobia. Behaviour Research and Therapy, 33(2), 215–221.

    Article  PubMed  CAS  Google Scholar 

  8. Salassa, J. R., & Zapala, D. A. (2009). Love and fear of heights: The pathophysiology and psychology of height imbalance. Wilderness and environmental medicine, 20(4), 378–382.

    Article  PubMed  Google Scholar 

  9. Olatunji, B. O., Cisler, J. M., & Tolin, D. F. (2007). Quality of life in the anxiety disorders: a meta-analytic review. Clinical Psychological Review, 27(5), 572–581.

    Article  Google Scholar 

  10. Barrera, T. L., & Norton, P. J. (2009). Quality of life impairment in generalized anxiety disorder, social phobia, and panic disorder. Journal of Anxiety Disorders, 23(8), 1086–1090.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Depla, M. F., ten Have, M. L., van Balkom, A. J., & de Graaf, R. (2008). Specific fears and phobias in the general population: results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Social Psychiatry and Psychiatric Epidemiology, 43(3), 200–208.

    Article  PubMed  Google Scholar 

  12. Lamnek, S. (2010). Qualitative Sozialforschung (5Ed.). Basel: Beltz.

  13. Flick, U. (2009). An Introduction to Qualitative Research (4Ed.). London: SAGE Publications.

  14. Witzel, A. (1982). Verfahren der qualitativen Sozialforschung. Überblick und Alternativen. Campus: Frankfurt am Main.

    Google Scholar 

  15. Witzel, A. (2000). The Problem-Centered Interview. Forum: Qualitative social research.

  16. Ware, J. E., Jr, & Sherbourne, C. D. (1992). The MOS 36-Item Short-Form Health Survey (SF-36): I. Conceptual Framework and Item Selection. Medical Care, 30(6), 473–483.

    Article  PubMed  Google Scholar 

  17. Grill, E., & Stucki, G. (2011). Criteria for validating comprehensive ICF Core Sets and developing brief ICF Core Set versions. Journal of Rehabilitation Medicine, 43(2), 87–91.

    Article  PubMed  Google Scholar 

  18. Mayring, P. (2004). Qualitative Content Analysis. In E. Kardorff, I. Steinke, U. Flick (Ed.), A Companion to Qualitative Research (pp. 266–269). London: SAGE Publications.

  19. Schmidt, C. (2004). The Analysis of Semi-structured Interviews. In E. Kardorff, I. Steinke, U. Flick (Ed.), A Companion to Qualitative Research (pp. 253–258). London: SAGE Publications.

  20. Mayring, P. (2000). Qualitative content analysis. Forum: Qualitative social research.

  21. Kelle, U., Kluge, S. (2010). Vom Einzelfall zum Typus. Fallvergleich und Kontrastierung in der qualitativen Sozialforschung (2Ed.). Wiesbaden: VS.

  22. Flick, U. (2009). Sozialforschung. Methoden und Anwendungen. Ein Überblick für BA-Studiengänge.. Rowohlt: Reinbeck.

    Google Scholar 

  23. Stefanucci, J. K., & Proffitt, D. R. (2009). The roles of altitude and fear in the perception of height. Journal of Experimental Psychology: Human Perception and Performance, 35(2), 424–438.

    PubMed Central  PubMed  Google Scholar 

  24. Lochner, C., Mogotsi, M., du Toit, P. L., Kaminer, D., Niehaus, D. J., & Stein, D. J. (2003). Quality of life in anxiety disorders: a comparison of obsessive-compulsive disorder, social anxiety disorder, and panic disorder. Psychopathology, 36(5), 255–262.

    Article  PubMed  Google Scholar 

  25. Rapaport, M. H., Clary, C., Fayyad, R., & Endicott, J. (2005). Quality-of-life impairment in depressive and anxiety disorders. American Journal of Psychiatry, 162(6), 1171–1178.

    Article  PubMed  Google Scholar 

  26. Norberg, M. M., Diefenbach, G. J., & Tolin, D. F. (2008). Quality of life and anxiety and depressive disorder comorbidity. Journal of Anxiety Disorders, 22(8), 1516–1522.

    Article  PubMed  Google Scholar 

  27. Magee, W. J., Eaton, W. W., Wittchen, H. U., McGonagle, K. A., & Kessler, R. C. (1996). Agoraphobia, simple phobia, and social phobia in the National Comorbidity Survey. Archives of General Psychiatry, 53(2), 159–168.

    Article  PubMed  CAS  Google Scholar 

  28. Brandt, T., Benson, J., Huppert, D. (2012). What to call “non-phobic” fear of heights? The British Journal of Psychiatry, 190(81).

Download references

Acknowledgments

We are very grateful to the participants who agreed to share their perspectives and experiences. This project was supported by funds from the German Federal Ministry of Education and Research under the Grant code 01 EO 0901 and the Hertie Foundation. The authors bear full responsibility for the content of this publication. The authors thank Constance Engelfried, Christian Janßen, Andreas Panitz, Gabriela Zink and Johann Dotzler from the University of Applied Sciences Munich and especially Elisabeth Foot for the fruitful discussions on methods. We thank Judy Benson for copyediting the manuscript.

Conflict of interest

The authors declare that they have no competing interests.

Author information

Authors and Affiliations

  1. Institute for Medical Information Processing, Biometrics and Epidemiology (IBE), Ludwig-Maximilians Universität München, Marchioninistr. 17, 81377, Munich, Germany

    Florian Schäffler, Martin Müller, Theresa Tiffe & Eva Grill

  2. Department of Applied Social Sciences, Hochschule München, University of Applied Sciences, Am Stadtpark 20, 81243, Munich, Germany

    Florian Schäffler

  3. German Center for Vertigo and Balance Disorders, Ludwig-Maximilians Universität München, Marchioninistr. 15, 81377, Munich, Germany

    Martin Müller, Doreen Huppert, Thomas Brandt & Eva Grill

  4. Institute for Clinical Neurosciences, Ludwig-Maximilians Universität München, Marchioninistr. 15, 81377, Munich, Germany

    Doreen Huppert & Thomas Brandt

  5. Westsächsische Hochschule Zwickau, University of Applied Sciences, Dr.-Friedrichs-Ring 2, 08056, Zwickau, Germany

    Theresa Tiffe

Authors
  1. Florian Schäffler
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Martin Müller
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Doreen Huppert
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Thomas Brandt
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Theresa Tiffe
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Eva Grill
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eva Grill.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schäffler, F., Müller, M., Huppert, D. et al. Consequences of visual height intolerance for quality of life: a qualitative study. Qual Life Res 23, 697–705 (2014). https://doi.org/10.1007/s11136-013-0506-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-013-0506-6

Keywords

Search

Navigation