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Claustrophobia: Efficacy and Treatment Protocols

Part of the Series in Anxiety and Related Disorders book series (SARD)

Abstract

Claustrophobia is the fear and avoidance of enclosed spaces. It is described as a specific phobia and falls under the general “situational subtype” in the DSM-IV and corresponds to the “enclosed spaces” subtype of specific (isolated) phobia in International Classification of Diseases. It is defined as a marked, persistent, excessive, or unreasonable fear that is cued by being, or anticipation of being, in an enclosed space. For the claustrophobic person, feeling trapped or being in a confined space should almost invariably provoke fear and discomfort if the phobia is mild or anxiety and panic attack if the phobia is more severe. The patient usually avoids the feared claustrophobic situations or else endures them with intense anxiety, discomfort, and a desire to escape. To qualify as a phobia, the severity of the avoidance, anxiety, or anticipation must interfere significantly with the person’s life and the symptoms must have been present for at least 6 consecutive months. The anxiety, panic attacks, or avoidance must not be better accounted for by another mental disorder such as, for example, agoraphobia or posttraumatic stress disorder. Typical situations that trigger claustrophobic fears are small rooms, locked rooms, closets, tunnels, elevators, subway trains, airplanes, functional magnetic resonance imaging (fMRI) or computerized tomography (CT) scans, etc. Feared situations can also involve the mere subjective impression of being trapped, as in situations of physical restraint or in a crowded place. A potentially difficult case of differential diagnosis is between panic disorder with agoraphobia and claustrophobia.

Keywords

  • Claustrophobia
  • Fear of enclosed spaces
  • Clinical uses
  • Physiological arousal

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Notes

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    Note: It is only possible to install the VR environment if a legaly purchased copy of the game is installed on the user’s computer.

References

  • American Psychiatric Association (APA). (2000). Diagnostic and statistical manual of mental disorders fourth edition text revision. Washington, DC: American Psychiatric Association.

    CrossRef  Google Scholar 

  • Bourdon, K. H., Boyd, J. H., Rae, D. S., & Burns, B. J. (1988). Gender differences in phobias: Results of a ECA community survey. Journal of Anxiety Disorders, 2, 227–241.

    CrossRef  Google Scholar 

  • Booth, R., & Rachman, S. (1992). The reduction of claustrophobia—I. Behaviour Research and Therapy, 30(3), 207–221.

    PubMed  CrossRef  Google Scholar 

  • Botella, C., Baños, R. M., Perpiñá, C., Villa, H., Alcañiz, M., & Rey, A. (1998). Virtual reality treatment of claustrophobia: A case report. Behaviour Research and Therapy, 36, 239–246.

    PubMed  CrossRef  Google Scholar 

  • Botella, C., Villa, H., Baños, R., Perpiñá, C., & García-Palacios, A. (1999). The treatment of claustrophobia with virtual reality: Changes in other phobic behaviors not specifically treated. Cyberpsychology and Behavior, 2(2), 135–141.

    PubMed  CrossRef  Google Scholar 

  • Botella, C., Baños, R. M., Villa, H., Perpiñá, C., & García-Palacios, A. (2000). Virtual reality in the treatment of claustrophobic fear: a controlled, multiple-baseline design. Behavior Therapy, 31(3), 583–595.

    CrossRef  Google Scholar 

  • Botella, C., Baños, R. M., & Perpiñá, C. (2002). Claustrophobia: Virtual reality treatment manual. Valencia: Promolibro.

    Google Scholar 

  • Bouchard, S., St-Jacques, J., Côté, S., Robillard, G., & Renaud, P. (2003). Exemples de l’utilisation de la réalité virtuelle dans le traitement des phobies (using virtual reality in the treatment of phobias). Revue Francophone de Clinique Comportementale et Cognitive, 8(4), 5–12.

    Google Scholar 

  • Bouchard, S., Robillard, G., Larouche, S., & Loranger, C. (2012). Description of a treatment manual for in virtuo exposure with specific phobia. In C. Eichenberg (Ed.), Virtual reality in psychological, medical and pedagogical applications (Ch. 4, pp. 82–108). Rijeka: InTech.

    Google Scholar 

  • Bullinger, A. H., Roessler, A., & Mueller-Spahn, F. (1998). Three-dimensional virtual reality as a tool in cognitive-behavioral therapy of claustrophobic patients. Cyberpsychology and Behavior, 1(2), 139–145.

    CrossRef  Google Scholar 

  • Bullinger, A. H., Bergner, J., Roessler, A., Estoppey, K. H., & Mueller-Spahn, F. (1999). Virtual reality in claustrophobia and acrophobia. Presentation at the Medecine Meets Virtual Reality, San Francisco, January 20–23.

    Google Scholar 

  • Costa, R. M., de Carvalho, L. A., Drummond, R., Wauke, A. P., & de Sá Guimaraes, M. (2002). The UFRJ-UERJ group: Interdisciplinary virtual reality experiments in neuropsychiatry. Cyberpsychology and Behavior, 5(5), 423–465.

    PubMed  CrossRef  Google Scholar 

  • Curtis, G. C., Magee, W. J., Eaton, W. W., Wittchen, H.-U., & Kessler, R. C. (1998). Specific fears and phobias: Epidemiology and classification. British Journal of Psychiatry, 173, 212.

    PubMed  CrossRef  Google Scholar 

  • Dumoulin, S., Bouchard, S., Robillard, G., & Arsenault, J.-E. (2008). “Reality tests” increase the efficacy of in virtuo exposure for claustrophobics. Presentation at the CyberTherapy Conference, San Diego, June 23–25.

    Google Scholar 

  • Febbraro, G. A. R., & Clum, G. A. (1995). A dimensional analysis of claustrophobia. Journal of Psychopathology and Behavioral Assessment, 17(4), 335–351.

    CrossRef  Google Scholar 

  • Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99, 20.

    PubMed  CrossRef  Google Scholar 

  • Fredrickson, M., Annas, P., Fischer, H., & Wik, G. (1996). Gender and age differences in the prevalence of specific fears and phobias. Behaviour Research and Therapy, 26, 241.

    Google Scholar 

  • Kamphuis, J. H., & Telch, M. J. (2000). Effects of distraction and guided threat reappraisal on fear reduction during exposure-based treatments for specific fears. Behaviour Research and Therapy, 38, 1163.

    PubMed  CrossRef  Google Scholar 

  • Kennedy, R. S., Lane, N. E., Berbaum, K. S., & Lilienthal, M. G. (1993). Simulator sickness questionnaire: An enhanced method for quantifying simulator sickness. International Journal of Aviation Psychology, 3(3), 203–220.

    CrossRef  Google Scholar 

  • Krijn, M., Emmelkamp, P. M. G., Olapsson, R. P., Bouwman, M., van Gerven, L. J., Spinhoven, P., Schuemie, M. J., & van der Mast, C. A. P. G. (2007). Fear of flying treatment methods: Virtual reality exposure vs cognitive behavioural therapy. Aviation, Space, and Environmental Medicine, 78, 121–128.

    PubMed  Google Scholar 

  • Lang, P. J. (1977). Imagery in therapy: An information processing analysis of fear. Behavior Therapy, 8, 862–886.

    CrossRef  Google Scholar 

  • Malbos, E., Mestre, D. R., Note, I. D., & Gellato, C. (2008). Virtual reality in claustrophobia: Multiple components therapy involving game editor virtual environments exposure. Cyberpsychology and Behavior, 11(6), 695–697.

    PubMed  CrossRef  Google Scholar 

  • Mager, R., Bullinger, A. H., Mueller-Spahn, F., Kuntze, M. F., & Stoermer, R. (2001). Real-time monitoring of brain activity in patients with specific phobia during exposure therapy, employing a stereoscopic virtual environment. Cyberpsychology and Behavior, 4(4), 465–469.

    PubMed  CrossRef  Google Scholar 

  • Öst, L.-G., Johansson, J., & Jerrehalm, A. (1982). Individual response patterns and the effects of different behavioral methods in the treatment of claustrophobia. Behaviour Research and Therapy, 20(5), 445–460.

    PubMed  CrossRef  Google Scholar 

  • Öst, L.-G., Alm, T., Brandberg, M., & Breitholtz, E. (2001). One vs five sessions of exposure of cognitive therapy in the treatment of claustrophobia. Behaviour Research and Therapy, 39, 167.

    PubMed  CrossRef  Google Scholar 

  • Powers, M. B., Smits, A. J., Telch, M. J. (2004). Disentangling the effects of safety-behavior utilization and safety behaviour availability during exposure-based treatment: A placebo-controlled trial. Journal of Consulting and Clinical Psychology, 72(3), 448–454.

    PubMed  CrossRef  Google Scholar 

  • Rachman, S. J. (1997). Claustrophobia. In G. C. L. Davey (Ed.), Phobias: A handbook of theory, research and treatment (pp. 163–181). Chichester: Wiley.

    Google Scholar 

  • Rachman, S., & Taylor, S. (1993). Analyses of claustrophobia. Journal of Anxiety Disorders, 7, 281–291.

    CrossRef  Google Scholar 

  • Sik Lányi, C., Laky, V., Tilinger, A., Pataky, I., Simon, L., Kiss, M., Simon, V., Szabo, J., & Páll, A. (2004). Developing multimedia software and virtual reality worlds and their use in rehabilitation and psychology. In M. Duplaga et al. (Eds.), Transformation of health care with information technologies (pp. 273–284). Amsterdam: IOS Press.

    Google Scholar 

  • Stinson, F. S., Dawson, D. A., Chou, S. P., Smith, S., Goldstein, R. B., Ruan, W. J., & Grant, B. F. (2007). The epidemiology of DSM-IV specific phobia in the USA: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychological Medicine, 37, 1047.

    PubMed  CrossRef  Google Scholar 

  • Wiederhold, B. K. (2003). Conquering panic, anxiety, & phobias: Achieving success through virtual reality and cognitive behavioral therapy. San Diego: Interactive Media Institute.

    Google Scholar 

  • Wiederhold, B. K., & Wiederhold, M. D. (2000). Lessons learned from 600 virtual reality sessions. Cyberpsychology and Behavior, 3(3), 393–400.

    CrossRef  Google Scholar 

  • Wiederhold, B. K., & Wiederhold, M. D. (2005). Virtual reality therapy for anxiety disorders: Advances in evaluation and treatment. Washington, DC: American Psychological Association.

    CrossRef  Google Scholar 

  • Wiederhold, B. K., Jang, D. P., & Wiederhold, M. D. (2002). Refining the physiometric profile in virtual reality treatment. Proceedings of the VR and Mental Health Symposium, Medicine Meets Virtual Reality Conference, Newport Beach, CA.

    Google Scholar 

  • World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders. Geneva: WHO.

    Google Scholar 

Download references

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Correspondence to Brenda K. Wiederhold .

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Wiederhold, B., Bouchard, S. (2014). Claustrophobia: Efficacy and Treatment Protocols. In: Advances in Virtual Reality and Anxiety Disorders. Series in Anxiety and Related Disorders. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-8023-6_7

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