Increased interoceptive awareness in fear of flying: sensitivity to suffocation signals.

In flight phobia, particular environmental factors can facilitate a fear response. The current study aimed to explore the relationship between respiratory sensations and fear of flying: individuals with fear of flying may be more sensitive to suffocation signals and could experience more bodily sensations as a consequence of an added resistive respiratory load. The sample included 19 subjects with fear of flying and 19 controls. Each subject wore a mask to which a respiratory load could be added. First, an interference paradigm was used: respiratory loads were presented during a tone detection task. Next, subjects were asked to detect the loads. After each task, subjects reported their somatic sensations. All subjects showed interference of the respiratory loads. However, subjects with fear of flying were more accurate in detecting the loads, thereby indicating higher interoceptive awareness. Moreover, their superior accuracy was related to increased bodily sensations: a higher interoceptive awareness resulted in increased symptom reporting. It follows that treatment interventions for fear of flying should be supplemented with interventions that target internal stimuli.