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Acrophobia

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313: 74: 276:" is often used to describe a fear of heights, but it is more accurately a spinning sensation that occurs when one is not actually spinning. It can be triggered by looking down from a high place, by looking straight up at a high place or tall object, or even by watching something (i.e. a car or a bird) go past at high speed, but this alone does not describe vertigo. True vertigo can be triggered by almost any type of movement (e.g. standing up, sitting down, walking) or change in visual perspective (e.g. squatting down, walking up or down stairs, looking out of the window of a moving car or train). Vertigo is called 373:, as well as other animals of various ages, to be reluctant in venturing onto a glass floor with a view of a few meters of apparent fall-space below it. Although human infants initially experienced fear when crawling on the visual cliff, most of them overcame the fear through practice, exposure and mastery and retained a level of healthy cautiousness. While an innate cautiousness around heights is helpful for survival, extreme fear can interfere with the activities of everyday life, such as standing on a 242: 357:, is one of the most commonly suggested inborn or "non-associative" fears. The newer non-association theory is that a fear of heights is an evolved adaptation to a world where falls posed a significant danger. If this fear is inherited, it is possible that people can get rid of it by frequent exposure of heights in habituation. In other words, acrophobia could be associated with a lack of exposure to heights in early life. The degree of fear varies, and the term 350:
would learn the concepts about surfaces, posture, balance, and movement. Cognitive factors may also contribute to the development of acrophobia. People tend to wrongly interpret visuo-vestibular discrepancies as dizziness and nausea and associate them with a forthcoming fall. Experiencing these cognitive factors while associating them with the idea of falling may be enough to cause the same fear that would be expected after a traumatic fall.
537:(vHI). Up to one-third of people may have some level of visual height intolerance. Pure vHI usually has smaller impact on individuals compared to acrophobia, in terms of intensity of symptoms load, social life, and overall life quality. However, few people with visual height intolerance seek professional help. 341:
who had been injured in a fall between the ages of 5 and 9, compared them to children who had no similar injury, and found that at age 18, acrophobia was present in only 2 percent of the subjects who had an injurious fall but was present among 7 percent of subjects who had no injurious fall (with the
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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. Recent studies found that
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However, acrophobic individuals tend to have biases in self-reporting. They often overestimate the danger and question their abilities of addressing height relevant issues. A Height Interpretation Questionnaire (HIQ) is a self-report to measure these height relevant judgements and interpretations.
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are used to diagnose acrophobia. Acrophobia Questionnaire (AQ) is a self report that contains 40 items, assessing anxiety level on a 0–6 point scale and degree of avoidance on a 0–2 point scale. The Attitude Towards Heights Questionnaires (ATHQ) and Behavioural Avoidance Tests (BAT) are also used.
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More studies have suggested a possible explanation for acrophobia is that it emerges through accumulation of non-traumatic experiences of falling that are not memorable but can influence behaviours in the future. Also, fear of heights may be acquired when infants learn to crawl. If they fell, they
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experience. Recent studies have cast doubt on this explanation. Individuals with acrophobia are found to be lacking in traumatic experiences. Nevertheless, this may be due to the failure to recall the experiences, as memory fades as time passes. To address the problems of self report and memory, a
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for acrophobia. Botella and colleagues and Schneider were the first to use VR in treatment. Specifically, Schneider utilised inverted lenses in binoculars to "alter" the reality. Later in the mid-1990s, VR became computer-based and was widely available for therapists. A cheap VR equipment uses a
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treatment: (1) therapist can control the situation better by manipulating the stimuli, in terms of their quality, intensity, duration and frequency; (2) VR can help participants avoid public embarrassment and protect their confidentiality; (3) therapist's office can be well-maintained; (4) VR
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Some people are known to be more dependent on visual signals than others. People who rely more on visual cues to control body movements are less physically stable. An acrophobic, however, continues to over-rely on visual signals, whether because of inadequate vestibular function or incorrect
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and anxiety. Confusion may arise in differentiating between height vertigo and acrophobia due to the conditions' overlapping symptom pools, including body swaying and dizziness. Further confusion can occur due to height vertigo being a direct symptom of acrophobia.
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Traditional treatment of phobias is still in use today. Its underlying theory states that phobic anxiety is conditioned and triggered by a conditional stimulus. By avoiding phobic situations, anxiety is reduced. However, avoidance behaviour is reinforced through
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Krijn, Merel; Emmelkamp, Paul M. G.; Biemond, Roeline; de Wilde de Ligny, Claudius; Schuemie, Martijn J.; van der Mast, Charles A. P. G. (1 February 2004). "Treatment of acrophobia in virtual reality: The role of immersion and presence".
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and nearby visual cues to reckon position and motion. As height increases, visual cues recede and balance becomes poorer in people without acrophobia. However, most people respond to such a situation by shifting to more reliance on the
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Morina, Nexhmedin; Ijntema, Hiske; Meyerbröker, Katharina; Emmelkamp, Paul M. G. (1 November 2015). "Can virtual reality exposure therapy gains be generalized to real-life? A meta-analysis of studies applying behavioral assessments".
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Jacob, Rolf G; Woody, Shelia R; Clark, Duncan B; et al. (December 1993). "Discomfort with space and motion: A possible marker of vestibular dysfunction assessed by the situational characteristics questionnaire".
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A recombinant model of the development of acrophobia is very possible, in which learning factors, cognitive factors (e.g. interpretations), perceptual factors (e.g. visual dependence), and biological factors (e.g.
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to help participants avoid "avoidance". Research results have suggested that even with a decrease in therapeutic contact, desensitization is still very effective. However, other studies have shown that
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is reserved for those at the extreme end of the spectrum. Researchers have argued that a fear of heights is an instinct found in many mammals, including domestic animals and humans. Experiments using
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in high places and become too agitated to get themselves down safely. Approximately 2–5% of the general population has acrophobia, with twice as many women affected as men. The term is from the
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Abelson, James L.; Curtis, George C. (1 January 1989). "Cardiac and neuroendocrine responses to exposure therapy in height phobics: Desynchrony within the 'physiological response system'".
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large cohort study with 1000 participants was conducted from birth; the results showed that participants with less fear of heights had more injuries because of falling. Psychologists
1104:; Menzies, Ross G; Craske, Michelle G; Silva, Phil A (1 January 2001). "Failure to overcome 'innate' fear: a developmental test of the non-associative model of fear acquisition". 1057:
Davey, Graham C.L.; Menzies, Ross; Gallardo, Barbara (1997). "Height phobia and biases in the interpretation of bodily sensations: Some links between acrophobia and agoraphobia".
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Another possible contributing factor is a dysfunction in maintaining balance. In this case, the anxiety is both well-founded and secondary. The human balance system integrates
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Arroll, Bruce; Wallace, Henry B.; Mount, Vicki; Humm, Stephen P.; Kingsford, Douglas W. (3 April 2017). "A systematic review and meta-analysis of treatments for acrophobia".
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Choi, Young H.; Jang, Dong P.; Ku, Jeong H.; Shin, Min B.; Kim, Sun I. (1 June 2001). "Short-Term Treatment of Acrophobia with Virtual Reality Therapy (VRT): A Case Report".
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Campos, Joseph J.; Anderson, David I.; Barbu-Roth, Marianne A.; Hubbard, Edward M.; Hertenstein, Matthew J.; Witherington, David (1 April 2000). "Travel Broadens the Mind".
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Poulton, Richie; Davies, Simon; Menzies, Ross G.; Langley, John D.; Silva, Phil A. (1998). "Evidence for a non-associative model of the acquisition of a fear of heights".
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Isableu, Brice; Ohlmann, Théophile; Crémieux, Jacques; Amblard, Bernard (May 2003). "Differential approach to strategies of segmental stabilisation in postural control".
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Coelho, Carlos M.; Santos, Jorge A.; Silva, Carlos; Wallis, Guy; Tichon, Jennifer; Hine, Trevor J. (9 November 2008). "The Role of Self-Motion in Acrophobia Treatment".
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Williams, S. Lloyd; Dooseman, Grace; Kleifield, Erin (1984). "Comparative effectiveness of guided mastery and exposure treatments for intractable phobias".
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Botella, C.; Baños, R. M.; Perpiñá, C.; Villa, H.; Alcañiz, M.; Rey, A. (1 February 1998). "Virtual reality treatment of claustrophobia: a case report".
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Bles, Willem; Kapteyn, Theo S.; Brandt, Thomas; Arnold, Friedrich (1 January 1980). "The Mechanism of Physiological Height Vertigo: II. Posturography".
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Whitney, Susan L.; Jacob, Rolf G.; Sparto, Patrick J.; Olshansky, Ellen F.; Detweiler-Shostak, Gail; Brown, Emily L.; Furman, Joseph M. (May 2005).
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participants experienced increased anxiety not only when the height increased, but also when they were required to move sideways at a fixed height.
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Whitney, Susan L; Jacob, Rolf G; Sparto, Patrick J; Olshansky, Ellen F; Detweiler-Shostak, Gail; Brown, Emily L; Furman, Joseph M (1 May 2005).
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Many different types of medications are used in the treatment of phobias like fear of heights, including traditional anti-anxiety drugs such as
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Coelho, Carlos M.; Waters, Allison M.; Hine, Trevor J.; Wallis, Guy (2009). "The use of virtual reality in acrophobia research and treatment".
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Brandt, T; F Arnold; W Bles; T S Kapteyn (1980). "The mechanism of physiological height vertigo. I. Theoretical approach and psychophysics".
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model is also very appealing for considering both vicarious learning and hereditary factors such as personality traits (i.e., neuroticism).
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The Depression Scale of the Depression Anxiety Stress Scales short form (DASS21-DS) is a self report used to examine validity of the HIQ.
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Coelho, Carlos; Alison Waters; Trevor Hine; Guy Wallis (2009). "The use of virtual reality in acrophobia research and treatment".
1886: 385:. It is uncertain if acrophobia is related to the failure to reach a certain developmental stage. Besides associative accounts, a 499:
encourages more people to seek treatment; (5) VR saves time and money, as participants do not need to leave the consulting room.
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Menzies, RG; Clarke, JC (1995). "The etiology of acrophobia and its relationship to severity and individual response patterns".
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Huppert, Doreen; Grill, Eva; Brandt, Thomas (1 February 2013). "Down on heights? One in three has visual height intolerance".
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Cohen, David Chestney (1 January 1977). "Comparison of self-report and overt-behavioral procedures for assessing acrophobia".
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Some desensitization treatments produce short-term improvements in symptoms. Long-term treatment success has been elusive.
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systems sense a body movement that is not detected by the eyes. More research indicates that this conflict leads to both
1559:"A New Questionnaire for Estimating the Severity of Visual Height Intolerance and Acrophobia by a Metric Interval Scale" 1908:
Baker, Bruce L.; Cohen, David C.; Saunders, Jon Terry (February 1973). "Self-directed desensitization for acrophobia".
489: 2276: 186:. A head for heights is advantageous for hiking or climbing in mountainous terrain and also in certain jobs such as 17: 2521:; Henderson, A.S.; Strotzka, H.; Lipowski, Z.; Yu-cun, S.; You-xin, X.; Strömgren, E.; Glatzel, J.; et al. 2651: 2523:"The ICD-10 Classification of Mental and Behavioural Disorders Clinical descriptions and diagnostic guidelines" 1006: 346:
was 7 times less common in subjects at age 18 who had injurious falls as children than subjects that did not).
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Menzies, Ross G.; Clarke, J. Christopher (1 February 1995). "Danger expectancies and insight in acrophobia".
2656: 229:(hypsos), meaning "height". In Greek, the actual term used for this condition is "υψοφοβία" (Hypsophobia). 2551: 2022: 530:
Approximately 2–5% of the general population has acrophobia, with twice as many women affected as men.
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Redfern, M. S.; Yardley, L.; Bronstein, A. M. (January 2001). "Visual influences on balance".
337:, Simon Davies, Ross G. Menzies, John D. Langley, and Phil A. Silva sampled subjects from the 2021:
Emmelkamp, Paul; Mary Bruynzeel; Leonie Drost; Charles A. P. G. van der Mast (1 June 2001).
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Kitamura, Fumiaki; Matsunaga, Katsuya (December 1990). "Field Dependence and Body Balance".
2609: 2268: 481: 329: 296: 288: 175:, called space and motion discomfort, that share similar causes and options for treatment. 2522: 2457:
Kapfhammer, Hans-Peter; Fitz, Werner; Huppert, Doreen; Grill, Eva; Brandt, Thomas (2016).
1658:"Cognitive processing and acrophobia: Validating the Heights Interpretation Questionnaire" 1457:"Acrophobia and pathological height vertigo: indications for vestibular physical therapy?" 1223:"Acrophobia and pathological height vertigo: indications for vestibular physical therapy?" 829:"Acrophobia and Pathological Height Vertigo: Indications for Vestibular Physical Therapy?" 673:"Acrophobia and pathological height vertigo: indications for vestibular physical therapy?" 413:
strategy. Locomotion at a high elevation requires more than normal visual processing. The
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of heights, especially when one is not particularly high up. It belongs to a category of
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play an essential role in acrophobia treatment. Treatments like reinforced practice and
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Most people experience a degree of natural fear when exposed to heights, known as the
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A related, milder form of visually triggered fear or anxiety is called
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Traditionally, acrophobia has been attributed, like other phobias, to
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Juan, M. C.; Baños, Rosa; Botella, Cristina; et al. (2005).
494: 370: 317: 2589: 1317: 1177: 434: 382: 374: 366: 358: 168: 2517: 1454: 2348:"An Augmented Reality system for the treatment of acrophobia" 1403: 573:"An Augmented Reality system for the treatment of acrophobia" 438: 378: 223:, "fear". The term "hypsophobia" derives from the Greek word 1656:
Steinman, Shari A.; Teachman, Bethany A. (1 October 2011).
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Loftus, Elizabeth F. (2016). "Memories of Things Unseen".
45:"Fear of heights" redirects here. For the Drake song, see 1942: 100: 2082: 1503: 719: 627: 283:
Height vertigo is caused by a conflict between vision,
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when the sensation of vertigo is triggered by heights.
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Dunedin Multidisciplinary Health and Development Study
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Huppert, Doreen; Grill, Eva; Brandt, Thomas (2017).
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Journal of Psychopathology and Behavioral Assessment
1056: 121: 106: 1455:Whitney, SL; Jacob, Rolf G; Sparto, BG (May 2005). 779: 112: 2450: 2405: 2078: 2076: 1907: 1840: 1556: 777: 775: 773: 771: 769: 767: 765: 763: 761: 759: 1352: 2638: 2124: 2122: 1655: 947: 2073: 756: 475:There have been a number of studies into using 2172: 1155:. No. 202. pp. 67–71. Archived from 2119: 1945:Journal of Consulting and Clinical Psychology 1765: 1712: 1147:Gibson, Eleanor J.; Walk, Richard D. (1960). 2511: 1448: 913:Current Directions in Psychological Science 426:) interact to provoke fear or habituation. 316:530 feet (160 m) above the streets of 224: 218: 212: 206: 1214: 1146: 869: 72: 2490: 1734: 1689: 1592: 1574: 1525: 1472: 1267: 1238: 904: 844: 688: 232: 1842:"Psychotherapy by reciprocal inhibition" 311: 193:People with acrophobia can experience a 492:(CAVE). VR has several advantages over 14: 2639: 1220: 910: 490:computer automatic virtual environment 2401: 2399: 2290: 2288: 1838: 1651: 1649: 1647: 1615: 459:. Wolpe developed a technique called 81:Some jobs require working at heights. 2345: 2269:10.1093/acref/9780199549351.001.0001 409:branches of the equilibrium system. 236: 2061:from the original on 27 August 2021 211:, meaning "peak, summit, edge" and 38:. For the fear of open spaces, see 34:. For the amusement park ride, see 24: 2396: 2384:from the original on 9 August 2017 2285: 1820:from the original on 24 April 2021 1644: 609:from the original on 9 August 2017 25: 2668: 2552:"The scariest path in the world?" 2545: 2346:Juan, M. C.; et al. (2005). 1889:from the original on 24 July 2020 1038:from the original on 11 July 2018 381:, or even walking up a flight of 342:same sample finding that typical 2297:The Medical Journal of Australia 1839:Wolpe, Joseph (1 October 1968). 925:10.1111/j.0963-7214.2004.00294.x 353:A fear of falling, along with a 240: 93: 2554:, a direct test, video shot on 2339: 2253: 2209: 2166: 2014: 1979: 1936: 1901: 1832: 1802: 1759: 1706: 1609: 1550: 1497: 1397: 1346: 1311: 1171: 1140: 1093: 990: 525: 2219:Behaviour Research and Therapy 2175:CyberPsychology & Behavior 2132:Behaviour Research and Therapy 2085:Behaviour Research and Therapy 2027:CyberPsychology & Behavior 1910:Behaviour Research and Therapy 1768:Behaviour Research and Therapy 1715:Behaviour Research and Therapy 1506:CyberPsychology & Behavior 1106:Behaviour Research and Therapy 1059:Behaviour Research and Therapy 1007:Behaviour Research and Therapy 956:Behaviour Research and Therapy 878:Behaviour Research and Therapy 820: 713: 664: 621: 564: 163:, is an extreme or irrational 13: 1: 2144:10.1016/S0005-7967(03)00139-6 2097:10.1016/S0005-7967(97)10006-7 2000:10.1016/j.janxdis.2009.01.014 1674:10.1016/j.janxdis.2011.05.001 1630:10.1016/S0005-7894(77)80116-0 1221:Furman, Joseph M (May 2005). 1118:10.1016/S0005-7967(99)00156-4 1071:10.1016/s0005-7967(97)10004-3 1065:(11). 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This occurs when 225: 213: 202: 142: 85: 80: 71: 66: 30:For the online game, see 1576:10.3389/fneur.2017.00211 52:Not to be confused with 477:virtual reality therapy 27:Extreme fear of heights 1563:Frontiers in Neurology 630:Acta Oto-Laryngologica 457:negative reinforcement 321: 233:Confusion with vertigo 47:Fear of Heights (song) 2652:Environmental phobias 2367:10.1162/pres.15.4.393 1518:10.1089/cpb.2008.0023 592:10.1162/pres.15.4.393 315: 2463:Journal of Neurology 2408:Journal of Neurology 1474:10.1093/ptj/85.5.443 1255:on 26 September 2007 1240:10.1093/ptj/85.5.443 1149:"The "Visual Cliff"" 846:10.1093/ptj/85.5.443 690:10.1093/ptj/85.5.443 484:(HMD). In contrast, 482:head-mounted display 2657:Situational phobias 2309:10.5694/mja16.00540 1153:Scientific American 355:fear of loud noises 1859:10.1007/BF03000093 1847:Conditional Reflex 1289:10.1007/BF00965035 322: 2634: 2633: 2562:"Fear of Heights" 2556:El Camino del Rey 2469:(10): 1946–1953. 1100:Poulton, Richie; 488:uses an advanced 365:have shown human 270: 269: 154: 153: 61:Medical condition 36:Acrophobia (ride) 32:Acrophobia (game) 16:(Redirected from 2664: 2569: 2568: 2541: 2539: 2537: 2527: 2505: 2504: 2494: 2454: 2448: 2447: 2403: 2394: 2393: 2391: 2389: 2383: 2352: 2343: 2337: 2336: 2292: 2283: 2282: 2257: 2251: 2250: 2213: 2207: 2206: 2170: 2164: 2163: 2126: 2117: 2116: 2080: 2071: 2070: 2068: 2066: 2018: 2012: 2011: 1983: 1977: 1976: 1940: 1934: 1933: 1905: 1899: 1898: 1896: 1894: 1844: 1836: 1830: 1829: 1827: 1825: 1806: 1800: 1799: 1763: 1757: 1756: 1738: 1710: 1704: 1703: 1693: 1653: 1642: 1641: 1618:Behavior Therapy 1613: 1607: 1606: 1596: 1578: 1554: 1548: 1547: 1529: 1501: 1495: 1494: 1476: 1461:Physical Therapy 1452: 1446: 1445: 1401: 1395: 1394: 1350: 1344: 1343: 1326:(5–6): 513–523. 1320:Acta Otolaryngol 1315: 1309: 1308: 1271: 1265: 1264: 1262: 1260: 1251:. 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Index

Fear of heights
Acrophobia (game)
Acrophobia (ride)
Agoraphobia
Fear of Heights (song)
Fear of falling

/ˌækrəˈfbiə/
Specialty
Psychiatry
fear
phobia
specific phobias
fear of falling
head for heights
steeplejacks
panic attack
Greek

adding to it
Vertigo
vestibular
somatosensory
vestibular
somatosensory
motion sickness
young child leaning against and looking out a skyscraper window on a floor that is also glass
Calgary
conditioning
traumatic

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