Claustrophobia

The onset of claustrophobia has been attributed to many factors, including a reduction in the size of the amygdala, classical conditioning, or a genetic predisposition to fear small spaces.

One study indicates that anywhere from five to ten percent of the world population is affected by severe claustrophobia, but only a small percentage of these people receive some kind of treatment for the disorder.

The term claustrophobia comes from Latin claustrum "a shut in place" and Greek φόβος, phóbos, "fear".

It is not always the small space that triggers these emotions, but it's more the fear of the possibilities of what could happen while confined to that area.

Nuclei send out impulses to other nuclei, which influence respiratory rate, physical arousal, the release of adrenaline, blood pressure, heart rate, behavioral fear response, and defensive responses, which may include freezing up.

A study done by Fumi Hayano found that the right amygdala was smaller in patients who suffered from panic disorders.

The reduction of size occurred in a structure known as the corticomedial nuclear group which the CE nucleus belongs to.

In claustrophobic people, this translates as panicking or overreacting to a situation in which the person finds themselves physically confined.

In a study involving claustrophobia and MRI, it was reported that 13% of patients experienced a panic attack during the procedure.

[6] Panic attacks experienced during the procedure can stop the person from adjusting to the situation, thereby perpetuating the fear.

[4]" As Aureau Walding states in "Causes of Claustrophobia", many people, especially children, learn who and what to fear by watching parents or peers.

As Erin Gersley says in "Phobias: Causes and Treatments", humans are genetically predisposed to become afraid of things that are dangerous to them.

Claustrophobia may fall under this category because of its "wide distribution… early onset and seeming easy acquisition, and its non-cognitive features".

As Rachman explains in the article: "The main features of prepared phobias are that they are very easily acquired, selective, stable, biologically significant, and probably [non-cognitive]."

These criteria include:[1] This method was developed in 1979 by interpreting the files of patients diagnosed with claustrophobia and by reading various scientific articles about the diagnosis of the disorder.

[15] For example, cognitive therapy would attempt to convince a claustrophobic patient that elevators are not dangerous but are, in fact, very useful in getting them where they would like to go faster.

Rachman shows that cognitive therapy decreased fear and negative thoughts/connotations by an average of around 30% in claustrophobic patients tested, proving it to be a reasonably effective method.

Rachman has also tested the effectiveness of this method in treating claustrophobia and found it to decrease fear and negative thoughts/connotations by an average of nearly 75% in his patients.

[16] This method attempts to recreate internal physical sensations within a patient in a controlled environment and is a less intense version of in vivo exposure.

[16] Other forms of treatment that have also been shown to be reasonably effective are psychoeducation, counter-conditioning, regressive hypnotherapy and breathing re-training.

Medications often prescribed to help treat claustrophobia include anti-depressants and beta-blockers, which help to relieve the heart-pounding symptoms often associated with anxiety attacks.

[17] The average MRI takes around 50 minutes; this is more than enough time to evoke extreme fear and anxiety in a severely claustrophobic patient.

This experiment concludes that the primary component of anxiety experienced by patients was most closely connected to claustrophobia.

[17] The present case series with two patients explored whether virtual reality (VR) distraction could reduce claustrophobia symptoms during a mock magnetic resonance imaging (MRI) brain scan.

Two patients who met DSM-IV criteria for specific phobia, situational type (i.e., claustrophobia) reported high levels of anxiety during a mock 10-min MRI procedure with no VR, and asked to terminate the scan early.

When immersed in an illusory three-dimensional (3D) virtual world named SnowWorld, patient 1 was able to complete a 10-min mock scan with low anxiety and reported an increase in self-efficacy afterwards.

The results from this treatment proved to be successful in reducing the fear of enclosed spaces and additionally improved over the course of 3 months.

The data was compiled into a "fear scale" of sorts with separate subscales for suffocation and confinement.

[18] A group of students attending the University of Texas at Austin were first given an initial diagnostic and then given a score between 1 and 5 based on their potential to have claustrophobia.

The students were then asked how well they felt they could cope if forced to stay in a small chamber for an extended period of time.

Amygdala
The red structure is the amygdala.
Neuron upclose
Brain synapse
GE Signa MRI
In an MRI, the patient is inserted into the tube.
Miners in small spaces
The conditions inside a mine