Fear of Heights and Visual Height Intolerance in Children 8–10 Years Old

Abstract

Objective: To evaluate the prevalence, symptoms, spontaneous course, and behavioral consequences of visual height intolerance in children in comparison to adults. Methods:Survey in three primary schools on the frequency of visual height intolerance in 455 children aged 8 to 10 years. Individual structured interviews of 90 susceptible children and 54 of their parents. Results:The prevalence of visual height intolerance in children amounted to 34%; there was no gender preponderance. The condition began at a mean age of 5.9 years and rarely showed a tendency to generalize with respect to trigger stimuli. Triggers and symptoms were similar to those in adults. Avoidance behavior was reported by less than one third of the children, and there was only minimal subjective impairment of life quality. The condition was not perceived to be a disease or an individual weakness. Frequency and severity had already spontaneously improved in nearly one half of the children by the time of the survey. Conclusion:More than one third of prepubertal girls and boys exhibited susceptibility for visual height intolerance which -in contrast to the adult-onset type of the condition -appeared to take a benign spontaneous course.

Acrophobia and visual height intolerance: advances in epidemiology and mechanisms

“…Epidemiological studies on children are available for anxiety disorders and specific phobias, especially fear of the dark, spider phobia, and medical phobias as well as for fear of heights, however, without detailed specification of its prevalence [37][38][39]. A survey among prepubertal children aged 8-10 years on the frequency and phenomenology of visual height intolerance and fear of heights revealed a prevalence of 34% with no gender preponderance [40]. The mean age at onset of symptoms was 5.9 years.…”

“…An essential difference of visual height intolerance in childhood is the good prognosis with spontaneous remission in up to 48% until the age of 10. Since corresponding epidemiological studies in adults found only 4.5% of individuals who reported an emergence of symptoms when exposed to heights during their first decade of life [22], it can be hypothesized that two separate courses of the development of susceptibility may exist: an early beginning visual height intolerance that usually resolves spontaneously in contrast to a, in most cases, persistent form that occurs during adulthood [23,40]. Fearrelated to height stimuli can be assumed to be a protective mechanism that restrains children from potentially harmful situations, with which they are yet too immature to cope.…”

“…However, active hazard of height exposure during maturation may have an anti-phobic effect [41]. One could argue that a controlled exposure to the feared or avoided situations represents a successful strategy of desensitization, whereas a too restrictive behavior may promote persistence of the condition [40].…”

A New Questionnaire for Estimating the Severity of Visual Height Intolerance and Acrophobia by a Metric Interval Scale

“…This means that untreated vHI in adults is mostly a chronic, more or less distressing disability. This does not hold for prepubertal primary school children aged 8–10 years who also showed a prevalence of vHI of about one-third (20). However, in contrast to the adult-onset type of the condition, vHI in children appears to take a benign spontaneous course.…”

Seltenere, aber klinisch relevante episodische Schwindelsyndrome

“…Eine visuelle Höhenintoleranz findet sich nicht nur bei Erwachsenen, sondern auch bei Kindern; im Grundschulalter von 8 bis 10 Jahren zeigte sich eine Häufigkeit von 34%, ohne Geschlechtsunterschiede. Im Gegensatz zu Erwachsenen nimmt der Höhenschwindel der Kindheit in den meisten Fällen einen benignen Verlauf mit spontaner Remission innerhalb weniger Jahre [57]. [59], die bevorzugt hirnstammnah proximal der Übergangszone vom peripheren Nerven auf das zentrale Myelin (Oligodendroglia) lokalisiert ist.…”