Emotional processing and fear measurement synchrony as indicators of treatment outcome in fear of flying.

Minimal-therapist-involvement stress inoculation training was used to treat flying phobics. Relative to no-treatment controls, treatment subjects reported more fear reduction, were more likely to participate in an exposure session, and flew more during a two-month follow-up period. Subjects who exhibited synchronous changes in heart rate and report of anxiety during exposure had greater fear reduction than subjects showing less synchrony. Subjects who voluntarily took plane flights in the two months following treatment showed greater indications of emotional processing during in vivo exposure. Relative to flight avoiders, fliers had higher mean heart rate in the plane, a greater reduction in heart rate from the beginning to the end of the flight, and greater reported fear reduction from pre- to post-flight.