Bornas Agustí, F., Tortella-Feliu, M., García de la Banda García, G., Fullana Rivas, M., & Llabrés, J. (1999). Validación factorial del cuestionario de miedo a volar. Análisis y Modificación de Conducta.
Botella, C., Osma, J., García-Palacios, A., Quero, S. & Baños, R.M. (2004). Treatment of Flying Phobia using Virtual Reality: Data from a 1-Year Follow-up using a Multiple Baseline Design. Clinical Psychology & Psychotherapy, 11(5), 311-323.
Bretón-López, J., Tortella-Feliu, M., Del Amo, A. R., Baños, R., Llabrés, J., Gelabert, J. M., & Botella, C. (2015). Patients’ preferences regarding three computer based exposure treatments for fear of flying. Behavioral Psychology/ Psicologia Conductual.
Da Costa, R.T., Sardinha, A. & Nardi, A.E. (2008). Virtual reality exposure in the treatment of fear of flying. Aviation, Space, and Environmental Medicine, 79(9), 899-903.
Haug, T., Brenne, L., Johnsen, D. H., Brentzen, D., Götestam, K. G., & Hughdal, K. (1987). A three systems analysis of fear of flying: A comparison of a consonant versus a non-consonant treatment method. Behaviour Research and Therapy, 25, 187-194. doi:10.1016/0005-7967(87)90045-3
Hirsch, J.A. (2012). Virtual reality exposure therapy and hypnosis for flying phobia in a treatment resistant patient: A case report. American Journal of Clinical Hypnosis, 55(2), 168-173.
Tortella-Feliu, M., Botella, C., Llabrés, J., Bretón-López, J. M., del Amo, A. R., Baños, R. M., & Gelabert, J. M. (2011). Virtual reality versus computer-aided exposure treatments for fear of flying. Behavior Modification. https://doi.org/10.1177/0145445510390801
Wallach, H.S. & Bar-Zvi, M. (2007). Virtual-reality-assisted treatment of flight phobia. Israel Journal of Psychiatry and Related Sciences, 44(1), 29-32.
Wiederhold, B.K., Jang, D.P., Gervirtz, R.G., Kim, S.I., Kim, I.Y. & Wiederhold, M.D. (2002). The Treatment of Fear of Flying: A Controlled Study of Imaginal and Virtual Reality Graded Exposure Therapy. IEEE Transactions on Information Technology in Biomedicine, 6(3), 218-223.
To increase the sense of immersion in Virtual Reality, you can include comments, questions or ideas in the session so the experience will seem more realistic to your patient.
Some suggestions for flying environments:
Waiting at home, or in the taxi
Today you are going to catch a flight to (choose a city). The plane leaves at 6 a.m., but we should be at the boarding gate by 11.15 a.m. Also, we have to go through the security controls… It is now 10 a.m., and the taxi will come pick you up in 5 minutes.
Would you want to watch the weather news before we leave home?
They just said that it is rainy. Does that make you more anxious? Can you tell me why?
You have to be aware that, even though it is raining, the taxi is still going to come pick you up to take you to the airport.
You are going to catch a plane by yourself. When was the last time you flew alone?
At the Gate area, or during the flight
Now we are going to watch the planes taking off through the window. In a while you are going to be inside one of those planes.
What does the person beside you/in front of you evoke in you?
Now we are going to look at the displays where the boarding gates are indicated.
Do you think your mate is nervous?
Would you ask the lady sitting next to you for help if you felt an increase in your levels of anxiety?
It’s been a while since you last saw a flight attendant in the aisle. Does that make you feel more insecure?
(In the middle of a turbulence) Would you like to call the flight attendant in a moment like this?
Para incrementar el sentido de presencia puedes incluir comentarios, preguntas o indicaciones para que el paciente se involucre más en la situación y experimente, de este modo, una sesión más realista.
Algunas sugerencias para los entornos relacionados con volar:
Esperando en casa o en el taxi al Aeropuerto
Hoy vas a coger un vuelo a (elegir una ciudad). El avión sale a las 12 de la mañana. Pero tendríamos que llegar a la puerta de embarque a las 11.15 como muy tarde. Además, hay que pasar el control de seguridad… Ahora son las 10 de la mañana… El taxi vendrá a buscarte dentro de 5 minutos.
¿Quieres que miremos las noticias del tiempo antes de salir de casa?
Acaban de decir que hay lluvias. ¿Esto te pone más nervioso? ¿Por qué?
Tienes que ser consciente de que está lloviendo pero que aun así pronto va a venir el taxi a recogerte para llevarte al aeropuerto.
Hoy vas a coger un avión tú solo. ¿Cuándo fue la última vez que volaste solo? ¿Te sientes preparado para volar solo? En la sala de espera o durante el vuelo.
En el Área de Embarque o durante el vuelo
Ahora vamos a mirar por la ventana como despegan los aviones. En un rato tú vas a estar dentro de uno de estos aviones
¿Qué te transmite la persona que tienes al lado/delante?
Ahora vamos a mirar las pantallas donde se indican las puertas de embarque.
¿Crees que está nervioso tu compañero? ¿Y si te confiesa que también le da miedo a volar?
¿Le pedirías ayuda a la señora sentada a tu lado si sintieras que tus niveles de ansiedad empezaran a subir?
Hace rato que no se ve ninguna azafata por el pasillo, ¿esto te hace sentir más inseguro?
Estamos a punto de despegar. ¿Te sientes preparado?
(en medio de turbulencia) ¿Te gustaría llamar a una azafata en un momento así?
“All the information contained in this section is for guidance only. Psious environments are supporting tools that must be used by the healthcare professional within an evaluation and intervention process designed according to the characteristics and needs of the user.
Also remember that you have the General Clinical Guide in which you have more information on how to adapt psychological intervention techniques (exposure, systematic desensitization, cognitive restructuring, chip economy…) to Psious environments.”
Example of intervention Fear of flying
A proposal for a treatment protocol that includes the Psious tool is described below. It is recommended to combine virtual reality with traditional techniques, such as relaxation or cognitive restructuring.
SESSION 1: PSYCHOEDUCATION
Information about flying phobia is provided (origin, upkeep and appearance of the triple system cognitive, physiological and motor).
Information about the functioning and safety of planes.
Treatment techniques that will be used throughout the protocolare explained (emphasizing the exposure to the Virtual Reality environments).
HOMEWORK Hand out of the Psychoeducation file (see appendix).
SESSION 2- 3: RELAXATION
The patient learns and practices two types of relaxation techniques: controlled breathing and Jacobson’s progressive muscular relaxation.
Familiarization with the Psious platform. The patient learns to use the VR helmets and navigate inside the virtual scenes.
HOMEWORK Daily practice of relaxation techniques. The self-registers of relaxation and negative thoughts are completed (see appendix)
SESSION 4: COGNITIVE RESTRUCTURING
Revision and adjustment of the patients negative thoughts.
Cognitive restructuring for each of the negative thoughts. Two kinds of cognitive therapy may be used: the one proposed by Beck or the one belonging to Ellis.
HOMEWORK Daily practice of relaxation techniques. The self-registers of relaxation and negative thoughts are completed (see appendix)
SESSION 5: VR EXPOSURE + TRADITIONAL TECHNIQUES
As of the fifth session of treatment the gradual and systematic exposure to the virtual environments begins. Throughout all exposure sessions, VR is combined with techniques of relaxation and cognitive restructuring.
The patient is exposed to:
Patients house on a sunny day (the news is on TV).
Taxi ride on a sunny day (the news is on the radio).
Boarding gate on a sunny day.
HOMEWORK Daily practice of the relaxation techniques and tasks of self-exposure to stimulus related to planes.
SESSION 6: VR EXPOSURE + TRADITIONAL TECHNIQUES
Homework review.
The patient is exposed to:
Taxi ride on a sunny day
Boarding gate on a sunny day. The display with the flight schedule is shown, also the window with planes taking off and landing.
Plane take-off on a sunny day.
HOMEWORK Daily practice of relaxation techniques and tasks of self-exposure to stimulus related to planes.
SESSION 7: VR EXPOSURE + TRADITIONAL TECHNIQUES
Homework review.
The patient is exposed to:
Boarding gate on a sunny day and with comments from other passengers. The screen with the flight schedule and the window with planes taking off and landing are observed.
Plane take-off on a sunny day.
Flight situation. Elements of internal sense exposure are introduced.
HOMEWORK Daily practice of relaxation techniques and self-exposure tasks to stimuli related to planes.
SESSION 8: VR EXPOSURE + TRADITIONAL TECHNIQUES
Homework review.
The patient is exposed to:
Plane take-off on a sunny day. Turn on comments.
Flight situation and short turbulence. Internal sense exposure.
Landing.
HOMEWORK Daily practice of relaxation techniques and self-exposure tasks to stimulus related to planes.
SESSION 9 VR EXPOSURE + TRADITIONAL TECHNIQUES
As of the ninth session of treatment the exposure is re-started to the virtual environments but with a higher level of difficulty. Like in the rest of the exposure it is used in combination with relaxation and cognitive restructuring.
The patient is exposed to:
At home on a rainy day (the news is on TV).
Taxi ride on a rainy day (the news is on the radio).
Boarding gate on a rainy day.
HOMEWORK Daily practice of relaxation techniques and self-exposure tasks to stimulus related to planes.
SESSION 10 VR EXPOSURE + TRADITIONAL TECHNIQUES
The patient is exposed to:
Taxi ride on a rainy day with the radio on. Elements of internal sense exposure are introduced.
Boarding gate on a rainy day. The screen with the flight schedule and window with planes landing and taking off is observed.
Plane take-off on a rainy day.
HOMEWORK Daily practice of relaxation techniques and self-exposure tasks related to planes.
SESSION 11 VR EXPOSURE + TRADITIONAL TECHNIQUES
Homework revision.
The patient is exposed to:
Boarding gate on a rainy day. Elements of internal sense exposure are introduced.
Plane take-off on a rainy day. Elements of internal sense exposure are introduced.
Flight situation on a rainy day with comments. Elements of internal sens exposure are introduced.
HOMEWORK Daily practice of relaxation techniques and self-exposure tasks to stimulus related to planes.
SESSION 12 VR EXPOSURE + TRADITIONAL TECHNIQUES
Homework review
The patient is exposed to:
Plane take-off on a rainy day. Turbulence appears.
Flight situation on a rainy day with turbulence. Elements of internal sense exposure plus comments
Landing on a rainy day with turbulence.
HOMEWORK Daily practice of relaxation techniques and tasks of self-exposure to flight-related stimuli.
SESSION 13: VR EXPOSURE + TRADITIONAL TECHNIQUES
The therapeutic process is evaluated and future self-exposure tasks are programmed, as well as booster sessions.
“Toda la información contenida en este apartado es de carácter orientativo. Los entornos de Psious son herramientas de apoyo terapéutico que deben ser utilizadas por el profesional de la salud dentro de un proceso de evaluación e intervención diseñado según las características y necesidades del usuario.
Recuerda además que dispones de la Guía Clínica General en la que tienes más información sobre cómo adaptar las técnicas de intervención psicológica (exposición, desensibilización sistemática, reestructuración cognitiva, economía de fichas…) a los entornos de Psious.”
Ejemplo de intervención Miedo a volar
A continuación se describe una propuesta de protocolo de tratamiento que incluye la herramienta de Psious. Se recomienda combinar la realidad virtual con técnicas tradicionales, como la relajación o la reestructuración cognitiva.
SESIÓN 1: PSICOEDUCACIÓN
Se ofrece información sobre la fobia a volar (origen, mantenimiento y manifestación en el triple sistema cognitivo, fisiológico y motor).
Información acerca del funcionamiento y la seguridad de los aviones
Se explican las técnicas de tratamiento que se utilizarán a lo largo del protocolo (enfatizando la exposición a los ambientes de Realidad Virtual).
TAREAS PARA CASA Entrega del dossier de Psicoeducación (ver apéndice).
SESIÓN 2 y 3: RELAJACIÓN
El paciente aprende y practica dos tipos de técnicas de relajación: respiración controlada y relajación muscular progresiva de Jacobson.
Familiarización con la plataforma Psious. El paciente aprende a utilizar los cascos de RV y a navegar dentro de los ambientes virtuales
TAREAS PARA CASA Práctica diaria de las técnicas de relajación. Se completan los autorregistros de relajación y de pensamientos negativos (ver apéndice).
SESIÓN 4: REESTRUCTURACIÓN COGNITIVA
Revisión y graduación de los pensamientos negativos del paciente
Reestructuración cognitiva para cada uno de los pensamientos negativos. Se utiliza la terapia cognitiva de Beck o bien la terapia racional-emotiva de Ellis.
TAREAS PARA CASA Práctica diaria de las técnicas de relajación. Se completan los autorregistros de relajación y de pensamientos negativos (ver apéndice).
SESIÓN 5: EXPOSICIÓN RV + TÉCNICAS TRADICIONALES
A partir de la quinta sesión de tratamiento se inicia la exposición gradual y sistemática a los ambientes virtuales. A lo largo de todas las sesiones de exposición, la RV se combina con las técnicas de relajación y de reestructuración cognitiva.
Se realiza la exposición a:
Casa del paciente en un día soleado (se observan las noticias).
Trayecto en taxi en un día soleado (se escuchan las noticias).
Puerta de embarque en un día soleado.
TAREAS PARA CASA Práctica diaria de las técnicas de relajación y tareas de auto-exposición a estímulos relacionados con los aviones.
SESIÓN 6: EXPOSICIÓN RV + TÉCNICAS TRADICIONALES
Se realiza la exposición a:
Revisión de las tareas para casa.
Trayecto en taxi en un día soleado.
Puerta de embarque en un día soleado. Se observa la pantalla con los horarios de los vuelos y la ventana con aviones despegando y aterrizando.
Despegue del avión en un día soleado.
TAREAS PARA CASA Práctica diaria de las técnicas de relajación y tareas de auto-exposición a estímulos relacionados con los aviones.
SESIÓN 7: EXPOSICIÓN RV + TÉCNICAS TRADICIONALES
Revisión de las tareas para casa.
Se realiza la exposición a:
Puerta de embarque en un día soleado y con comentarios de los otros pasajeros. Se observa la pantalla con los horarios de los vuelos y la ventana con aviones despegando y aterrizando.
Despegue del avión en un día soleado.
Situación de vuelo. Se introducen elementos de exposición interoceptiva.
TAREAS PARA CASA Práctica diaria de las técnicas de relajación y tareas de auto-exposición a estímulos relacionados con los aviones.
SESIÓN 8: EXPOSICIÓN RV + TÉCNICAS TRADICIONALES
Revisión de las tareas para casa.
Se realiza la exposición a:
Despegue del avión en un día soleado. Activar comentarios.
Situación de vuelo y turbulencias cortas. Exposición interoceptiva.
Aterrizaje.
TAREAS PARA CASA Práctica diaria de las técnicas de relajación y tareas de auto-exposición a estímulos relacionados con los aviones.
SESIÓN 9: EXPOSICIÓN RV + TÉCNICAS TRADICIONALES
A partir de la novena sesión de tratamiento se reinicia la exposición a los ambientes virtuales pero con un mayor nivel de dificultad. Como en el resto de sesiones la exposición se utiliza de forma conjunta con la relajación y la reestructuración cognitiva.
Se realiza la exposición a:
Casa del paciente en un día lluvioso (se observan las noticias).
Trayecto en taxi en un día lluvioso (se escuchan las noticias).
Puerta de embarque en un día lluvioso.
TAREAS PARA CASA Práctica diaria de las técnicas de relajación y tareas de auto-exposición a estímulos relacionados con los aviones.
SESIÓN 10: EXPOSICIÓN RV + TÉCNICAS TRADICIONALES
Revisión de las tareas para casa.
Se realiza la exposición a:
Trayecto en taxi en un día lluvioso y se escucha la radio. Se introducen elementos de exposición interoceptiva.
Puerta de embarque en un día lluvioso. Se observa la pantalla con el horario de los vuelos y la ventana con aviones despegando y aterrizando.
Despegue del avión en un día con tormenta.
TAREAS PARA CASA Práctica diaria de las técnicas de relajación y tareas de auto-exposición a estímulos relacionados con los aviones.
SESIÓN 11: EXPOSICIÓN RV + TÉCNICAS TRADICIONALES
Revisión de las tareas para casa.
Se realiza la exposición a:
Puerta de embarque en un día con tormenta. Se introducen elementos de exposición interoceptiva.
Despegue del avión en un día lluvioso. Se introducen elementos de exposición interoceptiva.
Situación de vuelo en un día lluvioso + comentarios. Se introducen elementos de exposición interoceptiva.
TAREAS PARA CASA Práctica diaria de las técnicas de relajación y tareas de autoexposición a estímulos relacionados con los aviones.
SESIÓN 12: EXPOSICIÓN RV + TÉCNICAS TRADICIONALES
Revisión de las tareas para casa.
Se realiza la exposición a:
Despegue del avión en un día lluvioso. Aparecen turbulencias.
Situación de vuelo en un día lluvioso y con turbulencias. Se introducen elementos de exposición interoceptiva y comentarios.
Aterrizaje en un día lluvioso y con turbulencias.
TAREAS PARA CASA Práctica diaria de las técnicas de relajación y tareas de autoexposición a estímulos relacionados con los aviones.
SESIÓN 13: PREVENCIÓN DE RECAÍDAS
Se evalúa el proceso terapéutico y se programan futuras tareas de autoexposición y sesiones de refuerzo.
“All the information contained in this section is for guidance only. Psious environments are supporting tools that must be used by the healthcare professional within an evaluation and intervention process designed according to the characteristics and needs of the user.
Also remember that you have the General Clinical Guide in which you have more information on how to adapt psychological intervention techniques (exposure, systematic desensitization, cognitive restructuring, chip economy…) to Psious environments.”
Fear of Flying
Evaluation Objectives
Evaluate the presence and comorbidity of other emotional disorders, in particular specific phobias, other anxiety and emotional disorders.
Set the feared stimulative settings for the patient and define to what extent. Exposure hierarchy development.
Measure the presence of distorted thoughts.
Some useful instruments for fear of flying
Taking the evaluation objectives into account let’s proceed onto listing some tools and devices that can be useful in gathering relevant information on the user characteristics. Always remember good goal setting, patient characterization and intervention planning are important in effective and efficient therapies, as that of your patients’ satisfaction. The following are the articles you will find in the bibliography where you can refer to the proposed tool characterization:
Open or semi-structured interview
Structured interview: ADIS-IV
Behavioral approach test/behavior avoidance (in vivo or with virtual reality).
SELF-REPORTING
Cuestionario de Miedo a Volar/Fear of Flying Questionnaire/Questionari de por de volar (CMV-II/FFQ-II/QPV-II, Bornas et al. 1999).
Fear of flying Scale (FFS, Haug et al., 1987).
Psious Self-Reports for the elaboration of the hierarchy (annexes).
Exposure Hierarchy development with Psious environments
Once we have received the evaluation information we can then proceed to develop the hierarchy exposure. To do this, in addition to using the data obtained during the initial evaluation, we can carry out a series of questions, (For example, what level of discomfort, on a scale of 0 to 100, does flight generate? What level of discomfort, on a scale of 0 to 100, would lead you to take a plane? Is there something that makes you feel even more uncomfortable?) all geared at the planning of the intervention via the virtual reality.
“Toda la información contenida en este apartado es de carácter orientativo. Los entornos de Psious son herramientas de apoyo terapéutico que deben ser utilizadas por el profesional de la salud dentro de un proceso de evaluación e intervención diseñado según las características y necesidades del usuario.
Recuerda además que dispones de la Guía Clínica General en la que tienes más información sobre cómo adaptar las técnicas de intervención psicológica (exposición, desensibilización sistemática, reestructuración cognitiva, economía de fichas…) a los entornos de Psious.”
Evaluación del miedo a volar
Objetivos de evaluación
Evaluar presencia y comorbilidad de otros trastornos emocionales, en especial la presencia de otras fobias y de trastornos de ansiedad y emocionales.
Evaluar ansiedad asociada a componentes: intensidad, frecuencia, características…
Definir configuraciones estimulares temidas por el paciente y en qué grado. Elaboración jerarquía de exposición.
Evaluar la presencia de pensamientos distorsionados.
Algunos instrumentos útiles para la evaluación del miedo a volar
Teniendo en cuenta los objetivos de evaluación pasamos a enumerar algunas herramientas que pueden serte útiles para obtener información relevante sobre las características de tu usuario. Recuerda que una buena definición de objetivos, caracterización del paciente y planificación de la intervención son importantes para la eficiencia y eficacia terapéutica, así como para la satisfacción de tu usuario. En la bibliografía encontrarás los artículos en los que revisar las características de los instrumentos propuestos a continuación:
Entrevista abierta o semiestructurada
Entrevista estructurada: ADIS-IV
Test de aproximación/ evitación conductual
AUTO-INFORMES
Cuestionario de Miedo a Volar/Fear of Flying Questionnaire/Questionari de por de volar (CMV-II/FFQ-II/QPV-II, Bornas et al. 1999).
Fear of flying Scale (FFS, Haug et al., 1987).
Autoinformes Psious para la elaboración de la jerarquía (annexos)
Elaboración de la jerarquía de exposición con entornos de Psious
Una vez que tenemos la información de la evaluación podemos proceder a elaborar la jerarquía de exposición. Para ello, podemos realizar una serie de preguntas (ej. ¿Qué nivel de malestar, en una escala de 0 a 100, te genera tener que viajar en avión?, ¿Qué nivel de malestar, en una escala de 0 a 100, te generaría hacer viaje en avión?, ¿Crees que hay algo que pueda generarte un malestar aún mayor?) dirigidas a planificar la intervención mediante la realidad virtual.
Ejemplo de jerarquía
En el apéndice encontrarás una herramienta auto-informada para obtener la jerarquía de actuación usando los entornos de Psious.
Virtual Reality (VR) is a less complex, cheaper alternative to in vivo exposure for 2.2. Going to the airport 2.3. Boarding Gate 2.4. The Plane the treatment of flying phobia. This technology does not require a high imagination capacity on the patient as the case of the typical exposure techniques. Also, the exposure can be modified to the patients needs when using VR, as the healthcare professional can control different parameters such as duration of the flight, weather conditions, people on the flight,etc. healthcare professional
Many studies demonstrate the efficiency of VR as a treatment for specific phobias. A systematic review about the use of VR as a therapeutic tool of flying phobia showed that Cognitive Behavioral Therapy (CBT) combined with relaxation techniques and VR exposure is effective for the treatment of flying phobia (Costa et al. 2008). Also, a study by Botella (2004) demonstrated the efficiency of VR as treatment for flying phobia in long and short term.
La Realidad Virtual (RV) se sitúa como una herramienta especialmente adecuada para el tratamiento de la fobia a volar, ya que no resulta tan costosa ni compleja como la exposición en vivo, ni depende de la capacidad imaginativa del paciente como en el caso de la exposición a la imaginación.Además, la RV permite que el profesional de la salud pueda controlar distintos parámetros como la duración, las condiciones climáticas etc.
En una revisión sistemática de investigaciones sobre el uso de RV para el tratamiento de la fobia a volar Costa et al. (2008) hallaron que la terapia cognitivo conductual combinada con técnicas de relajación y la exposición con realidad virtual resulta muy efectiva para el tratamiento de la fobia a volar. Incluso se ha demostrado la efectividad del uso de la realidad virtual como única línea de tratamiento para la fobia a volar a corto-largo plazo (Botella et al., 2004).
I am a co-pilot on a sunny day, the highway seems very calm because there is no traffic.
I am driving a very rainy night by a bridge , and the co-pilot starts to show me something on his mobile phone.
There is not much traffic this rainy night and I am driving towards a tunnel that I enter. The tunnel is not very long and I will hit the road again soon after.
I am in the passenger seat, we are a few friends in the car and we are on the highway. It is a very good day, and then we see that there is an accident car on the right side of the road.
I am in the passenger seat, it is a very good day and we enter a tunnel. My partner is going at a normal pace because there is not much traffic.
I am driving with a group of friends inside the car because tonight we are going to have dinner outside. There is little traffic but all of a sudden it starts to rain.
I go as a co-pilot when we start to travel an area with many curves. My friend is going pretty fast because there is little traffic.
I’m driving, and I’m just crossing a bridge. It is night, and as it is raining, it seems that a lot of traffic has been concentrated.
There is a lot of traffic, and I find myself driving at night on the highway. I’m not going too fast and all of a sudden, the co-pilot plays the music very loud.
It’s a very good day, and I’m taking some friends to the beach. There is a lot of traffic on the highway, so I’m not going too fast.
I’m sitting in the passenger seat, we’re on the road on a very rainy night. At one point, we began to circulate through an area with many curves.
I find myself driving on a bridge, it is night but everything is very quiet because there is little traffic. At a certain moment I get a call on my mobile.
I am a co-pilot on a rainy day, the road is very quiet because there is no traffic at all.
I am driving on the highway at night, and a section with quite a few curves begins.
I am driving only on the dual carriageway. The weather is very good, and there is almost no traffic. I am going at a normal speed, not very fast, and suddenly the car begins to slow down until it stops; There seems to be an engine failure.
I am sitting in the passenger seat, it is night and it rains a lot. Still, there is not a lot of traffic when we are about to cross a bridge.
I find myself driving on the road on a rainy day, and I start driving on a very winding section.
I am driving on a bridge, there is not a lot of traffic so I am going quite a bit. Quick. As I go, I see on the shoulder that there is a crashed car.
While I am sitting next to a friend who is driving on a busy road, a phone call comes in.
It is a good day, and I am driving very fast down the highway When there is no traffic.
I find myself sitting next to a friend while he is driving through a tunnel. There is almost no traffic, so it goes a little fast. Suddenly, the car starts to slow down until it stops, because there is an engine failure.
When I am driving quietly through a tunnel, my friend starts playing the radio very loudly without asking for permission.
I am driving only on the road. It is night and it rains a lot, and as I move through the traffic I see a car that has had an accident.
I am driving on the road on a clear night. I go with some friends and there is also a lot of traffic.
I am driving with some friends on the highway. I’m not going too fast, and when we enter a tunnel, the car seems to stop responding until it comes to a complete stop. Then, an error signal appears in the car.
Co-pilot’s while a friend is driving on the highway. Although it rains a lot and there is a bit of traffic he goes quite fast, and I can see that there is a car on the shoulder that has suffered an accident.
When I am driving down a section of curves on the highway, in addition to raining, a friend starts me to teach things from his mobile.
I am driving on the highway on a sunny day, and there is no traffic.
I am driving on a very sunny day on the highway, and the co-pilot begins to teach me things from his mobile.
I am driving with a few friends in the car and we are on the highway.
It’s a very good day, and then we see that there is a crashed car on the right side of the road.
Self-report Hierarchy Psious environments: City
ITEM
LEVEL OF DISCOMFORT (0-100)
I am a co-pilot on a sunny day, the city is very quiet because there is nothing Traffic.
I am driving through the city at night, and as it is raining, it seems that a lot of traffic has been concentrated. I am moving forward but all of a sudden I have to brake sharply.
It is a very good day, and I am taking some friends to have a drink. There is a lot of traffic, so I am not going very fast.
I am a co-pilot on a rainy day, the city is very quiet because there is no traffic.
I am sitting in the co-pilot’s seat, it is night and it rains a lot. Still, there is not a lot of traffic.
It is a good day, and I am driving very fast through the city when there is no traffic.
I am driving with a group of friends in the car because tonight we are going to have dinner outside. There is little traffic and it starts to rain.
One night that it rains a lot I have taken the car, there is not a lot of traffic and then I hear an ambulance approaching and I must hurry to get away a little.
I am accompanying a friend in his car, it is night and it rains a lot. We are driving through the city with little traffic, but suddenly my friend stops.
I am driving through the city on a very sunny day. I go alone in my car and also there is no traffic.
I am accompanying a friend on a short journey in his car, and we are taking a tour of the city, where there is little traffic.
It is very sunny and I find myself driving in the city. There is little traffic, but as I am driving I begin to hear a loud horn near me.
I am driving on a rather rainy day, and since there is a lot of traffic I have to move slowly. After a while, I find myself in a traffic jam that I don’t move for 5 minutes.
I’m in the passenger seat, accompanying a friend by car around the city, and it seems that there is a lot of traffic, maybe it’s because it’s raining a lot.
I am in town driving a clear night with a little traffic. My journey is very short and simple, so I am going a bit fast.
I find myself driving at night through the city, I am taking some friends, there is a little traffic and there is a very loud horn near me.
I am a co-pilot in my friend’s car, it is a very good day but there is a lot of traffic. Also, we are crossing many streets where cars come from both directions.
I am driving very calmly since there are not many people circulating, and then I hear a siren. Immediately I stop and an ambulance crosses in front of me.
It is daytime and it rains a lot, and I am driving with some friends in the car. There is a lot of traffic and we must cross several streets with cars in both directions. At some point, I have to give the car a hard braking.
I am in the passenger seat because a friend has come to pick me up. We are circulating and there is a lot of traffic, so after a while we were stuck in a traffic jam for about 10 minutes.
While sitting in the passenger seat, I see how it rains and I hear the siren of an ambulance. As there is a lot of traffic, the driver stops quickly and the ambulance crosses in front of us.
I am driving on a very rainy day, and since there is a lot of traffic I have to circulate slowly.
I am driving on a clear night, and there is a lot of traffic around the city. On my route I have to go through quite a few corners, and also on many streets where cars circulate in both directions.
I am sitting next to a friend who is driving his car around the city. Although there is not much traffic, he is going fast enough, and suddenly I hear a loud horn.
I am driving a clear night through the city, and there is a lot of traffic. After a while I find myself in a traffic jam, but soon it dissolves and the circulation seems to be smoother
It is daytime and very sunny, I am driving quietly through the city and I find myself in a traffic jam of about 5 minutes
While sitting next to my friend, who is driving the car, I see that there is a little traffic. I don’t know what’s going on, but suddenly my friend gives a very hard braking.
I’m driving a rainy night through the city. There is not a lot of traffic and I am going quite slow.
Today is a very rainy day, and I am driving with some friends. Let talking and moving, and we heard a siren, so I stop and letgo to the ambulance coming very fast.
Tonight it rains a lot, and I’m driving very fast through the city when there is no traffic.
As I drive calmly through the city, even if there is little traffic, I must suddenly stop.
[ DISCLAIMER: This document has been automatically translated using Google Translate. ]
