A Survey of Cognitive and Psychological Factors Effective on Travelling


Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran


Nowadays, due to the advances of many industries people tend to travel much more in compared to the past. Without any doubt, various types of climates and weathers, vemacular diseases, changes in life style and qualitative and quantitative changes of nutrition are all the factors of which many diseases occur during trips. Travel associated anxieties and fears are common. It has been suggested that enjoyment of travel depends upon a predisposition to cope well with a variety of physical and psychological stresses. In this study we have aimed to survey the cognitive and psychological factors effecting the passengers as they travel.


  1. Jameson JP, Blank MB. Diagnosis and treatment of depression and anxiety in rural and nonrural primary care: national survey results. Psychiatr Serv. 2010;61(6):624-7.
  2. Rizzolo CL, Taylor JE, Cerciello RL. Anxiety and anxiety-related disorders in the adolescent population: an overview of diagnosis and treatment. Adolesc Med State Art Rev. 2009;20(1):188-202, x-xi.
  3. Valente SM. Diagnosis and treatment of panic disorder and generalized anxiety in primary care. Nurse Pract. 1996;21(8):26, 32-4, 37-8, passim.
  4. Flinn DE. Transient psychotic reactions during travel. Am J Psychiatry. 1962;119:173-4.
  5. Singh H. A case of psychosis precipitated by confinement in long distance travel by train. Am J Psychiatry. 1961;117:936-7.
  6. Zislin S. Ocherki Klinichishoy Psychiatrii (in Russian). Moscow: Medicina, 1965.
  7. Miller WB, Zarcone V. Psychiatric behavior disorders at an international airport. Arch Environ Health. 1968;17(3):360-5.
  8. Cheng WS, Hung C. Three years' experience in passenger medical care at Taipei International Airport. Aerosp Med. 1974;45(1):82-3.
  9. Hiatt CC, Spurlock RE. Geographical flight and its relation to crisis theory. Am J Orthopsychiatry. 1970;40(1):53-7.
  10. Shapiro S. A study of psychiatric syndromes manifested at an international airport. Compr Psychiatry. 1976;17(3):453-6.
  11. Bar-El I, Witztum E, Kalian M, Brom D. Psychiatric hospitalization of tourists in Jerusalem. Compr Psychiatry. 1991;32(3):238-44.
  12. Waterhouse J, Reilly T, Edwards B. The stress of travel. J Sports Sci. 2004;22(10):946-65.
  13. Bandelow B, Lichte T, Rudolf S, Wiltink J, E Beutel M. The diagnosis of and treatment recommendations for anxiety disorders. Dtsch Arztebl Int. 2014;111(27-28):473-80.
  14. McIntosh IB, Swanson V, Power KG, Raeside F, Dempster C. Anxiety and health problems related to air travel. J Travel Med. 1998;5(4):198-204.
  15. Bor R. Psychological factors in airline passenger and crew behaviour: a clinical overview. Travel Med Infect Dis. 2007;5(4):207-16.
  16. Stradling S, Carreno M, Rye T, Noble A. Passenger perceptions and the ideal urban bus journey experience. Transp Policy. 2007;14(4):283-92.
  17. Li YW. Evaluating the urban commute experience: a time perception approach. J Public Transp. 2003;6(4),41-67.
  18. Cheng YH. Exploring passenger anxiety associated with train travel. Transportation. 2010;37:875-96.
  19. Cox T, Houdmont J, Griffiths A. Rail passenger crowding, stress, health and safety in Britain. Transp Res. 2006;40(3):244-58.
  20. Galovski TE, Blanchard EB, Malta LS, Freidenberg BM. The psychophysiology of aggressive drivers: comparison to non-aggressive drivers and pre- to post-treatment change following a cognitive-behavioural treatment. Behaviour Research & Therapy. 2003;41:1055-67.
  21. Gaynes BN. Identifying difficult-to-treat depression: differential diagnosis, subtypes, and comorbidities. J Clin Psychiatry. 2009;70(Suppl 6):10-5.
  22. Jacob KS. The diagnosis and management of depression and anxiety in primary care: the need for a different framework. Postgrad Med J. 2006;82(974):836-9.
  23. Greenberg J, Tesfazion AA, Robinson CS. Screening, diagnosis, and treatment of depression. Mil Med. 2012;177(8 Suppl):60-6.
  24. Khouzam HR. The diagnosis and treatment of depression in the geriatric population. Compr Ther. 2009;35(2):103-14.
  25. Srinivasan V, Singh J, Pandi-Perumal SR, Brown GM, Spence DW, Cardinali DP. Jet lag, circadian rhythm sleep disturbances, and depression: the role of melatonin and its analogs. Adv Ther. 2010;27(11):796-813.
  26. Tec L. Depression and jet lag. Am J Psychiatry. 1981;138(6):858.
  27. Jauhar P, Weller MP. Psychiatric morbidity and time zone changes: a study of patients from Heathrow airport. Br J Psychiatry. 1982;140:231-5.
  28. Boulos Z, Macchi MM, Stürchler MP, Stewart KT, Brainard GC, Suhner A, et al. Light visor treatment for jet lag after westward travel across six time zones. Aviat Space Environ Med. 2002;73(10):953-63.
  29. Young DM. Psychiatric morbidity in travelers to Honolulu, Hawaii. Compr Psychiatry. 1995;36(3):224-8.
  30. Oyewumi LK. Jet lag and relapse of schizoaffective psychosis despite maintenance clozapine treatment. Br J Psychiatry. 1998;173:268.
  31. Vanden Bogaerde A, De Raedt R. Cognitive vulnerability in fear of flying: the role of anxiety sensitivity. Depress Anxiety. 2008;25(9):768-73.
  32. McCarthy GW, Craig KD. Flying therapy for flying phobia. Aviat Space Environ Med. 1995;66(12):1179-84.
  33. Walder CP, McCracken JS, Herbert M, James PT, Brewitt N. Psychological intervention in civilian flying phobia. Evaluation and a three-year follow-up. Br J Psychiatry. 1987;151:494-8.
  34. Trimmel M, Burger M, Langer G, Trimmel K. Treatment of fear of flying: behavioral, subjective, and cardiovascular effects. Aviat Space Environ Med. 2014;85(5):550-62.
  35. Ss
  36. Daly RJ, Aitken RC, Rosenthal SV. Flying phobia: phobia: phenomenological study. Proc R Soc Med. 1970;63(9):878-82.
  37. Cárdenas G, Botella C, Quero S, Moreyra L, De La Rosa A, Muñoz S A Cross-Cultural Validation of VR Treatment System for Flying Phobia in the Mexican Population. Stud Health Technol Inform. 2009;144:141-4.
  38. Ahn JC, Lee O. Alleviating travel anxiety through virtual reality and narrated video technology. Bratisl Lek Listy. 2013;114(10):595-602.
  39. Rothbaum BO, Hodges LF, Kooper R, Opdyke D, Williford JS, North M. Effectiveness of computer-generated (virtual reality) graded exposure in the treatment of acrophobia. Am J Psychiatry. 1995;152(4):626-8.
  40. Botella C, Baños RM, Perpiñá C, Villa H, Alcañiz M, Rey A. Virtual reality treatment of claustrophobia: a case report. Behav Res Ther. 1998;36(2):239-46.
  41. Wald J, Taylor S. Efficacy of virtual reality exposure therapy to treat driving phobia: a case report. J Behav Ther Exp Psychiatry. 2000;31(3-4):249-57.
  42. Richard A, Klein P. Virtual reality exposure therapy in the treatment of fear of flying. Journal of Contemporary Psychotherapy. 2000;2:195-210.
  43. Wallach HS1, Bar-Zvi M. Virtual-reality-assisted treatment of flight phobia. Isr J Psychiatry Relat Sci. 2007;44(1):29-32.
  44. Eslami P, Monshi G, Haj Ebrahimi Z. Effectiveness of virtual reality therapy to reduce fear of flying in people with fear of flying. Journal of Clinical Psychology. 2013;13(4):43-61. Persian
  45. Brenda K, Wiederhold MSA, Richard G, Mark D, Wiederhold MD. Fear of flying: A case report using virtual reality therapy with physiological monitoring. Cyberpsychology and Behavior. 1998;(1)2:77:97-102.
  46. Rothbaum BO, Hodges L, Anderson PL, Price L, Smith S. Twelve-month follow-up of virtual reality and standard exposure therapies for the fear of flying. J Consult Clin Psychol. 2002;70(2):428-32.
  47. Kaplan A. Virtual reality exposure therapy effective for patients with specific phobias. Psychiatric Times. 2000;17:123-5.
  48. Beckham JC, Vrana SR, May JG, Gustafson DJ, Smith GR. Emotional processing and fear measurement synchrony as indicators of treatment outcome in fear of flying. J Behav Ther Exp Psychiatry. 1990;21(3):153-62.
  49. Waterhouse J, Reilly T, Atkinson G, Edwards B. Jet lag: trends and coping strategies. Lancet. 2007;369(9567):1117-29.
  50. Reilly T, Waterhouse J, Edwards B. Jet lag and air travel: implications for performance. Clin Sports Med. 2005;24(2):367-80, xii.
  51. Sack RL. The pathophysiology of jet lag. Travel Med Infect Dis. 2009;7(2):102-10.
  52. Oxenkrug GF, Requintina PJ. Melatonin and jet lag syndrome: experimental model and clinical implications. CNS Spectr. 2003;8(2):139-48.
  53. Katz G, Durst R, Zislin Y, Barel Y, Knobler HY. Psychiatric aspects of jet lag: review and hypothesis. Med Hypotheses. 2001;56(1):20-3.
  54. Forbes-Robertson S, Dudley E, Vadgama P, Cook C, Drawer S, Kilduff L. Circadian disruption and remedial interventions: effects and interventions for jet lag for athletic peak performance.Sports Med. 2012;42(3):185-208.
  55. Auger RR, Morgenthaler TI. Jet lag and other sleep disorders relevant to the traveler. Travel Med Infect Dis. 2009;7(2):60-8
  56. Ariznavarreta C, Cardinali DP, Villanúa MA, Granados B, Martín M, Chiesa JJ, and et al. Circadian rhythms in airline pilots submitted to long-haul transmeridian flights. Aviat Space Environ Med. 2002;73(5):445-55.
  57. Manfredini R, Manfredini F, Fersini C, Conconi F. Circadian rhythms, athletic performance, and jet lag. Br J Sports Med. 1998;32(2):101-6.
  58. Zisapel N. Circadian rhythm sleep disorders: pathophysiology and potential approaches to management. CNS Drugs. 2001;15(4):311-28.
  59. Reilly T, Waterhouse J, Edwards B. Some chronobiological and physiological problems associated with long-distance journeys. Travel Med Infect Dis. 2009;7(2):88-101.
  60. Coste O, Lagarde D, Coste O, Lagarde D. Travel Med Infect Dis. Clinical management of jet lag: what can be proposed when performance is critical? 2009;7(2):82-7.
  61. Boulos Z, Macchi MM, Stürchler MP, Stewart KT, Brainard GC, Suhner A, and et al. Light visor treatment for jet lag after westward travel across six time zones. Aviat Space Environ Med. 2002;73(10):953-63.
  62. Vosko AM, Colwell CS, Avidan AY. Jet lag syndrome: circadian organization, pathophysiology, and management strategies. Nat Sci Sleep. 2010;2:187-98.
  63. Reynolds NC Jr, Montgomery R. Using the Argonne diet in jet lag prevention: deployment of troops across nine time zones. Mil Med. 2002;167(6):451-3.
  64. Srinivasan V, Singh J, Pandi-Perumal SR, Brown GM, Spence DW, Cardinali DP. Jet lag, circadian rhythm sleep disturbances, and depression: the role of melatonin and its analogs. Adv Ther. 2010;27(11):796-813.