Abstract
BACKGROUND: Aviophobia (AP), or fear of flying, is a common situational phobia that can profoundly impact an individual's personal, social, and professional life. Investigating personality traits through the framework of the five-factor model (FFM) and their relationship to AP may offer valuable insights with potential applications in preventive and therapeutic interventions. Here, we conducted a case-control analysis comparing the "big five" personality dimensions between individuals with AP and frequent fliers (FFs). We specifically selected FFs as controls due to their demonstrated ability to adapt to aviation-related scenarios and regular exposure to flight environments. METHODS: We included 60 subjects who met the DSM-5 criteria for specific phobia (situational type: flying), matched in a 1:1 ratio, with 60 FFs serving as controls. Personality traits were assessed using the NEO Five-Factor Inventory (NEO-FFI), a validated 60-item instrument that evaluates five core personality dimensions: neuroticism, extraversion, conscientiousness, agreeableness, and openness. Multivariable logistic regression analysis was performed to explore independent associations between the "big five" personality dimensions and the presence of AP. RESULTS: Subjects with AP exhibited significantly higher neuroticism scores (36.2 versus 30.8, p < 0.001) and lower scores for conscientiousness (40.7 versus 45.4, p < 0.001) and agreeableness (37.4 versus 42.2, p < 0.001) compared to FFs. No significant differences were observed with respect to extraversion or openness. In a fully adjusted multivariable model, neuroticism (OR = 1.14, 95% CI = 1.05-1.23, p < 0.001), conscientiousness (OR = 0.85, 95% CI = 0.77-0.93, p < 0.001), and agreeableness (OR = 0.87, 95% CI = 0.79-0.94, P < 0.01) remained independently associated with AP. CONCLUSIONS: We identified distinct personality profiles among individuals with AP compared to FFs, characterized by elevated neuroticism and diminished conscientiousness and agreeableness. The current findings may enhance our understanding of the psychological mechanisms underlying flight-related anxiety and suggest the value of personality-based approaches in developing targeted interventions for AP.