Norwegian airline passengers are not more afraid of flying after the terror act of September 11. The flight anxiety, however, is significantly attributed to acts of terrorism

Abstract

The aim of this paper is to study: (1) the prevalence of flight anxiety among Norwegian airline passengers; (2) situations that may be of concern during flights and situations not related to flying; (3) whether passengers feel more afraid after the terror act of September 11, 2001; and (4) whether passengers were more afraid in 2002 than in 1986.A questionnaire was distributed during domestic flights in Norway in 1986 and 2002. To asses flight anxiety, a six point scale was used, from 0 = not afraid at all, to 5 = always very afraid, and sometimes avoid flying because of that. A 10-cm visual analogue scale (VAS) was used to measure the degree of anxiety. There were 50.8% who were not afraid at all. There were 12 women (5.2%) and one man (0.4%) with flight phobia. However, 22 (4.5%) had cancelled flights because of anxiety during the last two years. Situations that caused most concern during flights were turbulence and fear of terrorism and highjacking. After September 11, 48% were not more afraid, 38% a little more, 10% moderately, 3% rather much and 2% very much. The passengers, however, were not more afraid of flying in 2002 than in 1986. About 3% of Norwegian airline passengers have a flight phobia. Women are significantly more concerned than men. The impact of the terror act September 11, 2001 was rather moderate. The level of flight anxiety among Norwegian airline passengers was not significantly different in 2002 and 1986.

Full text

Personality and Social Psychology
Norwegian airline passengers are not more afraid of flying after the
terror act of September 11. The flight anxiety, however, is significantly
attributed to acts of terrorism
ØIVIND EKEBERG,
1
BERIT FAUSKE
2
and BENTE BERG-HANSEN
3,†
1
Department of Acute Medicine Oslo University Hospital, Ulleval, and Department of Behavioral Sciences in Medicine, Faculty of Medicine,
University of Oslo, Norway
2
Sydsiden Legesenter, Tønne Huitfeldtsplass 2, 1767, Halden, Norway
3
SAS, 0080, Oslo, Norway
Ekeberg, Ø., Fauske, B. & Berg-Hansen, B. (2014). Norwegian airline passengers are not more afraid of flying after the terror act of September 11.
The flight anxiety, however, is significantly attributed to acts of terrorism. Scandinavian Journal of Psychology 55, 464–468.
The aim of this paper is to study: (1) the prevalence of flight anxiety among Norwegian airline passengers; (2) situations that may be of concern during
flights and situations not related to flying; (3) whether passengers feel more afraid after the terror act of September 11, 2001; and (4) whether passen-
gers were more afraid in 2002 than in 1986.A questionnaire was distributed during domestic flights in Norway in 1986 and 2002. To asses flight anxi-
ety, a six point scale was used, from 0 = not afraid at all, to 5 = always very afraid, and sometimes avoid flying because of that. A 10-cm visual
analogue scale (VAS) was used to measure the degree of anxiety. There were 50.8% who were not afraid at all. There were 12 women (5.2%) and one
man (0.4%) with flight phobia. However, 22 (4.5%) had cancelled flights because of anxiety during the last two years. Situations that caused most con-
cern during flights were turbulence and fear of terrorism and highjacking. After September 11, 48% were not more afraid, 38% a little more, 10% mod-
erately, 3% rather much and 2% very much. The passengers, however, were not more afraid of flying in 2002 than in 1986. About 3% of Norwegian
airline passengers have a flight phobia. Women are significantly more concerned than men. The impact of the terror act September 11, 2001 was rather
moderate. The level of flight anxiety among Norwegian airline passengers was not significantly different in 2002 and 1986.
Key words: Airline passengers, anxiety, flying, phobia, travel.
Øivind Ekeberg, Department of Acute Medicine Oslo University Hospital, Ulleval, Box 4950 Nydalen, 0424 Oslo. Tel: +47 22 11 73 00;
e-mail: oivind.ekeberg@ous-hf.no
†
Present address: Krusesvingen 4, 2050, Jessheim, Norway.
INTRODUCTION
There are only a few studies on the prevalence of flight anxi-
ety, especially among airline passengers. Most are population
studies, where questionnaires are mailed to the subjects at
home. We are only aware of one study among passengers
made during flight (Ekeberg, Seeberg & Ellertsen, 1988). On
the other hand, there are many studies on different kinds of
treatment for those who suffer from flight anxiety (Van Gerwen
& Diekstra, 2000).
In the study among airline passengers, (Ekeberg et al., 1988)
found that 48% of the respondents reported some flight anxiety
and 2% were considered to have flight phobia. Women were sig-
nificantly more affected than men. In a study on the prevalence
of flight anxiety in Norway, we found that some degree of flight
anxiety was reported by 46% (Ekeberg, Seeberg & Ellertsen,
1989). There were 8% who were considered flight phobics, as
they reported to be “always very afraid, but never avoid flying
because of it” or “never fly because of flight anxiety,” 14%
among women and 3% men. Nordlund (1983) found that 20–
30% of the Swedish population experienced considerable dis-
comfort on each flight, 50% were apprehensive about flying and
10% did not dare to fly at all. Arnarson (1987) found that less
than 10% of males and about a quarter of female Icelanders suf-
fered from intense fear of flying. Wilhelm and Roth (1997)
found that 20–30% of the US population was apprehensive
about flying. Fredrikson, Annas, Fisher and Wik (1996) found
the point prevalence for DSM-IV (American Psychiatric
Association, 1994) simple phobia (flying) to be 2.6%. In an old
American study, Agras, Sylvester and Oliveau (1969) found that
20% had a moderate and 10% an intense fear of flying. A
German study showed that 15% of the German population has
this fear and that an additional 20% are apprehensive while
flying (M
€
uhlberger, Herrmann, Wiedemann, Ellgring & Pauli,
2001). In all these studies, women reported more flight anxiety.
Ekeberg et al. (1988, 1989) found that discomfort was mainly
caused by turbulence during flight and heights in situations other
than flying. On the other hand, there are many studies on differ-
ent kinds of treatment for those who suffer from flight anxiety
(Van Gerwen & Diekstra, 2000; Van Gerwen, Diekstra, Arondeus
& Wolfger, 2004).
Another topic to study is whether occurrences like the terror
act of September 11, 2001 made passengers more afraid of flying.
Many articles were written about September 11, but we have only
found one related to fear of flying. M
€
uhlberger, Alpers and Pauli
(2005), found that the number of German airline passengers
declined sharply in the months following the attacks. Most air-
lines in the US and Europe reported a noticeable decline in the
number of passengers after the attacks, probably a consequence
of this having been a prominent topic in the US and European
© 2014 Oslo University Hospital. Scandinavian Journal of Psychology published by Scandinavian Psychological Associations and John Wiley & Sons Ltd.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and
distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Scandinavian Journal of Psychology, 2014, 55, 464–468 DOI: 10.1111/sjop.12137

media. In Germany there was a 50–80% increase in cancellations
due to passengers reporting sick in the four months after the
attacks. Was this a result of increased fear of flying? Because
they had coincidentally collected data for the standardization of
the German version of the Fear of Flying Scale in the months
before September 11, they were able to examine whether the
prevalence of fear of flying increased in Germany as a conse-
quence of the attacks. They found no evidence for an increase in
fear of flying. They did not observe an increase in avoidance of
flights, other specific flying-related fears, or trait anxiety in the
wake of the September 11 attacks. Other studies have also shown
a decline in airline passengers after September 11, among those
Ito and Lee (2005) and Gigerenzer (2004).
The aims of this study are to investigate:
1. the prevalence of flight anxiety among Norwegian airline
passengers;
2. how this prevalence relates to sociodemographic variables;
3. what kinds of concerns are related to flight anxiety during
flights;
4. the passengers’ opinion about the frequency of flight acci-
dents, the mortality when accidents occur and whether air
traffic authorities do enough to ensure safety;
5. whether passengers feel more afraid after the terror act of
September 11, 2001; and
6. were Norwegian airline passengers more afraid of flying in
2002 than in 1986?
METHODS
Procedure
The study was conducted during the period October 27–30, 2002, in coop-
eration with the Norwegian airline Braathens (later absorbed by SAS). This
is the same airline as in the study in 1986 (Ekeberg et al., 1988). Fifteen
Norwegian domestic flights were randomly selected to cover unequal days
and all hours. On each flight, 50 questionnaires were to be distributed by
the cabin attendants to random passengers while seated. They were
informed to try to limit the distribution to passengers in the age group 18–
70 years and to invite passengers seated on aisle, middle or window seats
and front, middle or back in the cabin to get a representative sample. If
there were less than 50 passengers, the number of distributed question-
naires should be registered in order to assess the response rate. The ques-
tionnaires were collected by the cabin crew after landing. The cabin crew
received written and verbal information on the procedures and that it was
approved by the airline company. The passengers got written information
about the purpose of the study and that it was approved by the company.
The written information pointed out that it was voluntary to participate and
that all responses were anonymous. There were no names or other informa-
tion that might identify the respondents.
Participants
On the 15 flights, 606 questionnaires were distributed, 19–50 question-
naires on each flight, and 484 participated (79.7%), with 48.1% women
(mean age 40.8 years, range 13–78) and 51.9% men (mean age
43.0 years, range 18–78).
The majority of the passengers were married (47.5%) or cohabitants
(18.8%), whereas 21.1% were single. There were 91.5% who had
children, and 83.5% were in regular work. There were 60.5% who had
to fly in connection with their work, 45.0% of the women and 74.8% of
the men (chi-square = 21.2, p < 0.001).
There were 2.5% who had not flown during the last two years,
whereas 8.2% had flown more than 50 times (Table 1).
Comparisons with the level of flight anxiety in Norway 1986 were
made by using the same questionnaire (Ekeberg et al., 1988) in addition
to new questions on the impact of the September 11, 2001 terror acts in
the USA, safety measures at the airports and air safety.
Assessments
The questionnaire contained 47 items. Ten items covered background
variables like gender, age, marital and occupational status, number of
children and flight habits.
A 10-cm visual analogue scale (VAS) was used to measure the degree
of 21 possible concerns in relation to a flight, like fire in an engine,
engine trouble, foreign objects in the engine, unfamiliar sounds, terror
acts etc. The end points (0 = no anxiety and 10 = maximum anxiety)
were verbally anchored.
In addition, the subjects were asked to indicate their anxiety on the
VAS for six situations not related to flying, namely, riding elevators, big
gatherings, enclosement, walking across open spaces, traveling by bus/
train and heights, as these are situations that commonly may cause anxi-
ety without necessarily being related to flight anxiety.
The degree of flight anxiety was assessed on a six point scale ranging
from 0 = not afraid at all, 1 = sometimes a little afraid, 2 = always a lit-
tle afraid, 3 = sometimes very afraid, 4 = always very afraid, but never
cancel flights because of that and 5 = always very afraid, and sometimes
avoid flying because of that. Grades 4 and 5 were considered at the level
of flight phobia. Those who were afraid should also answer three ques-
tions concerning (a) the duration of the anxiety, (b) whether the fear was
caused by a frightening flight experience and (c) whether they became
more afraid after having children (yes/no).
The passengers were asked if they had become more afraid of
flying after the terror acts at the World Trade Center and Pentagon on
September 11, 2001 and to what degree they feel that the airport staff
and airline companies do enough to ensure safety, measured on a five
point Likert scale from 1 = not at all to 5 = very much. Finally, there
were two items about air safety. The passengers should choose one of
seven alternatives and answer how often they believed that a passenger
aircraft in scheduled traf fic were involved in accidents and estimate the
percentage of fatalities in an average plane crash.
Statistics
Comparisons between groups were made using student’s t-test,
chi-square, Mann-Whitney U, Kruskal-Wallis and Pearson’s correlation
coefficient. Data are presented as means +/ SE. P < 0.05 was consid-
ered statistically significant. Data were analyzed with SPSS version 15
(IBM, Chicago, IL).
Ethics
The anonymous study was approved by the airline company SAS.
Table 1. Number of flights the last two years according to gender
Men% Women% Total%
0 1.6 3.5 2.5
1–10 33.0 55.8 44.1
11–20 23.5 25.1 24.3
21–50 23.9 11.3 17.7
More than 50 13.6 2.6 8.2
Several times, but no specific
number of flights
4.5 1.7 3.2
Total 100.1 100.0 100.0
© 2014 Oslo University Hospital. Scandinavian Journal of Psychology published by Scandinavian Psychological Associations and John Wiley & Sons Ltd.
Flight anxiety among airline passengers 465Scand J Psychol 55 (2014)

RESULTS
Prevalence of flight anxiety according to sociodemographic
variables
There were 50.8% of the passengers who were not afraid of fly-
ing at all (Table 2). Thirteen passengers (2.8%) were in grades 4
and 5, and were considered to have flight phobia, 12 (5.2%)
women and one (0.4%) man. Women reported significantly more
flight anxiety than men (chi-square = 42.6, p < 0.001).
There were 22 (4.5%) who had cancelled at least one flight
because of flight anxiety during the last two years, 17 women
and five men. Thirteen of these passengers were in grades 0–3.
Anxiety did not differ across age levels (≤ 29, 30–49 and
≥ 50 years).
Of the passengers, 310 (46.8% women) answered the question
whether they had become more afraid of flying after having chil-
dren. Significantly more women (21.4%) than men (3.0%) had
become “quite much” or “very much” more afraid after having
children (chi-square = 37.8, p < 0.001).
There were 84 (17.4%; 67% women) who answered the ques-
tion how many years they had been afraid of flying. Of these,
7.1% had been afraid less than one year and 70.2% for more than
10 years (73.2% of the women and 64.3% of the men, n.s.).
There were 94 (19.4%; 64% women) who answered the ques-
tion whether they had become more afraid after a frightening
flight, and 37.2% answered yes.
Situations that cause concern during flight
The scores for the passengers according to situations that cause
concern during flight were significantly higher for women than
for men (Fig. 1). The items with the highest scores were: turbu-
lence 2.3, terrorism 2.2, highjacking 2.1, collision in air 2.1 and
foreign objects in the engine 2.0.
The mean anxiety score according to situations other than
flying was 1.0, significantly higher for women (1.3) than for men
(0.7), t = 5.7, p < 0.001. The average scores were highest for
heights (2.9), riding elevators (0.8) and enclosement (0.8). There
was a medium, positive correlation (r = 0.31, p < 0.00), between
the degree of flight anxiety and anxiety in other situations.
Passengers’
opinion about safety and flight accidents
Men felt significantly more confident that airline companies
and airport staff do enough to ensure safety than women
((3.7  0.07 vs. 3.4  0.08), t = 3.17, p < 0.01). There were
15.7% who thought that only “not at all” or “a little” was made,
and 17.8% “very much.”
Table 2. Degree of flight anxiety according to gender
Women%
(n = 229)
Men%
(n = 247)
Total%
(n = 476)
Not afraid at all
(Grade 0)
36.7 64.0 50.8
Sometimes a little afraid
(Grade 1)
45.4 30.4 37.8
Always a little afraid
(Grade 2)
10.0 4.5 7.1
Sometimes very afraid
(Grade 3)
2.6 0.8 1.7
Always very afraid,
but never cancel flights
because of that (Grade 4)
3.1 0.0 1.5
Always very afraid, and
sometimes avoid flying
because of that (Grade 5)
2.2 0.4 1.3
Total 100.0 100.1 100.2
Note: Grades 4 and 5 in bold are considered flight phobia.
0
0,5
1
1,5
2
2,5
3
3,5
Fire in engine
Engine trouble
Engine fall of plane
Extraneous matter in engine
Wings break
Pressure falls in cabin
Collision in air
Turbulence
L
ightning in plane
Pilot
loses controll
Unknown sounds
W
heels puncture
Landing gear failure
The plane doesn` t climb
Miss the runway
Enclosement
No control
Afra
id of being ill
Lose controll/panic
Terror act
Capturing
Means Men
Means Women
Fig. 1. Discomfort during flights according to sex (mean and standard error).
© 2014 Oslo University Hospital. Scandinavian Journal of Psychology published by Scandinavian Psychological Associations and John Wiley & Sons Ltd.
466 Ø. Ekeberg et al. Scand J Psychol 55 (2014)

There were no significant gender differences according to the
estimate of the frequency of flight accidents as 5,1% thought that
the frequency was 1 per 10 000 flights or more often whereas
70.9% thought that the frequency was from 1 per million or per
10 million. Among those with flight phobia (grades 4 and 5),
33.3% thought that the frequency was 1 per 10 000 or more
often, thus considering the risk significantly higher than those
without phobia (chi-square = 62.3, p < 0.001).
Neither were there significant gender differences concerning
the estimated mortality rate in an airplane accident. 42.7% esti-
mated the mortality rate to be more than 90%, and 17.9% 50%
or less. Among those with flight phobia, significantly more
(91%) thought that the mortality rate was 90% or more
(chi-square = 8.3, p < 0.01).
More flight anxiety after the terror attacks September 11, 2001?
More women than men reported more flight anxiety after the
terror attacks against the World Trade Center and Pentagon,
USA on September 11, 2001, 8.7% and 1.3% respectively being
quite much, or very much more afraid of flying (chi-square =
36.8, p < 0.001) (Table 3).
Were Norwegian airline passengers more afraid of flying
in 2002 than in 1986?
As shown in Table 4, there were no significant differences in the
level of flight anxiety in Norway in 1986 and 2002.
DISCUSSION
About one half of the airline passengers experience some degree
of apprehension during flight, and 2.8% were considered to have
flight phobia. Many other passengers experience some discom-
fort when flying, often related to specific situations, but not to
the level of flight phobia. It was not possible to make a formal
diagnosis of flight (specific) phobia with this study design. The
fact that 4.5% of the passengers had cancelled at least one flight
because of flight anxiety during the last two years indicates that
the estimated level of flight phobia is a minimum figure.
As people with flight phobia fly less or not at all, the preva-
lence of flight anxiety is lower among airline passengers than in
the general population. The finding of 2.7% with flight phobia in
the present study and the findings of Ekeberg et al. (1988) that
5% of the general Norwegian population never fly because of
flight anxiety indicate that Fredrikson et al.’s (1996) finding of
2.6% with flight phobia in the general Swedish population is
most likely an underestimate. The prevalence is expected to be
quite similar in the two neighbouring countries.
Women who fly are significantly more afraid than men. Their
flight anxiety more often increased after having children than
men’s. Women were also more afraid in situations other than
flying. This is in accordance with the fact that symptoms of pho-
bias and anxiety are more common among women than men
(Van Gerwen & Diekstra, 2000). Fear and having a phobia is
not the same, but reflect different levels of the same phenome-
non. Women may be more willing to admit fears and phobias.
The studies of Ekeberg et al. (1988, 1989), however, showed
that women seemed to report the same level of flight anxiety
when asked during flight or at home, whereas men reported
somewhat more anxiety during flight. After correcting for this
however, women still reported significantly more flight anxiety.
Another reason may be that men fly more often than women, in
particular related to their job. It is likely that those who fly most
have less flight anxiety because they fly more.
Only 37% attributed their flight anxiety to a speci fic frighten-
ing flight. Thus, in the majority of cases, flight anxiety devel-
oped in the absence of a particular frightening event. This may
indicate that there has been a general apprehension of flying that
has been increasing. This is in accordance with the experience
that anxiety often is related to the fear of new attacks of anxiety,
that is, a negative snowball effect, even in the absence of a par-
ticularly frightening event. The finding that 70% of those with
flight anxiety had been afraid for more than 10 years shows that
there is a significant risk of chronic concerns for those who do
not get help. We did not ask whether those who were afraid had
been seeking professional help.
Turbulence, foreign sounds, terrorism and highjacking caused
most concern during flight and nearly at the same degree. The
finding that turbulence is of major concern is in accordance with
previous studies (Ekeberg
et al., 1988, 1989). The finding that
the passengers were not more afraid than in 1986 indicates that
the passengers are more inclined to attribute their anxiety to ter-
rorism and highjacking, but that it has no effect on the total
level of flight anxiety.
Heights caused by far the most concern in situations other
than flying for both sexes, and particularly in women. This is
also in accordance with phobia and anxiety being more common
among women than men (Van Gerwen & Diekstra, 2000). In
general, the level of anxiety in other situations was quite low.
The moderate correlation between flight anxiety and anxiety in
Table 3. Influence of the terror attacks 11.09.2001 on flight anxiety
Women%
(n = 208)
Men%
(n = 225)
Total%
(n = 433)
Not at all 34.6 60.0 47.8
A little 42.8 32.9 37.6
Moderate 13.9 5.8 9.7
Quite much 5.8 0.9 3.2
Very much 2.9 0.4 1.6
Total 100.0 100.0 99.9
Table 4. Degree of flight anxiety among Norwegian airline passengers
in 1986 and 2002
1986 (%)
(n = 300)
2002 (%)
(n = 476)
Grade 0 52 51
Grade 1 36 38
Grade 2 8 7
Grade 3 2 2
Grade 4 1 2
Grade 5 1 1
Total 100 101
Note: Grades 4 and 5 in bold are considered flight phobia.
© 2014 Oslo University Hospital. Scandinavian Journal of Psychology published by Scandinavian Psychological Associations and John Wiley & Sons Ltd.
Flight anxiety among airline passengers 467Scand J Psychol 55 (2014)

other situations may indicate that many people experience flight
anxiety without other concerns and vice versa.
The fatal accident rate per million departures for the world-
wide commercial jet fleet 2002–2011 was 0.39 (www.boeing.
com). Accordingly, 70.9% of the passengers had a realistic view
of how often accidents happen. About 50% die in a flight acci-
dent (www.boeing.com). Among the passengers, there were
8.8% who believed that from 41%–60% perished, whereas the
majority thought that over 70% died. Those with most anxiety
also had the greatest assessment of the risk.
The degree of flight anxiety among Norwegian passengers
was the same in 2002 as in 1986. The same questionnaire and
method were used. This indicates that attribution is important,
and that the passengers attribute their anxiety to terror acts like
September 11, or other possible events. The safety associated
with flights and airports is even better than in the 1980’s, where
the last study was conducted. The number of flights has also
increased significantly, but the level of anxiety among the
passengers is the same.
Strengths and limitations
A strength of the study is that the questionnaires were distributed
onboard the airplanes. It is most likely that the passengers’
answers are more reliable when they are studied in a real life sit-
uation. The same questionnaires and methods were used in the
present study and the one from 1986. The response rate was also
good. The random selection of flights with the same airline com-
pany is also a strength. The lack of a formal diagnosis of flight
anxiety is a limitation. The degree of anxiety, however, can be
reliably assessed without a diagnosis. Most likely, passengers
who travel on international flights are less afraid of flying than
those who make domestic flights. Accordingly, assessments on
international flights should also be conducted. Some passengers
do not board the aircraft because of flight anxiety. This does not
happen on every flight, and the number is so small that it does
not represent a significant bias.
CONCLUSION
A significant number of airline passengers are apprehensive
about flying. Women are more afraid than men. Passengers are
most concerned about turbulence, foreign sounds and terrorism/
highjacking. The impact of the terror attacks on September 11
2001 is rather moderate and transient, and does not seem to have
made passengers more afraid than before, even though more
anxiety is attributed to terrorism. The prevalence of flight anxi-
ety among Norwegian passengers was not different in 2002
compared with 1986.
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468 Ø. Ekeberg et al. Scand J Psychol 55 (2014)