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“Air rage”: A systematic review of research on disruptive airline passenger behaviour 1985-2020



Purpose: Disruptive airline passenger behaviour (DAPB), i.e. “air rage”, has an adverse impact on crew and passenger well-being and is costly to manage and prevent. Given recent changes in airport management, aircraft design, air traffic volume and behavioural norms this review summaries research findings 1985-2020. Methodology: A systematic review of the research literature containing qualitative or quantitative data examining DAPB. Findings: Nineteen articles satisfied the criteria for inclusion. Most studies involved surveys of cabin crew members and to a lesser extent pilots, airline representatives, passengers and business customers. Content primarily focussed on the frequency and characteristics of DAPB, whilst consequences for staff and evaluation of training to manage DAPB was less represented. A paucity of current research was noted which is not in keeping with the changes over the last decade in the aviation industry and the increase in DAPB events. Originality: This study presents a summary of current findings on DAPB. Practical Implications: A better understanding of the environmental, social and psychological factors underlying DAPB and the effectiveness of staff training and interventions that promote a safe travel environment are required. Social Implications: The current industry trend toward sustainability and better management of security challenges must extend its focus to DAPB, in order to reverse the recent trend of social irresponsibility in air travellers.
JAIRM, 2020 – 10(1), 31-49
Online ISSN: 2014-4806 – Print ISSN: 2014-4865
“Air Rage”: A Systematic review of Research on Disruptive Airline
Passenger Behaviour 1985-2020
Sarven S. McLinton 1, Doug Drury 2, Shepard Masocha 3, Harry Savelsberg 3,
Lucy Martin 1, Kurt Lushington 1
1Discipline of Psychology, Justice and Society Unit, University of South Australia (Australia)
2Discipline of Aviation, STEM Unit, University of South Australia (Australia)
3Discipline of Social Work and Human Services, Justice and Society Unit, University of South Australia
Received April, 2020
Accepted June, 2020
Purpose: Disruptive airline passenger behaviour (DAPB), i.e. “air rage”, has an adverse impact
on crew and passenger well-being and is costly to manage and prevent. Given recent changes in
airport management, aircraft design, air traffic volume and behavioural norms this review
summaries research findings 1985-2020.
Design/methodology: A systematic review of the research literature containing qualitative or
quantitative data examining DAPB.
Findings: Nineteen articles satisfied the criteria for inclusion. Most studies involved surveys of
cabin crew members and to a lesser extent pilots, airline representatives, passengers and business
customers. Content primarily focussed on the frequency and characteristics of DAPB, whilst
consequences for staff and evaluation of training to manage DAPB was less represented. A
paucity of current research was noted which is not in keeping with the changes over the last
decade in the aviation industry and the increase in DAPB events.
Journal of Airline and Airport Management 10(1), 31-49
Practical implications: A better understanding of the environmental, social and psychological
factors underlying DAPB and the effectiveness of staff training and interventions that promote
a safe travel environment are required.
Social implications: The current industry trend toward sustainability and better management of
security challenges must extend its focus to DAPB, in order to reverse the recent trend of social
irresponsibility in air travellers.
Originality/value: This study presents a summary of current findings on DAPB.
Keywords: Disruptive Airline Passenger Behaviour (DAPB), Unruly Passenger Behaviour (UPB), Air
Rage, Cabin Rage.
To cite this article:
McLinton, S. S., Drury, D., Masocha, S., Savelsberg, H., & Lushington, K. (2020). “Air Rage”: A Systematic
Review of Research on Disruptive Airline Passenger Behaviour 1985-2020. Journal of Airline and Airport
Management, 10(1), 31-49.
1. Introduction
Air travel can be stressful with passengers likely to experience a range of stressors before boarding (e.g. tiring
airport commutes; early or late flight times; pressured security and boarding procedures) and whilst in-flight (e.g.
cramped seating; physical discomfort; hypoxia; headaches; noise and anxiety) (Genç & Dural, 2009; Hubbard &
Bor, 2016). These stressors in combination with individual factors (e.g. anxiety, intoxication and mental illness)
can lead to disruptive behaviour and jeopardise safety—a phenomenon known as Disruptive Airline Passenger
Behaviour (DAPB), unruly Passenger Behaviour (UPB) or more generally (and especially if aggression is
involved) as “air-rage” or “cabin-rage” (Felkai & Kurimay, 2017; Gordon, Kingham & Goodwin, 2004;
International Air Transport Association, 2019; Lane, Bor & Laughead, 2002; Rhoden, Ralston & Ineson, 2008;
Vivian, 2000).
DAPB includes: refusing to comply with safety instructions, verbal/physical/sexual abuse directed towards cabin
crew and other passengers, assault, damage to the aircraft, and damage to employee property (Barron, 2002). It
encompasses incidents that occur in the airport and in-flight. Available evidence suggests that the frequency of
DAPB has dramatically increased over the past few decades and may only be reaching a plateau in the last few
years (Timmis, Ison & Budd, 2016). According to the International Air Transport Association (IATA), 58,000
DAPB incidents were reported from 2007 to 2016 (International Air Transport Association, 2019) with an
Australian airline reporting an average of 30 incidents per month in 2015 (Goldsmid, Fuller, Coghian & Brown,
2016). DAPB is known to adversely impact both cabin staff (e.g. poor job satisfaction, worse psychological and
physical well-being and compromised occupational health and safety) and, although less well documented,
accompanying passengers (e.g. increased vulnerability and decreased well-being) (Akgeyik, 2011; Ballard et al.,
2006; Boyd, 2002; Gale, Mordukhovich, Newlan & McNeely, 2018; Hu, Hu & King, 2017; Williams, 2000).
DAPB is also costly. For example, in 2015 the consequent re-routing of a transatlantic flight to Belfast together
with the fuel dump and a mandatory 24-hour delay is reported to cost one airline an estimated £500,000 (“Air-
rage accused does not accept he caused flight diversion”, 2015). DAPB has been associated with alcohol
intoxication, illegal smoking, arguments about carry-on bags, poor customer service, mental illness, cramped
seating, delayed flights, front loading and class envy, upgrade disputes and environmental stressors (e.g. low cabin
pressurisation and hypoxia) (Akgeyik, 2011; Anglin, Neves, Giesbrecht & Kobus-Matthews, 2003; Baranishyn,
Cudmore & Fletcher, 2010; Bell, Green, Fisher & Baum, 2001; Bor, 2003; Bor, Russell, Parker & Papadopoulos,
2001; DeCelles & Norton, 2016b; Hunter, 2007; Moyle & Muir, 2005; Smart & Mann, 2003).
Journal of Airline and Airport Management 10(1), 31-49
A consistent call in the literature has been for a better understanding of the factors underlying DAPB to thereby
inform prevention strategies and cabin crew training (Yang & Chang, 2012). Almost two decades ago Morgan
and Nickson (2001) reviewed the air rage phenomenon in an effort to measure its extent, contributory factors,
and identify potential solutions, however this was published prior to the 9/11 terrorist attack. Since that time the
landscape of air travel has changed considerably with a greater emphasis on security, larger planes but more
cramped seating, larger but more congested airports and an increasing number of travellers and especially from
Asia (with many first-time travellers). To address the demand for current and topical air safety research, the aim
of the present study was to review the extant research literature and provide an overview of DAPB findings to
2. Method
A systematic review of the literature was conducted in January 2020, using the following exclusion criteria,
inclusion criteria, search terms, and databases.
2.1. Exclusion Criteria
Studies were excluded if they were; 1) not peer-reviewed, i.e. legal commentary, industry commentaries, case
studies, policy reviews, expert opinion papers or book chapters, and unpublished work; 2) secondary sources
including general summaries and reviews, letters to the editor and replies to letters; 3) studies where the body of
the text was not in English, or where the full text was not available; or 4) studies examining flight anxiety and
phobia which have not included DAPB data and any articles that discussed anger, rage and violence, but did not
included DAPB-related data.
2.2. Inclusion Criteria
Studies were included in the systematic review if they were published in scholarly (peer reviewed) journals and
included an analysis of empirical data (qualitative or quantitative).
2.3 Search Terms
The following search terms were used in the systematic review: air rage; disruptive airline passenger behaviour;
DAPB, cabin rage; airborne stress; unruly passenger behaviour; misbehaviour; UPB; and travel and disruptive
behaviour. Boolean terms were used to link specific words, for example: “air rage”.
2.4 Databases
General, psychology, engineering, and safety specific databases were used to identify articles and include:
Academic Search Premier; BASE; Compendex; Health and Safety Science Abstracts; HSELINE; JSTOR; Oxford
Academic; ProQuest: Advanced Technologies and Aerospace Database; PsychINFO; Research Library; Science
Direct; Scopus; SpringerLink. Publications were limited to English.
3. Results
We identified 19 studies in the systematic review and the findings are summarised in Table 1. The overarching
characteristics of the 19 studies are outlined here, whilst the Discussion synthesises the findings therein.
Most studies administered questionnaires to cabin crews and to a lesser extent passengers, business customers,
and specialised airline staff (e.g. pilots, safety officers, cabin crew instructors, operations mangers and airline
customer service workers). Five studies examined DAPB databases. These were sourced from government
departments, airline companies and an airport police department (Bor, 2003; DeCelles et al., 2019; DeCelles &
Norton, 2016a; Burgess, 2002). One study reviewed newspaper articles of DAPB incidents (Smart & Mann,
2003), and a further observed passenger behaviour prior to boarding (DeCelles et al., 2019).
Apart for one exception, studies have overwhelmingly reported findings which have examined passenger versus
airline staff conflict. The exception was Salinger et al. (1985) who administered a questionnaire to 251 US cabin
Journal of Airline and Airport Management 10(1), 31-49
crew assessing the frequency of assault for the calendar year 1982 and report a 4% incidence of airline staff
versus airline staff assault. Most studies report findings from a single data source (e.g. questionnaires, interviews,
database records or newspaper articles). Only two studies report findings from multiple data sources. Most
studies have focussed on inflight DAPB incidents with only two examining pre-boarding and a further both
inflight and pre-boarding DAPB incidents. The majority of studies have examined airlines, participants or
databases from the US (Ballard et al., 2006; DeCelles et al., 2019; Gale et al., 2018; Girasek & Olsen, 2009;
Hunter, 2007; Salinger et al., 1985; Vredenburgh et al., 2015), followed by the UK (Bor, 2003; Boyd, 2002;
Burgess, 2002; Rhoden et al., 2008), while single studies have reported findings from cabin crews servicing
Australian (Williams, 2000), Taiwanese (Hu, Hu et al., 2017), Turkish (Akgeyik, 2011) and Italian (Ballard et al.,
2006) airlines. Single studies have also surveyed passengers at Hong Kong airport (Tsang, Masiero et al., 2018)
and Taiwanese airline customer service workers (Yang & Chang 2012), and summarised media reports of
passengers flying on Canadian airlines (Smart & Mann, 2003). Two studies did not define the nationality of the
cohort or database (Bor, Russell et al., 2001; DeCelles & Norton 2016b). Eleven studies were undertaken
between 1985-2009 and eight between 2010-2019.
4. Discussion
Examination of the research findings revealed three overarching research themes; 1) the frequency and
characteristics of DAPB; 2) the consequence of DAPB for crew well-being and training, and; 3) the factors
explaining DAPB. Studies conducted in the last decade reveal that the focus remains on the frequency and
characteristics of DAPB, with only a single study examining the consequence of DAPB for staff well-being and
training (Yang and Chang, 2012), and a further study on possible underlying factors (DeCelles, DeVoe et al.,
2019). Overall, the scientific literature examining DAPB is limited, mainly focused on the frequency and
characteristics of DAPB, and much of the work is dated.
4.1. Frequency and Characteristics of DAPB
Several issues bedevil the accuracy of DAPB estimates. These include: under-reporting due to the personal
nature of incidents, legal risk associated with disclosure, administrative burden and negative publicity; the biases
inherent with mandatory reporting systems such as minimisation and selective reporting; and the adequacy of
staff training and reporting mechanisms (Hunter, 2016; Salinger et al., 1985; Vredenburgh et al., 2015). A further
difficulty faced by airline staff is deciding whether an incident has met criteria—i.e. the line between ‘common’
behaviours like impolite passengers and actual abuse can be blurred. As discussed by several authors, DAPB
estimates also vary according to national reporting regimes (Schaaf, 2018; Timmis et al., 2016).
Data from the mid-1980s to early 2000s suggests an escalating rate of DAPB. Survey responses from US cabin
crew collected in 1985 suggest that 16% had experienced either verbal or physical abuse with 8% experiencing
multiple incidents. Questionnaire responses from Australian cabin crew collected in 1994 revealed that 79% of
female and 73% of male cabin crew on international flights and 37% of pursers on domestic flights frequently
dealt with angry passengers (Williams, 2000). Survey responses collected over the period 1999-2003 indicate that
up to a fifth of UK cabin crew have experienced an abusive passenger often or on every flight with the majority
of UK cabin crew expressing concerns about the number of incidents of abuse and rudeness that are not
recorded (Boyd, 2002; Rolfe, 2000). One UK study also reported that half of the DAPB incidents were serious
enough to require police assistance (Burgess, 2002). In contrast to self-report staff survey data, examination of
airline database records suggests that DAPB incidents may have actually decreased rather than increased from
late 1990s to early 2000s. In their analysis of UK Civil Aviation Authority database of DAPB incidents, Bor
(2003) reports a decrease in frequency from 1:15,000 in 1992 to 1:36,000 in 2003. Reconciling the inconsistencies
between self-report and database responses is complex and is likely explained by reporting and methodological
In response to the need for standardised reporting the IATA have employed the Safety Trend Evaluation,
Analysis and Data Exchange System (STEADES) to generate a global database of DAPB incidents coded
according to International Civil Aviation Organisation criteria (1 = verbal disruptive behaviour, 2 = physically
Journal of Airline and Airport Management 10(1), 31-49
disruptive behaviour, 3 = life-threatening behaviour and 4 = attempted or actual breach of the flight crew
compartment). Inspection of the IATA database suggests that the frequency of DAPB incidents has steadily
increased since 2007 reaching a peak in 2015 with a possible plateau in the last few years (Timmis et al., 2016).
The IATA report the frequency of DAPB incidents at 1:1,424 flights in 2015 and 1:1,053 flights in 2016 (IATA,
2018). On balance, the available evidence suggests that DAPB has increased over the past few decades and
remains elevated.
Although the number of DAPB incidents may have plateaued in the last few years there is some debate as to
whether the seriousness of incidents may have increased. In his examination of the 2009-2003 UK database
records, Bor (2003) classified DAPB incidents as ‘significant’ (e.g. smoking in the aircraft’s toilet, refusal to follow
a crew member’s instruction) and ‘serious’ (e.g. violent or abusive behaviour). Bor concluded that 54% of DAPB
incidents were ‘significant’ while 19% were ‘serious’ with an estimated frequency of serious incidents at 1:30,000
flights. The proportion of ‘serious’ incidents appears to have remained relatively stable in the last two decades.
Timmis et al. (2016) in their 2016 report to the UK Department of Transport observe that while the majority of
incidents reported to the IATA were Level 1 (i.e. verbal abuse), nonetheless, 14% were Level 2-4 (i.e. physical
abuse, life threatening incidents and cockpit breaches), i.e. ‘serious’ and comparable to the earlier estimate
reported by Bor.
Taken together the self-report and database findings from the last decades both suggest that the absolute
number of DAPB incidents have increased while the relative proportion of ‘serious’ incidents appears to be
Frequency of Type-1 DAPB Incidents: Verbal Abuse
The most commonly reported DAPB incident was verbal abuse. In their 2001 survey of cabin crew, Lane et al.
(2002) reported that staff experienced very high rates of verbal abuse with many indicating that they felt at risk
of physical violence "beyond their control". In a survey of UK cabin crew, Boyd (2002) notes that 50% had
experienced an increase in verbal abuse over the preceding year. The high frequency of verbal abuse appears to
be a longstanding issue. More recent IATA data collected in 2016 indicates that verbal abuse accounted for 86%
of DAPB incidents (IATA, 2018). Consistent with the 2016 IATA findings, Gale et al. (2018) in their 2014
questionnaire report that 89.6% of US and Canadian cabin crew (N = 4,549) had experienced verbal abuse.
Frequency of Type-2 DAPB Incidents: Physical Abuse
Airline crew are responsible for handling DAPB incidents and are therefore most exposed to physical conflict.
IATA data for 2016 indicate that 12% of DAPB incidents were rated at Level 2, i.e. physical abuse (IATA, 2018).
Exposure to violence is a recognised occupational stressor in cabin crews, especially women who are also at extra
risk of sexual violence (Ballard et al., 2006; Gale et al., 2018; Pontell, Salinger & Geis, 1983). Boyd (2002)
surveyed airline and rail cabin crew and found for both cohorts combined that 60% had experienced at least one
episode of physical abuse in the preceding year. Francis-Way (2002) found that 1% of US business leaders
admitted striking airline staff. Airline staff may not be the only group at risk for assault. In a detailed
examination of UK incidents between 1999-2003, Bor (2003) found passengers were equally as likely as airline
staff to be the target of physical violence (48% versus 52%). Smart and Mann (2003) reviewed newspaper
articles which reported the 66% of DAPB incidents on Canadian airlines involved physical aggression directed at
airline staff and 28% at other passengers. A possible interaction between the gender of cabin crew and
passenger may also exist. Female cabin crew report that male and female passengers are equally like to perpetrate
DAPB whereas male cabin crew report that DAPB perpetrators are overwhelmingly male (Akgeyik, 2011).
Female cabin crew compared to other female dominated professions such as teaching and nursing are at a
notably higher risk of sexual harassment (Gale et al., 2018; Gunnarsdottir, Sveinsdottir, Bernburg, Fridriksdottir
& Tomasson, 2006). Nevertheless, while it is a recognised issue in the workplace, there is a paucity of research
regarding the nature of sexual harassment from passengers. Ballard et al. (2006) report that 23% of Italian
female cabin crew had experienced sexual harassment by a passenger, 4% also stating it had occurred in the
preceding year. A decade later Gale et al. (2018) report a much higher frequency of sexual harassment in US and
Journal of Airline and Airport Management 10(1), 31-49
Canadian cabin crew. For both genders combined, 69% of cabin crew report passenger-related sexual
harassment in the past year, 1% of which were sexual assault. Moreover, they report that 26.4% of flight
attendants had experienced sexual harassment and 2.1% sexual assault, both of which were in turn associated
with increased odds for depression, fatigue, sleep and musculoskeletal complaints and especially in female flight
Sexual harassment and assault of airline staff extends beyond incidents perpetrated by passengers. Of note is
that the frequency of sexual harassment and assault by a superior or co-worker in Gale et al.’s (2018) study was
only slightly lower than those perpetrated by passengers, suggesting a broader issue of workplace safety.
4.2. Consequences of DAPB for Crew Well-being and Training
The literature examining the consequence of DAPB on staff well-being is relatively limited. The immediate
impact of dealing with angry passengers is the disruption in work performance (Williams, 2000). In the longer
term it is associated with a dread of similar incidents, questioning career choices, greater emotional exhaustion,
higher levels of fatigue, aggression and social anxiety, lower self-confidence and poorer physical health (Williams,
2000; Hu et al., 2017; Akgeyik, 2011; Williams, 2000; Gale et al., 2018). Negative consequences have also been
reported for cabin staff who have witnessed but not directly experienced DAPB (Akgeyik, 2011). Although the
dimension is under-researched, there is also a possible interaction between DAPB, gender and well-being. Female
cabin crew are likely to respond less assertively to aggressive passengers than males, but as a consequence are
more likely to experience greater fatigue (Williams, 2000). As yet, the consequences of verbal versus physical
abuse on well-being are unclear. One exception is research into sexual abuse, which demonstrates that regardless
of gender, both sexual harassment and assault have been associated with worse physical and psychological health
(Ballard et al., 2006; Gale et al., 2018). The impact of DAPB on other measures of staff well-being such as
absenteeism and staff turnover are poorly documented. In 1994, a survey of 2,912 Australian Flight Attendants,
reported that 17% took time off work as a result of passenger abuse (Williams, 2000). Current data is not
Only a handful of studies have examined the consequences of DAPB for crew training and the relevance of
earlier findings is questionable given the changes in work practices over the past decades. Barron (2002)
interviewed 15 flight crew educators and found that DAPB was not included in 80% of program curricula. Bor
et al. (2001) found that 38% of airlines do not have any policy around the role of flight deck crew in assisting
cabin crew to manage incidents of passenger violence, and likewise do not offer formal training in the area. Lane
et al. (2002) surveyed 104 cabin crew who overwhelmingly reported that not enough was being done to manage
DAPB and they actively welcome the opportunity for further training. Boyd (2002) quotes an airline cabin crew
member, Airlines should invest more in the experience of all staff in all areas and encourage consistency of
strict rules in application (p164)”. Rhoden et al. (2008) undertook in-depth interviews with eight experienced
cabin crew and instructors regarding the effectiveness of training programs. While Rhoden et al. (2008) assert
that comprehensive training is widely supported by stakeholders (p.540) they note that the format and efficacy of
such training is still questioned. The programs reviewed by participants in Rhoden et al.’s study on average lasted
for 4h and all contained content aimed at raising cabin crew awareness of the factors contributing to DAPB.
However, they varied in depth, contributory factors were sometimes overlooked (e.g. altered behaviour because a
medical issue versus DAPB), and information on aggression theory and explicit instructions on aggression
management was sometimes missing. They further noted that while a focus on knowledge of DAPB triggers and
social/emotional contexts in training courses is important, it does not necessarily provide cabin crew with the
confidence to cogently intervene in DAPB incidents. Indeed, as Rhoden et al. suggest, evaluation of the efficacy
of DAPB training courses may not be possible due to “…the spontaneous and unique natures of DAPB
incidents…”(p. 546). Teaching social skills such as aggression management is a challenge. A promising approach
is problem-based 3D simulations (e.g. Reisoğlu, Topu, Yılmaz, Karakuş Yılmaz & Göktaş, 2017) which may
provide the realistic challenges faced in the moment of a disruptive airline passenger behaviour requiring the
learner to prepare, respond and then reflect on a DAPB incident. Consistent with Rhoden et al.s finding
regarding a lack of standardised training, Yang and Chang (2012) also report that competence in recognition and
management of DAPB differed widely according to company policy, training, and supports—limitations which
Journal of Airline and Airport Management 10(1), 31-49
point to the opportunity for evaluation studies to establish best practice. In a study conducted in 2000
interviewed ten UK cabin crew and reported that the majority were satisfied with their initial DAPB training
(Rolfe, 2000). Nevertheless, the participants in Rolfe’s study also pointed to the need for annual refresher training
for cabin crew, involvement of the police and Crown Prosecution Service in real-time scenarios, more time
allocated for role playing and that annual refresher training needs to include statistical updates about DAPB
incidents. On balance and when the research findings are considered together with expert commentaries a clear
message is the need for more effective training (Goldsmid et al., 2016; Schaaf, 2018).
At present information on the effectiveness of training programs for managing DAPB have not been reported
and it is difficult to make recommendations. Authors have proposed the development of best practice
frameworks, greater service training, gamification training techniques and recommended simulation-based
training approaches (Berkley & Ala, 2001; Goldsmid et al., 2016; Morgan & Nickson, 2001; Yang & Chang, 2012;
Hunter, 2011; James, 2014; Hu et al., 2017; Piñar-Chelso & Fernández-Castro, 2011). It has also been proposed
that lessons can be learned from studies into road rage (Barron, 2002), and the propensity for road rage has been
associated with a propensity for ‘air rage’. For example, (Bricker, 2005) developed a 22-item air travel stress scale
containing three factors: air travel anxiety; air travel anger; and Airline/airport trust; which overall displayed a
strong relationship with driving anger (r = .50) and trait anger (r = .43).
Whilst not the industry standard, some airlines have also proposed self-defence training as a strategy to manage
DAPB. Hong Kong Airlines is training its cabin crew in martial arts as an active measure in managing unruly
passenger behaviour (Whitehead, 2013). The US Transportation Security Administration (TSA) Office of Law
Enforcement/ Federal Air Marshal Service (FAMS) is offering free self-defence training for any current flight
crew member employed at an airline (Aratani, 2016). Korean Air staff have been trained to use tasers in order to
deal with unruly or violent passengers (Schwarz, 2017).
As a more systemic response to DAPB, airlines have also constructed databases to identify and blacklist
disruptive passengers and, as well, have implemented stricter pre-boarding screening protocols (Berkley and Ala,
2001). They have also trialled notification strategies. Since 1998, British Airways have used ‘yellow card’ warnings
to unruly passengers in flight and in 2015 have extended this to those in check-in and departure areas (Leff,
2015). Burgess (2002) evaluated the effectiveness of police patrols issuing 'yellow cards' as warnings to
passengers displaying erratic and aggressive behaviour at Manchester airport and reported a subsequent decrease
of inflight DAPB incidents.
Authors have also called for stronger legal penalties to deter DAPB. Bor et al. (2001) note that responses from
airlines indicated that the media have made ‘air rage’ fashionable and the penalties for aggressive behaviour are
inadequate. Since that publication, governments have introduced stronger penalties. In Australia, two Federal acts
encompass mid-air offences—the Crimes (Aviation) Act 1991 and the Civil Aviation Act 1988 both of which
allow for hefty jail terms, including 10 years behind bars for anyone who assaults, threatens with violence or
intimidates a cabin crew member (McKinnell, 2019). The advent of social media is also changing the awareness
of unruly behaviour by documenting events related to passengers and airline employees (Carruthers, 2018).
Recently, advertising campaigns have started targeting attitudes of potential passengers to address poor
behaviour toward service staff, such as curbing the increasing rates of violence in healthcare settings toward
nurses and first-response teams (Jones, 2017; Tyeson, 2017). A similar awareness-raising campaign may be
effective in setting standards of behaviour for passengers and pre-empting DAPB.
4.3. Factors explaining DAPB
A diversity of factors are thought to explain DAPB, but evidence of causation is presently lacking. In a study
examining in-flight customer service, Yang et al. (2010) identified 16 unruly passenger behaviours faced by cabin
crew. The three most challenging behaviours included: (1) passengers with poor mental condition; (2) passengers
who conceal or avoid providing important information; and (3) passengers under intoxication or inebriation on
the plane. Yang and Chang (2012) in a parallel study involving ground staff from three international airlines
servicing a Taiwanese airport identified 17 unruly passenger behaviours. Of these, five were in-common to all
airlines: (1) violent speech or behaviour; (2) under the influence of alcohol or drugs; (3) customers who are picky
Journal of Airline and Airport Management 10(1), 31-49
or fussy about services; (4) passengers who collect evidence using digital equipment; and (5) customers who
demand to speak to the duty supervisor. The findings from the latter two studies are consistent with the general
findings that the most commonly attributed causes of DAPB are alcohol/medications and illegal smoking,
medications and drugs and poor customer service. Other less frequently reported causes of DAPB include:
airport-related stressors, airplane-related stressors, passenger-type and a change in public mores regarding
appropriate travel behaviour.
Alcohol and Illegal Smoking
Alcohol is thought to be a major contributor to DAPB. This has been attributed to the disinhibition association
with intoxication exacerbated by the hypoxia associated with lowered barometric pressure (Petros et al., 2003).
Bor et al. (2001) collated ten contributing DAPB factors commonly cited by attendees at training events and
presented the list to the chief pilot or operations manager of 197 airlines, 88% agreed that the excessive
consumption of alcohol was a key factor. Bor’s (2003) analysis of airline incident records 1999-2003 confirmed
that approximately 80% of DAPB incidents involved excessive consumption of alcohol, or illegal smoking (e.g.
in lavatories). Excessive alcohol consumption and illegal smoking has also been widely reported in media reports
of DAPB (Smart and Mann, 2003). Two studies report that alcohol was involved in 40% (Anglin et al., 2003) and
41% (Salinger et al., 1985) of DAPB incidents. IATA data indicates that 31% of DAPB incidents in 2016
involved alcohol/intoxication and 26% compliance with smoking regulations (Timmis et al., 2016). DAPB
incidents involving alcohol intoxication and illegal smoking are also evident prior to boarding. In passengers
using Manchester airport, Burgess (2002) report that 9% of DAPB incidents involved alcohol or illegal smoking.
Despite the high number of incidents involving alcohol, intoxication itself may only partly explain DAPB.
Surveys of air crews themselves suggest that precipitant factors go beyond intoxication (Lane et al., 2002).
Surveys undertaken in passengers who fly and intend to consume alcohol suggests that they do not expect to
pose a risk to others (Girasek & Olsen, 2009). Passenger attribution of alcohol as a precipitating factor for
DAPB has also changed after the 9/11 terrorist attack. In a serendipitous study, Francis-Way (2002) in October
2001 assessed the factors contributing to DAPB in cohort of US Chamber of Commerce members thus
permitting an examination of behaviours pre and post ‘9/11’. Francis-Way (2002) reported after 9/11 there was
less agreement that alcohol contributed to DAPB (81% vs 65%) but continued and strong agreement that
oversold and crowded flights contributed to DAPB (76% vs 72%). The immediate post 9/11 period was also
characterised by a notable decrease in passenger and airline staff conflict with business leaders reporting fewer
arguments with airline staff (17% vs 6%) and a lower likelihood of striking staff (1% vs 0%).
Medication and Illicit Drugs
It is likely that frequency of DAPB will be higher in population cohorts which tend to be over-reported in
case/survey studies, such as passengers on medications. Unfortunately, and while identified as a cause of DAPB,
data examining the relationship between medication use and DAPB is limited to case studies. There is anecdotal
evidence, however, that the risk of physical abuse is higher if the incident involves a medicated passenger. In a
2018 survey of 100 flight attendants, a UK travel insurance company reported that 38% of respondents had
been physically abused, 46% had received a verbal insult and 7% had been sexually harassed by a medicated
passenger (Matousek, 2019). That study, however, did not distinguish illicit from prescribed drug use and to date
information on the percentage of DAPB incidents that are related to illicit medications is limited. Dowdall
(2000) reports that British Airways experienced 3,386 inflight medical incidents or about 1 per 11 000 passengers
with drug overdose account for 2% of cases, representing a very small proportion of passengers who have likely
taken illicit medications. Despite the potentially high frequency of illicit medication, Smart and Mann (2003) note
that none of the 29 DAPB incidents reported in the Canadian Press identified illicit drug use as a cause.
Customer Service
Customer service has been identified as a contributing factor to DAPB. Although receiving poor customer
service may not in itself translate directly into DAPB, Hunter (2007) demonstrated that passengers were more
likely to approve of another patron engaging in DAPB if customer service was considered poor. Conversely,
Journal of Airline and Airport Management 10(1), 31-49
good service has been associated with a lower propensity for DAPB (Hunter, 2007). In one of the few studies to
examine in detail the behaviours affecting customer service, Piñar-Chelso and Fernández-Castro (2011)
developed an observational scale to evaluate cabin crew management of disruptive behaviour and asked two
expert cabin crew and five airline customers to evaluate the responses of 18 Spanish cabin crew to video
simulations of two Type 1 (i.e. verbal) and Type 2 (i.e. physical) disruptive passenger behaviours. They found that
the expert cabin crew positively judged: eye contact; clear gestures; rate of speech; fluency; duration of
explanation; transmits self-confidence; inspires trust and credibility; shows concern for service with
consideration and respect; and, negatively judged, uncontrolled attitude (i.e. insecurity, nervousness and fear).
These attributes are mostly in contrast to the behaviours which were judged positively by airline customers:
transmits self-confidence; has put himself/herself in the client’s position; has understood what the client wanted
and has tried to provide it; kindly; with consideration and respect; and, negatively, uncontrolled attitude and
excessive firmness. The contrasting set of attributes indicate that the perception of good customer service is not
the same for cabin staff and passengers which has direct implications for staff training and management of
Airport Stressors
Airports can be stressful and if travel expectations are unmet and coping strategies ineffective can lead to anger
(Menon & Dube, 2004; Menon & Dubé, 2007). DeCelles et al. (2019) report findings from an observational
study of passenger behaviour prior to boarding. They found that passenger aggression was related to situational
stressors (e.g. security line waiting time, time to departure gate, number of oversold seats, longest question line at
counter, time passengers started to line up, weather related flight delays and non-weather-related flight delays)
and physiological stressors (noise, babies crying, subjective temperature, subjective crowdedness, number of
passengers and employee helpfulness). They also observed that situational but not physiological stress was
associated with greater employee helpfulness. In a series of follow-up studies aimed at delineating the
observational findings, DeCelles et al. (2019) also examined the emotional responses of passengers and airline
custom service workers to vignettes containing descriptions of either neutral, situational or physiologically
stressful incidents. They found that situational and to a lesser extent physiological stress was associated with
increased passenger anger and fear which, in turn, were associated with increased passenger aggression. Turning
to customer service workers, they found that situational but not physiological stress was associated with an
increased perception of passenger fear which, in turn, was associated with increased customer service workers
empathy and helpfulness.
The contribution of specific airport-related stressors to DAPB is limited to studies examining flight delay. Flight
delays are common and a known source of passenger dissatisfaction especially if it is attributed to internal (e.g.
flight cancellations) compared to external causes (e.g. weather) (Anderson, Baggett, and Widener, 2009). Delayed
flights have been associated with DAPB in some but not all studies (Baranishyn et al., 2010; Bor et al., 2001;
DeCelles et al., 2019; DeCelles & Norton, 2016a). Flight Delay is but one of many situational stressors
experienced by travellers and point to the role that the travel experience prior to boarding can potentially deplete
emotional and cognitive resources and in vulnerable individuals consequently lead to less self-control and
aggression in the aircraft.
Airplane Stressors
Aircraft can be a stressful environment (Ahmadpour, Robert & Lindgaard, 2016; Moyle & Muir, 2005). Of the
various potential stressors and their contribution to DAPB, the only items explored to date are boarding through
first class, flying Economy and reduced personal space.
Boarding through first class and possibly the presence of First class itself has been associated with DAPB.
DeCelles and Norton (2016a) report a higher frequency of DAPB in Economy classes on flights with compared
to those without a First class cabin (1:632 versus 1:7,142 with the frequency of DAPB for First class passengers
at 1:3,225 per flight). Nevertheless, DeCelles and Norton’s (2016a) findings have been contested and not all
studies report an association between flying economy and DAPB (Crede et al., 2016; DeCelles & Norton, 2016b;
DeCelles & Norton, 2016c; Giner-Sorolla, 2016; Salinger et al., 1985).
Journal of Airline and Airport Management 10(1), 31-49
It is unclear why Economy class is necessarily associated with DAPB, but a noticeable trend in the last few
decades is the steady decrease in leg room and seat pitch and, consequently a greater likelihood that personal
space will be violated (Whitley and Gross, 2019). Violation of personal space has been reported as potent
precursor for DAPB in some but not all studies (Vredenburgh et al., 2015; DeCelles & Norton, 2016a). In a
study that examined personal space, passenger ethnicity and DAPB, Tsang et al. (2018) report that Asian
compared to non-Asian passengers were more tolerant of intrusion into personal space. However, and regardless
of ethnicity, passengers were less tolerant of intrusions into personal space if they had a higher education, were
on longer flight durations, flying business/first class, travelling for leisure or business (versus visiting
friends/family) and were more frequent flyers. In a study investigating the factors influencing passengers anger,
Vredenburgh et al. (2015) report that 15% of passengers had experienced serious disagreements with fellow
passengers and that the top three reasons for disputes involved intrusion into personal space (i.e. conflict over
armrests, someone reclining into the passenger’s space and child kicking the seat). Of note is that passengers so
affected are unlikely to ask for assistance when dealing with a disruptive passenger with only 19% of affected
passengers asking a flight attendant for assistance. These authors also examined the factors that led passengers to
act on their anger. They found that confinement, discomfort, and lack of personal space were factors in
passengers acting out anger, whereas noise and hunger led to anger but not action.
Passenger Characteristics
Several personal characteristics have been associated DAPB and include male gender (especially younger males),
higher education levels and a demanding and intolerant personality (Akgeyik, 2011; Bor, 2003; Salinger et al.,
1985; Smart & Mann, 2003; Bor et al., 2001). It is also likely that over-anxious and anger-prone passengers are
more likely to become stressed by air travel (Bricker, 2005; McIntosh et al., 1998; Menon & Dube, 2004; Menon
& Dubé, 2007). As a consequence, it is reasonable to assume that they will more likely to rely on alcohol and
smoking as coping strategies (McIntosh et al., 1998), if anger-prone more likely to be belligerent and if
possessing low-control more likely to act antisocially (Meldrum, 2016). Given these risk factors they be
potentially at greater risk for DAPB. As yet the psychological profile of DAPB individuals is unknown and as
observed by several authors there is not a stereotypical DAPB perpetrator.
Travel Mores
A change in societal attitudes regarding acceptable public behaviour and a greater sense of entitlement may also
account for increased disruptive behaviour in air travellers. Hunter (2016) cites Pam Terry a US passenger service
agent, As a society, our manners are simply getting worse… And it doesn’t have to involve violence. When a
passenger becomes vocal or menacing, you get gun shy knowing there is a chance they might go over the edge. It
causes me enormous stress even when they don’t get physical” (p117). Small and Harris (2018) reviewed the
public reaction to the findings of DeCelles and Norton (2016a) which were reported in a Washington Post article
entitled ‘Air rage incidents are on the rise. First-class sections aren’t helping’. They report that the public
attributed DAPB in the article to the stressors associated with air travel (i.e. checking and boarding procedures,
limited carry-on space, crowding, small seat size, minimal leg-room and discomfort), unfriendly cabin crew and
over-reaction to incidents and the poor treatment of Economy passengers. The public also attributed DAPB to
personal characteristics such as lack of responsibility and self-control, and importantly, a change in public mores
and an increased sense of entitlement. Notably in their study, the public did not attribute DAPB to a
demographic profile. Undoubtably, with the advent of cheaper flights more people are flying and more often,
and therefore cabin and ground crew are having to manage a broader range of people and in higher numbers.
This includes less sophisticated flyers, and elites who expect preferential treatment (Heaver, 2019; Kim et al.,
2018). As society changes so too must the research focus, in particular toward addressing highly prevalent
adverse phenomena like DAPB.
5. Conclusion
This systematic review identified 19 peer-reviewed articles containing DAPB data. These studies have mainly
focused on the frequency and characteristics of DAPB and to a lesser extent the consequence of DAPB for crew
Journal of Airline and Airport Management 10(1), 31-49
well-being and training and the factors underlying DAPB. Although studies to date have been informative, a
theoretical understanding of the phenomenon remains to be developed. A better understanding of the nature
and psychological and social processes by which DAPB works is required. Rhoden et al. (2008) suggest that
applying the principles behind the ‘psychology of anger’ may assist in understanding what triggers otherwise
normal people to engage in DAPB. Practical implications are also clear, as many of the articles emphasise strong
grounds for the development of better training programs.
DAPB poses a considerable cost, both in terms of financial burdens to airlines and the individual cost to staff
and passengers. The current industry trend toward sustainability and better management of security challenges
must extend to addressing DAPB with an evidence-based practice approach. This systematic review
demonstrates that there is a dearth of empirical peer-reviewed information, and despite a surface-level
understanding of contributing factors and prevalence, the processes behind the phenomenon are not well
understood. Future research into the theoretical underpinnings of air rage will better assist with the development
of new training programs to support staff with the recognition of hazards and management of risks involved
with disruptive behaviours.
Author(s) Data format Sample/
Participants Key finding(s)
Salinger, Jesilow,
Pontell & Geis
assessing the
frequency of
251 cabin crew
15.9% cabin crew reported having been assaulted
96% cabin crew assaults committed by passengers
4% cabin crew assaults committed by other cabin staff
90.2% cabin crew assaults committed by male passengers
with 41% of incidents involving alcohol
44% of incidents involved a prior request refusal by the
cabin crew (38.1% liquor, 23.8% baggage, 9.5% information,
9.5% meals and 19.1% other)
In almost half of incidents (percentage not reported),
offender failed to comply with a request
Frequency of assaults higher in first compared to other class
No serious injuries reported
Williams (2000)
assessing how
often staff dealt
with angry
2912 Australian
cabin crew
More incidents involving angry passengers on international
compared to domestic flights
Dealing with angry passengers was associated with increased
frequency of backache, neck pain, indigestion and fatigue
Dealing with angry passengers was associated with lower
management engagement and increased work speed, pressure
and workload
17% of cabin crew took time off because passenger abuse
57% reported that passenger abuse distracted them from
doing their job properly
41% of cabin crew developed a long term a sense of
discomfort or dread about similar incidents
25% of cabin crew were left questioning their career choice
Journal of Airline and Airport Management 10(1), 31-49
Bor, Russel, Parker
& Papadopoulos
assessing the
requirement to
report DAPB
incidents, policy
crew training,
and perception
of causes
A representative
staff member
from 197 airlines
(i.e. chief pilot,
safety officer, or
Country of
origin not
88% reported requirement to report and record DAPB
48% reported specific policy regarding the management of a
DAPB incident
68% reported that policy on passenger violence was given to
passengers however only 18% gave details on how the
information was provided with most reporting that it was in
confrontation with a violent passenger
38% of airlines offer no training to manage passenger
Causes of DAPB in descending order included: excess
alcohol; belligerent passenger; flight delays; stress of travel;
smoking ban; seating discomfort; denial of carry-on bag;
excessive passenger expectation; mishandling of passenger
problem; and denial of upgrade
Burgess (2001)
frequency and
Cabin crew from
7 airlines using
airport (number
of cabin crew
not reported)
Majority of cabin crew reported: experiencing DAPB (with
half of the cases needing police assistance), insufficient training,
insufficient knowledge of the law and awareness of the Greater
Manchester Police disruptive behaviour protocol
DAPB database
Manchester UK
airport (2000-
Number of
DAPB incidents
not reported
Evaluation of the effectiveness of Greater Manchester
Police DAPB protocol revealed that police patrols and the
'yellow card' protocol reduced the DAPB incidence rate
Majority of pre-flight DAPB incidents involved arguments
with airline staff and only 9% were alcohol or smoking related
Boyd (2002)
assessing DAPB
921 cabin crew
from three UK
70% reported increased number of abusive passengers in
the last year
32% identified abusive behaviour as a high occupational
health safety concern
21% reported abusive passengers often or on every flight
Less than half received in-depth training on handling
assessing verbal
and physical
abuse DAPB
252 cabin crew
from 2 UK
airlines and UK
railway company
50% of airline cabin crew reported increase in verbal abuse
in the last year
60% of cabin crew experienced at least one type of physical
abuse in the last year (nb airline and railway cabin crew data
Bor (2003)
DAPB database
4158 DAPB
DAPB more likely to involve male passengers aged 30-49y
Two main contributing factors were illegal smoking (36%)
and excessive drinking (45%)
Cabin crew warnings effective in 25-66% of incidents
Prevalence decreased from 1999 (1:15,000) to 2003
224/4158 incidents deemed serious (e.g. physical
threats/violence, property damage)
2255/4158 incidents deemed less serious (e.g. smoking, not
following safety instructions)
Smart & Mann
Review of
(Canadian press
51.7% of DAPB incidents involved alcohol and 20.7% illegal
Physical aggression rarely led to serious injuries
93.1% of DAPB incidents involved male passengers
65.5% of DAPB incidents involved physical aggression to
airline staff and
27.6% of DAPB incidents involved physical aggression to
other passengers
Journal of Airline and Airport Management 10(1), 31-49
Ballard et al. (2006)
frequency of
harassment and
938 in service
1017 not in-
service Italian
female cabin
22.5% of cabin crew in service and 21.8% not in service
reported passenger sexual harassment during their career
3.7% of cabin crew in service experienced sexual
harassment by passenger in the last 12 months
Sexual harassment by passenger in the last 12 months
associated with an increased likelihood of poor health and
psychological distress
Hunter (2006)
attitudes and
feelings about
244 Passengers
(boarding 4
major US
A positive customer perception for service was not
significantly related to customers having an approving attitude
but was significantly related to a lower propensity DAPB
A negative customer perception for service was significantly
related to a more approving customer attitude but not
significantly related to a customer’s propensity to DAPB
Rhoden, Ralston &
Ineson (2008)
assessing staff
training and
management of
DAPB incidents
2 training and 6
cabin crew (UK-
Most training courses were found to be too short, lacked
realism and paid insufficient attention to learning styles.
A need was suggested for greater experiential learning
Girasek & Olsen
passenger and
factors thought
to contribute to
1,548 Passengers
(boarding 24
domestic flights
US airport)
14% reported the intention to drink alcohol
The intentions to drink was associated with: (1) endorsing
social norms that condoned in-flight drinking, (2) holding
positive outcome expectancies about drinking, (3) traveling with
friends, (4) sitting (or hoping to be seated) in First or Business
Class, (5) longer flights, (6) history of drinking more alcohol in
other contexts, and (7) having consumed alcohol earlier in the
Passengers who do intend to drink don't expect to pose a
risk to others
Problematic drinking is rare
Akgeyik (2011)
profile of
passengers and
impact on cabin
187 cabin crew
of a Turkish
DAPB more likely to involve male passengers and those with
high school and above education levels
The majority of female cabin crew reported that male and
female passengers equally often displayed unruly behaviour
versus the majority of male cabin crew who reported that male
passengers more often displayed unruly behaviour
Cabin crew who were victims of DAPB compared to those
not involved reported lower self-confidence and higher levels of
fatigue, aggression and social anxiety.
Cabin crew who witnessed DAPB compared to those who
were not involved reported higher levels of fatigue, aggression
and social anxiety
Yang & Chang
assessing staff
competency to
manage DAPB
494 Taiwanese
customer service
workers from 3
Identified 17 airport-related DAPBs which were grouped
into six categories: (1) Behaviour affecting the company’s rights
and benefits; (2) Behaviour causing services to be disrupted; (3)
Enlarging the scope of the problem by causing trouble
intentionally (e.g. threatening to go to the media); (4) Baggage-
related; (5) Selfish, devious customers; and (6) Non-compliance
with company regulations
Competence of ground staff at managing DAPB differed
according to airline policy, training, and supports
Zackowitz &
frequency of
DAPB incidents
and contributing
245 Passengers
(4 US airports)
Confinement, discomfort and personal space were
associated with anger and acting out
Noise and hunger were associated with anger but not acting
15% of passengers reported having a disagreement with
fellow passengers the top three reasons for disputes involved
armrests, someone reclining into the passenger’s space and child
kicking the seat
Out of the passengers who reported a conflict, 39% sought
resolution by speaking to the person disturbing them, 39% did
nothing/were miserable and 19% spoke with a flight attendant
Journal of Airline and Airport Management 10(1), 31-49
DeCelles &
Norton (2016b)
DAPB database
airline (circa
Number of
DAPB incidents
not reported
DAPB is relatively more common: in economy class on
flights with first class; in economy versus first class; on longer
flights; on flights with first class cabin, and where physical
design factors that highlight inequality such as front boarding
through first class cabins
DAPB was not related to seat width, delay length, and
international/domestic flight
DAPB incidents per flight estimated at 1:1000
Hu, Hu & King
assessing the
impact of
336 Taiwanese
cabin crew
Passenger misbehaviour was directly associated with greater
emotional exhaustion. It also had an impact on role stress and
emotional labour which in turn were both associated with
greater emotional exhaustion
Newlan &
McNeely (2018)
exposure to
workplace abuse
4,549 US and
Canadian cabin
crew (gender
68.7% report sexual harassment by passenger in the past
1.0% report sexual assault by passenger in the last year
Sexual harassment in both male and female cabin crew
associated with poor physical and psychological health
Sexual assault in both male and female cabin crew associated
with poor physical and psychological health
Tsang, Masiero &
Schuckert (2018)
acceptance of
behaviour and
impact on travel
298 Passengers
(HK airport)
For both Asian and non-Asian passengers: higher education,
long flight durations, flying business/first class, leisure and
business travellers, and more frequent flyers were less tolerant
of violation of personal space
For both Asian and non-Asian passengers: older age,
business/first class (vs visiting friends/relatives) and more
frequent flyers were more tolerant of aggressive acts
For both Asian and non-Asian passengers: leisure and
business travellers (vs visiting friends/relatives) were less
disturbed by service disruption
For both Asian and non-Asian passengers: low level of
acceptance of aggressive and violent behaviour including abuse
of alcohol, vandalism, foul or inappropriate language and
kicking others’ seat.
Asian compared to non-Asian travellers less disturbed by
violations of personal space and disturbance to service delivery
DeCelles, DeVoe,
Rafaeli & Agas
DAPB database
airline (circa
observed prior
to boarding (30
minutes prior
for domestic
and 60 minutes
for international
Number of
DAPB incidents
not reported
117 Flights from
US airport (35
DAPB was associated with: crowding and flight delays; travel
from upper South America to North America, North America
to Western Europe and North America to Middle East; and
flights on Tuesdays
DAPB was not associated with month of travel
Passenger aggression was related to situational stressors
(security line waiting time, time to departure gate, number of
oversold seats, longest question line at counter, time passengers
started to line up, weather related flight delays and non-weather-
related flight delays) and physiological stressors (noise, babies
crying, subjective temperature, subjective crowdedness, number
of passengers and employee helpfulness).
The greater the situational stress the greater the employee
The level of physiological stress was not associated with
employee helpfulness
containing 3
vignettes (either
a neutral,
situational or
365 US travellers
(79 assigned to
neutral, 156
situational, and
130 physiological
Anger and aggression ratings: situational and physiological >
Fear ratings: situational > physiological
Situational and physiological stress were associated with
higher anger which, in turn, was associated with higher
aggression scores
Situational stress was associated with greater fear which, in
turn, was associated with greater aggression
Journal of Airline and Airport Management 10(1), 31-49
containing 3
situational or
169 US Airline
customer service
Rating of perceived passenger fear: situational >
physiological = neutral
Empathy ratings: situational stressors > physiological
Situational stress was associated with greater perception of
passenger fear which, in turn, was associated with greater
service worker helpfulness
Situational stress was associated with greater service worker
empathy which, in turn, was associated with greater service
worker helpfulness
Perceived passenger anger was not related to service worker
empathy or helpfulness
Table 1. Summary of key findings from 19 included articles, presented in chronological order of publication
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or
publication of this article.
The authors received no financial support for the research, authorship, and/or publication of this article.
Ahmadpour, N., Robert, J.M., & Lindgaard, G. (2016). Aircraft passenger comfort experience: Underlying factors
and differentiation from discomfort. Applied Ergonomics, 52, 301-308.
Air-rage accused does not accept he caused flight diversion. (2015, 1/9/15). The Irish Times. Retrieved from
Akgeyik, T. (2011). Air Rage: Violence Toward Cabin Crew (A Study on Victimization of Unruly Passengers in
Turkey). Review of Business Research, 11(3), 68-73.
Anderson, S. W., Baggett, L. S., & Widener, S. K. (2009). The impact of service operations failures on customer
satisfaction: evidence on how failures and their source affect what matters to customers. Manufacturing & Service
Operations Management, 11(1), 52-69.
Anglin, L., Neves, P., Giesbrecht, N., & Kobus-Matthews, M. (2003). Alcohol-related air rage: From damage
control to primary prevention. Journal of Primary Prevention, 23(3), 283-297.
Aratani, L. (2016). Flight and fight: Attendants learn self-defense in the air. Retrieved from
Ballard, T. J., Romito, P., Lauria, L., Vigiliano, V., Caldora, M., Mazzanti, C., & Verdecchia, A. (2006). Self
perceived health and mental health among women flight attendants. Occupational and Environmental Medicine,
63(1), 33-38.
Baranishyn, M., Cudmore, B. A., & Fletcher, T. (2010). Customer service in the face of flight delays. Journal of
Vacation Marketing, 16(3), 201-215.
Barron, P. E. (2002). Air rage: an emerging challenge for the airline industry. Asia Pacific Journal of Transport,
4(Summer), 39-44.
Bell, P. A., Green, T., Fisher, J. D., & Baum, A. (2001). Environmental Psychology. New Jersey: Harcourt.
Journal of Airline and Airport Management 10(1), 31-49
Berkley, B. J., & Ala, M. (2001). Identifying and controlling threatening airline passengers. Cornell Hotel and
Restaurant Administration Quarterly, 42(4), 6-23.
Bor, R. (2003). Trends in disruptive passenger behaviour on board UK registered aircraft: 1999–2003. Travel
Medicine and Infectious Disease, 1(3), 153-157.
Bor, R., Russell, M., Parker, J., & Papadopoulos, L. (2001). Survey of world's airlines highlights various
approaches to handling disruptive passengers. ICAO Journal, 56(2), 21-23.
Boyd, C. (2002). Customer Violence and Employee Health and Safety. Work, Employment and Society, 16(1), 151-
Bricker, J. B. (2005). Development and evaluation of the Air Travel Stress Scale. Journal of Counseling Psychology,
52(4), 615-628.
Burgess, T. (2002). Disruptive passengers at Manchester Airport: A problem-oriented approach. International
Journal of Police Science and Management, 4(2), 139-147.
Carruthers, M. (2018). Air rage: how airlines cope in social media age with unruly passengers and angry
employees. Retrieved from
Crede, M., Gelman, A., & Nickerson, C. (2016). Questionable association between front boarding and air rage.
Proceedings of the National Academy of Sciences, 113(47), E7348-E7348.
Dahlberg, A. (2017). Air rage: The underestimated safety risk. New York: Routledge.
DeCelles, K. A., DeVoe, S. E., Rafaeli, A., & Agasi, S. (2019). Helping to reduce fights before flights: How
environmental stressors in organizations shape customer emotions and customer–employee interactions.
Personnel Psychology, 72(1), 49-80.
DeCelles, K. A., & Norton, M. I. (2016a). Physical and situational inequality on airplanes predicts air rage.
Proceedings of the National Academy of Sciences, 113(20), 5588-5591.
DeCelles, K. A., & Norton, M. I. (2016b). Reply to Crede et al.: Association between front boarding and air rage
is supported by theory and analysis. Proceedings of the National Academy of Sciences, 113(47), E7349-E7350.
DeCelles, K. A., & Norton, M. I. (2016c). Reply to Giner-Sorolla: Relationships between inequality and air rage
are robust to additional specifications. Proceedings of the National Academy of Sciences, 113(29), E4120-
Dowdall, N. (2000). “Is there a doctor on the aircraft?” Top 10 in-flight medical emergencies. British Medical
Journal, 321(7272), 1336.
Felkai, P., & Kurimay, T. (2017). Patients with mental problems - the most defenseless travellers. Journal of Travel
Medicine, 24(5).
Firak, N., & Schmaltz, K. A. (1999). Air rage: Choice of law for intentional torts occurring in flight over
international waters. Albany Law Review, 63(1), 1-124.
Francis-Way, K. (2002). Examination of Factors that Influence Air Rage. (Master of Science). Oklahoma State University.
Gale, S., Mordukhovich, I., Newlan, S., & McNeely, E. (2018). The Impact of Verbal Abuse, Sexual Harassment and
Sexual Assault at Work: An Investigation into the Health of Flight Attendants in the Harvard Flight Attendant Health
Study. (August 13, 2018).
Genç, B., & Dural, U. (2009). Flight anxiety, coping and management. British Travel Health Association Journal, 14,
Journal of Airline and Airport Management 10(1), 31-49
Giner-Sorolla, R. (2016). Linear controls are not enough to account for multiplicative confound effects on air
rage. Proceedings of the National Academy of Sciences, 113(29), E4119-E4119.
Girasek, D. C., & Olsen, C. H. (2009). Airline passengers' alcohol use and its safety implications. Journal of Travel
Medicine, 16(5), 311-316.
Goldsmid, S., Fuller, G., Coghian, S., & Brown, R. (2016). Responding to unruly airline passengers: The
Australian context. Trends & Issues in Crime and Criminal Justice (510). Retrieved from
Gordon, H., Kingham, M., & Goodwin, T. (2004). Air travel by passengers with mental disorder. Psychiatric
Bulletin, 28(8), 295-297.
Gunnarsdottir, H. K., Sveinsdottir, H., Bernburg, J. G., Fridriksdottir, H., & Tomasson, K. (2006). Lifestyle,
harassment at work and self-assessed health of female flight attendants, nurses and teachers. Work, 27(2), 165-
Heaver, S. (2019). Air rage: how it differs in West and East, and why Chinese passengers are in a league of their own. South
China Morning Post. Retrieved from
Hu, H-H., Hu, H-Y., & King, B. (2017). Impacts of misbehaving air passengers on frontline employees: role
stress and emotional labor. International Journal of Contemporary Hospitality Management, 29(7), 1793-1813. https://
Hubbard, T., & Bor, R. (2016). Psychological factors relating to physical health issues: how physical factors in
aviation and travel affect psychological functioning. In Aviation Mental Health (pp. 49-60). New York: Routledge.
Hunter, J. A. (2007). A correlational study of how airline customer service and consumer perception of airline
customer service affect the air rage phenomenon. Journal of Air Transportation, 11(3), 78-109.
Hunter, J. A. (2011). A study of consumer perception of smiling customer service within the airline industry.
Journal of Transportation Security, 4(1), 35-56.
Hunter, J. A. (2016). Anger in the air: Combating the air rage phenomenon. New York: Routledge.
International Air Transport Association. (2018). Safety Report 2017. Retrieved from
International Air Transport Association. (2019). Unruly passengers. Retrieved from
James, L. (2014). Air rage: gamification techniques for managing passenger behavior. American International Journal
of Contemporary Research, 4(10), 24-30.
Jones, R. (2017). Violence in Adelaide hospitals targeted in social media campaign. Retrieved from
Kim, R. C., Yoo, K. I., & Uddin, H. (2018). The Korean Air nut rage scandal: Domestic versus international
responses to a viral incident. Business Horizons, 61(4), 533-544.
Lane, P., Bor, R., & Laughead, B. (2002). Cabin Crew Experiences and Perceptions of" Air Rage". International
Journal of Applied Aviation Studies, 2(2), 57-70.
Lane, P., Bor, R., & Laughead, B. (2002). Cabin Crew Experiences and Perceptions of" Air Rage". International
Journal of Applied Aviation Studies, 2(2), 57-70.
Journal of Airline and Airport Management 10(1), 31-49
Leff, G. (2015). Here’s What a British Airways “Yellow Card” Warning Looks Like — Before They Ban You From Flying
(and Call the Police). Retrieved from
Li, B. Q. (2005). In-flight aggression: a cabin crew and passenger perspective. (Masters of Aviation). Massey University.
Matousek, M. (2019). 38% of flight attendants said in a new survey that they were physically abused by a passenger taking
medication during the past year. Retrieved from
McIntosh, I. B., Swanson, V., Power, K. G., Raeside, F., & Dempster, C. (1998). Anxiety and health problems
related to air travel. Journal of Travel Medicine, 5(4), 198-204.
McKinnell, J. (2019). How 'air rage' could leave you with a massive bill, travel ban or criminal conviction. Retrieved from
Meldrum, R. C. (2016). Low self-control takes flight: The association between indicators of low self-control and
imprudent airline passenger behavior. The Social Science Journal, 53(4), 444-454.
Menon, K., & Dube, L. (2004). Service provider responses to anxious and angry customers: different challenges,
different payoffs. Journal of Retailing, 80(3), 229-237.
Menon, K., & Dubé, L. (2007). The effect of emotional provider support on angry versus anxious consumers.
International Journal of Research in Marketing, 24(3), 268-275.
Morgan, M., & Nickson, D. (2001). Uncivil aviation: a review of the air rage phenomenon. International Journal of
Tourism Research, 3(6), 443-457.
Moyle, J. T. B., & Muir, H. (2005). Disruptive Behaviour (“Air Rage”): Possible Aetiology. In Air quality in airplane cabins
and similar enclosed spaces (pp. 123-136). Berlin: Springer.
Petros, T., Bridewell, J., Jensen, W., Ferraro, F. R., Bates, J., Moulton, P., & Gorder, D. (2003). Postintoxication
effects of alcohol on flight performance after moderate and high blood alcohol levels. The International Journal
of Aviation Psychology, 13(3), 287-300.
Piñar-Chelso, M. J., & Fernández-Castro, J. (2011). A New Scale to Evaluate Disruptive Passenger Management
by Cabin Crew. Aviation Psychology and Applied Human Factors, 1(1), 21-30.
Pontell, H. N., Salinger, L. R., & Geis, G. (1983). Assaults in the air: Concerning attacks against flight attendants.
Deviant Behavior, 4(3-4), 297-311.
Reisoğlu, I., Topu, B., Yılmaz, R., Karakuş Yılmaz, T., & Göktaş, Y. (2017). 3D virtual learning environments in
education: a meta-review. Asia Pacific Education Review, 18(1), 81-100.
Rhoden, S., Ralston, R., & Ineson, E. M. (2008). Cabin crew training to control disruptive airline passenger
behavior: A cause for tourism concern? Tourism Management, 29(3), 538-547.
Rolfe, P. (2000). Air Rage: Disruptive Passenger: The Causes and Cures. (Master Degree). Aerospace Medical and Human
Salinger, L. M., Jesilow, P., Pontell, H. N., & GEIS, G. (1985). Assaults against airline flight attendants: A
victimization study. Transportation Journal, 66-71.
Schaaf, M. M. (2018). Air rage: a policy research study. The Collegiate Aviation Review International, 19(1), 168-182.
Journal of Airline and Airport Management 10(1), 31-49
Schwarz, K. (2017). Unruly passengers are getting worse, so should airlines arm their cabin crew? Retrieved from
Small, J., & Harris, C. (2018). Air rage: Who is responsible for unruly behaviour? CAUTHE 2018: Get Smart:
Paradoxes and Possibilities in Tourism, Hospitality and Events Education and Research, 710-714.
Smart, R. G., & Mann, R. E. (2003). Causes and consequences of air rage in Canada. Canadian Journal of Public
Health, 94(4), 251-253.
Timmis, A., Ison, S., & Budd, L. (2016). International comparison of disruptive passenger prevalence: Briefing note prepared
for the Department for Transport Retrieved from
Tsang, S., Masiero, L., & Schuckert, M. (2018). Investigating Air Passengers' Acceptance Level of Unruly In-
Flight Behavior. Tourism Analysis, 23(1), 31-43.
Tyeson, C. (2017). WATCH: VIC Launches Powerful New Ad Aimed At Curbing Violence Against Ambos. Retrieved
Vivian, M. (2000). Disruptive passenger behavior: Analyzing the causes. Aviation Security International, 6 12-15.
Vredenburgh, A. N., Zackowitz, I. B., & Vredenburgh, A. G. (2015). Air Rage:What Factors Influence Airline
Passenger Anger? Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 59(1), 400-404.
Whitehead, K. (2013). High-kicking cabin crew using wing chun to defend against aggressive passengers. Retrieved from
Whitley, A., & Gross, S. (2019). Legroom on Planes Has Been Shrinking for Years. It's About to Get Much, Much Worse.
Retrieved from
Williams, C. R. (2000). A pain in the neck: passenger abuse, flight attendants and emotional labour. Journal of
Occupational Health and Safety-Australia and New Zealand, 16(5), 429-435.
Yang, C. H., & Chang, H. L. (2012). Exploring the perceived competence of airport ground staff in dealing with
unruly passenger behaviors. Tourism Management, 33(3), 611-621.
Yang, C. H., Wan, K. M., & Lee, Y. C. (2010). Applying the Rasch measurement to explore the abilities and
difficulties of Chinese cabin crew in airlines in terms of handling the unruly passengers. Journal of Aeronautics,
Astronautics and Aviation, Series B, 42(1), 55e66.
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... An airline's marketing campaign, support for safety assurance from upper management, cabin crews' perception of their ability to enforce safety regulations, and the company's reaction to reported safety violations are all representations of the fragile nature of an airline's safety culture. There is currently a gap in the literature regarding the consequences that disruptive passengers face, how that might influence not only repeat offenders but also new offenders, and the robustness of a safety culture that has penalties in place, yet seldom imposes them (Borillio 2000;Martinussen 2017;McLinton et al. 2020). ...
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There is a rising trend in the number of disruptive airline passenger reports filed to the International Air Transport Association’s Incident Data eXchange and National Aeronautics and Space Administration’s Aviation Safety Reporting System over the past 20 years. Passenger behavioral safety is vital for the comfort, well-being, and safety of other passengers, crew, and an airline’s smooth operations. Safety culture has been shown to impact the implementation and efficiency of safety management systems. This paper has evaluated the relationship between disruptive passenger occurrences and the intentions of a safety management system, through the lens of safety culture. An analysis of disruptive passenger reports from National Aeronautics and Space Administration’s Aviation Safety Reporting System gave evidence of the consequential actions taken against disruptive passengers There was a tendency for disruptive passengers to either not be dealt consequences, or be subject to consequences that are not in full alignment with the concept of a robust safety culture. This perpetuated a sense that company support was lacking for frontline staff. It also potentially created an awareness amongst passengers that disruptive behaviors on aircraft were not statistically an arrestable offence. This reduces the efficiency of threat of punishment as a deterrent.
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ÖZET Sivil havacılık sektöründe uçuş emniyeti ve güvenliğini tehdit eden kural dışı yolcu olayları, son yıllarda giderek artmakta ve sektör açısından birçok olumsuz sonucu beraberinde getirmektedir. Bu kapsamda literatür taraması ışığında yapılan bu araştırmanın amacı, sivil havacılık sektöründe kural dışı yolcu olaylarının sebeplerini nitel bir araştırma ile incelemektir. Araştırmada nitel araştırma desenlerinden fenomenolojik araştırma yöntemi kulanılmıştır. Araştırmanın örneklemini 2005-2020 yılları arasında meydana gelen ve dünyanın farklı coğrafi bölgelerinde yaşayan yolcuların dâhil olduğu 203 kural dışı yolcu olayı oluşturmaktadır. Veri toplamak amacıyla döküman incelemesi yöntemi kullanılmıştır. Elde edilen veriler, NVivo 12 programı kullanılarak tümevarımcı ve betimsel bir yaklaşımla içerik analizine tabi tutulmuştur. İçerik analizi sonucunda, kural dışı yolcu davranışına sebep olan yedi tema bulunmuştur. Bu temalar; yolcular ile ilgili sebepler, uçak içindeki fiziksel ortam, uçak içindeki sosyal ortam, kurallara uymamak, havayolu işletmesi hizmet kalitesi, havalimanı ile ilgili sebepler ve mevsimsel sebepler olarak sınıflandırılmıştır. Araştırmanın kural dışı yolcu kavramı ve havacılık güvenliği ile ilgili literatüre özgün bir katkı yapacağı düşünülmektedir. ABSTRACT Unruly passenger incidents that threaten flight safety and security in the civil aviation sector have been increasing in recent years and bring many negative consequences for the sector. In this context, the purpose of this study conducted in the light of literature review, is to examine the causes of unruly passenger incidents in the civil aviation sector with a qualitative research. The phenomenological research method, one of the qualitative research designs, was used in the research. The sample of the research consists of 203 unruly passenger incidents that occurred between 2005-2020 and included passengers living in different geographical regions of the world. Document analysis method was used to collect data. The data obtained were subjected to content analysis with an inductive and descriptive approach using NVivo 12 program. As a result of the content analysis, seven themes that cause unruly passenger behavior were found. These themes are classified as reasons related to passengers, physical environment inside the aircraft, social environment inside the aircraft, failure to comply with the rules, airline service quality, reasons related to the airport and seasonal reasons. It is thought that the research will make an original contribution to the literature on the concept of unruly passenger and aviation security.
Conference Paper
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Bu araştırmanın amacı, havacılık sektöründe kural dışı yolcu olaylarının sebeplerini nitel bir araştırma ile incelemektir. Araştırmada nitel araştırma desenlerinden fenomenolojik araştırma yöntemi kullanılmıştır. Araştırmanın örneklemini 2005-2020 yılları arasında dünyanın farklı coğrafi bölgelerinde yaşayan yolcuların dâhil olduğu 203 kural dışı yolcu olayı oluşturmaktadır. Veri toplamak amacıyla döküman incelemesi yöntemi kullanılmıştır. Elde edilen veriler, tümevarımcı ve betimsel bir yaklaşımla içerik analizine tabi tutulmuştur. İçerik analizi sonucunda, kural dışı yolcu davranışına sebep olan yedi tema bulunmuştur. Bu temalar; yolcular ile ilgili sebepler, uçak içindeki fiziksel ortam, uçak içindeki sosyal ortam, kurallara uymamak, havayolu işletmesi hizmet kalitesi, havalimanı ile ilgili sebepler ve mevsimsel sebepler olarak sınıflandırılmıştır. Araştırmanın kural dışı yolcu kavramı ve havacılık güvenliği ile ilgili literatüre katkı yapacağı düşünülmektedir. Anahtar Kelimeler: Kural Dışı Yolcu, Yıkıcı Yolcu, Havada Öfke, Havacılık Güvenliği
Technical Report
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Internationally, disruptive and unruly passenger behaviour has become a growing concern and has gained increasing media attention facilitated by the spread of social media. Behaviour of this nature ranges from relatively minor infractions such as verbal abuse towards crew and other passengers and smoking, through to potentially lethal actions which threaten the safety of the entire passengers on an aircraft. The purpose of this briefing note is to conduct a desktop review of the prevalence of disruptive and unruly passenger incidents. In addition, this note will also review the penalties and legal mechanisms countries use to manage such behaviour.
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Previous examinations of environmental stressors in organizations have mostly emphasized their dysfunctional effects on individuals’ emotions and behaviors. Extending this work by drawing from the social functional perspective on emotion, we propose that customers’ negative emotional responses to environmental stressors in organizations can exert both dysfunctional and functional effects on customer‐employee interactions. Specifically, we theorize that situational and physiological forms of environmental stressors can be dysfunctional by incurring customer anger, precipitating customer aggression, and diminishing employee helpfulness. We further theorize that situational relative to physiological stressors can exert functional effects in inducing customer fear that elicits empathy and helpfulness from employees. We test our model via an archival, observational, and critical incident yoked experimental study set in the airport context. This research contributes to stress theory and its organizational application by integrating theory from the social functional approach to emotion with appraisal based theories of stress in organizations. This article is protected by copyright. All rights reserved
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This article investigates responses of the international and domestic (South Korean) publics to one of the most hotly debated corporate scandals in recent years: Korean Air's so-called nut rage incident. By analyzing both international and domestic media coverage of the occurrence, we reveal contrasting interpretations between the two. Whereas the South Korean public tends to generate intense debates addressing a lack of ethics in Korean Air's public communication following the incident, international public criticism is dominated by questions regarding South Korea's chronic chaebol system and its negative image in relation to South Korea's unique institutional context. Korean Air's incongruent notice of the employee as a key stakeholder is also discussed in the international media. Our research findings indicate how, rather than focusing on legal responsibility, the normative attitude of businesses toward stakeholder pressures is crucial as a means of escaping legitimacy-threatening events. The results of this study demonstrate how public responses to a single incident are diverse in global society and offer new insights regarding the importance of ethics in management leadership and public communication after a crisis incident.
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Purpose The study aimed to investigate the impact of customer misbehaviors on airline in-flight customer contact personnel. A theoretical framework was proposed to test the meditating role of role stress and emotional labor in the relationship between consumer misbehaviors and emotional exhaustion. Design/methodology/approach In all, 336 cabin crew members employed by international airline companies participated in the study. The hypothesized model was tested using structural equation modeling with AMOS 20.0. Findings The results provide evidence that customer misbehaviors relate positively to employee role stress, emotional labor and emotional exhaustion. Moreover, role stress and emotional labor play important roles in enhancing the impacts of customer misbehaviors and thereby influence employee emotional exhaustion. Practical implications The findings potentially impact on employers both within and beyond the airline industry by demonstrating how frontline employees can be provided with support to reduce stress or exhaustion, leading ultimately to increased satisfaction. Originality/value This study has provided deeper theoretical insights into customer misbehaviors and their effects on employee role stress, emotional labor and emotional exhaustion.
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The aim of this study is to investigate recent empirical research studies about 3D virtual learning environments. A total of 167 empirical studies that involve the use of 3D virtual worlds in education were examined by meta-review. Our findings show that the “Second Life” platform has been frequently used in studies. Among the reviewed papers, case study designs and quasi-experimental studies were more common. Sample sizes were below 100 for most studies. 3D virtual learning environments are mainly designed for learning support, simulation, and game. Language learning and science have been the most extensively studied topics. Collaborative and exploration-based learning strategies have been used most frequently in 3D virtual learning environments. Presence, satisfaction, communication skills, and engagement were examined as emotional and cognitive achievements.
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An occupational health and safety perspective is used to analyse how Australian domestic and international flight attendants deal with unsavoury passenger behaviour. Organisational variables (for example, how airline companies and managements acknowledge workplace issues) and health and safety are the salient indicators which affect relations with difficult passengers and the strategies to deal with them. Angry passengers are a problem for male and female flight attendants, but they are slightly more of a problem for women because of the injunctions of patriarchal femininity which are still embedded in the emotional labour that they are required to do. Thus, emotional labour in this indifferent and abusive environment can be a health hazard - literally a pain in the neck and in other parts of the body as well.
Background: Severe mental illness occurring abroad is a difficult situation for patients, their families, and for the local medical community. Patients with mental problem are doublely stigmatized due to their mental illness and because they are foreigners in an unfamiliar country. The appropriate treatment is often delayed, while patients are often dealt with in a manner that violates their human rights. Moreover, repatriation - which is vital in this case - is often delayed due to the lack of international protocols for the transportation and treatment of mentally ill travelers. Methods: Authors analyzed several factors related to acute mental health problems during travel: the etiology of symptoms, the appropriate treatment possibilities abroad, and medical evacuation and repatriation of the psychotic patient. The article presents a brief review of travel-related mental disorders, the epidemiology of mental health issues faced by travelers, and the significance of pre-travel advice for these patients. The first problem is to recognize (and redress) the particular challenges faced by a psychotic patient in a strange country. The second challenge is to prepare the patients, often in a poor psychiatric state, for medical evacuation by commercial aircraft. Another important question is the best way to take the patient through customs and security control. All of these, as yet unresolved, issues can make the mental patient virtually defenseless. Conclusions: Although timely repatriation of a mentally ill patient is vital and urgent, most travel insurance policies exclude treatment and repatriation costs incurred due to acute mental illness. The high cost of treatment and repatriation must be paid by the patient or their family, which could lead to severe financial strain or insolvency. Changing the approaches taken by the local mental health care community, police, airport security, and insurance companies remain a challenge for psychiatrists.
Service quality is an important issue for airlines. However, incidents of unruly passenger behavior (UPB) are increasing. Such incidents may have a negative impact on passengers’ evaluation of the overall service quality of an airline, making it harder for the airline to maintain standards. This study investigates the relationship between acceptability of in-flight UPB and traveler profile. It also examines the relative impact of different dimensions of UPB on passengers’ evaluation of their overall travel experience and re-patronage intentions. The results show that aggression and violence were the most unacceptable forms of UPB. Educational and cultural background, frequency of travel, and duration of flight were the main factors influencing participants’ acceptance of UPB. This study provides information on the acceptability of different forms of UPB and the impact of different passenger characteristics. It closes with recommendations to airlines for dealing with UPB.