Discomfort with Space and Motion - A Possible Marker of Vestibular Dysfunction Assessed by the Situational Characteristics Questionnaire

Sep 5, 2026

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Space and motion discomfort (SMD) denotes symptoms that arise in vestibular dysfunction when visual or kinesthetic information is inadequate for normal spatial orientation. Two studies evaluate the construct validity of the Situational Characteristics Questionnaire (SitQ), which includes SMD-I and SMD-II subscales. Results show distinct SMD levels across self-help balance groups, panic disorder patients, anxiety/depression samples, vestibular patients, and hearing-loss controls, with internal consistency and reliability reported. SMD-II is recommended for quantifying SMD in anxiety and/or balance disorders.

LanguageEnglish

CategoryResearch & Report

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Pages26

Reading Time1 h 6 min

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INTRODUCTION

Space and motion discomfort definition and causes

Vestibular processing and multisensory spatial orientation

Central compensation and situational dependence

Space and motion phobic patterns

Discomfort with Space and Motion:A PossibleMarker of Vestibular Dysfunction Assessedby the Situational Characteristics Questionnaire Rolf G.Jacob,1,5 Sheila R.Woody,Duncan B.Clark,Scott O.Lilienfeld,3 Barry E.Hirsch,4 Gail D.Kucera,Joseph M.Furman,4 and John D.Durrant⁴ Accepted:September 20,1993 Space and motion discomfort (SMD)refers to the situational specificity ofsymptoms occurring in some patients with vestibular dysfunction,such as thosewith balance disorders and some with panic disorder.SMD occurs in situationscharacterized by inadequate visual or kinesthetic information for normal spatialorientation.We report the results of two studies of the construct validity of theSituational Characteristics Questionnaire(SitQ),which has two subscales,both of which measure SMD:the SMD-I and SMD-II.In Study 1,the SitQwas administered to members of a self-help group for balance disorders,apsychiatric sample consisting of patients with panic disorder,nonpanic anxiety Study 1 was funded by MH 40757.Study 2 was funded by a grant from the Upjohn Companyand MH 19816. University of Pittsburgh School of Medicine,Department of Psychiatry,Western PsychiatricInstitute and Clinic,3811 O'Hara Street,Pittsburgh,Pennsylvania 15213. ²University of British Columbia,Department of Psychiatry,2255 Wesbrook Mall,Vancouver,British Columbia V6T 2A1,Canada. ³SUNY,University at Albany,Department of Psychology,138A Social Sciences,1400Washington Avenue,Albany,New York 12222. 4University of Pittsburgh School of Medicine,Department of Otolaryngology,The Eye andEar Institute of Pittsburgh,203 Lothrop Street,Pittsburgh,Pennsylvania 15213.5To whom correspondence should be addressed. disorders,depression,and a sample of normals.SMD levels were the highestin the self-help balance group,next to the highest in the panic groups,andlowest in the remaining groups.In Study 2,the SitQ was administered tootolaryngological patients with vestibular dysfunction and to patients withhearing loss.SMD levels were higher in the vestibular patients.Data on internalconsistency,test-retest reliability,and convergent and discriminant validity arepresented.The SitQ,particularly the SMD-II,is recommended for quantifyingspace and motion discomfort in patients with anxiety and/or balance disorders. KEY WORDS:space and motion discomfort;space phobia;vestibular dysfunction;panicdisorder;anxiety disorders;depression;balance disorders. # INTRODUCTION Space and motion discomfort (SMD)refers to symptoms elicited bya stimulus pattern characterized by inadequate visual or kinestheticinformation for normal spatial orientation.This pattern elicits distress insome patients with vestibular dysfunction.SMD may contribute topromoting agoraphobic avoidance in patients with vestibular dysfunction.A review of the physiology of spatial orientation,or maintenance ofbalance,willprovide a necessary context for understanding the mechanismsunderlying SMD. Spatial orientation involves an integration of input not only from thevestibular system but also of information from the pathways of vision andproprioception(Paulus,Straube,&Brandt,1984;Paulus,Straube,&Brandt,1987;Lackner &Graybiel,1978;Yardley,Lerwill,Hall,&Gresty,1992).The visual,proprioceptive and vestibular inputs converge at multiplelevels in the central nervous system(Leigh &Zee,1990;Brandt,1991;Akbarian et al,1988;Waespe &Henn,1977).As a result of vestibularprocessing,reflex activities are modified,including the vestibular-ocular,vestibular-spinal,and vestibular-autonomic reflexes (Leigh &Zee,1990;Yates,1992;Jacob,Furman,Clark,Durrant,&Balaban,1993).This nor-mally occurs without conscious awareness(Jongkees,1974;Guedry,1974).Vestibular sensations or “symptoms”arise only under certain conditions,including (a)intense vestibular stimulation,such as during abrupt headmovements;(b)unfamiliar body accelerations;and (c)discordance or in-congruence in the information among the three sensory channels(c.f.Brandt &Daroff,1980;Jacob,Lilienfe

FAQs

What is space and motion discomfort (SMD) in vestibular dysfunction?

SMD refers to symptoms elicited by stimulus patterns where visual or kinesthetic information is insufficient for normal spatial orientation. It is linked to certain patients with vestibular dysfunction and related balance or anxiety disorders.

What is the Situational Characteristics Questionnaire (SitQ) used for?

The SitQ assesses SMD through two subscales, SMD-I and SMD-II. The paper reports evidence supporting the construct validity of this questionnaire through two studies.

Which SitQ subscale is recommended for quantifying SMD?

SMD-II is recommended for quantifying space and motion discomfort in patients with anxiety and/or balance disorders.

Sep 5, 2026

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